Allergic Reactions Affecting Mucosal Surfaces

  • J. Wesley Sublett
  • Jonathan A. BernsteinEmail author


Local vaginal IgE immune responses have been underappreciated by allergists. Seminal plasma (SP) hypersensitivity and chronic vulvovaginal Candida hypersensitivity are two examples or such reactions that respond to ­desensitization to relevant seminal plasma proteins and Candida albicans, respectively. Both ­disorders probably occur more frequently in the general population than realized and therefore clinicians should be familiar with the evaluation, diagnosis, and ­treatment options available for these disorders.


Human seminal plasma Vulvovaginal candidiasis Immunotherapy 


  1. 1.
    Bernstein, I.L., et al., Localized and systemic hypersensitivity reactions to human seminal fluid. Ann Intern Med, 1981. 94(4 Pt 1): p. 459–65.PubMedGoogle Scholar
  2. 2.
    Bernstein, J.A., et al., Evaluation and treatment of localized vaginal immunoglobulin E-mediated hypersensitivity to human seminal plasma. Obstet Gynecol, 1993. 82(4 Pt 2 Suppl): p. 667–73.PubMedGoogle Scholar
  3. 3.
    Marcus, Z.H., et al., In vitro studies in reproductive immunology. 1. Suppression of cell-mediated immune response by human spermatozoa and fractions isolated from human seminal plasma. Clin Immunol Immunopathol, 1978. 9(3): p. 318–26.PubMedCrossRefGoogle Scholar
  4. 4.
    Bernstein, J.A., et al., Is burning semen syndrome a variant form of seminal plasma hypersensitivity? Obstet Gynecol, 2003. 101(1): p. 93–102.PubMedCrossRefGoogle Scholar
  5. 5.
    Basagana, M., et al., Allergy to human seminal fluid: cross-reactivity with dog dander. J Allergy Clin Immunol, 2008. 121(1): p. 233–9.PubMedCrossRefGoogle Scholar
  6. 6.
    Weidinger, S., et al., Prostate-specific antigen as allergen in human seminal plasma allergy. J Allergy Clin Immunol, 2006. 117(1): p. 213–5.PubMedCrossRefGoogle Scholar
  7. 7.
    Presti, M.E. and H.M. Druce, Hypersensitivity reactions to human seminal plasma. Ann Allergy, 1989. 63(6 Pt 1): p. 477–81.PubMedGoogle Scholar
  8. 8.
    Bernstein, J.A., et al., Prevalence of human seminal plasma hypersensitivity among symptomatic women. Ann Allergy Asthma Immunol, 1997. 78(1):p.42–8.Google Scholar
  9. 9.
    Resnick, D.J., et al., The approach to conception for women with seminal plasma protein hypersensitivity. Am J Reprod Immunol, 2004. 52(1): p. 42–4.PubMedCrossRefGoogle Scholar
  10. 10.
    Lee, J., et al., Anaphylaxis to husband’s seminal plasma and treatment by local desensitization. Clin Mol Allergy, 2008. 6: p. 13.PubMedCrossRefGoogle Scholar
  11. 11.
    Mittman, R.J., et al., Selective desensitization to seminal plasma protein fractions after ­immunotherapy for postcoital anaphylaxis. J Allergy Clin Immunol, 1990. 86(6 Pt 1): p. 954–60.PubMedCrossRefGoogle Scholar
  12. 12.
    Sobel, J.D., Recurrent vulvovaginal candidiasis. A prospective study of the efficacy of maintenance ketoconazole therapy. N Engl J Med, 1986. 315(23): p. 1455–8.PubMedCrossRefGoogle Scholar
  13. 13.
    Rosedale, N. and K. Browne, Hyposensitisation in the management of recurring vaginal candidiasis. Ann Allergy, 1979. 43(4): p. 250–3.PubMedGoogle Scholar
  14. 14.
    Witkin, S.S., Immunology of recurrent vaginitis. Am J Reprod Immunol Microbiol, 1987. 15(1): p. 34–7.PubMedGoogle Scholar
  15. 15.
    Witkin, S.S., J. Hirsch, and W.J. Ledger, A macrophage defect in women with recurrent Candida vaginitis and its reversal in vitro by prostaglandin inhibitors. Am J Obstet Gynecol, 1986. 155(4): p. 790–5.PubMedGoogle Scholar
  16. 16.
    Meech, R.J., J.M. Smith, and T. Chew, Pathogenic mechanisms in recurrent genital candidosis in women. N Z Med J, 1985. 98(771): p. 1–5.PubMedGoogle Scholar
  17. 17.
    Witkin, S.S., J. Jeremias, and W.J. Ledger, A localized vaginal allergic response in women with recurrent vaginitis. J Allergy Clin Immunol, 1988. 81(2): p. 412–6.PubMedCrossRefGoogle Scholar
  18. 18.
    Koivikko, A., et al., Allergenic cross-reactivity of yeasts. Allergy, 1988. 43(3): p. 192–200.PubMedCrossRefGoogle Scholar
  19. 19.
    Rigg, D., M.M. Miller, and W.J. Metzger, Recurrent allergic vulvovaginitis: treatment with Candida albicans allergen immunotherapy. Am J Obstet Gynecol, 1990. 162(2): p. 332–6.PubMedGoogle Scholar
  20. 20.
    Moraes, P.S., S. de LimaGoiaba, and E.A. Taketomi, Candida albicans allergen immunotherapy in recurrent vaginal candidiasis. J Investig Allergol Clin Immunol, 2000. 10(5): p. 305–9.PubMedGoogle Scholar

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© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Division of Immunology/Allergy Section, Department of Internal MedicineUniversity of Cincinnati College of MedicineCincinnatiUSA

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