Clinical and Molecular Allergy最新文献

{"title":"Management of patients with severe asthma: results from a survey among allergists and clinical immunologists of the Central Italy Inter-Regional Section of SIAAIC.","authors":"G Carli, A Farsi, S Bormioli, E Ridolo, F Fassio, S Pucci, M Montevecchi, M Riparbelli, L Cosmi, P Parronchi, O Rossi","doi":"10.1186/s12948-021-00160-x","DOIUrl":"https://doi.org/10.1186/s12948-021-00160-x","url":null,"abstract":"<p><strong>Background: </strong>Asthma, and severe asthma in particular, is often managed within a specialized field with allergists and clinical immunologists playing a leading role. In this respect, the National Scientific Society SIAAIC (Società Italiana di Allergologia, Asma ed Immunologia Clinica), structured in Regional and Inter-Regional sections, interviewed a large number of specialists involved in the management of this respiratory disease.</p><p><strong>Methods: </strong>A survey entitled \"Management of patients with asthma and severe asthma\" based on 17 questions was conducted through the SIAAIC newsletter in 2019 thanks to the collaboration between GlaxoSmithKline S.p.A. and the Inter-Regional Section of SIAAIC of Central Italy.</p><p><strong>Results: </strong>Fifty-nine allergists and clinical immunologists participated to the survey, and 40 of them completed the entire questionnaire. Almost all of the specialists (88%) reported that asthma control was achieved in above 50% of their patients, even if only one third (32%) actually used validated clinical tools such as asthma control test (ACT). Poor adherence to inhaled therapy was recognized as the main cause of asthma control failure by 60% of respondents, and 2-5 min on average is dedicated to the patient inhaler technique training by two-thirds of the experts (65%). Maintenance and as-needed therapy (SMART/MART) is considered an appropriate approach in only a minority of the patients (25%) by one half of the respondents (52%). A high number of exacerbations despite the maximum inhalation therapy were recognized as highly suspicious of severe asthma. Patients eligible for biological therapies are 3-5% of the patients, and almost all the responders (95%) agreed that patients affected by severe asthma need to be managed in specialized centers with dedicated settings. Biological drugs are generally prescribed after 3-6 months from the initial access to the center, and once started, the follow-up is initially programmed monthly, and then every 3-6 months after the first year of treatment (96% of responders). After phenotyping and severity assessment, comorbidities (urticaria, chronic rhinosinusitis with or without nasal polyps, vasculitis, etc.) are the drivers of choice among the different biological drugs. In the management of severe asthma, general practitioners (GPs) should play a central role in selecting patients and referring them to specialized centers while Scientific Societies should train GPs to appropriately recognize difficult asthma and promote public disease awareness campaigns.</p><p><strong>Conclusions: </strong>This survey which collects the point of view of allergists and clinical immunologists from Central Italy highlights that asthma control is still not measured with validated instruments. There is a general consensus that severe asthma should be managed only in dedicated centers and to this aim it is essential to encourage patient selection from a primary care s","PeriodicalId":38753,"journal":{"name":"Clinical and Molecular Allergy","volume":"19 1","pages":"22"},"PeriodicalIF":0.0,"publicationDate":"2021-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8647303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39787120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential uptake of three clinically relevant allergens by human plasmacytoid dendritic cells.","authors":"Noelle Zurmühl,&nbsp;Anna Schmitt,&nbsp;Ulrike Formentini,&nbsp;Johannes Weiss,&nbsp;Heike Appel,&nbsp;Klaus-Michael Debatin,&nbsp;Dorit Fabricius","doi":"10.1186/s12948-021-00163-8","DOIUrl":"https://doi.org/10.1186/s12948-021-00163-8","url":null,"abstract":"<p><strong>Background: </strong>Human plasmacytoid dendritic cells (pDC) have a dual role as interferon-producing and antigen-presenting cells. Their relevance for allergic diseases is controversial. and the impact of pDC on allergic immune responses is poorly understood.</p><p><strong>Methods: </strong>This in vitro study on human pDC isolated from peripheral blood was designed to compare side by side the uptake of three clinically relevant representative allergens: fluorochrome-labeled house dust mite Der p 1, Bee venom extract from Apis mellifera (Api) and the food allergen OVA analyzed flow cytometry and confocal microscopy.