Abstract:
The present invention relates to the field of IgE-mediated allergy, particularly occupational asthma such as bakers asthma. More specifically the invention relates to the identification of a novel wheat allergen and the use thereof in therapy and diagnosis of IgE-mediated allergy. Furthermore the present invention provides the use of known peptides and proteins in therapy and diagnosis. The invention also relates to methods for diagnosis and treatment of IgE-mediated allergy in mammals.

Description:
FIELD OF THE INVENTION 
       [0001]    The present invention relates to the field of IgE-mediated allergy, particularly occupational asthma such as baker&#39;s asthma. More specifically the invention relates to the identification of a novel wheat allergen and the use thereof in therapy and diagnosis. The invention also relates to methods for diagnosis and treatment of IgE-mediated allergy in mammals. 
       BACKGROUND 
       [0002]    Allergens from wheat ( Triticum aestivum ) can cause three distinct IgE-mediated allergies, respiratory allergy by inhalation of wheat flour, food allergy by ingestion of wheat products and wheat pollen allergy which belongs to the group of grass pollen allergies. Allergic sensitization to wheat flour components is one of the most frequent causes of occupational asthma and approximately 1-10% of bakery workers are affected, therefore it is called baker&#39;s asthma. These bakery workers develop IgE antibodies against wheat flour allergens and flour-induced asthma and/or rhinitis. Support for the assumption that baker&#39;s asthma is a true occupational disease comes from the finding that the prevalence of sensitization to bakery-associated allergens is approximately tenfold higher in flour-exposed persons as compared to control populations without flour exposure. Furthermore, it has been possible to establish threshold values for wheat flour which are known to cause bronchial asthma in sensitized persons. A first systematic investigation on flour allergy was carried out already in 1933 by Baggoe. Other early reports focused on the description of cases of baker&#39;s asthma followed by mechanistic studies demonstrating the importance of IgE-mediated mechanisms in baker&#39;s asthma. Thereafter several attempts were made to characterize the disease-eliciting flour allergens by immunochemical methods, RAST technology, immunoblotting and recently by molecular cloning techniques. 
         [0003]      Triticum aestivum  is an important member of the grass family. Up to 40% of all allergic individuals carry serum IgE antibodies reacting with grass pollen allergens. Several studies have reported cross-reactivity between wheat flour and grass pollen due to common IgE epitopes in wheat flour and grass pollen proteins. Cross-reactivity between grass pollen allergens and wheat seed allergens has been described and there is evidence that patients suffering from bakers&#39; asthma and IgE-mediated food allergy to wheat may recognize different allergens which may be used for the differential diagnosis of baker&#39;s asthma, food allergy flour to wheat and grass pollen allergy. However, the great majority of the soluble wheat flour allergens has not yet been identified. Today, only a few wheat flour allergens have been identified and characterized and they include the members of the alpha amylase inhibitor family, acyl-CoA oxidase, peroxidase, fructore-biphosphate aldolase and recently thioredoxins. 
         [0004]    Diagnosis based on wheat flour extract does not discriminate between patients suffering from respiratory allergy or food allergy to wheat. Therefore precise diagnosis still relies on specific inhalation challenge in case of respiratory allergy to wheat flour and double-blind placebo-controlled food challenge (DBPCFC) in case of suspected food allergy and the question is open whether it is possible to identify allergens that can be used for selective diagnosis and treatment of the various wheat induced manifestations of allergy such as baker&#39;s asthma, food allergy and pollinosis. Thus there is a need to identify novel wheat allergens and to establish methods and diagnostic tests to specifically identify patients suffering from IgE-mediated allergy, such as respiratory allergy, e.g. baker&#39;s asthma, in order to discriminate them from patients suffering from food allergy and/or pollen allergy. Furthermore there is a need to use such novel wheat allergens for use in the treatment of IgE-mediated allergy. The present invention addresses these needs by providing novel wheat allergens and the use thereof in therapy and diagnosis. Furthermore the present invention provides the use of known peptides and proteins in therapy and diagnosis. Some of these peptides are known from Gennaro S. D. et al, Biological Chemistry, April 2005, 386:383-389; UNIPROT accession number P82977; UNIPROT accession number Q6W8Q2; U.S. Pat. No. 7,214,786 and US2006/0107345. 
       SUMMARY OF THE INVENTION 
       [0005]    As stated above the few wheat flour allergens that have been identified and characterized include members of the alpha amylase inhibitor family, acyl-CoA oxidase, peroxidase, fructore-biphosphate aldolase and thioredoxins. So far no allergens have been identified that can be used for selective diagnosis and treatment of various wheat induced manifestations of allergy such as baker&#39;s asthma, food allergy and pollinosis. This led the present inventors to look for additional, not yet identified wheat allergens. 
         [0006]    The present invention meets at least partly needs of prior art by providing novel wheat allergens and methods for diagnosis and treatment of IgE-mediated allergy in mammals. 
         [0007]    In a first aspect the invention relates to polypeptides representing novel wheat allergens isolated from wheat or recombinantly produced and fragments or variants thereof sharing epitopes for antibodies. The isolated polypeptides comprise an amino acid sequence of clone #10, #112, or #126. 
         [0008]    In a second aspect the invention relates to nucleic acids encoding the polypeptides of the invention, the nucleic acids having the nucleotide sequence of clone #10, #112, or #126. 
         [0009]    In another aspect the invention relates to a polypeptide having clone identity #10, #38, #112, or #126 for use in therapy or diagnosis, preferably therapy and diagnosis of IgE-mediated allergy, such as respiratory allergy to wheat flour, e.g. baker&#39;s asthma. Furthermore the invention relates to an isolated polypeptide comprising the amino acid sequence of clone #37 for use in therapy or diagnosis, preferably therapy and diagnosis of IgE-mediated allergy, such as respiratory allergy to wheat flour, e.g. baker&#39;s asthma. 
         [0010]    In still another aspect the invention provides a pharmaceutical composition comprising a polypeptide having clone identity #10, #38, #112, #126 or #37 or a hypoallergenic form thereof modified to abrogate or attenuate its IgE-binding response, and optionally pharmaceutically acceptable excipients, carriers, buffers and/or diluents. The hypoallergenic form of a polypeptide having clone identity #10, #38, #112, #126 or #37 may be modified by fragmentation, truncation or tandemerization of the molecule, deletion of internal segments, domain rearrangement, substitution of amino acid residues, disruption of disulfide bridges. 
         [0011]    In a further aspect the invention relates to an allergen composition “spiked” with a polypeptide having clone identity #10, #38, #112, #126 or #37. Such an allergen composition may be an allergen extract or a mixture of purified or recombinant allergen components having no or a low content of the polypeptide of the invention, wherein the polypeptide is added in order to bind IgE from patients whose IgE would not bind or bind poorly to the other allergen components in the composition. This aspect of the invention also relates to a method for producing such a composition, which method comprises the step of adding a polypeptide having clone identity #10, #38, #112, #126 or #37 to an allergen composition, such as an allergen extract (optionally spiked with other components) or a mixture of purified native or recombinant allergen components. 
         [0012]    In a further aspect the invention relates to an allergen composition obtainable by the above method. 
         [0013]    The invention further relates to a method for in vitro diagnosis of IgE-mediated allergy comprising the steps of bringing a body fluid sample, such as a blood, plasma or serum sample, from a mammal suspected of having IgE-mediated allergy such as respiratory allergy to wheat flour, e.g. baker&#39;s asthma, in contact with the polypeptide having clone identity #10, #38, #112, #126 or #37, and detecting the presence, in the sample, of IgE antibodies that bind specifically to the polypeptides of the invention. The presence of such antibodies specifically binding to the polypeptide having clone identity #10, #38, #112, #126 or #37 is indicative of IgE-mediated allergy. One embodiment of such a method comprises carrying out the method by micro-array analysis. 
         [0014]    In a further aspect the invention provides a diagnostic kit for performing the method of in vitro diagnosis of IgE-mediated allergy, such as respiratory allergy to wheat flour, e.g. baker&#39;s asthma, said kit comprising a polypeptide having clone identity #10, #38, #112, #126 or #37, and means for detecting the IgE binding to said polypeptide, such as a solid support, e.g. a nitrocellulose membrane or a microarray having a polypeptide with clone identity #10, #38, #112, #126 or #37 bound thereto. 
         [0015]    In still a further aspect the invention provides a method for treatment of an IgE-mediated allergy in a mammal, such as respiratory allergy, e.g. baker&#39;s asthma. In one embodiment the method comprises administering to an individual susceptible to such a treatment a polypeptide having clone identity #10, #38, #112, #126 or #37 or a fragment or a variant thereof sharing epitopes for antibodies. In another embodiment the method comprises administering to an individual susceptible to such a treatment a pharmaceutical composition according to a previous aspect. 
       DEFINITIONS 
       [0016]      
         [0000]    
       
         
               
             
               
               
               
             
               
               
               
             
           
               
                 TABLE A 
               
             
             
               
                   
               
               
                 Definition of clones 
               
             
          
           
               
                 Clone 
                 Nucleic acid sequence 
                 Amino acid sequence 
               
               
                   
               
             
          
           
               
                 #10 
                 SEQ ID NO: 1 
                 SEQ ID NO: 2 
               
               
                 #37 
                 SEQ ID NO: 3 
                 SEQ ID NO: 4 
               
               
                 #38 
                 SEQ ID NO: 5 
                 SEQ ID NO: 6 
               
               
                 #112 
                 SEQ ID NO: 7 
                 SEQ ID NO: 8 
               
               
                 #126 
                 SEQ ID NO: 9 
                 SEQ ID NO: 10 
               
               
                   
               
             
          
         
       
     
         [0017]    Variants and fragments of a polypeptide of the invention should be construed as meaning proteins or peptides with a length of at least 10 amino acids, more preferably at least 25, even more preferably at least 50 or 75 amino acid residues and a sequence identity to said polypeptide of at least 50%, preferably over 60%, 70%, 80%, 90%, 95%, 96%, 97%, 98% or 99%. 
         [0018]    A modified polypeptide should in the context of the present invention be construed as meaning a polypeptide that has been chemically or genetically modified to change its immunological properties, e.g. as exemplified in relation to the immunotherapy aspect of the invention. 
         [0019]    Variants and fragments of a polypeptide sharing epitopes for antibodies with said polypeptide should be construed as being those fragments and variants whose binding of IgE antibodies from a serum sample from a representative patient sensitized with the polypeptide of the invention can be significantly inhibited by the polypeptide. Such an inhibition assay may e.g. be performed according to the protocol disclosed in Example 4. 
         [0020]    A hypoallergenic modified polypeptide or variant or fragment of a polypeptide should be construed as being a modified polypeptide or variant or fragment of a polypeptide that is not capable of binding IgE antibodies reactive to said polypeptide from a serum sample of a representative polypeptide-sensitized patient, as determined e.g. by the protocol according to Example 1 or which displays no or significantly reduced biological allergen activity, as determined by a cellular activation assay such as the basophil histamine release assay. 
     
    
     
