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Primary respiratory and food allergy to mealworm

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1 Primary respiratory and food allergy to mealworm
Henrike C.H.P. Broekman, MD, André C. Knulst, MD, PhD, Constance F. den Hartog Jager, BSc, Jolanda H.M. van Bilsen, PhD, Florine M.L. Raymakers, RN, Astrid G. Kruizinga, PhD, Marco Gaspari, PhD, Caterine Gabriele, PhD, Carla A.F.M. Bruijnzeel-Koomen, MD, PhD, Geert F. Houben, PhD, Kitty C.M. Verhoeckx, PhD  Journal of Allergy and Clinical Immunology  Volume 140, Issue 2, Pages e7 (August 2017) DOI: /j.jaci Copyright © 2017 American Academy of Allergy, Asthma & Immunology Terms and Conditions

2 Fig 1 IgE-binding profile in mice and human subjects. A, Antibody responses (IgE and IgG1) to mealworm extract, shrimp extract, and control (PBS) in a mouse model on day 16. Data represent the mean log2 antibody titer ± SEM. Horizontal dotted lines represent detection limits of the assays (minimum/maximum). B, Subjects show IgE binding to allergens in both the mealworm and shrimp extracts. No binding is seen to Pen a 1 (shrimp tropomyosin) IgE from patients with mealworm food allergy; subjects 3 and 4 additionally bind to proteins with low molecular weight. Journal of Allergy and Clinical Immunology  , e7DOI: ( /j.jaci ) Copyright © 2017 American Academy of Allergy, Asthma & Immunology Terms and Conditions

3 Fig 2 Patients' characteristics. A, Mealworm exposure and clinical history to direct inhalation (while working with the animal) and ingestion of mealworm, HDM, and shrimp. AA, allergic asthma; AD, atopic dermatitis; AR, Allergic rhinitis; C, conjunctivitis; D, dyspnea; Dom, domestic farmer; F, female; GI, gastrointestinal; M, male; N, nasal congestion; OA, oral allergy; OFC, oral food challenge; Prof, professional farmer; R, rhinitis; S, sneezing; U, general urticaria; W, wheezing. B, Sensitization in SPTs, CAP tests, and ISAC tests (with at least 1 subject <0.3 ISU) for mealworm, HDM, and shrimp are included in the table. Der p 1, HDM peptidase C1; Der p 2, HDM NPC2 family; Der p 10, HDM tropomyosin; Pen m 1, shrimp tropomyosin. C, Challenge results. neg, Negative; pos, positive. Journal of Allergy and Clinical Immunology  , e7DOI: ( /j.jaci ) Copyright © 2017 American Academy of Allergy, Asthma & Immunology Terms and Conditions

4 Fig E1 Functional IgE binding. BATs showing basophil activation to mealworm proteins (Tris/urea extract) and shrimp (SPT, ALK-Abelló). No reactivity to Pen a 1 (shrimp tropomyosin) was seen. Clinically, subjects 1 and 2 showed respiratory symptoms to mealworm; subjects 3 and 4 showed food-induced allergic symptoms. Journal of Allergy and Clinical Immunology  , e7DOI: ( /j.jaci ) Copyright © 2017 American Academy of Allergy, Asthma & Immunology Terms and Conditions

5 Fig E2 Three patients with mealworm allergy sensitized to the LCP A1A on immunoblotting. Both patients 3 and 4 with food allergy show IgE binding to the mealworm LCP A1A. IgE from 1 subject with inhalant allergy bound to LCP A1A. Journal of Allergy and Clinical Immunology  , e7DOI: ( /j.jaci ) Copyright © 2017 American Academy of Allergy, Asthma & Immunology Terms and Conditions

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