</p><p><strong>Results: </strong>We found that the internalization and its regulation by TLR9 ligation was significantly different between allergens in terms of time course and strength of uptake. Api and OVA uptake in pDC of healthy subjects was faster and reached higher levels than Der p 1 uptake. CpG ODN 2006 suppressed OVA uptake and to a lesser extent Der p 1, while Api internalization was not affected. All allergens colocalized with LAMP1 and EEA1, with Api being internalized particularly fast and reaching highest intracellular levels in pDC. Of note, we could not determine any specific differences in antigen uptake in allergic compared with healthy subjects.</p><p><strong>Conclusions: </strong>To our knowledge this is the first study that directly compares uptake regulation of clinically relevant inhalative, injective and food allergens in pDC. Our findings may help to explain differences in the onset and severity of allergic reactions as well as in the efficiency of AIT.</p>","PeriodicalId":38753,"journal":{"name":"Clinical and Molecular Allergy","volume":"19 1","pages":"23"},"PeriodicalIF":0.0,"publicationDate":"2021-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8597288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39899850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of vitamin D, magnesium and zinc supplements on interferon signaling pathways and their relationship to control SARS-CoV-2 infection.","authors":"Mohsen Nabi-Afjadi,&nbsp;Hadis Karami,&nbsp;Kaveh Goudarzi,&nbsp;Iraj Alipourfard,&nbsp;Elham Bahreini","doi":"10.1186/s12948-021-00161-w","DOIUrl":"https://doi.org/10.1186/s12948-021-00161-w","url":null,"abstract":"<p><p>The concern of today's communities is to find a way to prevent or treat COVID-19 and reduce its symptoms in the patients. However, the genetic mutations and more resistant strains of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerge; the designed vaccines and adjuvant therapies would potentially control the symptoms and severity of COVID-19. The most important complication of this viral infection is acute respiratory distress syndrome, which occurs due to the infiltration of leukocytes into the alveoli and the raised cytokine storm. Interferons, as a cytokine family in the host, play an important role in the immune-related antiviral defense and have been considered in the treatment protocols of COVID-19. In addition, it has been indicated that some nutrients, including vitamin D, magnesium and zinc are essential in the modulation of the immune system and interferon (IFN) signaling pathway. Several recent studies have investigated the treatment effect of vitamin D on COVID-19 and reported the association between optimal levels of this vitamin and reduced disease risk. In the present study, the synergistic action of vitamin D, magnesium and zinc in IFN signaling is discussed as a treatment option for COVID-19 involvement.</p>","PeriodicalId":38753,"journal":{"name":"Clinical and Molecular Allergy","volume":"19 1","pages":"21"},"PeriodicalIF":0.0,"publicationDate":"2021-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8573303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39601406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The potential protective role of corticosteroid therapy in patients with asthma and COPD against COVID-19.","authors":"Fabiana Furci,&nbsp;Marco Caminati,&nbsp;Gianenrico Senna,&nbsp;Sebastiano Gangemi","doi":"10.1186/s12948-021-00159-4","DOIUrl":"https://doi.org/10.1186/s12948-021-00159-4","url":null,"abstract":"<p><strong>Background: </strong>The observation of patients hospitalized for coronavirus disease (COVID-19) led us to note a lower prevalence of patients affected by chronic respiratory disease, in particular asthmatic patients, compared to the general population. Therefore, the aim of this paper is to evaluate the possible protective role of corticosteroid therapy in patients with chronic lung disease, regarding the risk of contracting severe COVID-19.</p><p><strong>Main body: </strong>SARS-CoV-2 uses angiotensin-converting enzyme 2 (ACE2) receptors to enter the cells. Considering the high number of these receptors in patients affected by asthma and chronic obstructive pulmonary disease (COPD), the evidence that these patients do not have a high risk of hospitalization for COVID-19 needs further study to understand what the possible protective \"factors\" are in these patients. In particular, the finding in some studies of reduced coronavirus replication in cell lines treated with steroids, molecules commonly used for treating chronic lung diseases, needs further attention.