       BRIEF DESCRIPTION OF TABLES AND FIGURES 
         [0021]    Table I shows the demographic, clinical and serological characteristics of patients suffering from bakers&#39; asthma. 
           [0022]    Table II shows the demographic, clinical and serological characteristics of patients suffering from food allergy to wheat (F1-F4) and grass pollen allergy (G1-G4). 
           [0023]    Table III shows the percentage amino acid sequence identities between the clone 10-derived allergen and homologous proteins, wherein proteins numbered 1-30 are the following: 1. gi|122065237 ( Triticum aestivum ), 2. gi|66356278 ( Triticum aestivum ), 3. gi|124122 ( Hordeum vulgare  subsp.  vulgare ), 4. gi|48093360 ( Zea diploperennis ), 5. gi|48093418 ( Tripsacum dactyloides ), 6. gi|75994161 ( Zea mays  subsp.  parviglumis ), 7. gi|58396945 ( Oryza sativa  [japonica cultivar-group]), 8. gi|115649132 ( Strongylocentrotus purpuratus ), 9. gi|37904392 ( Brachypodium distachyon ), 10. gi|26224744 ( Citrus×paradise ), 11. gi|224447 ( Vicia faba ), 12. gi|124395862 ( Paramecium tetraurelia ), 13. gi|50262213 ( Cucurbita maxima ), 14. gi|547743 ( Nicotiana sylvestris ), 15. gi|54610713 ( Lumbricus terrestris ), 16. gi|169491 ( Solanum tuberosum ), 17. gi|218290 ( Nicotiana glauca×Nicotiana langsdorffii ), 18. gi|124121 ( Vigna angularis ), 19. gi|603890 ( Sambucus nigra ), 20. gi|14718445 ( Ipomoea batatas ), 21. gi|114950 ( Momordica charantia ), 22. gi|109138554 ( Fagopyrism esculentum ), 23. gi|18404883 ( Arabidopsis thaliana ), 24. gi|27734408 ( Canavalia lineate ), 25. gi|37901103 ( Hevea brasiliensis ), 26. gi|92874842 ( Medicago truncatula ), 27. gi|13959383 ( Linum usitatissimum ), 28. gi|22759723 ( Zinnia elegans ), 29. gi|37359345 ( Vitis vinifera ) and 30. gi|6453287 ( Amaranthus hypochondriacus ). 
           [0024]    Table IV shows clinical data for baker&#39;s asthma patients of Example 2. 
           [0025]    Table V shows clinical data for food and grass pollen allergic patients of Example 2. 
           [0026]    Table VI shows PCR primers used for amplification of cDNAs for clones #10, #38, #112, #123 #126 and #37. 
           [0027]    Table VII. Demographic, clinical and serological characteristics of patients suffering from baker&#39;s asthma 
           [0028]    Table VIII. Demographic, clinical and serological characteristics of patients suffering from grass pollen allergy 
           [0029]    Table IX. Demographic, clinical and serological characteristics of patients suffering from food allergy to wheat 
           [0030]      FIG. 1  illustrates the nucleotide and deduced amino acid sequence of the clone 10-derived allergen (SEQ ID NO: 1). Coding and non-coding region are in upper and lower case letters, respectively, the start (ATG) and stop codons are underlined. Amino acids of the potato inhibitor I family signature are printed with grey background. Left hand numbers are for the nucleotides and right hand numbers for the amino acids. The sequence has been submitted to the GenBank under the accession number (EU051824). 
           [0031]      FIG. 2  illustrates the characterization of purified serine proteinase inhibitor-like allergen. A, Coomassie brilliant blue-stained SDS-PAGE containing purified clone 10-derived allergen. A molecular weight marker (kDa) is shown on the left side. B, Mass spectrometry (MS) of the purified clone 10-derived allergen. The mass/charge ratio is shown on the x-axis and the intensity is displayed on the y-axis as a percentage of the most intensive signal obtained in the investigated mass range. C, Far-ultraviolet circular dichroism (CD) analysis of the purified clone 10-derived allergen. The spectra are expressed as mean residue ellipticities (θ) (y-axis), recorded at 25° C. (bold line), 95° C. (regular line) and 25° C. after cooling (dotted line) at given wave lengths (x-axis). 
           [0032]      FIG. 3  illustrates the IgE reactivity of patients suffering from bakers&#39; asthma, grass pollen allergy and food allergy. Purified clone 10-derived allergen, HSA, rPhl p 1, rPhl p 5, rPhl p 7, rPhl p 12, wheat pollen extract and wheat seed extract were dotted onto nitrocellulose membrane strips and incubated with sera from 22 bakers&#39; asthma patients (1-22), four grass pollen allergic patients sera (G1-04), four sera from patients suffering from food allergy to wheat (F1-F4), one non-allergic individual (NC) and buffer without addition of serum (B). Bound IgE antibodies were detected with  125 I-labelled anti-human IgE antibodies and visualized by autoradiography. 
           [0033]      FIG. 4  is a box plot representation of IgG subclass reactivities to clone 10-derived allergen. IgG 1-4  subclass reactivities to the clone 10-derived allergen were determined by ELISA for patients suffering from bakers&#39; asthma (n=22) and are displayed as box plots where 50% of the values are within the boxes and non-outliers between the bars. The lines within the boxes indicates the median values, circles are outliers and asterisks extreme values. 
           [0034]      FIG. 5  illustrates the allergenic activity of the clone 10-derived allergen. RBL cells were loaded with serum IgE from three bakers&#39; asthma patients (#2, #4, #12) or with serum of a non-allergic patient (NC) and then challenged with recombinant clone 10-derived allergen or timothy grass pollen allergen rPhl p 1. The mean β-hexosaminidase releases are shown on the y-axis as percentages of total release after subtraction of percentages for spontaneous release. 
           [0035]      FIG. 6  shows the expression of the serine proteinase inhibitor-like allergen in seeds during seed maturation. Nitrocellulose-blotted wheat extract from immature (day 7, 10, 15, 20, 25, 30, 35) and mature (M) wheat seeds were probed with rabbit antibodies specific for the clone 10-derived allergen, and for control purposes, with the corresponding pre-immune serum. Molecular weights are indicated on the left side in kilo Dalton (kDa). 
           [0036]      FIG. 7  shows the identification of the clone 10-derived allergen in wheat pollen and seed extracts. Nitrocellulose blotted extracts were probed with rabbit antibodies specific for the clone 10-derived allergen (20), antibodies specific for wheat profilin (I #123), for a mite allergen (NC) or with buffer without addition of rabbit antibodies (B). The corresponding pre-immune sera are referred as P #10 and P #123 respectively. Bound IgG antibodies were detected with  125 I-labelled donkey anti-rabbit antibodies and visualized by autoradiography. Molecular weight markers (in kDa) are indicated on the left. 
           [0037]      FIG. 8  illustrates the detection of the serine proteinase inhibitor-like allergen in extracts from wheat seeds, rice, maize, bean and potato. A, Coomassie blue-stained gel containing extracts from wheat (W), rice (R) and maize (M), common bean (B) and potato (P). B, Nitrocellulose blotted extracts were exposed to rabbit pre-immune serum and C, rabbit antibodies specific for the clone 10-derived allergen. Molecular masses (kDa) are indicated on the left side. 
           [0038]      FIG. 9  shows the localization of clone 10-derived allergen by transmission immunogold electron microscopy in a wheat seed. A and B, Cross section of a wheat grain at low (A) and high (B) magnification. A shows fruit and seed coat (C), aleuron layer (AL) and the beginning of the starchy endosperm (SE). The rectangle in A indicates an area comparable to the area shown in B, i.e. border between aleuron layer and starchy endosperm. The rectangles in B indicate areas shown in high magnification in C, D and E, F, respectively. C and D, Detail of a wheat seed aleurone cell probed with rabbit anti-clone 10 derived Ig (C) or preimmune Ig (D). E and F, High magnification micrograph of the starchy endosperm after immunogold localization of wheat protein 10 with rabbit anti-clone 10 derived Ig (E) or preimmune Ig (F). Bound rabbit antibodies were detected with a gold-conjugated goat anti-rabbit Ig antiserum (gold particles=black dots). Arrows point to colloidal gold particles. The bars represent: A, 20 μm; B, 5 μm; C—F, 0.5 μm. AG, aleuron grain; AL, aleuron layer; C, multilayered fruit and seed coat; CY, cytoplasmic materials; L, lipid body; M, mitochondrion; SE, starchy endosperm; SG, starch grain; W, cell wall. 
           [0039]      FIG. 10 . IgE Dot Blot of patients suffering from baker&#39;s asthma. 
           [0040]      FIG. 11 . IgE Dot Blot of patients suffering from food allergy to wheat and grass pollen allergy. 
           [0041]      FIG. 12 . Allergen microarray. A, Application scheme of micro-arrayed proteins and wheat pollen extract. Recombinant wheat proteins are designated as: 10, 37, 38, 112, 123, 126; WP: wheat pollen extract; recombinant timothy grass pollen allergens: Phl p 1, Phl p 5, Phl p 7 and Phl p 12. Numbers in the box at the bottom indicate position markers. B and C, Images of microarrays after incubation with serum and detection of IgE-reactive spots with fluorophore-conjugated anti-IgE antibodies. B, Image after incubation with serum from a non allergic individual. C, Images after incubation with serum from a representative patient suffering from baker&#39;s asthma (1: B4), wheat induced food allergy (2: F26), grass pollen allergy (3: G16). Dots on the bottom of the slides indicate position markers which are purified IgE antibodies detected with fluorophore-conjugated anti-IgE antibodies. 
           [0042]      FIG. 13 . Prevalence of IgE reactivity to wheat seed proteins, wheat pollen extract and grass pollen allergens. Percentages of patients with IgE reactivity are shown for baker&#39;s asthma (A) (n=23), food allergy to wheat (B) (n=38) and grass pollen allergy (C) (n=17) at the y-axis. The x-axis shows the tested recombinant wheat proteins #10, #37, #38, #112, #123 and #126, wheat pollen extract, recombinant grass pollen allergens Phl p 1, Phl p 5, Phl p 7 and Phl p 12, a “Wheat Mix” comprising all recombinant wheat proteins, wheat flour and timothy grass CAP used to measure IgE reactivity. 
       
    
    
