Sensitisation to molecular components of fungi in atopic dermatitis patients, the relation to the occurrence of food hypersensitivity reactions

Figures & data

Table 1. Number of patients with clinical symptoms of food hypersensitivity reactions to examined food allergens.

	Number of patients with clinical symptoms of food hypersensitivity reactions, 100 patients included (=100 %)
	The whole number of patients with clinical symptoms	OAS	GIT	Pruritus	Worsening of AD	Worsening of breath	Urticaria
Peanuts	46 (46 %)	35 (35 %)	12 (12 %)	7 (7 %)	8 (8 %)	–	–
Walnuts	44 (44 %)	26 (26 %)	8 (8 %)	8 (8 %)	7 (7 %)	–	–
Hazelnuts	43 (43 %)	22 (22 %)	8 (8 %)	6 (6 %)	7 (7 %)	–	–
Fish	11 (11 %)	0 (%)	6 (6 %)	3 (3 %)	4 (4 %)	–	–
Apple	23 (23 %)	21 (21 %)	13 (13 %)	10 (10 %)	8 (8 %)	–	4 (4 %)
Peach	18 (18 %)	18 (18 %)	12 (12 %)	5 (5 %)	8 (8 %)	–	3 (3 %)
Celery	21 (21 %)	20 (20 %)	15 (15 %)	5 (5 %)	5 (5 %)	1 (1 %)	3 (3 %)
Egg	20 (20 %)	0	2 (2 %)	13 (13 %)	20 (20 %)	1 (1 %)	–
Soy	12 (%)	2 (2 %)	9 (9 %)	8 (8 %)	6 (6 %)	–	–
Wheat	12 (12 %)	0 (%)	3 (3 %)	12 (12 %)	10 (10 %)	0	0
Cow milk	13 (13 %)	0 (%)	10 (10 %)	2 (2 %)	3 (3 %)	1 (%)	0
Kiwi	15 (15 %)	10 (10 %)	2 (2 %)	7 (7 %)	9 (9 %)	2 (2 %)	(%)
Carrot	17 (17 %)	5 (5%)	10 (10%)	5 (5%)	5 (5 %)	0 (%)	(%)
Spices	19 (19 %)	10 (10 %)	6 (6 %)	6 (6 %)	8 (8 %)	0 (%)	2 (2 %)
Tomato	15 (15%)	10 (10 %)	4 (4 %)	6 (6 %)	7 (7 %)	0 (%)	0 (%)
Oranges	26 (26 %)	4 (4 %)	3 (3 %)	20 (20 %)	15 (15 %)	0 (%)	0 (%)

OAS, oral allergy syndrome; GIT, gastrointestinal symptoms; AD, atopic dermatitis.

Table 2. The overview of allergen reagents (allergenic extracts and molecular components) of moulds and yeast according to the frequency of sensitisation in classes 0, 1, 2, 3, 4 in 100 atopic dermatitis patients (=100 %).

Allergen reagents		The number of patients in % according to the level of specific IgE in classes 0–4 (included 100 patients = 100 %)
		Class 0	Class 1	Class 2	Class 3	Class 4
Alt a 1	Alternaria alternata	74%	0%	0%	4%	22%
Alt a 6	Enolase, Alternaria alternata	88%	2%	4%	4%	2%
Asp f 1	Aspergilus fumigatus Mitogillin family	96%	2%	1%	1%	0%
Asp f 3	Aspergilus fumigatus Peroxysomal protein	85%	8%	5%	1%	1%
Asp f 4	Aspergilus fumigatus	97%	0%	1%	1%	1%
Asp f 6	Aspergilus fumigatus, Mn superoxide dismutase	80%	2%	4%	9%	5%
Cla h	Cladosporium herbarum	94%	5%	1%	0%	0%
Cla h 8	Mannitol dehydrogenase, Cladosporium herbarum	85%	14%	1%	0%	0%
Mala s 11	Manganese superoxide dismutase, Malassezia sympodialis	76%	0%	7%	1%	16%
Mala s 5	Malassezia sympodialis	90%	1%	3%	1%	5%
Mala s 6	Malassezia sympodialis, Cyclophilin	86%	5%	6%	3%	0%
Pen ch	Penicillium chrysogenum	97%	3%	0%	0%	0%
Sacc	Saccharomyces cerevisiae	86%	7%	7%	0%	0%

