Component-Resolved Diagnostics Study on Nut Sensitization and
Cross-Reactivity in China
Abstract
Background: Nut sensitization in China is not well-documented.
Component-resolved diagnosis (CRD) technology can distinguish true food
allergies from pollen-induced cross-sensitizations without the risks
associated with oral food challenge (OFC) tests. This study aims to
explore the major sensitizing components and cross-reactivity of nuts in
pollen-food allergy syndrome (PFAS) patients. Methods: This
study evaluated the sensitization profiles of 104 self-reported PFAS
patients to crude extracts and major allergenic components of pollen and
nuts. Furthermore, we conducted serum inhibition assays to validate the
cross-reactivity between pollen and nut allergens. Results: The
study revealed that PFAS patients were predominantly from northern
China, where sensitization to weed pollen, particularly mugwort, was
higher than that to tree and grass pollen and the most common nut
allergens identified were hazelnut and walnut. Further analysis using
CRD and serum inhibition assays indicated a common cross sensitization
between pollen and nut allergens. Notably, the hazelnut component Cor a
1-sIgE was significantly inhibited by birch pollen and Bet v 1, while
Cor a 8-sIgE showed effective inhibition by mugwort pollen and Art v 3.
Conclusion: This is the first study to evaluate nut
sensitization and its major sensitizing components in Chinese PFAS
patients, confirming the presence of cross-sensitization between pollen
and nut allergens. Specifically, birch and mugwort pollen significantly
inhibited the binding of hazelnut to IgE. These findings provide
component-resolved insights into the prevalence and mechanisms of food
allergies in China, enhancing our understanding of the allergenic
landscape and informing management strategies.