森 雄司

In this study, monoclonal antibodies against two major fruit allergens-gibberellin-regulated protein (GRP) and lipid transfer protein (LTP)-were established. Sandwich enzyme-linked immunosorbent assays (ELISAs) for the quantification of peach GRP and LTP were constructed using these antibodies. Both ELISAs reacted with the respective antigens when heated at 100ºC for 20 min, but not when reduced with sodium sulfite, indicating that GRP and LTP are heat-stable, while disulfide bonds play an important role in their native steric structures. GRP and LTP in peaches and peach-containing foods were quantified by these ELISAs. In both cases, there were few differences among peach cultivars normally available on the market; however, concentrations were higher when the peach was ripe. GRP was localized in the pulp of the peach, while LTP was present in the peel. They could be quantified in peach-containing beverages, as well as in dried and canned peaches. GRP in Japanese apricots could also be determined using this ELISA, as its amino acid sequence is the same as that of peach GRP. Then, high concentrations of GRP were detected in umeboshi, a traditional Japanese pickled apricot. Peach leaves were found to have a high LTP content, accordingly, LTP was also observed in lotions containing peach leaf extract. The ability to quantitatively detect GRP and LTP in this study will, therefore, contribute to the improvement of component-resolved diagnoses and quality of life in patients allergic to peaches.

BACKGROUND: Pollen-food allergy syndrome (PFAS) usually manifests as an itching sensation in the mouth and throat immediately after eating fresh fruits and vegetables. However, some patients with PFAS experience systemic symptoms including anaphylaxis. In Europe, cypress gibberellin-regulated protein (GRP) has been noted to cause allergenicity and exhibit cross-reactivity with peach GRP. Japanese cedar (Cryptomeria japonica), classified in the cypress family, is the primary causative substance among all environmental allergens in Japan. However, studies on the prevalence of GRP sensitization in patients with cedar pollinosis are lacking. OBJECTIVE: This study examined the prevalence of GRP sensitization in patients with Japanese cedar pollinosis. METHODS: We enrolled 52 patients who had requested sublingual immunotherapy treatment with mild-to-severe rhinitis during spring, and had a JCP-specific immunoglobulin E (IgE) levels of >0.7 UA/mL. Peach GRP was purified using affinity chromatography with a monoclonal antibody column. Specific IgE levels to peach GRP were measured using an enzyme-linked immunosorbent assay. Samples exhibiting absorbance at 450 nm of over mean plus three standard deviations of the negative control value were defined as positive. Sera from three patients with severe peach allergy were used as positive controls. RESULTS: Eleven sera from 52 patients with JCP-induced allergic rhinitis were positive for peach GRP. CONCLUSION: Twenty percent of patients with cedar pollinosis were sensitized to peach GRP. Well-powered studies are needed to clarify whether these patients are at an increased risk for systemic symptoms or whether they primarily demonstrate only localized symptoms.

Background: Lipid transfer protein (LTP) is a major fruit allergen. It has, however, recently been revealed that the systemic reaction in peach-allergic patients is related not only to LTP (Pru p 3) but also to gibberellin-regulated protein (Pru p 7). We investigated recombinant Pru p 7 (rPru p 7) for its potential use in worldwide standardization for the diagnosis of peach allergy. Methods: Natural Pru p 7 (nPru p 7) was purified from peach crude extract using a monoclonal antibody affinity column. Complementary DNA for Pru p 7 was cloned and expressed in Escherichia coli and Pichia pastoris. Serum immunoglobulin (Ig) E in peach-allergic patients was examined by enzyme-linked immunosorbent assay (ELISA) using nPru p 7 and rPru p 7 (E. coli product: erPru p 7 and P. pastoris product: prPru p 7). Results: Peach-allergic patients (n = 27) were diagnosed and categorized into oral reaction (n = 10) or systemic reaction (n = 17). The nPru p 7 positivity based on serum IgE levels was 52% in the systemic-reaction group and 0% in the oral-reaction group (P &lt 0.05). In the systemic-reaction group, there was no significant difference in reactivity between nPru p 7 and prPru p 7, but the reactivity of erPru p 7 was significantly lower than those of nPru p 7 and prPru p 7 (P &lt 0.05). Conclusions: We found that prPru p 7 exhibited reactivity in ELISA comparable to that of nPru p 7 for the diagnosis of peach allergy with systemic reaction.

