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Pollenassoziierte Nahrungsmittelallergie aktuell sortiert

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Zusammenfassung

Hintergrund

Der Großteil der IgE-vermittelten Nahrungsmittelallergien bei Erwachsenen basiert auf einer Sensibilisierung gegenüber Pollen mit anschließenden Reaktionen auf strukturverwandte, häufig instabile Allergene insbesondere in Obst (inklusive Schalenfrüchten), Gemüse und Gewürzen.

Material und Methoden

Diese Arbeit ist ein aktueller Überblick ausgewählter, wissenschaftlichen Arbeiten über pollenassoziierte Nahrungsmittelallergie und wurde durch Recherchen in Pubmed, der Studie zur Gesundheit Erwachsener in Deutschland (DEGS) des Robert Koch-Instituts sowie den nationalen und internationalen Leitlinienregistern erstellt.

Ergebnisse

Als häufigste Form pollenassoziierter Nahrungsmittelallergien werden in Nordeuropa zumeist birkenpollenassoziierte Beschwerden beobachtet. Die Obstsorten, die am häufigsten zu Symptomen führen, gehören zur Familie der Rosaceae (zum Beispiel Äpfel, Kirschen) und der Fagales (Haselnuss). Ebenfalls hervorzuheben sind Reaktionen auf Leguminosen (zum Beispiel Erdnüsse, Soja) und auf die Gemüsesorten Sellerie, Karotte, Tomate und Paprika. Die klinischen Symptome der pollenassoziierten Nahrungsmittelallergie können neben einer oropharyngealen Kontakturtikaria auch eine Beteiligung weiterer Organsysteme bis hin zum anaphylaktischen Schock umfassen. Die wesentlichen pflanzlichen Nahrungsmittelallergene gehören zu wenigen Proteinfamilien (Bet-v-1-Homologe, Profiline, Lipidtransferproteine, Speicherproteine und Thaumatinartige Proteine).

Schlussfolgerung

Die Diagnostik pollenassozierter Nahrungsmittelallergie hat sich auch unter Einbeziehung der komponentenaufgelösten/molekularen Allergologie in den letzten Jahren stark erweitert und ermöglicht so einen sicheren Nachweis. Die Therapie umfasst eine diätetische Beratung und die Verordnung von Notfallmedikamenten. Zudem scheint eine allergenspezifische Immuntherapie auf kreuzreagierende Pollenallergene bei einem Teil der Patienten positive Aspekte auf die begleitende Nahrungsmittelallergie zu entfalten.

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Abb. 1

Abbreviations

ASIT:

Allergenspezifische Immuntherapie

CCD:

Kreuzreaktive Kohlenhydrat-Determinaten

DEGS:

Studie zur Gesundheit Erwachsener in Deutschland

FAQL:

Food allergy quality of life (Fragebogen)

HPT:

Haut-Pricktest

IgE:

Immunoglobulin E

IgG:

Immunoglobulin G

KAD:

Komponentenaufgelöste Diagnostik

kDa:

Kilodalton

LTP:

Lipidtransferproteine

NMA:

Nahrungsmittelallergie

OAS:

Oropharyngeale Kontakturtikaria (früher: orales Allergiesyndrom)

PR:

Familie der Pathogenese-assoziierten Proteine

sIgE:

Spezifisches Immunglobulin E

TLP:

Thaumatinartige Proteine

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Authors and Affiliations

  1. Leipziger Interdisziplinäres Centrum für Allergologie (LICA), Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig, Leipzig, Deutschland

    Regina Treudler & Jan-Christoph Simon

  2. Leipziger Interdisziplinäres Centrum für Allergologie Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig, Philipp-Rosenthal-Straße 23, 04103, Leipzig, Deutschland

    Regina Treudler

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Regina Treudler erhielt Honorare für Beratungstätigkeiten, Vorträge, Reisekostenübernahmen oder Studienunterstützungen von folgenden Firmen: Allergopharma J. Ganzer KG, ALK-Abello, Novartis, Shire.

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Zitierweise

Treudler R, Simon J-C. Pollen-related food allergy: an update. Allergo J Int 2017;26:273-82 https://doi.org/10.1007/s40629-017-0022-2

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Treudler, R., Simon, JC. Pollenassoziierte Nahrungsmittelallergie aktuell sortiert. Allergo J 26, 41–53 (2017). https://doi.org/10.1007/s15007-017-1418-5

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