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Nettle Allergy: a Review and Clinical Perspective

  • Allergic Rhinitis (J Maspero, Section Editor)
  • Published:
Current Treatment Options in Allergy Aims and scope Submit manuscript

Abstract

Purpose of review

Stinging nettle (Urtica dioica) is a common cause of contact urticaria worldwide; however, its clinical relevance in allergic rhinitis and aeroallergen immunotherapy has not been well established. This presents a clinical conundrum to the physician and can potentially impact the effectiveness of treatment of allergic rhinitis in nettle sensitized patients. The objectives of this article are to review the available literature regarding the geographic distribution of nettle, allergen(s) involved, cross-reactivity, role in allergic rhinitis, immunotherapy efficacy, and provide a clinical perspective on the evaluation and treatment of nettle sensitized patients.

Recent findings

Stinging nettle (Urtica dioica) is a bi-annual pollinator with worldwide distribution and wide use in homeopathy. Limited data suggest that nettle pollen allergens may be considered clinically relevant and that nettle pollen allergy may be underestimated. More recent allergomic analysis of nettle pollen has revealed protein allergens including an osmotin and a pectin esterase which may implicate cross-reactivity with other pollens and foods. One study describes in vivo nettle immunotherapy.

Summary

Overall, there is a paucity of medical literature evaluating the role of nettle in allergic rhinitis with even fewer studies assessing the clinical efficacy of nettle immunotherapy. Cross-reactivity patterns with other pollens and foods remains to be fully elucidated. Given the immense medical and economic impact of allergic rhinitis and the worldwide distribution of nettle, prospective randomized controlled trials are needed to evaluate the possible contribution of nettle allergy and efficacy of nettle immunotherapy.

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References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Singh K, Axelrod S, Bielory L. The epidemiology of ocular and nasal allergy in the United States, 1988–1994. J Allergy Clin Immunol. 2010;126(4):778–83.

    Article  PubMed  Google Scholar 

  2. Settipane RA. Demographics and epidemiology of allergic and nonallergic rhinitis. Allergy Asthma Proc. 2001;22(4):185–9.

    PubMed  CAS  Google Scholar 

  3. Ray NF, Baraniuk JN, Thamer M, Rinehart CS, Gergen PJ, Kaliner M. Direct expenditures for the treatment of allergic rhinoconjunctivitis in 1996, including the contributions of related airway illnesses. J Allergy Clin Immunol. 1999;103(3 Pt 1):401.

    Article  PubMed  CAS  Google Scholar 

  4. Soni A Allergic rhinitis: trends in use and expenditures, 2000 to 2005. Statistical Brief #204, Agency for Healthcare Research and Quality; Bethesda, MD 2008.

  5. Lewis WH, Vinay P, Zenger VE Airborne and allergenic pollen of North America. Johns Hopkins University Press, 1983.

  6. Joshi BC, Mukhija M, Kalia AN. Pharmacognostial review of Urtica dioica L. Int J Green Pharm. 2014;8(4):201–9.

    Article  CAS  Google Scholar 

  7. Mueen Ahmed KK, Parsuraman S. Urtica dioica L., (Urticaceae): a stinging nettle. Sys Rev Pharm. 2014;5(1):6–8.

    Article  CAS  Google Scholar 

  8. Plants Profile for Urtica dioica (Stinging Nettle), plants.usda.gov/core/profile?symbol=URDI. Accessed 23 Feb 2018.

  9. Roschek B Jr, Fink RC, McMichael M, Alberte RS. Nettle extract (Urtica dioica) affects key receptors and enzymes associated with allergic rhinitis. Phytother Res. 2009;23(7):920–6.

    Article  PubMed  CAS  Google Scholar 

  10. Cummings AJ, Olsen M. Mechanism of action of stinging nettles. Wilderness Environ Med. 2011;22(2):136–9.

    Article  PubMed  Google Scholar 

  11. Riehemann K, Behnke B, Schulze-Osthoff K. Plant extracts from stinging nettle (Urtica dioica), an antirheumatic remedy, inhibit the proinflammatory transcription factor NF-κB. FEBS Lett. 1999;442(1):89–94.

    Article  PubMed  CAS  Google Scholar 

  12. Rayburn K, Fleischbein E, Song J, Allen B, Kundert M, Leiter C. Stinging nettle cream for osteoarthritis. Altern Ther Health Med. 2009;15(4):60–1.

    PubMed  Google Scholar 

  13. Chrubasik JE, Roufogalis BD, Wagner H, Chrubasik SA. A comprehensive review on nettle effect and efficacy profiles, Part I: herba urticae. Phytomedicine. 2007;14(6):423–35.

    Article  PubMed  CAS  Google Scholar 

  14. Czarnetzki BM, Thiele T, Rosenbach T. Immunoreactive leukotrienes in nettle plants (Urtica urens). Int Arch Allergy Appl Immunol. 1990;91:43–6.

    Article  PubMed  CAS  Google Scholar 

  15. Mittman P. Randomized, double-blind study of freeze-dried Urtica dioica in the treatment of allergic rhinitis. Planta Med. 1990;56(1):44–7.

    Article  PubMed  CAS  Google Scholar 

  16. • Francišković M, Gonzalez-Pérez R, Orčić D, Sánchez de Medina F, Martínez-Augustin O, Svirčev E. Chemical composition and immune-modulatory effects of Urtica dioica L. (stinging nettle) extracts. Phytother Res. 2017;31(8):1183–91. The authors performed a chemical analysis of the phytochemistry and immune-modulatory potential of Urtica dioica.