【背景】アトピー性皮膚炎に罹患した乳幼児は鶏卵アレルギー発症のリスクが高い。オボムコイドを減量した加熱全卵を含むベビーフードのアトピー性皮膚炎の乳幼児に対する安全性を評価した。【方法】卵白未摂取のアトピー性皮膚炎乳幼児に対し、オボムコイド減量加熱全卵を含有するベビーフード1瓶を用いた経口負荷試験をオープン法で行った。【結果】対象症例は46症例(男児24例、女児22例)、中央値はそれぞれ年齢10.0ヵ月(9〜21ヵ月)、卵白特異的IgE 10.1UA/ml、オボムコイド特異的IgE 0.21UA/ml、血清TARC 1,553pg/mlだった。負荷試験では43例(93.4%)が症状なく全量摂取できた。3例が全量摂取後に軽微な皮膚症状を呈したが、再試験では症状誘発はなかった。【考察】オボムコイド減量加熱全卵を含有するベビーフードは、アトピー性皮膚炎乳幼児が安全に摂取できることが示唆された。今後はオボムコイド特異的IgE高値の乳幼児に対する安全性の確認が必要である。(著者抄録)

Rotavirus gastroenteritis causes substantial morbidity and mortality worldwide in children. We report three infants with rotavirus gastroenteritis complicated by various severity of gastrointestinal bleeding. Two patients (cases 1 and 2) recovered completely without any specific treatments. One patient (case 3) died despite extensive treatments including a red blood cell transfusion and endoscopic hemostatic therapy. Rotavirus genotypes G1P[8] and G9P[8] were detected in cases 2 and 3, respectively. Rotavirus antigenemia levels were not high at the onset of melena, suggesting that systemic rotaviral infection does not play an important role in causing melena.

某県の歯科医院と市中病院2施設に対してラテックスアレルギー(LA)に関する意識調査を行なった。回答はA病院勤務者419名、B病院勤務者325名、歯科医院勤務者458名より得られた。今回、この調査結果を2005年に報告された明石らによる全国調査と比較した。ゴム手袋で蕁麻疹を起こすことを知っていた割合は60%から90%になっていた。また、アナフィラキシーを起こす可能性があることを知っていた割合は33%から60%になっていた。一方、果物との交差反応性があることを知っていた割合は10%以下から10〜40%に、更に特定のグループに多いことを知っていた割合は10%以下から約50%と、それぞれ認知度が高くなっていることが確認された。特にLAに関する知識が高かったB病院ではラテックスフリー手袋の使用率が高く、ラテックス手袋使用時もパウダーフリーの割合が高いことが明らかとなった。

Ichthyosis prematurity syndrome (IPS) is a rare autosomal recessive disorder characterized by prematurity, a thick caseous scale at birth and lifelong atopic diathesis. Here, we describe the first Japanese case of IPS and report novel compound heterozygous mutations (p.C403Y and p.R510H) in fatty acid transport protein 4 (FATP4). She is the first reported patient of Asian origin, entirely distinct from the Scandinavian population, in whom the heterozygote carrier frequency is very high.

症例は3歳10ヵ月の男児。妊娠・分娩経過は正常であった。1歳時に気管支炎で近医へ入院した際に肝機能異常と肝腫大を指摘された。サイトメガロウイルス(CMV)IgM抗体が陽性だったため、CMV水平感染に伴う肝炎と診断された。その後、トランスアミナーゼ値は徐々に正常化したが肝腫大が持続し、原因不明の肝腫大として経過観察されていた。2歳半頃から言語発達遅滞が明らかとなり、3歳時に保存されていた乾燥臍帯を用いてCMV DNAを測定し、66コピー/μgDNAのCMV DNAが検出されたため、無症候性先天性CMV感染と診断した。聴力は正常で、頭部MRI検査でも明らかな異常はなかった。(著者抄録)