     DETAILED DESCRIPTION OF THE INVENTION 
       [0043]    The examples below illustrate the present invention with the isolation and use of the polypeptide of the invention. The examples are only illustrative and should not be considered as limiting the invention, which is defined by the scope of the appended claims. Clone #123 mentioned in the Examples is profilin, known from e.g. U.S. Pat. No. 7,214,786. 
       Example 1 
     The Novel Wheat Allergen Clone #10 
       [0044]    Example 1 shows the identification and characterization of a novel wheat seed allergen, clone #10, belonging to the potato inhibitor family, a family of serine protease inhibitors, which together with other protease inhibitors are referred to as pathogenesis related proteins (PR), family PR6. Clone #10 is the first allergen identified and described for the PR6 family. Furthermore Example 1 shows the expression and purification of a recombinant clone 10-derived allergen. 
         [0045]    Clone #10 was specifically recognized by serum IgE from patients with baker&#39;s asthma but showed no IgE reactivity when tested with sera from patients suffering from food allergy to wheat, celiac disease or grass pollen allergy. Therefore the clone 10-derived allergen together with other wheat allergens may be used to establish diagnostic tests which allow to specifically identify patients suffering from IgE-mediated baker&#39;s asthma and to discriminate these patients from allergic patients with food or pollen allergy. 
       Techniques 
     Biological Materials, Patients&#39; Sera and Antibodies 
       [0046]    Wheat seeds from  Triticum aestivum  cv. Michael were obtained from the Österreichische Agentur für Gesundheit and Ernährungssicherheit GmbH and planted in a glasshouse. Immature seeds were harvested 7, 10, 15, 20, 25, 30 and 35 days after the onset of pollination directly into liquid nitrogen and stored at −80° C. until use. Wheat pollen was obtained from Allergon (Välinge, Sweden). Rice, maize, beans and potatoes were bought at a local market. Recombinant Phl p 1, Phl p 5, Phl p 7 and Phl p 12 were purchased from BIOMAY (Vienna, Austria) and human serum albumin (HSA) from Behring (Marburg, Germany). Sera were obtained from 22 patients suffering from bakers&#39; asthma. Baker&#39;s asthma was diagnosed on the basis of a positive case history, IgE specific for wheat and rye flour by CAP-FEIA System (Phadia, Uppsala, Sweden) and included specific inhalation challenge tests for confirmation of a clinically relevant sensitization (1). Demographic, clinical and serological data of these patients are summarized in Table I. In addition, serum from a non-allergic individual, sera from 4 patients suffering from food allergy to wheat and 4 grass pollen allergic patients without baker&#39;s asthma but serum IgE reactivity to wheat and rye flour were included in the experiments (Table II). Sera from grass pollen allergic patients had been analyzed for total serum IgE levels and IgE specific timothy grass pollen by CAP-FEIA System (Phadia) and patients with food allergy to wheat have been characterized as described previously (2). The specificity of the clone 10-derived allergen for baker&#39;s asthma was confirmed by testing additional 20 sera from celiac disease patients, 119 food allergic patients, 23 sera from grass pollen allergic patients and 25 baker&#39;s asthma patients by chip analysis (Constantin et al, unpublished). 
         [0047]    Specific rabbit antibodies against the clone 10-derived allergen were raised by immunization of a rabbit in monthly intervals with purified clone 10-derived allergen (200 μg per injection) using once Freud&#39;s complete adjuvant and twice IFA (Charles River, Kisslegg, Germany). Pre-immune serum was obtained from the rabbit before immunization. For control purposes, a rabbit immune serum specific for a house dust mite allergen and rabbit antiserum specific for wheat profilin were used. 
         [0000]    Construction of a λgt11 cDNA Library from Wheat Seeds 
         [0048]    Total RNA was extracted according to Yeh (3) from wheat seeds, harvested twenty five days after the onset of pollination, and stored at −80° C. Then the RNA pellet was dissolved in guanidinium isothiocyanate buffer (4M guanidinium isothiocyanate, 0.83% v/v 3M sodium acetate, pH 6, 11 mM β-mercaptoethanol) and purified by cesium chloride density gradient ultracentrifugation (4). Poly-A +  RNA was isolated by oligo-dT cellulose affinity chromatography (Nucleo Trap mRNA; Machery-Nagel) and double stranded cDNA was synthesized with a cDNA synthesis kit (cDNA synthesis System; Roche Diagnostics, Mannheim, Germany). After methylation with EcoRI methylase (New England Biolabs, Beverly, Mass.), EcoRI linkers (New England Biolabs) were added to the cDNA. Linkered cDNA was digested with EcoRI (Roche Diagnostics). Digested linkers were removed with a Nick column (Pharmacia Biotech, Uppsala, Sweden) and the cDNA was ligated into λgt11 arms (Stratagene, La Jolla, Calif., USA). The ligation product was packed in vitro (Gigapack III Gold Cloning Kit, Stratagene) resulting in a λgt11 expression cDNA library with 2.43×10 6  PFU. 
         [0000]    Isolation and Characterization of IgE-Reactive Clones from a Wheat Seed cDNA Library 
         [0049]      E. coli  Y1090 were infected with 7×10 5  PFU of recombinant phages and immunoscreened with serum IgE of four patients (#1, #2, #4, #12) suffering from bakers&#39; asthma as described (5). Fifteen IgE-reactive phage clones were selected for further re-cloning and their DNA was PCR-amplified using Platinum PCR Supermix (Invitrogen, Life Technologies) with λgt11 primers and sequenced (MWG, Ebersberg, Germany). The obtained sequences were compared with sequences submitted to the GenBank database at the National Center for Biotechnology Information (NCBI). Multiple sequence alignment was performed using the GenBank database at the NCBI. For amino acid sequence identities the Clustal W multiple alignment tool was used. A motif search was carried out with the PROSITE tool of the ExPASy proteomics server, for amino acid composition the ProtParam tool of ExPASy was used. Solvent accessibility and secondary structure prediction was calculated using the PROT software from the Columbia University Bioinformatics Center. A phylogenetic tree was reconstructed based on the amino acid sequence of the clone 10-derived allergen and homologous proteins using the “Multiple Alignment and Phylogenetic Tree Reconstruction” software provided by the Max Planck Institute for Molecular Genetics. 
       Expression and Purification of the Clone 10-Derived Recombinant Allergen 
       [0050]    The coding region of the clone 10 cDNA was amplified by PCR using the following primer pair: forward 5′-CATATGAGCCCTGTGGTGAAGAAGCCGGAGGGA-3′ and reverse, 5′- GAATTC TTAGTGATGGTGATGGTGATGGCCGACCCTGGGGAC-3′ (MWG). The PCR product contained NdeI (italics), EcoRI (underlined) restriction sites and a hexahistidine tag-encoding sequence (bold). The PCR product was subcloned into an AccepTor Vector (Novagen, Madison, Wis.) and sequenced again (MWG). Then the insert was cut out of the AccepTor Vector with NdeI and EcoRI (Roche Diagnostics), gel-purified (Promega, Madison, Wis., USA) and subcloned into the expression plasmid pET 17b (Novagen). The DNA sequence was confirmed by sequencing both DNA strands (Microsynth, Balgach, CH). The pET 17b-clone 10 construct was transformed into  E. coli  BL21 (DE3) (Stratagene) and grown in Luria Broth (17) medium containing 100 mg/l ampicillin at 37° C. to an OD (600 nm) of 0.8-1. Protein expression was induced by addition of isopropyl β-D-thiogalactopyranoside (IPTG) to a final concentration of 0.5 mM and growing the bacteria for additional 3 h. Bacteria were harvested by centrifugation and—homogenized in 25 mM imidazole, pH 7.5, 0.1% (v/v) Triton X-100 with an Ultraturrax (IKA, Stauffen, Germany). DNA was digested by addition of DNase I, stirred for additional 10 min at 20° C., the reaction was stopped with 200 μl of 5M NaCl and then centrifuged at 4° C. (6000×g, 20 min). The majority of the clone 10-derived allergen was found in the insoluble fraction of the bacterial extract. Clone 10-derived allergen was purified from the inclusion body-containing pellet under denaturing conditions using Ni-NTA resin affinity columns according to the QIAexpressionist handbook (QIAGEN, Hilden, Germany). Fractions containing the recombinant allergen were pooled and dialyzed against 10 mM NaH 2 PO 4  pH 7.5. The protein concentration was determined with a Micro BCA Protein Assay Kit (Pierce, Rockford, Ill.). 
       ELISA 
       [0051]    Clone 10-derived allergen was dissolved in PBS at a concentration of 5 μg/ml and coated on ELISA plates (Nunc Maxisorb, Roskilde, Denkmark). After blocking with 1% (w/v) BSA in PBS, 0.05% (v/v) Tween 20 (PBST), plates were incubated with sera diluted 1:50 in PBST, 0.5% (w/v) BSA for measurement of IgG 1 , IgG 2 , IgG 3  and IgG 4  as described (6). Bound antibodies were detected by incubating first with monoclonal mouse anti-human IgG subclass antibodies (BD Biosciences, Franklin Lakes, N.J.) diluted 1:1000 in PBST, 0.5% (w/v) BSA, and then with a horseradish-peroxidase-coupled sheep anti-mouse antiserum (GE Healthcare, Little Chalfont, UK) diluted 1:2000 in PBST, 0.5% (w/v) BSA as previously described (2). All determinations were performed as duplicates, and results are expressed as mean values. 
       Protein Extracts, SDS-PAGE and Immunoblots 
       [0052]    SDS-protein extracts from mature and immature wheat seeds, rice ( Oryza sativa ), maize ( Zea mays ), common bean ( Phaseolus vulgaris ) and potato ( Solanum tuberosum ) were prepared by homogenization of 3 grams of tissue in 32 ml of sample buffer (6) and subsequent boiling for 10 minutes. In order to remove insoluble particles, the extracts were centrifuged at 10,000×g for 10 min at 4° C. and the supernatants were stored in aliquots at −20° C. In addition a PBS-protein extract from wheat seeds was prepared as previously described (2).  Triticum aestivum  pollen (500 mg) were extracted at 4° C. over night in 5 ml PBS, 2 mM EDTA, 1 mM PMSF. After centrifugation for 1 h at 13,000×g 4° C., the protein concentration of the supernatant was determined with Micro BCA Protein Assay Kit (Pierce) and aliquots were stored at −20° C. until use. Equal amounts of SDS-protein extracts were separated by 14% preparative SDS-polyacrylamide gels (7). A protein molecular weight marker (Rainbow Marker, GE Healthcare; Precision Plus Protein Standard, BioRad, Herkules, Calif.; Page Ruler Pre-stained Protein Ladder, Fermentas, Burlington, Ontario) was used as a standard. After electrophoretic separation, proteins were either stained with Coomassie brilliant blue or blotted onto nitrocellulose membranes (Schleich 85 Schuell, Dassel, Germany) (8). Membranes were blocked in buffer A (50 mM sodium phosphate buffer, pH 7.4, 0.5% w/v BSA, 0.5% v/v Tween-20, 0.05% w/v NaN 3 ) twice for 10 min and once for 30 min and incubated overnight at 4° C. with a rabbit antiserum specific for the clone 10-derived allergen, the corresponding pre-immune serum, and for control purposes, with a rabbit antiserum specific for an unrelated antigen or buffer alone. Rabbit sera were diluted 1:50,000 in buffer A. Bound antibodies were detected with 1:2000 in buffer A diluted  125 I-labelled anti-rabbit antibodies from donkey (GE Healthcare) for 2 h at room temperature and visualized to Kodak XOMAT films with intensifying screens (Kodak, Heidelberg, Germany) at −70° C. 
         [0053]    For IgE dot blot experiments, 100 ng of recombinant clone 10-derived allergen and recombinant grass pollen allergens, Phl p 1, Phl p 5, Phl p 7 and Phl p 12, as well as 3 μg of wheat pollen extract and 2 μg of mature wheat seed PBS-extract were dotted onto a nitrocellulose membrane. The nitrocellulose strips were blocked with buffer A and exposed to patients sera at a 1:10 dilution in buffer A over night at 4° C. Bound IgE antibodies were detected with  125 I-labelled anti-human IgE antibodies (RAST RIA, Demeditec Diagnostics, Germany) diluted 1:20 in buffer A over night at room temperature and visualized by autoradiography using Kodak XOMAT films with intensifying screens (Kodak) at −70° C. 
       MS and CD Analysis of Recombinant Clone 10 
       [0054]    Laser desorption mass spectra were acquired in a linear mode with a TOF Compact MALDI II instrument (Kratos, Manchester, UK; piCHEM, Research and Development, Graz, Austria). Samples were dissolved in 10% acetonitrile (0.1% trifluoroacetic acid), and α-cyano-4 hydroxycinnamic acid (dissolved in 60% acetonitrile, 0.1% trifluoroacetic acid) was used as a matrix. For sample preparation a 1/1 mixture of protein and matrix solution was deposited onto the target and air-dried. 
         [0055]    CD measurements were performed with purified clone 10-derived allergen (in H 2 O) at a protein concentration of 0.1 mg/ml on a Jasco J-810 spectropolarimeter (Tokyo, Japan) using a 0.2 cm path length rectangular quarz cuvette. Far-UV CD spectra were recorded from 190 nm to 260 nm with 0.5 nm resolution at a scan speed of 50 nm/min and resulted from the average of three scans. Results are expressed as the mean residue ellipticity (θ) at a given wavelength. Temperature scans were performed according to a step-scan procedure, where the sample was heated from 25° C. to 95° C. with a heat rate of 2° C./min and cooled back to 25° C. at the same rate. Every 5° C. continuous wavelength spectra were recorded with the specified parameters. In addition, temperature scans were recorded at 215 nm with a step resolution of 0.5° C. Results are expressed as the molar mean residue ellipticity (θ MRE ) at a given wavelength. The final spectra were corrected by subtracting the corresponding baseline spectrum obtained under identical conditions. The secondary structure content of clone 10-derived allergen was calculated using the secondary structure estimation program CDSSTR (9). 
         [0000]    Human Rat Basophil Leukaemia (huRBL) Assay 
