Allergenic molecules
Table adapted from Allergome.org (11).
Allergen
|
Type
|
Mass (kDa)
|
---|
Cas s 1
|
PR-10 protein
|
22
|
Cas s 2
|
Profilin
|
14
|
Cas s 5
|
Chitinase
|
32
|
Cas s 8
|
Lipid transfer protein
|
9
|
Cas s 9
|
Heat shock protein
|
17.5
|
Cas s TLP
|
Thaumatin
|
25
|
The main chestnut allergens identified include Cas s 5 (a class I chitinase), Cas s 8 (a lipid transfer protein), Cas s 9 (a cytosolic class I small heat shock protein) and Cas s TLP (a thaumatin-like protein) (6).
Patients with primary chestnut allergy appear to react to Cas s 8 (lipid transfer proteins), whereas patients with associated latex hypersensitivity react to Cas s 5 (class I chitinases) (8).
Cross-reactivity
Latex-fruit syndrome is a cross-reactive condition where primary sensitized patients to latex react to fruits or nuts including chestnuts (8). Allergy to latex usually precedes food allergy, although this is not always the case. In latex-fruit syndrome, symptoms are often severe after ingestion of these foods (9, 12).
A study in patients with primary chestnut allergy (with no latex allergy) were sensitized to mugwort pollen (Cas s 8 reactivity to Art v 3) and peach (Cas s 8 reactivity to Pru p 3) (8).