Class 0 (< 0.3 kU_A/L) – negative; Class 1 (0.3 > 1 kU_A/L) – low positivity; Class 2 (1 >5 kU_A/L) – moderate positivity; Class 3 (5 >15 kUA/L) – high positivity; Class 4 (≥ 15 kU_A/L) – very high positivity.

Table 3. The relation between the sensitisation to molecular components of moulds and yeast and the food hypersensitivity reactions.

Molecular components, number of patients with positive and negative specific IgE	Number of patients with (+) and without (−) clinical reactions to examined food
	Peanuts+	Peanuts−	Hazelnut+	Hazelnuts−	Walnuts+	Walnuts−	Soy+	Soy−
Mala s 5+	4	6	5	5	5	5	2	8
Mala s 5−	42	48	38	52	39	51	10	80
p-value	0.749		0.741		0.745		0.343
Mala s 6+	7	7	6	8	6	8	2	12
Mala s 6−	39	47	37	49	38	48	10	76
p-value	0.779		1.000		1.000		0.673
Mala s 11+	13	11	11	13	13	11	4	20
Mala s 11−	33	43	32	44	31	45	8	68
p-value	0.481		0.815		0.345		0.474
Alt a 1+	16	10	13	13	16	10	3	23
Alt a 1−	30	44	30	44	28	46	9	65
p-value	0.072		0.491		0.042*		1.000
Alt a 6+	9	3	9	3	10	2	1	11
Alt a 6−	37	51	34	54	34	54	11	77
p-value	0.060		0.027*		0.005*		1.000
Asp f 3+	12	3	12	3	12	3	3	12
Asp f 3−	34	51	31	54	32	53	9	76
p-value	0.005*		0.003*		0.004*		0.382
Asp f 6+	11	9	10	10	12	8	3	17
Asp f 6−	35	45	33	47	32	48	9	71
p-value	0.454		0.614		0.133		0.702
Cla h 8+	11	4	10	5	10	5	2	13
Cla h 8−	35	50	33	52	34	51	10	75
p-value	0.026*		0.052		0.088		1.000

Molecular components, number of patients with positive and negative specific IgE	Number of patients with (+) and without (−) clinical reactions to examined food
	Egg+	Egg−	Fish+	Fish−	Wheat flour+	Wheat flour−	Cow milk+	Cow milk−
Mala s 5+	4	6	0	10	1	9	0	10
Mala s 5 -	16	74	11	79	11	79	13	77
p-value	0.109		0.596		1.000		0.351
Mala s 6+	5	9	5	9	1	13	1	13
Mala s 6−	15	71	6	80	11	75	12	74
p-value	0.147		0.007*		1.000		0.686
Mala s 11+	6	18	5	19	1	23	3	21
Mala s 11−	14	62	6	70	11	65	10	66
p-value	0.560		0.127		0.283		1.000
Alt a 1+	5	21	3	23	4	22	2	24
Alt a 1−	15	59	8	66	8	66	11	63
p-value	1.000		1.000		0.504		0.504
Alt a 6+	5	7	3	9	2	10	1	11
Alt a 6−	15	73	8	80	10	78	12	76
p-value	0.060		0.125		0.634		1.000
Asp f 3+	6	9	2	13	2	13	1	14
Asp f 3−	14	71	9	76	10	75	12	73
p-value	0.072		0.668		1.000		0.684
Asp f 6+	6	14	5	15	1	19	3	17
Asp f 6−	14	66	6	74	11	69	10	70
p-value	0.222		0.040*		0.450		0.720
Cla h 8+	7	8	3	12	2	13	1	14
Cla h 8−	13	72	8	77	10	75	12	73
p-value	0.012*		0.363		1.000		0.684

