# Kiwifruit Allergy--Molecular Basis, Diagnostics and Treatment
## 6 Patterns of Sensitization in Kiwifruit Allergy
He tried kiwifruit based on no clinical history of an allergy. No known cofactors were identified. Anaphylaxis was experienced after eating \begin{table}
\begin{tabular}{c c c c c c} \hline  & & & **IgE Titer (kUA/mL)** & \\ \hline
**Allergen** & **Protein** & **Patient 1** & **Patient 2** & **Patient 3** & **Patient 4** \\ \hline
**Act d 1** & Cysteine protease & & 8.16 & & \\
**Act d 2** & TLP & & & 10.32 & \\
**Act d 5** & Kiwellin & & & 4.65 & \\
**Act d 10** & nsLTP & 3.47 & & 16.88 & \\
**Aln g 1** & PR-10 & & 1.54 & & 35.63 \\
**Alt a 1** & & & & 5.45 & \\
**Api g 1** & PR-10 & & & 0.77 & 6.91 \\
**Api g 2** & nsLTP & 1.23 & & & \\
**Api g 6** & nsLTP & 1.57 & & 0.72 & \\
**Ara h 1** & 7/8 globulin & & & 4.65 & \\
**Ara h 6** & 2S albumin & & & 0.97 & \\
**Ara h 8** & PR-10 & & 1.59 & 8.26 & 26.13 \\
**Ara h 9** & nsLTP & 5.88 & & 10.44 & \\
**Art v 3** & nsLTP & 10.45 & & & \\
**Bet v 1** & PR-10 & & 23.79 & 39.79 & 38.32 \\
**Bet v 2** & Profilin & & & 7.99 \\
**Can s 3** & nsLTP & 1.38 & & & \\
**Cor a 1.0103** & PR-10 & & 4.64 & 17.33 & 38.08 \\
**Cor a 1.0401** & PR-10 & & 2.99 & 5.51 & 27.13 \\
**Cor a 11** & 7/8 globulin & & & 3.29 & \\
**Cor a 8** & nsLTP & 4.08 & & 1.31 & \\
**Cor a 9** & 11S globulin & & & 6.26 & \\
**Cuc m 2** & Profilin & & & 24.43 & \\
**Dau c 1** & PR-10 & & & 6.08 \\
**Fag s 1** & PR-10 & & 4.31 & 7.23 & 23.49 \\
**Fra a 1 + 3** & PR-10 + nsLTP & 1.04 & 0.89 & 9.12 & 10.48 \\
**Gly m 4** & PR-10 & & 3.18 & 9.83 & 26.68 \\
**Hev b 8** & Profilin & & & 6.26 \\
**Jug r 3** & nsLTP & 0.57 & & & \\
**Jug r 4** & 11S globulin & & & 11.47 & \\
**Mal d 1** & PR-10 & & 0.93 & 0.67 & 16.36 \\
**Mal d 3** & nsLTP & 4.03 & & 2.24 & \\
**Mer a 1** & Profilin & & & 13.90 \\
**Phil p 12** & Profilin & & & 8.32 \\
**Pho d 2** & Profilin & & & 19.87 \\
**Pis v 2** & 11S globulin & & & 1.84 & \\
**Pis v 3** & 7/8 globulin & & & 4.48 & \\
**Pla a 3** & nsLTP & 1.01 & & & \\
**Pru p 3** & nsLTP & 5.16 & & 1.60 & \\
**Ses i 1** & & & & 0.53 & \\
**Sola l 6** & nsLTP & 2.16 & & 2.01 & \\
**Tria a 14** & nsLTP & 1.17 & & & \\
**Vit v 1** & nsLTP & 4.06 & & & \\
**Zea m 14** & nsLTP & 10.58 & & 15.68 & \\ \hline \end{tabular}
\end{table} 
Table 2: Examples of sensitization profiles obtained using ALEX\({}^{2}\). Only IgE titers higher than 0.3 kUA/mL are shown. fresh, raw kiwifruit, this being an example of the real-life problem of the selection of an individual protein as an exclusive culprit of anaphylaxis. The patient showed sensitization to PR-10, but it is an unlikely cause of anaphylaxis due to protein instability. One candidate is nsLTP, a second is TLP, and a third is 11S globulins or 2S albumins. Sensitization to TLP is also associated with sensitization to Alt a 1. _Patient 4:_ An 18-year-old male suffered from allergic rhinitis and conjunctivitis for more than 12 years. The rhinitis and conjunctivitis symptoms increased during tree pollen season (March-May). Symptoms of PFAS were noted to hazelnuts, apples, cherries, soy milk, and fresh, raw kiwifruit. Unfortunately, both PR-10 and profilin can be a culprit in PFAS. The patient profile showed no sensitization to Act d 1, Act d 2, cross-reactive nsLTP, 11S globulins, or 2S albumins.