Anliker M D, Reindl J, Vieths S, Wüthrich B
Allergy Unit, Department of Dermatology, University Hospital of Zürich, Gloriastr 31, 8091 Zürich, Switzerland.
J Allergy Clin Immunol. 2001 Apr;107(4):718-23. doi: 10.1067/mai.2001.113568.
Allergy to persimmon (Diospyros kaki) is very rare and not yet confirmed by means of double-blind, placebo-controlled, food-challenge (DBPCFC). Thus far, specific IgE to this fruit and cross-reactivity to pollen and other foods has not been determined.
The objective was to confirm allergy to persimmon in 3 patients with an according personal history and to characterize allergens and cross-reactivity of specific IgE antibodies to pollen and food allergens. One patient reacted with pruritus, penis edema, urticaria, and asthma; the second reacted with nausea and vomitus; and the third reacted with rhinoconjunctivitis, asthma, and stomachache after ingestion of persimmon.
Patients underwent skin prick testing with routine allergens, latex, persimmon, and other foods. Allergy to persimmon was confirmed by means of a DBPCFC. Specific serum IgE levels were measured with CAP-FEIA and the enzyme allergosorbent test (EAST) method. EAST and immunoblot inhibitions were carried out with persimmon; birch, grass, and ragweed pollen; latex; and N-glycans as inhibitors.
All patients had positive skin test responses, DBPCFC and specific IgE assays to persimmon. Blot and EAST inhibition assays revealed IgE to cross-reactive profilin in one patient and IgE to cross-reacting carbohydrate determinants in all patients.
This is the first report on 3 cases of allergy to persimmon verified by means of DBPCFC and detection of specific IgE. The sensitization is due to cross-reactive profilin and carbohydrate determinants.
对柿子（柿属）过敏非常罕见，尚未通过双盲、安慰剂对照、食物激发试验（DBPCFC）得到证实。迄今为止，尚未确定针对这种水果的特异性IgE以及与花粉和其他食物的交叉反应性。
目的是在3例有相应个人病史的患者中证实对柿子的过敏，并对过敏原以及特异性IgE抗体与花粉和食物过敏原的交叉反应性进行表征。1例患者在食用柿子后出现瘙痒、阴茎水肿、荨麻疹和哮喘；第2例出现恶心和呕吐；第3例出现鼻结膜炎、哮喘和胃痛。
患者接受了常规过敏原、乳胶、柿子和其他食物的皮肤点刺试验。通过DBPCFC证实对柿子过敏。采用CAP-FEIA和酶联免疫吸附试验（EAST）方法测定特异性血清IgE水平。以柿子、桦树、草和豚草花粉、乳胶以及N-聚糖作为抑制剂进行EAST和免疫印迹抑制试验。
所有患者对柿子的皮肤试验反应、DBPCFC和特异性IgE检测均呈阳性。印迹法和EAST抑制试验显示，1例患者的IgE针对交叉反应性肌动蛋白结合蛋白，所有患者的IgE针对交叉反应性碳水化合物决定簇。
这是首例通过DBPCFC和特异性IgE检测证实的3例柿子过敏病例报告。致敏原因是交叉反应性肌动蛋白结合蛋白和碳水化合物决定簇。