Molecular components, number of patients with positive and negative specific IgE	Number of patients with (+) and without (−) clinical reactions to examined food
	Celery+	Celery−	Apple+	Apple−	Kiwi+	Kiwi−	Carrot+	Carrot−
Mala s 5+	2	8	4	6	2	8	2	8
Mala s 5−	19	71	19	71	13	77	15	75
p-value	1.000		0.232		0.643		0.677
Mala s 6+	5	9	6	8	3	11	4	10
Mala s 6−	16	70	17	69	12	74	13	73
p-value	0.164		0.083		0.436		0.250
Mala s 11+	8	16	4	20	5	19	5	19
Mala s 11−	13	63	19	57	10	66	12	64
p-value	0.147		0.578		0.345		0.546
Alt a 1+	5	21	7	19	7	19	4	22
Alt a 1−	16	58	16	58	8	66	13	61
p-value	1.000		0.595		0.060		1.000
Alt a 6+	3	9	1	11	2	10	2	10
Alt a 6−	18	70	22	66	13	75	15	73
p-value	0.712		0.286		1.000		1.000
Asp f 3+	4	11	4	11	3	12	4	11
Asp f 3−	17	68	19	66	12	73	13	72
p-value	0.512		0.743		0.693		0.278
Asp f 6+	7	13	3	17	3	17	3	17
Asp f 6−	14	66	20	60	12	68	14	66
p-value	0.123		0.552		1.000		1.000
Cla h 8+	4	11	4	11	4	11	3	12
Cla h 8−	17	68	19	66	11	74	14	71
p-value	0.512		0.743		0.232		0.716

Molecular components, number of patients with positive and negative specific IgE	Number of patients with (+) and without (−) clinical reactions to examined food
	Spices+	Spices−	Peach+	Peach−	Tomato+	Tomato−	Orange+	Orange−
Mala s 5+	4	6	2	8	2	8	2	8
Mala s 5−	15	75	16	74	13	77	24	66
p-value	0.092		1.000		0.643		1.000
Mala s 6+	4	10	4	10	3	11	5	9
Mala s 6−	15	71	14	72	12	74	21	65
p-value	0.460		0.272		0.436		0.511
Mala s 11+	6	18	5	19	4	20	7	17
Mala s 11−	13	63	13	63	11	65	19	57
p-value	0.385		0.761		0.752		0.790
Alt a 1+	4	22	7	19	3	23	9	17
Alt a 1−	15	59	11	63	12	62	17	57
p-value	0.773		0.233		0.753		0.300
Alt a 6+	1	11	3	9	1	11	5	7
Alt a 6−	18	70	15	73	14	74	21	67
p-value	0.453		0.448		0.687		0.289
Asp f 3+	3	12	3	12	2	13	7	8
Asp f 3−	16	69	15	70	13	72	19	66
p-value	1.000		0.730		1.000		0.060
Asp f 6+	5	15	4	16	2	18	5	15
Asp f 6−	14	66	14	66	13	67	21	59
p-value	0.524		0.753		0.728		1.000
Cla h 8+	2	13	4	11	2	13	5	10
Cla h 8−	17	68	14	71	13	72	21	64
p-value	0.729		0.463		1.000		0.528

Complement to Table 3. Foods with hypersensitivity reactions for which significantly higher sensitization to moulds and yeast is recorded.
Food allergen	Molecular components
Peanuts	Asp f 3 (Peroxysomal protein), Cla h 8 (Mannitol dehydrogenase)
Hazelnuts	Asp f 3 (Peroxysomal protein), Alt a 6 (Enolase).
Walnuts	Asp f 3 (Peroxysomal protein), Alt a 1, Alt a 6 (Enolase)
Fish	Asp f 6 (Mn superoxide dismutase), Mala s 6 (Cyclophilin)
Egg	Cla h 8 (Mannitol dehydrogenase)

The p-value is recorded; the significant relation is marked with p-value ≤ 0.05 extra bold*. peanuts+: food hypersensitivity reaction to peanuts confirmed; peanuts−: food hypersensitivity reactions to peanuts not confirmed.

