Detection of pan-allergens in commercial pollen extracts for allergen immunotherapy.

BACKGROUND: Up to 50% of patients with pollen allergy are sensitized to at least 1 of the 2 pollen pan-allergens profilin and polcalcin. These allergens could have clinical relevance but the content of profilin and polcalcin in commercial extracts for allergen immunotherapy (AIT) is unknown.

OBJECTIVE: To detect these pan-allergens in commercial pollen extracts for AIT from various sources.

METHODS: Immunoglobulin E (IgE) reactivity to Phl p 7 and Bet v 2 of sera from 18 adults hypersensitive to profilin and/or polcalcin was investigated by enzyme-linked immunosorbent assay before and after absorption with grass, birch, ragweed, pellitory, and olive pollen extracts for AIT from different producers. Immunoblot inhibition experiments also were carried out using the same allergens.

RESULTS: Birch, grass, ragweed, and olive pollen extracts for AIT contained large amounts of profilin, inducing 80% to 90% inhibition in most cases; Parietaria AIT extract appeared to contain little profilin. On immunoblot, grass and birch pollen extracts for sublingual AIT completely absorbed IgE specific for rBet v 2. Interestingly, only grass pollen extracts induced a significant inhibition of IgE binding to rPhl p 7 on enzyme-linked immunosorbent assay and immunoblot. A grass pollen allergoid lost most of its inhibitory potency, suggesting a much weakened affinity for specific IgE.

CONCLUSION: With the exception of Parietaria, commercial extracts for AIT of most pollens are rich in profilin and, hence, potentially able to desensitize to this allergen; in contrast, only grass pollen extracts seem rich in polcalcin. These are the pollens to use in case of severe symptoms induced by pollen pan-allergens.