         [0056]    For the quantification of IgE Ab-mediated, immediate-type reactions, huRBL cell mediator release assays were performed. RBL cells (clone RBL-703/21) transfected with the human FcεRI (10) were cultured in RPMI 1640 supplemented with 5% FCS, 4 mM L-Glutamine, and 1 mg/ml G418 sulfate. Cells were harvested after incubation with Trypsin/EDTA, washed, re-suspended in culture medium, and the cell concentration was adjusted to 2×10 6  cells/ml. Fifty μl aliquots of the cell solution were added to the wells of a 96-well flat-bottom microplate (cell density/well was 1×10 5  cells). Human sera were diluted 1:10 in culture medium, added to the cells and incubated overnight at 37° C., 7% CO 2 , 95% relative humidity. Medium was removed and the plates were washed 3 times with 200 μl/well of Tyrode&#39;s buffer+0.1% BSA. For IgE cross-linking, 100 μl of clone 10-derived allergen or rPhl p 1, (0.3 μg/ml), diluted in Tyrodes&#39;s buffer containing 50% D 2 O and 0.1% (w/v) BSA were added to the cells. For spontaneous release, Tyrodes&#39; buffer without protein was added to the wells. Total release was determined by addition of Tyrode&#39;s buffer containing 10% Triton X-100. After incubation at 37° C., 7% CO 2 , 95% relative humidity for 1 hour cells were harvested by centrifugation and 50 μl supernatant was transferred to a new plate, and 50 μl assay solution (0.1M Citric Acid or Sodium Citrate, pH 4.5 and 160 μM 4-methyl umbelliferyl-N-acetyl-β-D-glucosaminide) per well was added. After another one hour incubation the reaction was stopped by adding 100 μl glycine buffer (0.2M glycine, 0.2% NaCl, pH 10.7) to each well. Fluorescence was measured at λ ex : 360/λ em : 465 in a fluorescence microplate reader. Spontaneous release was determined from control wells that had not been lysed by Triton X-100. Specific release was calculated using the formula: (sample-spontaneous/total-spontaneous)×100. 
       Immunogold Electron Microscopy 
       [0057]    Dry grains of wheat were cut into small pieces (cubes of approximately 0.5 mm size) using a sharp razor blade. In order to preserve the dry state of the cells, the cubes were anhydrously fixed in acrolein vapor for 5 days at room temperature. They were transferred at room temperature for 1 day to dimethoxypropane (DMP) for removing any residual water and embedded into Lowicryl K4M resin using ascending series of DMP:ethanol and ethanol:monomeric Lowicryl K4 M as intermediate stages. Polymerization was performed at −35° C. 
         [0058]    Ultrathin sections were cut from both peripheral and central grain tissues and placed on silver grids for immunolabeling procedures. 
         [0059]    Labelling for clone 10-derived allergen was performed in a moist chamber at room temperature (PBS buffer+1% (w/v) BSA, pH 7.4, Tris buffer+1% (w/v) BSA, pH 8.2) as follows: 1.5% (w/v) BSA in PBS buffer, 15 minutes; 2. rabbit anti-wheat protein 10 antibodies and pre-immune antibodies, diluted 1:35 in PBS buffer, 2 hours; 3. PBS buffer, 5 minutes, Tris buffer, 2×5 minutes; 4. goat anti-rabbit IgG antibodies coupled to colloidal gold particles of 10 nm size (BioCell, Plano, Wetzlar, Germany), diluted 1:20 in Tris buffer; 5. Tris buffer, 1×5 minutes, distilled water, 2×5 minutes. 
         [0060]    Sections were stained using uranyl acetate (5 minutes) and lead citrate (10 seconds). 
         [0061]    Samples were analyzed in a transmission electron microscope EM 410 (FEI, Eindhoven, The Netherlands). 
       Results 
       [0062]    Isolation and Characterization of a Wheat cDNA Coding for a Serine Proteinase Inhibitor-Like Allergen 
         [0063]    A wheat seed cDNA expression library was screened with IgE antibodies from four patients suffering from bakers&#39; asthma. The open reading frame of the cDNA of the IgE-reactive clone 10 contained 262 nucleotides coding for a 84 amino acids polypeptide ( FIG. 1 ). A molecular mass of 9.4 kDa and an isoelectric point (pI) of 6.08 was calculated according to the deduced amino acid sequence for the clone 10-derived allergen. The analysis of amino acid composition showed a high content of valin residues (15.5%) and absence of cysteine residues. According to computer-aided secondary structure analysis the clone 10-derived allergen consists mainly of random coils and beta-sheets and one alpha-helical domain. According to solvent accessibility calculations almost 80% of the amino acids are solvent exposed. A search for sequence motifs revealed the presence of one potential casein kinase II phosphorylation site (amino acid 32), two N-terminal myristoylation sites (amino acids 11, 55) and a potato inhibitor I family signature ( FIG. 1 : amino acids 25-36 are boxed). A comparison of the clone 10-derived amino acid sequence with sequences deposited in the NCBI database showed that the allergen is almost identical to a  Triticum aestivum  subtilisin-chymotrypsin inhibitor WSCI precursor (accession no. gi|122065237) and to  T. aestivum  WSCI proteinase inhibitor (accession no. gi|66356278) and exhibits significant sequence homologies with a group of serine proteinase inhibitors occurring in plants and animals. These serine proteinase inhibitors constitute a family designated potato inhibitors I and are characterized by a typical consensus sequence pattern which is conserved in each of the proteins. The serine proteinase inhibitors belonging to the potato inhibitor I family are small proteins of 60-90 amino acids lacking disulphide bonds and contain only a single inhibitory site. The sequences of wheat serine proteinase inhibitors show a significant degree of sequence conservation to proteinase inhibitors of other monocotyledonic plants like barley ( Hordeum vulgare ), maize ( Zea mays, Zea diploperennis ), gamma grass ( Tripsacum dactyloides ) and rice ( Oryza sativa ), dicotyledonic plants and worms (Table III). Table III displays the percentages of sequence identities between each of the serine proteinase inhibitors. 
       Expression, Purification and Physicochemical Characterization of the Serine Proteinase Inhibitor-Like Allergen 
       [0064]    The clone 10-derived allergen was expressed in  E. coli  BL21 (DE3) with a C-terminal hexahistidine tag. Approximately 25 mg/L liquid culture of serine proteinase inhibitor-like allergen could be purified by nickel chromatography ( FIG. 2A ). MALDI-TOF analysis of purified recombinant protein 10 resulted in a mass peak of 9970.8 Da ( FIG. 2B ). The far-UV CD spectrum of purified recombinant clone 10-derived allergen ( FIG. 2C ) indicates that the protein is folded and contains a considerable amount of β-sheets and a low α-helical content. The spectrum is characterized by a minimum at 204 nm and a maximum at 190 nm. Secondary structure analysis using the program CDSSTR with the reference dataset 7 yielded 8% α-helix, 23% β-sheets, 14% β-turns and 53% random coils. The NRMSD value of 0.033 demonstrated a good fit between the calculated and the experimentally derived spectra. Upon heating to 95° C. a slight shift of the minimum of the CD spectrum (from 204 nm to 201 nm) was observed, indicating a partial denaturation of the protein. Upon cooling to 25° C. the protein refolded ( FIG. 2C ). However, the minimum at 204 nm was lower than before heating, which suggests a rearrangement of the β-sheets. In summary, the spectra observed during the temperature scan point to a high thermal stability of the clone 10-derived allergen. 
         [0000]    Recombinant Clone 10-Derived Allergen is a New Serine Proteinase Inhibitor-Like Allergen from Wheat 
         [0065]    Purified clone 10-derived allergen was tested for IgE reactivity using sera from patients suffering from bakers&#39; asthma, grass pollen allergy and food allergy to wheat by dot blot analysis ( FIG. 3 ). The recombinant clone 10-derived allergen reacted with IgE-antibodies from 3 (#1, #4, #12) out of 22 patients suffering from bakers&#39; asthma (13.6%). Patient #1 who had only low IgE levels specific for the major wheat allergen, alpha amylase inhibitor, showed strong IgE reactivity to the serine proteinase inhibitor-like allergen. Interestingly, the clone 10-derived allergen was exclusively recognized by IgE antibodies from patients with baker&#39;s asthma but not by patients suffering from IgE-mediated food allergy to wheat or patients suffering from grass pollen allergy. Several sera from each of the three patients groups showed IgE reactivity to recombinant timothy grass pollen allergens due to co-sensitization to grass pollen. The specific IgE reactivity of the clone 10-derived allergen by baker&#39;s asthma patients was confirmed in a chip analysis using additional 20 sera from celiac disease patients, 119 food allergic patients, 23 sera from grass pollen allergic patients and 25 baker&#39;s asthma patients (Constantin et al, unpublished, data not shown). 
         [0066]    The analysis of IgG subclass reactivities to the clone 10-derived allergen in the group of baker&#39;s asthma patients showed the presence allergen-specific IgG 1  and to a lower extent of allergen-specific IgG 4  levels both indicative of a Th 2  response whereas no relevant IgG 2  and IgG 3  reactivity specific for the clone 10-derived allergen was detected ( FIG. 4 ). 
         [0067]    To study the allergic activity of IgE antibodies specific for the serine proteinase inhibitor-like allergen RBL cells expressing the human FcεRI were loaded with serum IgE from patients with and without specific IgE antibodies and subsequently exposed to the allergen ( FIG. 5 ). RBL cells loaded with serum IgE from patient #1 showed the strongest degranulation upon allergen exposure (51% of total β-hexosaminidase release). A lower degranulation was obtained with RBL cells that had been loaded with IgE from patients #4 and #12 (22% and 19%, respectively) which corresponded with the intensity of IgE recognition in the dotblots ( FIG. 3 ). Almost no degranulation was observed when RBL cells were loaded with serum from a non-allergic person ( FIG. 5 : NC). The major timothy grass pollen allergen rPhl p 1 induced strong degranulation in RBL cells loaded with serum IgE from patient #12 and mild degranulation when RBL cells were loaded with sera from patients #1 and #4 ( FIG. 5 ). In fact, patients #1, #4 and #12 suffered also from grass pollen allergy (Table I). 
       The Serine Proteinase Inhibitor-Like Allergen Accumulates in Wheat Seeds During Maturation 
       [0068]    Rabbit antibodies, specific for clone 10-derived allergen, were used to investigate the expression of the protein during wheat seed maturation ( FIG. 6 ). Nitrocellulose sheets containing extracts from wheat seeds collected at different time points of seed maturation were probed with specific rabbit antibodies and the pre-immune Ig. The clone 10-specific antibodies reacted with a protein of 40 kDa, representing a tetramer of the serine proteinase inhibitor-like allergens ( FIG. 6 ) (11). The expression of the protein became detectable in 15 days old seeds and continued to increase during further maturation of seeds ( FIG. 6 ). No immunoreactivity was found when the blots were incubated with the pre-immune Ig from the same rabbit ( FIG. 6 ). 
       The Serine Proteinase Inhibitor-Like Allergen is Preferentially Detected in Wheat Seeds. 
       [0069]    When we compared pollen and seeds, we found that the serine proteinase inhibitor-like allergen is preferentially expressed in seeds ( FIG. 7 ) whereas only a weak signal was obtained at approximately 65 kDa in wheat pollen extract. The panallergen profilin was detected with rabbit anti-wheat seed profilin antibodies in wheat seeds and pollen ( FIG. 7 : # 123 ). No reactivity was found with pre-immune Ig ( FIG. 7 ). 
         [0070]    Next we used the serine proteinase inhibitor-like allergen-specific antibodies to search for cross-reactive structures in rice, maize, common bean and potato for which homologous proteins have been described with a sequence identity of 50% (bean), 49% (maize, rice) and 33% (potato) (Table III). 
         [0071]    The serine proteinase inhibitor-like allergen was detected again as tetramer in wheat seeds, a band of approximately 23 kDa was detected in rice but no reactivity was found in maize, common bean or potato ( FIG. 8C ) although comparable amounts of each extract had been subjected to SDS-PAGE ( FIG. 8A ). No reactivity was observed when the blots were incubated with the pre-immune Ig ( FIG. 8B ). 
       Localization of the Serine Proteinase Inhibitor-Like Allergen in the Aleurone Layer and Between Starch Granules of a Wheat Grain by Immunogold Electron Microscopy 
       [0072]      FIG. 9A  shows an ultra-thin section through a wheat grain at low magnification in the transmission electron microscope. Three major morphological components of the grain are visible: an outward multi-layered fruit and seed coat (C), the aleuron layer (AL) and the beginning of the voluminous interior of the grain, the starchy endosperm (SE). The rectangle marks an area comparable to the area shown in B.  FIG. 9B  displays the border between an aleuron cell and the adjoining starchy endosperm at higher magnification. The aleuron cell is filled with aleuron grains (AG) (protein vacuoles) which are surrounded by small lipid vesicles (L). Both components are embedded in the cytoplasmic matrix of the cell. The starchy endosperm consists of starch granules with variable size, closely packed just leaving small interspaces of amorphous cytoplasmatic material. The rectangles indicate areas shown in high magnification in C, D and E, F, respectively.  FIG. 9C  shows the localization of clone 10-derived allergen in an aleuron cell using Abs raised against wheat protein 10. Gold particles (arrows) indicate the presence of wheat protein 10 predominantly in the cytoplasmatic matrix between cell organelles but also in the peripheral parts of the lipid vesicles (L). In the starch region, wheat protein 10 is associated with the amorphous cytoplasmatic material (CY) in between the starch granules (SG) ( FIG. 9E ). Control experiments with preimmune Abs showed a very low degree of non-specific labelling ( FIGS. 9 , D and F). 
       Example 2 
     Expression and Purification of Recombinant Allergens 
       [0073]    Example 2 shows the identification and characterization of six IgE reactive wheat seed allergens named clones #10, #37, #38, #112, #123 and #126. Furthermore Example 2 shows a method for expression and purification of recombinant allergens of said clones. 
         [0000]    Biological Materials, Patients&#39; Sera Wheat seeds from  Triticum aestivum  cv. Michael were obtained from the Österreichische Agentur für Gesundheit and Ernährungssicherheit GmbH and planted in a glasshouse. Immature seeds were harvested directly into liquid nitrogen after a period of 25 days until pollination started and stored at −80° C. until use. Sera were obtained from 24 patients suffering from bakers&#39; asthma (Table IV). Baker&#39;s asthma was diagnosed on the basis of case history, total serum IgE levels, IgE specific for wheat and rye by CAP-FEIA System (Phadia, Uppsala, Sweden) and after specific inhalation challenge tests (1) ( FIG. 10 ). Serum from grass pollen allergic patients had been analyzed for total serum IgE levels and IgE specific timothy grass pollen by CAP-FEIA System (Phadia) and food allergic patients to wheat have been characterized as described previously (2) ( FIG. 11 ). Clinical data of these patients are summarized in table V. For control purposes serum from a non-allergic individual was included in the experiments.
 