Table 4. Number of patients with positive results of specific IgE to molecular components of peanuts, walnuts, hazelnuts, fish, shrimps end egg and number of patients with positive results of specific IgE to molecular components of moulds and yeast.

		Molecular components of moulds and yeast, number of patients with positive sIgE
		Mala s 5	Mala s 6	Mala s 11	Sac c	Alt a 1	Alt a 6	Asp f 3	Asp f 6	Cla h 8	Cla h
		10	14	24	14	26	12	15	20	15	6
Molecular components of peanuts, walnuts, hazelnuts, fish, shrimps, egg	Number of patients with positive sIgE	The significant relation is marked with p-value ≤ 0.05
Ana o Cashew	7						0.0356
Car i Pecan	9		0.0207				0.0112	0.0035		<0.001
Cor a 1.0401 Hazelnut, PR-10 protein	44		0.0009		0.0076		0.0295	0.0004		0.0004	0.0059
Cor a 11 Hazelnut, 7 S globulin	6				0.0345		0.0016	0.0043		0.0002	0.0407
Cor a 14 Hazelnut, 2 S albumin	6			0.0282	0.0032	0.0043	0.0016	0.0043		0.0043
Jug r 2 Walnut, 7S globulin	8		0.0126		0.0126	0.0265	0.0067	0.0001		0.0001
Jug r 6 Walnut, 7S globulin	6		0.0345		0.0345		0.0219	0.0043		0.0002
Ara h 1 Peanut, 7S globulin	9			0.0055	0.0024		0.001	0.027	0.0147	0.0003	0.009
Ara h 15 Peanut, Oleosin	8						0.0067	0.0017
Ara h 6 Peanut, 2S albumin	7
Ara h 8 Peanut, PR-10 protein	33		0.0125	0.0052	0.0002			0.0007	0.0317	0.0007	0.0143
Arah 9 Peanut, nsLTP	9			0.0342	0.0207	0.0486	0.001	0.027		0.0003	0.441
Cra c 6 North Sea shrimp, troponin C	7						0.0036				0.0039
Cyp c 1 Carp, Beta-parvalbumin	6		0.0345	0.0282	0.0345				0.0139
Hom g Lobster	15			0.0446			0.0164	0.0466			0.042
Chi spp. Crab	9							0.0035		0.027
Pen m 2 Shrimp, Arginine kinase	18		0.0031	0.0116	0.0031		0.0071	0.0267	0.0463	0.0007	0.0006
Rud spp. Clam	8							0.0165
Sal s 1 Salmon, Beta-parvalbumin	7		0.0069				0.0036		0.0281
Sco s Mackerel	6			0.0282	0.0345			0.042	0.0139
Sco s 1 Mackerel, Beta-parvalbumin	6		0.0032	0.0282					0.0139
Thu a 1 Tuna, Beta-parvalbumin	7		0.0069	0.0082					0.0033
Xip g 1 Swordfish, Beta-parvalbumin	6		0.0345	0.0282	0.0345				0.0011
Gal d white Egg white	16	0.0087	0.0013	0.0208	0.0001		0.0219		0.0032		0.0022
Gal d yolk Egg – yolk	6						0.0219			0.0407
Gal d 1 Egg, ovomucoid	6		0.0345		0.0345		0.0036			0.0023	0.042
Gal d 2 Egg, ovoalbumin	7				0.0069		0.0356			0.0001	0.0091
Gal d 3 Egg, ovotransferin	7
Gal d 4 Egg, lysozyme C	6		0.0345		0.0032					0.0407