</p><p><strong>Short conclusion: </strong>The hypothesis that corticosteroids, commonly used in treating airways diseases, might modify the severity of SARS-CoV-2 disease has become a key point and a possible predictive factor of a positive outcome of COVID-19 in patients treated everyday with these molecules.</p>","PeriodicalId":38753,"journal":{"name":"Clinical and Molecular Allergy","volume":"19 1","pages":"19"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8557959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39577860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adult onset egg allergy: a case report.","authors":"Elisa Maria Cremonte,&nbsp;Eugenia Galdi,&nbsp;Chiara Roncallo,&nbsp;Elisa Boni,&nbsp;Luigi Giovanni Cremonte","doi":"10.1186/s12948-021-00156-7","DOIUrl":"https://doi.org/10.1186/s12948-021-00156-7","url":null,"abstract":"<p><strong>Background: </strong>Egg allergy is one of the most frequent food allergies in childhood while adult onset of egg allergy is a rare condition.</p><p><strong>Case presentation: </strong>We report the case of a 30 years old man sent to our center in order to investigate gastrointestinal symptoms occurring since 2 years after egg and derivatives intake. He did not suffer from egg or other food allergies in childhood. He is an active smoker with a contact dermatitis related to nickel and mild allergic rhinoconjunctivitis to grass pollen. Skin prick test and serum specific IgE to egg were performed and revealed sensitization to egg proteins.</p><p><strong>Conclusions: </strong>Even though IgE-mediated egg allergy affects children, this report witnesses a rare case of adult onset.</p>","PeriodicalId":38753,"journal":{"name":"Clinical and Molecular Allergy","volume":"19 1","pages":"17"},"PeriodicalIF":0.0,"publicationDate":"2021-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8489036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39483384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IL-33 genetics and epigenetics in immune-related diseases.","authors":"Eleonora Di Salvo,&nbsp;Marco Casciaro,&nbsp;Sebastiano Gangemi","doi":"10.1186/s12948-021-00157-6","DOIUrl":"https://doi.org/10.1186/s12948-021-00157-6","url":null,"abstract":"<p><p>Interleukin-33 (IL-33) is a 30KDa protein, which belongs to the Interleukin-1 cytokine family. It is a crucial regulator of innate and adaptive immune responses. This interleukin is additionally involved in the inflammatory reaction versus helminthic infections. Interleukin 33 acts on group 2 innate lymphoid cells and mast cells macrophages, dendritic cells and CD4 + Th2 cells eliciting a type 2 immune response. Moreover, the cytokine can activate the ST2 of Tregs, demonstrating its ability to downregulate inflammation. IL-33 has also an intracellular function by regulating transcription. The active IL-33 doesn't have a signal peptide, so it's not released across a normal secretory pathway; the interleukin is released when the cells are damages and acts like an \"alarmin\". Its influence on immune activation could be slightly adjusted via fine epigenetic interactions involving cascade pathways and immune genes. Due to the diverse data emerged from different experimental research, we decided span literature to clarify, as much as possible, how IL-33 is influenced by and influence gene expression. The authors reported how its balance is influenced, according to the tissue considered. Fundamental for immune-related diseases, IL-33 has a key role in controlling inflammation. The understanding of the cytokine switch will be fundamental in a near future in order to block or activate some immune pathways. In fact, we could control interleukins effects not only by monoclonal antibodies but also by using siRNA or miRNAs for silencing or expressing key genes.</p>","PeriodicalId":38753,"journal":{"name":"Clinical and Molecular Allergy","volume":"19 1","pages":"18"},"PeriodicalIF":0.0,"publicationDate":"2021-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8467020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39473288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Processionary caterpillar reactions in Southern Italy forestry workers: description of three cases.","authors":"Luisa Ricciardi,&nbsp;Concetto Giorgianni,&nbsp;Giusi Briguglio,&nbsp;Sebastiano Gangemi,&nbsp;Giovanna Spatari","doi":"10.1186/s12948-021-00155-8","DOIUrl":"https://doi.org/10.1186/s12948-021-00155-8","url":null,"abstract":"<p><strong>Background: </strong>Processionary caterpillar (PC), also named Thaumatopea pityocampa, has been reported to cause hypersensitivity reactions after contact with a toxin contained in hair-like bristles which cover this insect. Occupational exposure to PC is underestimated in outdoor workers and especially in forestry workers (FW) and is globally diffusing because of rising temperatures.