Construction of a λgt11 cDNA Library from Wheat Seeds
 
         [0074]    Total RNA was extracted from wheat seeds stored at −80° C. according to Yeh [3]. Then the RNA pellet was dissolved in guanidinium isothiocyanate buffer (4M guanidinium isothiocyanate, 0.83% v/v 3M sodium acetate, pH 6, 0.11M β-mercaptoethanol) and purified by a cesium chloride density gradient ultracentrifugation. Poly-A +  RNA was isolated by oligo-dT cellulose affinity chromatography (Nucleo Trap mRNA; Machery-Nagel) and double stranded cDNA was synthesized via a cDNA synthesis kit (cDNA synthesis System; Roche Diagnostics, Mannheim, Germany). After methylation with EcoRI methylase (New England Biolabs, Beverly, Mass.), EcoRI linkers (New England Biolabs) were added to the cDNA. Linkered cDNA was digested with EcoRI (Roche Diagnostics). Digested linkers were removed with a Nick column (Pharmacia Biotech, Uppsala, Sweden) and the cDNA was ligated into λgt11 arms (Stratagene, La Jolla, Calif., USA). The ligation product was packed in vitro (Gigapack III Gold Cloning Kit, Stratagene) resulting in a λgt11 expression cDNA library with 2.43×10 6  PFU (plaque forming units). 
         [0000]    Isolation and Characterization of IgE-Reactive Clones from a Wheat Seed cDNA Library 
         [0075]      E. coli  Y1090 were infected with 7×10 5  PFU of recombinant phages and immunoscreened with serum IgE of four patients (#1, #2, #5, #13) suffering from bakers&#39; asthma as described [5]. Six IgE-reactive phage clones were selected for further re-cloning and their DNA was PCR-amplified using Platinum PCR Supermix (Invitrogen, Life Technologies) with λgt11 primers and sequenced (MWG, Ebersberg, Germany). The obtained sequences were compared with sequences submitted to the GenBank database at the National Center for Biotechnology Information (NCBI). 
       Expression and Purification of Recombinant Allergens 
       [0076]    The coding region of the clones were amplified by PCR using primers listed in table VI. The PCR products were subcloned into an AccepTor Vector (Novagen, Madison, Wis.) and sequenced again (MWG). Then the insert containing AccepTor Vectors were digested with NdeI and EcoRI (Roche Diagnostics), the inserts were gel-purified (Promega, Madison, Wis., USA) and subcloned into the expression plasmid pET 17b (Novagen). The DNA sequences were confirmed by sequencing both DNA strands (Microsynth, Balgach, CH). The pET 17b-insert constructs were transformed into  E. coli  BL21 (DE3) (Stratagene) and grown in Luria Broth (LB) medium containing 100 mg/l ampicillin at 37° C. to an OD (600 nm) of 0.8-1. Protein expression was induced by addition of isopropyl β-D-thiogalactopyranoside (IPTG) to a final concentration of 0.5 mM and growing the bacteria for additional 3 h. Then bacteria were harvested by centrifugation and homogenized in 25 mM imidazole, pH 7.5, 0.1% (v/v) Triton X-100 with an Ultraturrax (IKA, Stauffen, Germany). DNA was digested by addition of DNase I, stirred for additional 10 min at 20° C., stopped with 200 μl of 5M NaCl and then centrifuged at 4° C. (6000g, 20 min). Clone 10-derived allergen was purified from the inclusion body-containing pellet under denaturing conditions over Ni-NTA resin affinity columns according to the QIAexpressionist handbook, protocol 17 (QIAGEN, Hilden, Germany). Fractions containing the recombinant allergen were pooled and dialyzed against 10 mM NaH2PO4 pH 7.5. Recombinant proteins #37, #38, #112, #123 and #126 were purified from the pellet of the bacterial cell lysate under native conditions over Ni-NTA resin affinity columns according to the QIAexpressionist handbook, protocol 12 (QIAGEN). Fractions containing the recombinant proteins were pooled and dialyzed against 10 mM NaH2PO4 pH 7.5. Protein samples were analyzed for purity on a 14% SDS-PAGE gel and visualized by Coomassie brilliant blue staining. The protein concentrations were determined with Micro BCA Protein Assay Kit (Pierce, Rockford, Ill.). 
       Example 3 
     Allergen Array 
       [0077]    Example 3 shows an allergen micro-array revealing that recombinant wheat seed allergens, prepared as described in example 2, are specifically recognized by serum IgE from baker&#39;s asthma patients but not from patients with food allergy to wheat or grass pollen allergy. Hence the recombinant allergens are specific for respiratory allergy to wheat flour. Moreover Example 3 shows the use of timothy grass pollen marker allergens phl p 1 and Phl p 5 and wheat pollen in the array for improvement of in vitro diagnosis of respiratory allergy. 
       Techniques 
     Patients and Sera 
       [0078]    Sera were obtained from Spanish patients suffering from baker&#39;s asthma (B1-B23), Austrian (F1-F26) and German patients (F27-F38) suffering from wheat induced food allergy and Austrian patients (G1-017) suffering from grass pollen allergy. Patients were selected according to a positive case history, specific inhalation challenge tests for confirmation of a clinically relevant sensitization in case of baker&#39;s asthma (1) and double blind placebo controlled food challenge (DBPCFC) in infant patients with food allergy to wheat. Serum from all patients has been analyzed for total serum IgE levels and IgE specific for wheat flour and timothy grass pollen by the CAP-FEIA System (Phadia, Uppsala, Sweden). Demographic, clinical and serological data of these patients are summarized in Table VII, VIII and IX. For control purposes, sera from healthy individuals were included in all experiments. 
       Biological Materials 
       [0079]    Recombinant wheat proteins #10, #37, #38, #112, #123 and #126 derived from a cDNA library by screening with sera from baker&#39;s asthma patients were expressed in  E. coli  and purified as described (12). Wheat pollen were purchased from Allergon (Vällinge, Sweden) and recombinant Phl p 1, Phl p 5, Phl p 7, Phl p 12 from BIOMAY (Vienna, Austria). 
       Protein Extract 
       [0080]      Triticum aestivum  pollen (500 mg) was extracted at 4° C. over night in 5 ml PBS, 2 mM EDTA, 1 mM PMSF. After centrifugation for 1 h at 13,000×g 4° C., the protein concentration of the supernatant was determined with Micro BCA Protein Assay Kit (Pierce, Rockford, Ill.) and aliquots were stored at −20° C. until use. 
       Allergen Microarray Analysis 
       [0081]    Wheat pollen extract, 1-1.5 ng/spot, recombinant and purified wheat proteins and recombinant grass pollen allergens, 0.1-0.15 ng/spot, were spotted with a Nano Plotter NP2 (Gesellschaft für Silizium-Mikrosysteme mbH, GroBerkmannsdorf, Germany) on nitrocellulose membranes that were attached to microscope glass slides as described (13). Purified human IgE was used as a position marker (14). The spotted microarrays were pre-washed with 30 μl assaybuffer (weak phosphate buffer, pH 7.5) and incubated with 30 μl undiluted sera from allergic patients or controls. After washing with 30 μl assaybuffer bound IgE antibodies were detected with 20 μl fluorophore-conjugated anti-IgE antibody and fluorescence intensities (FI) were measured at a wavelength of 635 nm (GenePix 4000B fran Axon). The cut off level was set to FI=300 based on values obtained with human serum albumin. 
       Results 
     Description of Patients 
       [0082]    We analyzed patients suffering from baker&#39;s asthma, wheat-induced food allergy or grass pollen allergy. The group of baker&#39;s asthma patients consisted of 23 persons (4 females, 19 males: mean age 39 years, range 22-60 years) with occupational exposure to wheat flour. Ninety-one percent of the baker&#39;s asthma patients suffered from asthma due to inhalation of wheat flour and 94% complained about symptoms of rhinoconjunctivitis. A sensitization to other respiratory allergen sources (e.g., cat, cockroach, dog, grass pollen, horse, house dust mites, moulds and/or olive pollen) was found in 70% of the baker&#39;s asthma patients and 48% of the patients suffered from grass pollen allergy (Table VII). Interestingly, none of the baker&#39;s asthma patients exhibited allergy to food and symptoms were confined to respiratory manifestations. 
         [0083]    The group of patients suffering from wheat-induced food allergy comprised 38 individuals (25 females, 13 males: mean age 13 years, range 0.5-65 years) (Table VIII). Again we found that 71% are sensitized to other respiratory allergen sources (e.g., birch pollen, grass pollen, house dust mites and mugwort pollen) and 58% were also sensitized to food allergens (e.g., carrot, cow&#39;s milk, hazelnut, hen&#39;s egg, malt, nuts, orange, plum, rice, soybean, celery, seafood, shrimps and/or spices) (Table VIII). IgE-mediated sensitization to grass pollen was found in 55% of these patients. The symptoms of these patients varied from respiratory symptoms (e.g., asthma, bronchitis, cough, conjunctivitis, dyspnea, nasal congestion, rhinorrhoe, rhinoconjunctivitis) to gastrointestinal symptoms (e.g., abdominal pain, diarrhoea, flatulence, sore throat and vomiting) and cutaneous symptoms (e.g., eczema, pruritus and urticaria) (Table VIII). 
         [0084]    The group of grass pollen allergic patients consisted of 17 patients (5 females, 12 males: mean age 13 years, range 0.5-65 years). Seventy one percent of these patients suffered also from allergy to other respiratory allergen sources (e.g., birch pollen, cat, dog, house dust mites, rabbit and mugwort pollen) (Table IX). According to serology 65% exhibited IgE reactivity to wheat flour and 23% contained IgE against other food allergens. However, only one patient suffered from urticaria and no symptoms of food allergy could be recorded for these patients. Respiratory symptoms such as asthma, conjunctivitis, dyspnea, rhinoconjunctivitis and rhinitis dominated in the grass pollen allergic patients. 
       Composition of the Allergen Array 
       [0085]    Six recombinant wheat seed allergens designated as #10, #37, #38, #112, #123 and #126 were spotted onto nitrocellulose-coated glass slides ( FIG. 12 , A). The recombinant wheat proteins were expressed in  Escherichia coli  based on cDNAs which had been isolated from a wheat seed cDNA library with sera from baker&#39;s asthma patients as described (15). According to homology with sequences deposited in the NCBI database the wheat allergens can be described as follows: #10 has a 96% homology to a  Triticum aestivum  subtilisin-chymotrypsin inhibitor WSCI precursor (accession no. gi|122065237), #37 is a  T. aestivum  thioredoxin H (accession no. gi|27461140), #38 is a  T. aestivum  glutathione transferase (accession no. gi|20067419), #112 has a 99% homology with a  T. aestivum  1-Cys-peroxyredoxine (accession no. gi|34539782), #123 has a 96% homology with  T. aestivum  profilin (accession no. gi|1346803) and #126 has a 69% homology with  Hordeum vulgare  dehydrin 11 (accession no. gi|4105101). 
         [0086]    In addition to the recombinant wheat allergens, wheat pollen extract, recombinant timothy grass pollen allergens (rPhl p 1, rPhl p 5, rPhl p 7 and rPhl p 12) (16-19) and IgE were also spotted onto the slides ( FIG. 12 , A). Representative images of allergen microarrays after incubation with sera are shown in  FIG. 12 , B-C. On the chip probed with serum from a non-allergic person showed no reactivity with any allergen could be detected and only the spotted IgE markers were detected with the anti-IgE conjugate ( FIG. 12 , B). Figures in 12, C show representative images of microarray chips incubated with sera from a baker&#39;s asthma patient (1), a patient suffering from wheat-induced food allergy (2) and a grass pollen allergic patient (3). The baker&#39;s asthma patient (1: Table I: B4) shows strong IgE reactivity to recombinant wheat allergens #10 and weak reactivities to #126 and #112. For the food allergic patient (2: Table VIII: F26) strong IgE binding to recombinant profilin from wheat #123 and timothy grass pollen rPhl p 12 and weak binding to wheat pollen extract and rPhl p 1 was observed. The image of the chip from a grass pollen allergic patient (3: G16) shows strong signals to rPhl p 5 and rPhl p 12 and weaker signals with wheat profilin #123, wheat pollen extract and rPhl p 1. 
         [0000]    Identification of Wheat Seed Allergens Specifically Recognized by IgE Antibodies from Baker&#39;s Asthma Patients 
         [0087]    Ninety one percent of the baker&#39;s asthma patients were positive in the wheat flour CAP (Table VII). Using spotted wheat allergens the IgE reactivity profile for 62% of the baker&#39;s asthma patients could be established. Allergens #126 (30%), #10 (26%), #123 (22%) and #122 (17%) were the most frequently detected components whereas #37 and #38 reacted only with 4% of the sera ( FIG. 13 , A). Interestingly, the two patients who were negative in the wheat flour CAP (B5, B18: Table VII) reacted with allergen #126. Forty eight percent of the baker&#39;s asthma patients showed IgE reactivity to timothy grass pollen extract and each of these patients was also diagnosed with a combination of spotted rPhl p 1 and rPhl p 5. Recombinant Phl p 12 (35%) was always stronger and more often recognized than wheat profilin #123 (22%). The cross-reactive pollen allergen rPhl p 7 reacted with 13% of the sera. 
         [0000]    Recombinant Wheat Seed Allergens Recognized by Baker&#39;s Asthma Patients are not Targets for IgE Antibodies of Patients Suffering from Wheat-Induced Food Allergy 
         [0088]    All patients with food allergy to wheat were positive in the wheat flour CAP but the recombinant wheat proteins were hardly recognized (5%) ( FIG. 13 , B). The two patients who were positive to cross-reactive timothy grass pollen profilin, had also a positive signal to wheat profilin #123 in the microarray. Fifty five percent of patients with wheat induced food allergy showed IgE reactivity in the  Phleum  CAP but just 18% were positive to wheat pollen extract on the chip and 26% in the combination of spotted rPhl p 1 and rPhl p 5. Spotted rPhl p 1 and rPhl p 5 alone were recognized by 18% and 16% of the sera respectively, the cross-reactive allergens rPhl p 7 and rPhl p 12 reacted with 13% and 26% of the sera. 
         [0000]    rPhl p 1 and rPhl p 5 are Diagnostic Marker Allergens for Grass Pollen Allergy Whereas Profilin is Recognized by Baker&#39;s Asthma and Wheat Food Allergic Patients 
         [0089]    Sixty-five percent of grass pollen allergic patients were positive in the wheat flour CAP. Out of the recombinant wheat proteins tested in the microarray, only recombinant wheat protein #123 was recognized by 23.5% of the patients ( FIG. 13 , C). Each of these patients were also positive to cross-reactive timothy grass pollen profilin rPhl p 12. But rPhl p 12 was always stronger and more often (35%) recognized than #123. All patients suffering from grass pollen allergy were positive on the timothy grass pollen CAP and in the combination of spotted rPhl p 1 and rPhl p 5. Recombinant Phl p 1 alone was more often recognized (94%) than rPhl p 5 (88%) by patients with grass pollen allergy. Wheat pollen extract reacted with 82% of the sera and cross-reactive rPhl p 7 with 29%. 
         [0090]    All grass pollen allergic patients and baker&#39;s asthma patients with grass pollen allergy were positive in the combination of rPhl p 1 and rPhl p 5 in the microarray and in the  Phleum  CAP ( FIG. 13 , A; C). These findings are in agreement with previously published data showing that grass pollen allergy can be diagnosed by IgE reactivity to rPhl p 1 and rPhl p 5 (20, 21). However, among patients with wheat induced food allergy only 26% reacted with rPhl p 1 and rPhl p 5 in the microarray, but more than twice as many (55%) were positive in the  Phleum  CAP ( FIG. 13 , B). Furthermore, those patients reacting with grass pollen extract in the CAP system and with timothy grass pollen profilin (rPhl p 12) in the microarray were also positive to wheat profilin (22) due to cross-reactivity of plant profilins (23). Nevertheless, frequency and intensity of IgE recognition was always stronger to rPhl p 12 than to wheat profilin (22). 
       Example 4 
       [0091]    The analyte is immobilized to a solid support, such as ImmunoCAP (Phadia, Uppsala, Sweden). Serum samples from at least three representative human patients sensitized to the allergen and showing IgE reactivity to that allergen are incubated for 3 h at room temperature with the allergen at a final concentration of 100 μg/mL and, in parallel as negative controls, with buffer alone and the non-allergenic maltose binding protein (MBP) of  E. coli . The samples are then analysed for IgE binding to ImmunoCAP (Phadia, Uppsala, Sweden) tests carrying immobilized analyte to study whether preincubation with allergen specifically inhibits or significantly lowers IgE binding. 
         [0000]    
       
         
               
             
               
               
               
             
               
               
               
               
               
               
               
               
               
               
               
               
               
             
               
               
               
               
               
               
               
               
               
               
               
               
               
             
           
               
                 TABLE I 
               
             
             
               
                   
               
               
                 Demographic, clinical and serological characteristics of patients suffering from bakers&#39; asthma 
               
             
          
           
               
                   
                 IgE conc kUA/l 
                   
               
             
          
           
               
                   
                   
                   
                   
                 occupational 
                   
                   
                   
                 fungal 
                 SPT to grass 
                 total IgE 
                   
                   
               
               
                 Patients 
                 Age 
                 Sex 
                 Asthma 
                 exposure 
                 Wheat 
                 Rye 
                 Soybean 
                 α-Amylase 
                 pollen 
                 kU/l 
                 PC20 
                 mg/ml 
               
               
                   
               
             
          
           
               
                 1 
                 35 
                 m 
                 + 
                 + 
                 74.2 
                 20.7 
                 n.d. 
                 0.63 
                 + 
                 163 
                 + 
                 0.29 
               
               
                 2 
                 29 
                 m 
                 + 
                 + 
                 18 
                 7.9 
                 6.1 
                 1.5 
                 + 
                 271 
                 + 
                 2 
               
               
                 3 
                 36 
                 m 
                 + 
                 + 
                 1.66 
                 1.24 
                 &lt;0.35 
                 &lt;0.35 
                 − 
                 353 
                 + 
                 0.31 
               
               
                 4 
                 39 
                 m 
                 + 
                 + 
                 25.8 
                 15.6 
                 1.36 
                 18.6 
                 + 
                 1387 
                 + 
                 0.25 
               
               
                 5 
                 54 
                 m 
                 + 
                 + 
                 &lt;0.35 
                 &lt;0.35 
                 &lt;0.35 
                 3.21 
                 − 
                 30.1 
                   
                 n.d. 
               