    Article  PubMed  CAS  Google Scholar 

  17. Morgan M, Khan D. Stinging nettle anaphylaxis. J Allergy Clin Immunol. 2003;111(suppl 2):S98.

    Article  Google Scholar 

  18. Urtica dioica Urtica urens (nettle). Monograph. Altern Med Rev. 2007;12(3):280–4.

    Google Scholar 

  19. Dutkiewicz J, Skórska C, Milanowski J, Mackiewicz B, Krysińska-Traczyk E, Dutkiewicz E. Response of herb processing workers to work-related airborne allergens. Ann Agric Environ Med. 2001;8(2):275–83.

    PubMed  CAS  Google Scholar 

  20. Calabria CW, Dietrich J, Hagan L. Comparison of serum-specific IgE (ImmunoCAP) and skin-prick test results for 53 inhalant allergens in patients with chronic rhinitis. Allergy Asthma Proc. 2009;30(4):386–96.

    Article  PubMed  CAS  Google Scholar 

  21. •• Tiotiu A, Brazdova A, Longé C, Gallet P, Morisset M, Leduc V. Urtica dioica pollen allergy: clinical, biological, and allergomics analysis. Ann Allergy Asthma Immunol. 2016;117(5):527–34. The authors provide two interesting case studies of adverse reactions to nettle and perform biological and immunochemical analyses of Urtica dioica.

    Article  PubMed  CAS  Google Scholar 

  22. Sharma P, Singh AK, Singh BP, Gaur SN, Arora N. Allergenicity assessment of osmotin, a pathogenesis-related protein used for transgenic crops. J Agric Food Chem. 2011;59(18):9990–5.

    Article  PubMed  CAS  Google Scholar 

  23. Palacin A, Rivas LA, Gómez-Casado C, Aguirre J, Tordesillas L, Bartra J. The involvement of thaumatin-like proteins in plant food cross-reactivity: a multicenter study using a specific protein microarray. PLoS One. 2012;7(9):e44088.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  24. Min K, Ha SC, Hasegawa PM, Bressan RA, Yun DJ, Kim KK. Crystal structure of osmotin. a plant antifungal protein. Proteins. 2004;54(1):170–3.

    CAS  Google Scholar 

  25. Mahler V, Fischer S, Heiss S, Duchêne M, Kraft D, Valenta R. cDna cloning and characterization of a cross-reactive birch pollen allergen: identification as a pectin esterase. Int Arch Allergy Immunol. 2001;124(1–3):64–6.

    Article  PubMed  CAS  Google Scholar 

  26. Ciardiello MA, D’Avino R, Amoresano A, Tuppo L, Carpentieri A, Carratore V. The peculiar structural features of kiwi fruit pectin methylesterase: amino acid sequence, oligosaccharides structure, and modeling of the interaction with its natural proteinaceous inhibitor. Proteins. 2008;71(1):195–206.

    Article  PubMed  CAS  Google Scholar 

  27. Corbi AL, Cortes C, Bousquet J, Basomba A, Cistero A, Garcia-Selles J. Allergenic cross-reactivity among pollens of Urticaceae. Int Arch Allergy Appl Immun. 1985;77:377–83.

    Article  CAS  Google Scholar 

  28. Holgate ST, Jackson L, Watson HK, Ganderton MA. Sensitivity to Parietaria pollen in the Southampton area as determined by skin-prick and RAST tests. Clin Allergy. 1988;18(6):549–56.

    Article  PubMed  CAS  Google Scholar 

  29. Vega-Maray AM, Fernández-González D, Valencia-Barrera R, Suárez-Cervera M. Allergenic proteins in Urtica dioica, a member of the Urticaceae allergenic family. Ann Allergy Asthma Immunol. 2006;97(3):343–9.

    Article  PubMed  CAS  Google Scholar 

  30. Weber RW. Cross-reactivity of pollen allergens: impact on allergen immunotherapy. Ann Allergy Asthma Immunol. 2007;99(3):203–11.

    Article  PubMed  Google Scholar 

  31. Park HS, Jung KS, Jee SY, Hong SH, Kim HY, Nahm DH. Are there any links between Hop Japanese pollen and other weed pollens or food allergens on skin prick tests? Allergy Asthma Proc. 2001;22(1):43–6.

    Article  PubMed  CAS  Google Scholar 

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Acknowledgements

Susan Kosisky, Chief Microbiologist (for ELMS data via T-con 31Jan2018) at The United States Army Centralized Allergen Extract Laboratory.

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Authors and Affiliations

  1. Department of Allergy/Immunizations, Wilford Hall Ambulatory Surgical Center, Wilford Hall Loop Building 4554, Lackland AFB, TX, 78236-9908, USA

    Rebecca Schapira DO & Karla Adams MD

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  1. Rebecca Schapira DO
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  2. Karla Adams MD
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Correspondence to Rebecca Schapira DO.

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The authors declare that they have no competing interests.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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The opinions or assertions herein are the private views of the authors and are not to be construed as reflecting the views of the Department of the Air Force or the Department of Defense.

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This article is part of the Topical Collection on Allergic Rhinitis

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Schapira, R., Adams, K. Nettle Allergy: a Review and Clinical Perspective. Curr Treat Options Allergy 5, 310–318 (2018). https://doi.org/10.1007/s40521-018-0178-0

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  • DOI: https://doi.org/10.1007/s40521-018-0178-0

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