</p><p><strong>Cases presentation: </strong>We present the first three cases of FW from Sicily, a Southern Italy (SI) region, which reported hypersensitivity reactions due to exposure to PC infested trees. These cases were identified by the occupational health physician during the annual screening of FW working in the Mountains of north-eastern Sicily. Interviewing a population of 630 FW, 1 male and 2 females reported direct contact skin reactions together with airborne contact reactions to PC hairs causing mild respiratory symptoms in two cases and ocular symptoms in one case, which needed treatment with systemic corticosteroids and antihistamines.</p><p><strong>Conclusions: </strong>This is the first report of hypersensitivity reactions in SI FW due to occupational exposure to PC. Further screenings not only in FW but also in other populations of outdoor workers are needed in order to assess the real incidence of contact and airborne reactions due to occupational exposure to PC. Though so far no correlation has been found with atopy, it seems apparent that the reactions occur in susceptible subjects; further research is needed for a correct diagnosis and to identify possible desensitization procedures.</p>","PeriodicalId":38753,"journal":{"name":"Clinical and Molecular Allergy","volume":"19 1","pages":"15"},"PeriodicalIF":0.0,"publicationDate":"2021-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8422601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39389960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peanut components measured by ISAC: comparison with ImmunoCap and clinical relevance in peanut allergic children.","authors":"H K Brand,&nbsp;M W J Schreurs,&nbsp;J A M Emons,&nbsp;R Gerth van Wijk,&nbsp;H de Groot,&nbsp;N J T Arends","doi":"10.1186/s12948-021-00153-w","DOIUrl":"https://doi.org/10.1186/s12948-021-00153-w","url":null,"abstract":"<p><strong>Background: </strong>Specific IgE (sIgE) against the peanut component Arachis hypogaea (Ara h) 2 has been shown to be the most important allergen to discriminate between peanut allergy and peanut tolerance. Several studies determined sIgE cut off values for Ara h 2, determined by singleplex measurements. However, cut off values for Ara h 2 from multiplex arrays are less well defined. The aim of this study was to evaluate the correlation between Ara h 2 sIgE determined by singleplex versus multiplex measurements and to assess the diagnostic value of the different peanut components included in Immuno Solid-phase Allergen Chip (ISAC) multiplex analysis in children with a suspected peanut allergy.</p><p><strong>Methods: </strong>In this retrospective study we analyzed Ara h 2 sIgE values with singleplex Fluorescence Enzyme Immunoassay (FEIA, ImmunoCap) and multiplex microarray (ISAC) measurements in 117 children with a suspected peanut allergy. Also, other peanut components measured by ISAC were analyzed. Double blinded placebo controlled oral food challenges were used as golden standard.</p><p><strong>Results: </strong>Among all studied peanut components FEIA Ara h 2 sIgE showed the highest area under the curve (AUC, 0.922), followed by ISAC Ara h 6 and Ara h 2 sIgE with AUCs of respectively 0.906 and 0.902. Best cut off values to diagnose peanut allergy were 4.40 kU/l for FEIA Ara h 2 sIgE and, 7.43 ISU and 8.13 ISU for respectively Ara h 2 and Ara h 6 sIgE in ISAC microarray. Ara h 2 sIgE determined in FEIA and ISAC showed a good correlation (r = 0.88; p < 0.01).</p><p><strong>Conclusion: </strong>Ara h 6 and Ara h 2 sIgE in multiplex ISAC are both good predictors of clinical peanut allergy in Dutch children, and their performance is comparable to the use of Ara h 2 in singleplex FEIA. The simultaneous measurement of different peanut components using ISAC is an advantage and clinically useful to detect peanut allergic children that are Ara h 2 negative but sensitized to other peanut proteins such as Ara h 6.</p>","PeriodicalId":38753,"journal":{"name":"Clinical and Molecular Allergy","volume":"19 1","pages":"14"},"PeriodicalIF":0.0,"publicationDate":"2021-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8353733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39295413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distinct differences in analytical performance of two commercially available assays for specific IgE to egg white and house dust mite allergens.","authors":"Komei Ito,&nbsp;Kazunori Tagami","doi":"10.1186/s12948-021-00151-y","DOIUrl":"https://doi.org/10.1186/s12948-021-00151-y","url":null,"abstract":"<p><strong>Background: </strong>Measurements of allergen-specific IgE antibodies with different manufacturers' assays show modest or poor agreement. This study compares analytical performance of specific IgE tests for whole allergen extracts and individual allergen components of two assay systems, IMMULITE and ImmunoCAP, using human sera as well as monoclonal antibodies.