               
                 6 
                 35 
                 m 
                 + 
                 + 
                 24.3 
                 39.6 
                 5.73 
                 2.29 
                 + 
                 416 
                 + 
                 0.25 
               
               
                 7 
                 28 
                 m 
                 + 
                 + 
                 2.58 
                 3.77 
                 &lt;0.35 
                 5.39 
                 + 
                 248 
                 + 
                 0.25 
               
               
                 8 
                 27 
                 m 
                 + 
                 + 
                 7.86 
                 7.4 
                 3.19 
                 32.2 
                 + 
                 1773 
                 + 
                 0.47 
               
               
                 9 
                 24 
                 m 
                 − 
                 + 
                 2.35 
                 2.32 
                 1.62 
                 n.d. 
                 + 
                 204 
                 + 
                 0.09 
               
               
                 10 
                 60 
                 m 
                 + 
                 + 
                 3.44 
                 4.08 
                 &lt;0.35 
                 1.15 
                 + 
                 73.3 
                 + 
                 0.44 
               
               
                 11 
                 22 
                 m 
                 + 
                 + 
                 3 
                 2 
                 &lt;0.35 
                 &lt;0.35 
                 − 
                 2509 
                 + 
                 3.38 
               
               
                 12 
                 26 
                 m 
                 + 
                 + 
                 &gt;100 
                 &gt;100 
                 10.7 
                 7.63 
                 + 
                 321 
                 + 
                 0.5 
               
               
                 13 
                 54 
                 m 
                 + 
                 + 
                 2.48 
                 0.6 
                 0.71 
                 &lt;0.35 
                 − 
                 480 
                 + 
                 0.12 
               
               
                 14 
                 60 
                 m 
                 + 
                 + 
                 31.8 
                 31.1 
                 n.d. 
                 &lt;0.35 
                 + 
                 629 
                 + 
                 0.15 
               
               
                 15 
                 27 
                 m 
                 + 
                 + 
                 5.06 
                 n.d. 
                 n.d. 
                 &lt;0.35 
                 + 
                 278 
                 + 
                 0.079 
               
               
                 16 
                 42 
                 f 
                 + 
                 + 
                 3.71 
                 2.71 
                 1.69 
                 &lt;0.35 
                 + 
                 271 
                 + 
                 0.187 
               
               
                 17 
                 54 
                 m 
                 + 
                 + 
                 1.68 
                 1.13 
                 &lt;0.35 
                 &lt;0.35 
                 − 
                 79.2 
                 + 
                 16 
               
               
                 18 
                 59 
                 m 
                 + 
                 + 
                 &lt;0.35 
                 &lt;0.35 
                 &lt;0.35 
                 5 
                 − 
                 673 
                 + 
                 0.23 
               
               
                 19 
                 26 
                 m 
                 + 
                 + 
                 74.6 
                 58.4 
                 &lt;0.35 
                 &lt;0.35 
                 + 
                 17.7 
                 + 
                 1.16 
               
               
                 20 
                 43 
                 m 
                 + 
                 + 
                 13.8 
                 26.9 
                 0.77 
                 &lt;0.35 
                 + 
                 538 
                 + 
                 0.25 
               
               
                 21 
                 34 
                 f 
                 + 
                 + 
                 2.05 
                 1 
                 &lt;0.35 
                 &lt;0.35 
                 + 
                 n.d. 
                 + 
                 0.5 
               
               
                 22 
                 41 
                 f 
                 + 
                 + 
                 1.77 
                 0.75 
                 &lt;0.35 
                 &lt;0.35 
                 + 
                 23.4 
                 + 
                 0.23 
               
               
                   
               
               
                 m: male, 
               
               
                 f: female, 
               
               
                 +: positive, 
               
               
                 −: negative, 
               
               
                 n.d.: not done, 
               
               
                 kUA/l—kilounit antigen per liter, 
               
               
                 SPT: skin prick test, 
               
               
                 PC20: Methacholine inhalation challenge 
               
             
          
         
       
     
         [0000]    
       
         
               
             
               
               
               
             
               
               
               
               
               
               
               
               
               
             
               
               
               
               
               
               
               
               
               
             
           
               
                 TABLE II 
               
             
             
               
                   
               
               
                 Demographic, clinical and serological characteristics of patients 
               
               
                 suffering from food allergy to wheat and grass pollen allergy 
               
             
          
           
               
                   
                 IgE conc. 
                   
               
               
                   
                 kUA/l 
                 total 
               
             
          
           
               
                 Patients 
                 Age 
                 Sex 
                 RC 
                 AD 
                 Asthma 
                 Wheat 
                 Rye 
                 IgE kU/l 
               
               
                   
               
             
          
           
               
                 F1 
                 34 
                 f 
                 − 
                 + 
                 + 
                 18.6 
                 13.4 
                 &gt;2000 
               
               
                 F2 
                 34 
                 m 
                 + 
                 − 
                 − 
                 3.1 
                 3.08 
                 155 
               
               
                 F3 
                 24 
                 f 
                 − 
                 + 
                 − 
                 1.3 
                 n.d. 
                 336 
               
               
                 F4 
                 15 
                 f 
                 − 
                 + 
                 − 
                 5.91 
                 5.3 
                 915 
               
               
                 G1 
                 45 
                 m 
                 + 
                 − 
                 + 
                 1.76 
                 2 
                 175 
               
               
                 G2 
                 39 
                 m 
                 + 
                 − 
                 + 
                 11.1 
                 10.3 
                 401 
               
               
                 G3 
                 55 
                 f 
                 − 
                 − 
                 − 
                 3.16 
                 1 
                 157 
               
               
                 G4 
                 54 
                 m 
                 + 
                 − 
                 + 
                 n.d. 
                 n.d. 
                 1528 
               
               
                   
               
               
                 F: food allergy, 
               
               
                 G: grass pollen allergy, 
               
               
                 m: male, 
               
               
                 f: female, 
               
               
                 RC: rhinoconjunctivitis, 
               
               
                 AD: atopic dermatitis, 
               
               
                 +: positive, 
               
               
                 −: negative, 
               
               
                 n.d.: not done, 
               
               
                 kUA/l—kilounit antigen per liter 
               
             
          
         
       
     
         [0000]    
       
         
               
             
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
             
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
             
           
               
                 TABLE III 
               
               
                   
               
               
                 Percentage amino acid sequence identities 
               
               
                   
               
             
             
               
                   
               
             
          
           
               
                   
                 Clone #10 
                 # 1 
                 # 2 
                 # 3 
                 # 4 
                 # 5 
                 # 6 
                 # 7 
                 # 8 
                 # 9 
                 # 10 
                 # 11 
                 # 12 
                 # 13 
                 # 14 
                 # 15 
               
               
                   
                 (%) 
                 (%) 
                 (%) 
                 (%) 
                 (%) 
                 (%) 
                 (%) 
                 (%) 
                 (%) 
                 (%) 
                 (%) 
                 (%) 
                 (%) 
                 (%) 
                 (%) 
                 (%) 
               
               
                   
               
               
                 Clone #10 
                 100 
                 98 
                 94 
                 85 
                 54 
                 49 
                 49 
                 52 
                 43 
                 43 
                 35 
                 50 
                 43 
                 41 
                 32 
                 35 
               
               
                 # 1 
                   
                 100 
                 97 
                 88 
                 55 
                 50 
                 50 
                 53 
                 44 
                 44 
                 35 
                 50 
                 44 
                 41 
                 32 
                 36 
               
               
                 # 2 
                   
                   
                 100 
                 84 
                 52 
                 48 
                 47 
                 50 
                 44 
                 43 
                 33 
                 46 
                 41 
                 40 
                 30 
                 35 
               
               
                 # 3 
                   
                   
                   
                 100 
                 55 
                 50 
                 50 
                 53 
                 44 
                 44 
                 38 
                 50 
                 44 
                 43 
                 30 
                 40 
               
               
                 # 4 
                   
                   
                   
                   
                 100 
                 88 
                 97 
                 76 
                 35 
                 62 
                 33 
                 50 
                 41 
                 40 
                 27 
                 47 
               
               
                 # 5 
                   
                   
                   
                   
                   
                 100 
                 87 
                 73 
                 37 
                 63 
                 33 
                 50 
                 40 
                 40 
                 30 
                 44 
               
               
                 # 6 
                   
                   
                   
                   
                   
                   
                 100 
                 73 
                 34 
                 50 
                 38 
                 48 
                 48 
                 40 
                 29 
                 45 
               
               
                 # 7 
                   
                   
                   
                   
                   
                   
                   
                 100 
                 36 
                 59 
                 38 
                 46 
                 48 
                 38 
                 38 
                 55 
               
               
                 # 8 
                   
                   
                   
                   
                   
                   
                   
                   
                 100 
                 32 
                 41 
                 37 
                 48 
                 48 
                 34 
                 47 
               
               
                 # 9 
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 100 
                 30 
                 43 
                 35 
                 34 
                 30 
                 39 
               
               
                 # 10 
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 100 
                 43 
                 40 
                 52 
                 40 
                 34 
               
               
                 # 11 
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 100 
                 37 
                 46 
                 41 
                 45 
               
               
                 # 12 
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 100 
                 35 
                 37 
                 48 
               
               
                 # 13 
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 100 
                 37 
                 38 
               
               
                 # 14 
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 100 
                 35 
               
               
                 # 15 
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 100 
               
               
                 # 16 
               
               
                 # 17 
               
               
                 # 18 
               
               
                 # 19 
               
               
                 # 20 
               
               
                 # 21 
               
               
                 # 22 
               
               
                 # 23 
               
               
                 # 24 
               
               
                 # 25 
               
               
                 # 26 
               
               
                 # 27 
               
               
                 # 28 
               
               
                 # 29 
               
               
                 # 30 
               
               
                   
               
             
          
           
               
                   
                   
                 # 16 
                 # 17 
                 # 18 
                 # 19 
                 # 20 
                 # 21 
                 # 22 
                 # 23 
                 # 24 
                 # 25 
                 # 26 
                 # 27 
                 # 28 
                 # 29 
                 # 30 
               
               
                   
                   
                 (%) 
                 (%) 
                 (%) 
                 (%) 
                 (%) 
                 (%) 
                 (%) 
                 (%) 
                 (%) 
                 (%) 
                 (%) 
                 (%) 
                 (%) 
                 (%) 
                 (%) 
               
               
                   
                   
               
               
                   
                 Clone #10 
                 33 
                 32 
                 34 
                 31 
                 38 
                 35 
                 38 
                 32 
                 48 
                 31 
                 30 
                 30 
                 34 
                 35 
                 28 
               
               
                   
                 # 1 
                 33 
                 32 
                 34 
                 31 
                 38 
                 35 
                 38 
                 32 
                 48 
                 31 
                 30 
                 30 
                 34 
                 35 
                 28 
               
               
                   
                 # 2 
                 33 
                 30 
                 32 
                 31 
                 37 
                 35 
                 34 
                 30 
                 43 
                 28 
                 31 
                 28 
                 32 
                 35 
                 27 
               
               
                   
                 # 3 
                 29 
                 30 
                 32 
                 31 
                 35 
                 35 
                 37 
                 34 
                 43 
                 32 
                 34 
                 31 
                 35 
                 35 
                 30 
               
               
                   
                 # 4 
                 31 
                 37 
                 37 
                 38 
                 38 
                 42 
                 33 
                 41 
                 44 
                 32 
                 34 
                 30 
                 32 
                 38 
                 30 
               
               
                   
                 # 5 
                 30 
                 38 
                 45 
                 41 
                 41 
                 45 
                 34 
                 42 
                 44 
                 32 
                 37 
                 33 
                 34 
                 38 
                 25 
               
               
                   
                 # 6 
                 33 
                 36 
                 45 
                 38 
                 40 
                 44 
                 33 
                 41 
                 43 
                 34 
                 35 
                 38 
                 32 
                 38 
                 30 
               
               
                   
                 # 7 
                 29 
                 35 
                 35 
                 33 
                 33 
                 33 
                 38 
                 33 
                 40 
                 30 
                 30 
                 27 
                 35 
                 38 
                 27 
               
               
                   
                 # 8 
                 34 
                 34 
                 37 
                 38 
                 32 
                 40 
                 35 
                 34 
                 38 
                 28 
                 35 
                 37 
                 34 
                 38 
                 37 
               
               
                   
                 # 9 
                 28 
                 28 
                 28 
                 28 
                 30 
                 33 
                 28 
                 28 
                 33 
                 28 
                 28 
                 23 
                 31 
                 31 
                 24 
               
               
                   
                 # 10 
                 39 
                 39 
                 31 
                 46 
                 42 
                 54 
                 49 
                 54 
                 48 
                 51 
                 54 
                 57 
                 68 
                 58 
                 51 
               
               
                   
                 # 11 
                 35 
                 40 
                 69 
                 43 
                 48 
                 41 
                 37 
                 40 
                 79 
                 38 
                 37 
                 30 
                 38 
                 38 
                 33 
               
               
                   
                 # 12 
                 41 
                 37 
                 34 
                 31 
                 31 
                 34 
                 34 
                 35 
                 40 
                 35 
                 32 
                 34 
                 34 
                 34 
                 32 
               
               
                   
                 # 13 
                 37 
                 35 
                 41 
                 44 
                 40 
                 40 
                 41 
                 38 
                 47 
                 44 
                 43 
                 35 
                 41 
                 44 
                 37 
               
               
                   
                 # 14 
                 58 
                 68 
                 25 
                 38 
                 38 
                 39 
                 38 
                 42 
                 40 
                 37 
                 41 
                 37 
                 43 
                 39 
                 38 
               
               
                   
                 # 15 
                 26 
                 31 
                 38 
                 31 
                 34 
                 41 
                 37 
                 36 
                 49 
                 34 
                 37 
                 31 
                 38 
                 32 
                 35 
               
               
                   
                 # 16 
                 100 
                 57 
                 27 
                 32 
                 41 
                 42 
                 43 
                 42 
                 35 
                 34 
                 41 
                 38 
                 48 
                 43 
                 38 
               
               
                   
