Decuyper Ine, Ryckebosch Hanne, Van Gasse Athina L, Sabato Vito, Faber Margaretha, Bridts Chris H, Ebo Didier G
Department of Immunology, Allergology, Rheumatology, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp University Hospital, Campus Drie Eiken T.595, Universiteitsplein 1, 2610, Antwerp, Belgium.
Arch Immunol Ther Exp (Warsz). 2015 Oct;63(5):327-32. doi: 10.1007/s00005-015-0352-z. Epub 2015 Jul 16.
For about a decade, IgE-mediated cannabis (marihuana) allergy seems to be on the rise. Both active and passive exposure to cannabis allergens may lead to a cannabis sensitization and/or allergy. The clinical manifestations of a cannabis allergy can vary from mild to life-threatening reactions, often depending on the route of exposure. In addition, sensitization to cannabis allergens can trigger various secondary cross-allergies, mostly for plant-derived food. This clinical entity, which we have designated as the "cannabis-fruit/vegetable syndrome" might also imply cross-reactivity with tobacco, latex and plant-food derived alcoholic beverages. These secondary cross-allergies are mainly described in Europe and appear to result from cross-reactivity between non-specific lipid transfer proteins or thaumatin-like proteins present in Cannabis sativa and their homologues that are ubiquitously distributed throughout plant kingdom. At present, diagnosis of cannabis-related allergies rests upon a thorough history completed with skin testing using native extracts from buds and leaves. However, quantification of specific IgE antibodies and basophil activation tests can also be helpful to establish correct diagnosis. In the absence of a cure, treatment comprises absolute avoidance measures including a stop of any further cannabis (ab)use.
大约十年来,IgE介导的大麻过敏似乎呈上升趋势。主动和被动接触大麻过敏原都可能导致大麻致敏和/或过敏。大麻过敏的临床表现从轻微到危及生命的反应不等,这通常取决于接触途径。此外,对大麻过敏原的致敏可引发各种继发性交叉过敏,主要是对植物源性食物的过敏。我们将这种临床实体称为“大麻-水果/蔬菜综合征”,它可能还意味着与烟草、乳胶和植物源性酒精饮料存在交叉反应。这些继发性交叉过敏主要在欧洲有描述,似乎是由大麻中存在的非特异性脂质转移蛋白或类thaumatin蛋白与其在植物界广泛分布的同源物之间的交叉反应引起的。目前,大麻相关过敏的诊断依赖于详细的病史,并结合使用芽和叶的天然提取物进行皮肤测试。然而,特异性IgE抗体的定量和嗜碱性粒细胞活化试验也有助于做出正确诊断。由于无法治愈,治疗包括绝对避免措施,即停止任何进一步的大麻使用。