Complement to Table 4. Summary Table: The significant relation between the level of specific IgE to moulds and yeast and the level of specific IgE to molecular components of peanuts, hazelnuts, walnuts, fish, shrimps and egg. Positive results of specific IgE to molecular components of moulds and yeast are in significant relation to molecular components of Beta – parvalbumin, arginin kinase, 7S globulin, 2S albumin, PR-10 proteins and Non-specific lipid transfer protein. Moreover, there is a relationship between the levels of specific IgE to Alt a 6, Cla h and the level of Cra c 6 – Troponin C. Sensitisation to Mala 5, Mala 6, Mala 11, Sacc, Alt a 6, Asp f 6, Cla h and Cla h 8 is in significant relation with specific IgE results to molecular components of egg.
Significant relation between the positive results of specific IgE to molecular components of moulds and yeast and positive results of specific IgE to molecular components of peanuts, hazelnuts, walnuts, fish, shrimps and egg
Molecular components of moulds and yeast	Molecular components of peanuts, hazelnuts, walnuts, fish, shrimps and egg with the significant relation to specific IgE to moulds and yeast
Mala s 5	Gal d white
Mala s 11 Mn superoxide dismutase	Cor a 14 – 2S albumin Ara h 1 – 7S globulin Ara h 8 – PR 10 protein Ara h 9- Non-specific lipid transfer protein Pen m 2 – Arginin kinase Cyp c 1, Sco s 1, Thu a 1, Xip g 1-Beta-parvalbumin Hom g Gal d white
Mala s 6 Cyclophilin	Car i – pecan nut Cor a 1.0401, Ara h 8 – PR 10 protein Jug r 2, Jug r 6 – 7S globulin Pen m 2 - Arginin kinase Cyp c 1, Sal s 1, Sco s 1, Thu a 1, Xip g 1-Beta-parvalbumin Gal d white Gal d 1 - ovomucoid, Gal d 4 – Lysozyme C
Sacc	Cor a 1.0401, Ara h 8 – PR 10 protein Cor a 11. Jug r 2. Jug r 6. Ara h 1 – 7S globulin Cor a 14 – 2 S albumin Ara h 9- Non-specific lipid transfer protein Pen m 2 –Arginin kinase Cyp c 1, Sco s, Xip g 1-Beta-parvalbumin Gal d white Gal d 1-ovomucoid, Gal d 2 – ovalbumin, Gal d 4 – Lysozyme C
Alt a 1 Alt a 1 family	Cor a 14 – 2S albumin Jug r 2 – 7S globulin Ara h 9-Non-specific lipid transfer proteinCor a 14 – 2S albumin Jug r 2 – 7S globulin Ara h 9 - Non-specific lipid transfer protein
Alt a 6 Enolase	Jug r 2, Jug r 6, Ara h 1, Cor a 11 -7 S globulin Ana o – cashew nut Car i – pecan nut Cor a 1.0401 – PR 10 protein Cor a 14 – 2 S albumin Ara h 15 – oleosin Ara h 9 - Non-specific lipid transfer protein Cra c 6 – Troponin C Hom g Pen m 2 – Arginin kinase Sal s 1 – Beta-parvalbumin Gal d yolk Gal d 1-ovomucoid, Gal d 2 – ovalbumin, Gal d 3 - ovotransferrin

The hypothesis of independence from the alternative of addiction was tested. Fisher's exact test was used. The significant relation between the level of specific IgE to molecular components of moulds and yeast and specific IgE to molecular components of peanuts, hazelnuts, walnuts, fish and shrimps is recorded (the significant relation is marked with p-value ≤ 0.05). The relation was not calculated for the components of moulds and yeast for which the frequency of positive results of specific IgE is less than 6.