                 # 17 
                   
                 100 
                 25 
                 40 
                 42 
                 41 
                 37 
                 44 
                 38 
                 38 
                 44 
                 37 
                 44 
                 42 
                 35 
               
               
                   
                 # 18 
                   
                   
                 100 
                 34 
                 47 
                 39 
                 38 
                 40 
                 80 
                 38 
                 34 
                 31 
                 37 
                 38 
                 31 
               
               
                   
                 # 19 
                   
                   
                   
                 100 
                 37 
                 58 
                 58 
                 50 
                 48 
                 47 
                 52 
                 53 
                 52 
                 57 
                 42 
               
               
                   
                 # 20 
                   
                   
                   
                   
                 100 
                 41 
                 39 
                 35 
                 47 
                 35 
                 34 
                 37 
                 43 
                 42 
                 35 
               
               
                   
                 # 21 
                   
                   
                   
                   
                   
                 100 
                 50 
                 55 
                 44 
                 47 
                 57 
                 48 
                 58 
                 59 
                 50 
               
               
                   
                 # 22 
                   
                   
                   
                   
                   
                   
                 100 
                 49 
                 40 
                 49 
                 47 
                 55 
                 53 
                 43 
                 55 
               
               
                   
                 # 23 
                   
                   
                   
                   
                   
                   
                   
                 100 
                 43 
                 52 
                 50 
                 49 
                 58 
                 51 
                 51 
               
               
                   
                 # 24 
                   
                   
                   
                   
                   
                   
                   
                   
                 100 
                 41 
                 40 
                 33 
                 38 
                 40 
                 35 
               
               
                   
                 # 25 
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 100 
                 44 
                 50 
                 40 
                 58 
                 45 
               
               
                   
                 # 26 
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 100 
                 53 
                 59 
                 58 
                 47 
               
               
                   
                 # 27 
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 100 
                 58 
                 47 
                 80 
               
               
                   
                 # 28 
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 100 
                 59 
                 81 
               
               
                   
                 # 29 
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 100 
                 45 
               
               
                   
                 # 30 
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
                   
                 100 
               
               
                   
                   
               
             
          
         
       
     
         [0000]    
       
         
               
             
               
             
           
               
                 TABLE IV 
               
               
                   
               
               
                 Bakers&#39; asthma patients 
               
               
                   
               
             
             
               
                   
               
             
          
           
               
                 
                   
                             
                     
                         
                         
                     
                   
                 
               
               
                   
               
               
                 PC20: Methacholine inhalation challange 
               
               
                 m: male, f: female, +: positive, −: negative, n.d.: not done 
               
             
          
         
       
     
         [0000]    
       
         
               
             
               
               
               
               
               
             
               
               
               
               
               
               
               
               
               
             
               
               
               
               
               
               
               
               
               
             
           
               
                 TABLE V 
               
             
             
               
                   
               
               
                 Food and grass pollen allergic patients 
               
             
          
           
               
                   
                   
                   
                 IgE conc. 
                   
               
               
                   
                 Age at blood 
                   
                 kUA/l 
               
             
          
           
               
                 Patient group 
                 donation 
                 Sex 
                 RC 
                 AD 
                 Asthma 
                 Wheat 
                 Rye 
                 total IgE 
               
               
                   
               
             
          
           
               
                 Food allergic 1 
                 32 
                 m 
                 + 
                 − 
                 − 
                 3.1 
                 3.08 
                 155 
               
               
                 Food allergic 2 
                 34 
                 f 
                 − 
                 − 
                 + 
                 18.6 
                 n.d. 
                 &gt;2000 
               
               
                 Food allergic 3 
                 24 
                 f 
                 − 
                 + 
                 − 
                 1.3 
                 n.d. 
                 336 
               
               
                 Food allergic 4 
                 15 
                 f 
                 − 
                 + 
                 − 
                 5.91 
                 5.3 
                 915 
               
               
                 Grasspollen allergic 1 
                 45 
                 m 
                 + 
                 − 
                 + 
                 n.d. 
                 n.d. 
                 n.d. 
               
               
                 Grasspollen allergic 2 
                 39 
                 m 
                 + 
                 − 
                 + 
                 n.d. 
                 n.d. 
                 401 
               
               
                 Grasspollen allergic 3 
                 55 
                 f 
                 − 
                 − 
                 − 
                 n.d. 
                 n.d. 
                 n.d. 
               
               
                 Grasspollen allergic 4 
                 54 
                 m 
                 + 
                 − 
                 + 
                 n.d. 
                 n.d. 
                 1528 
               
               
                   
               
               
                 m: male, 
               
               
                 f: female, 
               
               
                 +: positive, 
               
               
                 −: negative, 
               
               
                 n.d.: not done 
               
             
          
         
       
     
         [0000]    
       
         
               
             
               
               
             
           
               
                 TABLE VI 
               
             
             
               
                   
               
               
                 PCR Primers used for the amptification of cDNAs 
               
             
          
           
               
                 Primer 
                 Sequence 
               
               
                   
               
               
                 10 fwd 
                 5′  CAT ATG  AGC CCT GTG GTG AAG AAG CCG 
               
               
                   
                 GAG GGA 3′ 
               
               
                   
               
               
                 10 rev 
                 5′  GAATTC  TTA  GTG ATG GTG ATG GTG ATG  GCC 
               
               
                   
                 GAC CCT GGG GAC 3′ 
               
               
                   
               
               
                 37 fwd 
                 5′  CAT ATG  GCC GCC GAG GAG GGA GCC GTG 
               
               
                   
                 ATA 3′ 
               
               
                   
               
               
                 37 rev 
                 5′  GAATTC  TTA  GTG ATG GTG ATG GTG ATG  GGC 
               
               
                   
                 AGA TGC AGA ACC 3′ 
               
               
                   
               
               
                 38 fwd 
                 5′  CAT ATG  GCG GGC GAG AAG GGC CTG GTG 
               
               
                   
                 CTG 3′ 
               
               
                   
               
               
                 38 rev 
                 5′  GAATTC  TTA  GTG ATG GTG ATG GTG ATG  CTC 
               
               
                   
                 GAT GCC GTA CTT 3′ 
               
               
                   
               
               
                 112 fwd 
                 5′  CAT ATG  CCG GGC CTC ACC ATC GGC GAC 
               
               
                   
                 ACC GTC 3′ 
               
               
                   
               
               
                 112 rev 
                 5′  GAATTC  TTA  GTG ATG GTG ATG GTG ATG  GAC 
               
               
                   
                 CTT GGT GAA GCG 3′ 
               
               
                   
               
               
                 123 fwd 
                 5′  CAT ATG  TCG TGG CAG ACG TAC GTC GAC 
               
               
                   
                 GAC 3′ 
               
               
                   
               
               
                 123 rev 
                 5′  GAATTC  TTA  GTG ATG GTG ATG GTG ATG  GAA 
               
               
                   
                 ACC CTG CTC GAC 3′ 
               
               
                   
               
               
                 126 fwd 
                 5′  CAT ATG  GCG GAC TAC GGT GGA GAG TAC 
               
               
                   
                 GGG 3′ 
               
               
                   
               
               
                 126 rev 
                 5′  GAATTC  TTA  GTG ATG GTG ATG GTG GTG  TCC 
               
               
                   
                 AGG GAG CTT 3′ 
               
               
                   
               
               
                 fwd: forward: rev: reverse: Nde: restriction sites are shown in italic letters, Eco RI restriction sites are 
               
               
                 underlined, hexahistidine-tags are shown in bold letters 
               
             
          
         
       
     
         [0000]    
       
         
               
             
               
               
               
               
               
               
               
               
               
               
               
               
             
               
               
               
               
               
               
               
               
               
               
               
               
             
           
               
                 TABLE VII 
               
             
             
               
                   
               
               
                 Demographic, clinical and serological characteristics of patients suffering from baker&#39;s asthma 
               
             
          
           
               
                   
                   
                   
                 Wheat flour 
                 
                   Phleum pratense 
                 
                 Total 
                   
                 Years 
                   
                 Other 
                 PC20 
                 SIC 
               
               
                 Patient 
                 Sex 
                 Age 
                 IgE kUA/l 
                 IgE kUA/l 
                 IgE kU/l 
                 Job 
                 exp. 
                 Symptoms 
                 allergies 
                 mg/ml 
                 wheat mg/ml 
               
               
                   
               
             
          
           
               
                 B1 
                 m 
                 35 
                 74.2 
                 5.25 
                 163 
                 Confectioner 
                 20 
                 A, RC 
                 g 
                 0.29 
                 0.039 
               
               
                 B2 
                 m 
                 29 
                 16 
                 53.5 
                 271 
                 Confectioner 
                 12 
                 A, RC 
                 g 
                 2 
                 n.d. 
               
               
                 B3 
                 m 
                 36 
                 1.66 
                 &lt;0.35 
                 353 
                 Baker 
                 8 
                 A, RC 
                 n.k. 
                 0.31 
                 n.d. 
               
               
                 B4 
                 m 
                 39 
                 25.8 
                 0.73 
                 1367 
                 Baker-Confectioner 
                 20 
                 A, RC, U 
                 g 
                 0.25 
                 n.d. 
               
               
                 B5 
                 m 
                 54 
                 &lt;0.35 
                 &lt;0.35 
                 30.1 
                 Baker 
                 42 
                 RC, A 
                 n.k. 
                 n.d. 
                 n.d. 
               
               
                 B6 
                 m 
                 35 
                 24.3 
                 4.67 
                 416 
                 Baker 
                 12 
                 RC, A 
                 g 
                 0.25 
                 n.d. 
               
               
                 B7 
                 m 
                 28 
                 2.56 
                 &lt;0.35 
                 246 
                 Baker 
                 14 
                 A, RC 
                 c, d, h, hdm 
                 0.25 
                 n.d. 
               
               
                 B8 
                 m 
                 27 
                 7.86 
                 &gt;100 
                 1773 
                 Baker 
                 26 
                 A, RC 
                 n.k. 
                 0.47 
                 0.625 
               
               
                 B9 
                 m 
                 24 
                 2.35 
                 &gt;100 
                 204 
                 Baker 
                 18 
                 RC 
                 c, d, g, h, hdm 
                 0.09 
                 n.d. 
               
               
                 B10 
                 m 
                 60 
                 3.44 
                 &lt;0.35 
                 73.3 
                 Confectioner 
                 46 
                 A, RC 
                 hdm, m 
                 0.44 
                 n.d. 
               
               
                 B11 
                 m 
                 22 
                 3 
                 &lt;0.35 
                 2509 
                 Baker 
                 5 
                 A, RC, U 
                 n.k. 
                 3.36 
                 0.0015 
               
               
                 B12 
                 m 
                 26 
                 &gt;100 
                 &gt;100 
                 321 
                 Baker-Confectioner 
                 5 
                 A, RC 
                 g 
                 0.5 
                 n.d. 
               
               
                 B13 
                 m 
                 54 
                 2.48 
                 &lt;0.35 
                 480 
                 Confectioner 
                 25 
                 A, RC 
                 n.k. 
                 0.12 
                 n.d. 
               
               
                 B14 
                 m 
                 60 
                 31.8 
                 &lt;0.35 
                 629 
                 Baker 
                 13 
                 A 
                 c, cr, d 
                 0.15 
                 0.002 
               
               
                 B15 
                 m 
                 27 
                 5.06 
                 42.2 
                 278 
                 Confectioner 
                 10 
                 A, RC 
                 c, cr, d, g 
                 0.079 
                 0.078 
               
               
                 B16 
                 f 
                 42 
                 3.71 
                 2.15 
                 271 
                 Pizza 
                 12 
                 A, RC, U 
                 g 
                 0.187 
                 0.625 
               
               
                 B17 
                 m 
                 54 
                 1.68 
                 &lt;0.35 
                 79.2 
                 Confectioner 
                 38 
                 A 
                 hdm 
                 16 
                 n.d. 
               
               
                 B18 
                 m 
                 59 
                 &lt;0.35 
                 &lt;0.35 
                 673 
                 Baker-Confectioner 
                 22 
                 A, RC 
                 n.k. 
                 0.23 
                 n.d. 
               
               
                 B19 
                 m 
                 26 
                 74.6 
                 57.4 
                 17.7 
                 Confectioner 
                 18 
                 A, RC 
                 g 
                 1.16 
                 0.15 
               
               
                 B20 
                 m 
                 43 
                 13.8 
                 11 
                 538 
                 Baker 
                 19 
                 A 
                 g, o 
                 0.25 
                 EAR 
               
               
                 B21 
                 f 
                 34 
                 2.05 
                 &lt;0.35 
                 229 
                 Confectioner 
                 2 
                 A 
                 hdm, o 
                 0.5 
                 DAR 
               
               
                 B22 
                 f 
                 41 
                 1.77 
                 &lt;0.35 
                 23.4 
                 Cook/pastry maker 
                 1 
                 A 
                 o 
                 0.23 
                 EAR 
               
               
                 B23 
                 f 
                 53 
                 0.41 
                 &lt;0.35 
                 469 
                 Homemaker 
                 n.k. 
                 n.k. 
                 n.k. 
                 n.d. 
                 n.d. 
               