</p><p><strong>Methods: </strong>Comparisons were performed for specific IgE to house dust mite (HDM, n = 44), egg white (EW, n = 36) and the allergen components rDer p 1, rDer p 2, nGal d 1, nGal d 2 and nGal d 4 in human sera and with monoclonal mouse/human chimeric IgE antibodies specific for the same allergen components. Competitive interference with IgE measurement was investigated using allergen-specific monoclonal IgG and IgG4 antibodies.</p><p><strong>Results: </strong>Measurements of IgE to HDM and EW in serial dilutions of human sera revealed weaker dilution linearity with IMMULITE than with ImmunoCAP. Analysis of five different monoclonal IgE antibodies with total and specific IgE assays, expected to return similar levels, gave an average specific/total IgE ratio of 0.96 (range 0.71-1.14) with ImmunoCAP and 1.89 (range 0.76-2.85) with IMMULITE, indicating overestimation of specific IgE by IMMULITE. With the EW IgE tests of both assay systems, measurements of a chimeric anti-Gal d 2 IgE antibody were unaffected by a competing mouse IgG antibody. While the same was true for measurement of a chimeric anti-Der p 1 IgE antibody using the HDM test in ImmunoCAP, a suppression of measured concentrations by up to 42% was observed in IMMULITE. Similarly, measurement of HDM-specific IgE in human sera by ImmunoCAP was unaffected by a competing monoclonal anti-Der p 2 IgG4 antibody while IMMULITE displayed a reduction of HDM-specific IgE values by up to 30%.</p><p><strong>Conclusions: </strong>In this evaluation of analytical performance of two widely used assay systems, ImmunoCAP showed higher accuracy in quantitation of specific IgE and greater resistance against competing allergen-specific non-IgE antibodies which may arise through natural or dietary exposure, or as a result of allergen immunotherapy treatment.</p>","PeriodicalId":38753,"journal":{"name":"Clinical and Molecular Allergy","volume":"19 1","pages":"13"},"PeriodicalIF":0.0,"publicationDate":"2021-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8330041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39271056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A spotlight on lime: a review about adverse reactions and clinical manifestations due to Citrus aurantiifolia.","authors":"Clara Alessandrello,&nbsp;Luca Gammeri,&nbsp;Serena Sanfilippo,&nbsp;Raffaele Cordiano,&nbsp;Silvia Brunetto,&nbsp;Marco Casciaro,&nbsp;Sebastiano Gangemi","doi":"10.1186/s12948-021-00152-x","DOIUrl":"https://doi.org/10.1186/s12948-021-00152-x","url":null,"abstract":"<p><p>Lime (Citrus aurantiifolia) is a plant belonging to the family of Rutaceae and to the genus Citrus. The fruit is widely used in the United States, Mexico, Southeast Asia, Latin America, but is increasingly widespread all over the world. It is used as a fresh fruit, in the preparation of foods, sweets and drinks and its oils are used in the cosmetic and pharmaceutical industry. The main adverse reactions to lime seem to be represented by contact dermatitis, allergic and phototoxic type. In the context of allergic forms, several allergens have been identified in the citrus family, the main one being limonene, but no noteworthy cross-reactivity has been identified. However, a case of fruit protein contact dermatitis has been described, showing sensitization to other fruits, such as kiwi, avocado, pineapple and apple. There are several molecules responsible for phototoxic reactions and mainly belonging to the coumarin and furocoumarins families. Reactions related to ingesting the fruit or inhaling pollen from the tree appear to be rare, as there are no known cases reported in the literature. The increasing diffusion of lime in Europe must pay attention to possible adverse reactions due to contact with this fruit, which seem destined to increase in future years. Further importance must be placed on patch tests and on the possibility of using alternative extracts to classic fragrance mixes.</p>","PeriodicalId":38753,"journal":{"name":"Clinical and Molecular Allergy","volume":"19 1","pages":"12"},"PeriodicalIF":0.0,"publicationDate":"2021-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s12948-021-00152-x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39217178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}