               
                   
               
               
                 m: male, 
               
               
                 f: female, 
               
               
                 kUA/l: kilounit antigen per liter, 
               
               
                 n.k.: not known, 
               
               
                 A: Asthma, 
               
               
                 RC: Rhinoconjunctivitis, 
               
               
                 U: Urticaria, 
               
               
                 c: cat, 
               
               
                 cr: cockroach, 
               
               
                 d: dog, 
               
               
                 g: grass pollen, 
               
               
                 h: horse, 
               
               
                 hdm: house dust mite, 
               
               
                 m: molds, 
               
               
                 o: olive pollen, 
               
               
                 PC20: Methochaline inhalation challenge (positiv if &lt;16 mg/ml), 
               
               
                 SIC: specific inhalation challenge, 
               
               
                 EAR: early athmatic response, 
               
               
                 DAR: dual asthmatic response, 
               
               
                 LAR: late asthmatic response, 
               
               
                 n.d.: not done 
               
             
          
         
       
     
         [0000]    
       
         
               
             
               
               
               
               
               
               
               
               
               
             
               
               
               
               
               
               
               
               
               
             
           
               
                 TABLE VIII 
               
             
             
               
                   
               
               
                 Demographic, clinical and serological characteristics of patients suffering from food 
               
             
          
           
               
                   
                   
                   
                 Wheat flour 
                 
                   Phleum pratense 
                 
                   
                   
                   
                   
               
               
                 Patient 
                 Sex 
                 Age 
                 IgE kUA/l 
                 IgE kUA/l 
                 Total IgE kU/l 
                 Symptoms 
                 DBPCFC 
                 Other allergies 
               
               
                   
               
             
          
           
               
                 F1 
                 f 
                 56 
                 0.74 
                 &lt;0.35 
                 820 
                 U 
                 n.d. 
                 s 
               
               
                 F2 
                 f 
                 50 
                 0.78 
                 &lt;0.35 
                 275 
                 Ab, CJ, Di, P 
                 n.d. 
                 hdm 
               
               
                 F3 
                 f 
                 49 
                 &gt;100 
                 0.65 
                 1794 
                 no symtoms-diet 
                 n.d. 
                 g, hdm, n, sh 
               
               
                 F4 
                 f 
                 72 
                 5.99 
                 &lt;0.35 
                 325 
                 E, D, P 
                 n.d. 
                 he, n, s 
               
               
                 F5 
                 f 
                 11 
                 2.15 
                 3.28 
                 11 
                 A, C, Ri 
                 n.d. 
                 g, n, s, o 
               
               
                 F6 
                 f 
                 40 
                 1.9 
                 &lt;0.35 
                 19.3 
                 C, CJ, S 
                 n.d. 
                 n.k. 
               
               
                 F7 
                 m 
                 11 
                 0.92 
                 1.21 
                 118 
                 n.k. 
                 n.d. 
                 g, n, s 
               
               
                 F8 
                 m 
                 24 
                 5.76 
                 &lt;0.35 
                 111 
                 C, CJ, N, R 
                 n.d. 
                 n.k. 
               
               
                 F9 
                 f 
                 21 
                 1.22 
                 25.8 
                 94.6 
                 C, N, P, R 
                 n.d. 
                 g 
               
               
                 F10 
                 f 
                 5 
                 1.93 
                 34.3 
                 453 
                 RC 
                 n.d. 
                 a, b, cm, g, n 
               
               
                 F11 
                 f 
                 29 
                 1.55 
                 10.4 
                 101 
                 De, Ri 
                 n.d. 
                 c, b, g, p 
               
               
                 F12 
                 f 
                 45 
                 5.72 
                 1.12 
                 30.1 
                 A, C, D, blisters on tongue 
                 n.d. 
                 g, n, s, r 
               
               
                 F13 
                 m 
                 7 
                 2.8 
                 &gt;100 
                 &lt;2000 
                 B, RC 
                 n.d. 
                 a, b, g 
               
               
                 F14 
                 f 
                 1 
                 0.81 
                 n.d. 
                 46.3 
                 n.k. 
                 n.d. 
                 cm, he 
               
               
                 F15 
                 f 
                 28 
                 1.27 
                 &gt;100 
                 616 
                 n.k. 
                 n.d. 
                 a, cm, g, l, m 
               
               
                 F16 
                 m 
                 50 
                 7.57 
                 22.6 
                 450 
                 A, C, D, N, RC 
                 n.d. 
                 b, g 
               
               
                 F17 
                 f 
                 51 
                 3.97 
                 5.12 
                 44.1 
                 Di, F 
                 n.d. 
                 f, g, n 
               
               
                 F18 
                 f 
                 43 
                 1.03 
                 58.3 
                 338 
                 C 
                 n.d. 
                 b, g, h, n, s 
               
               
                 F19 
                 f 
                 19 
                 20.5 
                 &lt;0.35 
                 949 
                 A, C, D, R 
                 n.d. 
                 n.k. 
               
               
                 F20 
                 f 
                 57 
                 17.6 
                 &lt;0.35 
                 174 
                 n.k. 
                 n.d. 
                 n.k. 
               
               
                 F21 
                 m 
                 12 
                 0.81 
                 1.47 
                 769 
                 A, RC 
                 n.d. 
                 he, g, w 
               
               
                 F22 
                 f 
                 55 
                 2.11 
                 &lt;0.35 
                 152 
                 no symtoms-diet 
                 n.d. 
                 n, sea 
               
               
                 F23 
                 m 
                 43 
                 4.24 
                 2.41 
                 207 
                 n.k. 
                 n.d. 
                 n.k. 
               
               
                 F24 
                 f 
                 33 
                 1.65 
                 &lt;0.35 
                 253 
                 n.k. 
                 n.d. 
                 n.k. 
               
               
                 F25 
                 m 
                 51 
                 1.64 
                 &gt;100 
                 45 
                 n.k. 
                 n.d. 
                 n.k. 
               
               
                 F26 
                 m 
                 27 
                 6.11 
                 67.7 
                 974 
                 C, Cj, D, Ri, in the past A 
                 n.d. 
                 ca, he, g, ce, sp 
               
               
                 F27 
                 f 
                 9 
                 6.47 
                 &gt;100 
                 1233.5 
                 E, Ri 
                 + 
                 n.k. 
               
               
                 F28 
                 m 
                 0.5 
                 7.39 
                 &lt;0.35 
                 65.2 
                 E, U, Wheezing 
                 + 
                 n.k. 
               
               
                 F29 
                 f 
                 1 
                 33.5 
                 &lt;0.35 
                 201 
                 Redness, itching 
                 + 
                 cm, he 
               
               
                 F30 
                 f 
                 1 
                 10 
                 n.d. 
                 25.5 
                 U, itching 
                 + 
                 cm, he, s 
               
               
                 F31 
                 m 
                 1 
                 18.6 
                 n.d. 
                 1343 
                 U 
                 + 
                 s 
               
               
                 F32 
                 m 
                 1 
                 35.1 
                 0.83 
                 325 
                 U, Ri, itching 
                 + 
                 g, s 
               
               
                 F33 
                 f 
                 1 
                 4.27 
                 &lt;0.35 
                 38.4 
                 U, Ri, Redness 
                 + 
                 n.k. 
               
               
                 F34 
                 f 
                 0.5 
                 21.3 
                 &lt;0.35 
                 1511 
                 U 
                 + 
                 cm 
               
               
                 F35 
                 f 
                 1 
                 5.21 
                 n.d. 
                 1718 
                 AD, G, U 
                 + 
                 cm 
               
               
                 F36 
                 m 
                 1 
                 61.4 
                 0.69 
                 876 
                 Redness, itching 
                 + 
                 g, cm 
               
               
                 F37 
                 m 
                 1 
                 52 
                 0.38 
                 254 
                 Ri, U 
                 + 
                 cm, he, g 
               
               
                 F38 
                 f 
                 0.5 
                 94.4 
                 1.9 
                 1524 
                 De, Ri, 
                 open challenge, + 
                 n.k. 
               
               
                   
               
               
                 m: male, 
               
               
                 f: female, 
               
               
                 n.k.: not known, 
               
               
                 n.d.: not done, 
               
               
                 kUA/l: kilounit antigen per liter, 
               
               
                 A: Asthma, 
               
               
                 Ab: Abdominaigia, 
               
               
                 B: Bronohitis, 
               
               
                 C: Cough, 
               
               
                 CJ: Conjunctivitis, 
               
               
                 D: Dyspnea, 
               
               
                 De: Dermatitis, 
               
               
                 Di: Diahmoe, 
               
               
                 E: Eczema, 
               
               
                 F: Flatulence, 
               
               
                 G: Gastro-intestinal symptoms, 
               
               
                 N: Nasal congestion, 
               
               
                 P: Pruritus, 
               
               
                 R: Rhinorrhos, 
               
               
                 RC: Rhinoconjunctivitis, 
               
               
                 Ri: Rhinitis, 
               
               
                 S: Scre throat, 
               
               
                 U: Urticaria, 
               
               
                 V: Vertigo, 
               
               
                 Vo: Vomiting, 
               
               
                 DBPCFC: double bind placebo controlled food challenge, 
               
               
                 a: artsmisia, 
               
               
                 b: birch pollen, 
               
               
                 o: oat, 
               
               
                 ca: caroites, 
               
               
                 cm: cows milk, 
               
               
                 f: formeldehyd, 
               
               
                 g: grass pollen, 
               
               
                 h: hazelnut, 
               
               
                 he: hens egg, 
               
               
                 hdm: house dust mite, 
               
               
                 l: latex, 
               
               
                 m: malt, 
               
               
                 n: nuts, 
               
               
                 o: orange, 
               
               
                 p: plum, 
               
               
                 r: rice, 
               
               
                 s: soybean, 
               
               
                 ce: celery, 
               
               
                 sea: seafood, 
               
               
                 sh: shrimps, 
               
               
                 sp: spices, 
               
               
                 w: wesp 
               
             
          
         
       
     
         [0000]    
       
         
               
             
               
               
               
               
               
               
               
               
             
               
               
               
               
               
               
               
               
             
           
               
                 TABLE IX 
               
             
             
               
                   
               
               
                 Demographic, clinical and serological characteristics of patients suffering from grass 
               
             
          
           
               
                   
                   
                   
                 
                   Phleum pratense 
                 
                 Wheat flour 
                   
                   
                   
               
               
                 Patient 
                 Sex 
                 Age 
                 IgE kUA/l 
                 IgE kUA/l 
                 Total IgE kU/l 
                 Symptoms 
                 Other allergies 
               
               
                   
               
             
          
           
               
                 G1 
                 m 
                 22 
                 37.8 
                 1.13 
                 529 
                 D, RC, U 
                 c, b, d, hdm, s 
               
               
                 G2 
                 m 
                 30 
                 44.6 
                 0.52 
                 290 
                 D, RC 
                 b, a, hdm, d 
               
               
                 G3 
                 f 
                 25 
                 59.8 
                 &lt;0.35 
                 1004 
                 RC 
                 b, d, hdm, h, ce 
               
               
                 G4 
                 m 
                 n.k. 
                 25.9 
                 3.62 
                 140 
                 RC 
                 a, b 
               
               
                 G5 
                 f 
                 22 
                 37.2 
                 &lt;0.35 
                 566 
                 R 
                 b, c, hdm 
               
               
                 G6 
                 f 
                 22 
                 22.4 
                 &lt;0.35 
                 77.4 
                 RC 
                 hdm, r 
               
               
                 G7 
                 m 
                 24 
                 30.8 
                 &lt;0.35 
                 60.8 
                 n.k. 
                 n.k. 
               
               
                 G8 
                 m 
                 35 
                 9.92 
                 &lt;0.35 
                 88.8 
                 D 
                 b 
               
               
                 G9 
                 m 
                 36 
                 20.7 
                 0.45 
                 128 
                 R 
                 ap, b, hdm 
               
               
                 G10 
                 f 
                 22 
                 &gt;100 
                 4.13 
                 &gt;5000 
                 RC 
                 b, c, hdm, rye 
               
               
                 G11 
                 m 
                 41 
                 49.3 
                 4.01 
                 &gt;2000 
                 A, CJ 
                 a, b, c, hdm 
               
               
                 G12 
                 m 
                 37 
                 n.d. 
                 1.11 
                 243 
                 n.k. 
                 n.k. 
               
               
                 G13 
                 m 
                 28 
                 39.3 
                 1.06 
                 144 
                 RC 
                 b, a 
               
               
                 G14 
                 f 
                 27 
                 &gt;100 
                 &lt;0.35 
                 260 
                 A, RC 
                 n.k. 
               
               
                 G15 
                 m 
                 39 
                 &gt;100 
                 11.1 
                 401 
                 n.k. 
                 n.k. 
               
               
                 G16 
                 m 
                 54 
                 &gt;100 
                 9.93 
                 1528 
                 A, CJ 
                 n.k. 
               
               
                 G17 
                 m 
                 45 
                 n.d. 
                 1.76 
                 175 
                 RC 
                 d, hdm, s, p 
               
               
                   
               
               
                 m: male, 
               
               
                 f: female, 
               
               
                 n.k.: not known, 
               
               
                 n.d.: not done, 
               
               
                 kUA/l: kilounit antigen per liter, 
               
               
                 A: Asthma, 
               
               
                 CJ: Conjunctivitis, 
               
               
                 D: Dyspnea, 
               
               
                 RC: Rhinoconjunctivitis, 
               
               
                 R: Rhinitis, 
               
               
                 U: Urticaria, 
               
               
                 a: artemisia, 
               
               
                 ap: apple, 
               
               
                 b: birch pollen, 
               
               
                 c: cat, 
               
               
                 d: dog, 
               
               
                 h: hazelnut, 
               
               
                 hdm: house dust mite, 
               
               
                 r: rabbit, 
               
               
                 s: soybean, 
               
               
                 ce: celery, 
               
               
                 p: potato 
               
             
          
         
       
     
       REFERENCES 
       [0000]    
       
         1. Quirce, S., M. Fernandez-Nieto, C. Escudero, J. Cuesta, M. de Las Heras, and J. Sastre. 2006. Bronchial responsiveness to bakery-derived allergens is strongly dependent on specific skin sensitivity.  Allergy  61:1202-1208. 
         2. Constantin, C., W. D. Huber, G. Granditsch, M. Weghofer, and R. Valenta. 2005. Different profiles of wheat antigens are recognised by patients suffering from coeliac disease and IgE-mediated food allergy.  Int Arch Allergy Immunol  138:257-266. 
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