Component-resolved diagnostics study on nut sensitization and cross-reactivity in China - 22/10/25

Doi : 10.1016/j.rmed.2025.108365

Wenting Luo ^a,^{^{1
Wenting Luo, Xianhui Zheng, Jiale Zhang, Aoli Li, Jing Wu, Jinhai Ma, Yan Zhao, Xin Sun, Chunhua Wei, Huali Ren, Siqin Wang, Hong Zhang, Yun Sun, Guoping Li, Jianxin Su, Dongming Huang, Ting Chen, Jinni Chen, Huashou Ke, Xiangping Ma, Bing Wan should be considered co-first authors.}}, Xianhui Zheng ^a,^{^{1
Wenting Luo, Xianhui Zheng, Jiale Zhang, Aoli Li, Jing Wu, Jinhai Ma, Yan Zhao, Xin Sun, Chunhua Wei, Huali Ren, Siqin Wang, Hong Zhang, Yun Sun, Guoping Li, Jianxin Su, Dongming Huang, Ting Chen, Jinni Chen, Huashou Ke, Xiangping Ma, Bing Wan should be considered co-first authors.}}, Jiale Zhang ^a,^{^{1
Wenting Luo, Xianhui Zheng, Jiale Zhang, Aoli Li, Jing Wu, Jinhai Ma, Yan Zhao, Xin Sun, Chunhua Wei, Huali Ren, Siqin Wang, Hong Zhang, Yun Sun, Guoping Li, Jianxin Su, Dongming Huang, Ting Chen, Jinni Chen, Huashou Ke, Xiangping Ma, Bing Wan should be considered co-first authors.}}, Aoli Li ^a,^{^{1
Wenting Luo, Xianhui Zheng, Jiale Zhang, Aoli Li, Jing Wu, Jinhai Ma, Yan Zhao, Xin Sun, Chunhua Wei, Huali Ren, Siqin Wang, Hong Zhang, Yun Sun, Guoping Li, Jianxin Su, Dongming Huang, Ting Chen, Jinni Chen, Huashou Ke, Xiangping Ma, Bing Wan should be considered co-first authors.}}, Jing Wu ^b,^{^{1
Wenting Luo, Xianhui Zheng, Jiale Zhang, Aoli Li, Jing Wu, Jinhai Ma, Yan Zhao, Xin Sun, Chunhua Wei, Huali Ren, Siqin Wang, Hong Zhang, Yun Sun, Guoping Li, Jianxin Su, Dongming Huang, Ting Chen, Jinni Chen, Huashou Ke, Xiangping Ma, Bing Wan should be considered co-first authors.}}, Jinhai Ma ^c,^{^{1
Wenting Luo, Xianhui Zheng, Jiale Zhang, Aoli Li, Jing Wu, Jinhai Ma, Yan Zhao, Xin Sun, Chunhua Wei, Huali Ren, Siqin Wang, Hong Zhang, Yun Sun, Guoping Li, Jianxin Su, Dongming Huang, Ting Chen, Jinni Chen, Huashou Ke, Xiangping Ma, Bing Wan should be considered co-first authors.}}, Yan Zhao ^d,^{^{1
Wenting Luo, Xianhui Zheng, Jiale Zhang, Aoli Li, Jing Wu, Jinhai Ma, Yan Zhao, Xin Sun, Chunhua Wei, Huali Ren, Siqin Wang, Hong Zhang, Yun Sun, Guoping Li, Jianxin Su, Dongming Huang, Ting Chen, Jinni Chen, Huashou Ke, Xiangping Ma, Bing Wan should be considered co-first authors.}}, Xin Sun ^e,^{^{1
Wenting Luo, Xianhui Zheng, Jiale Zhang, Aoli Li, Jing Wu, Jinhai Ma, Yan Zhao, Xin Sun, Chunhua Wei, Huali Ren, Siqin Wang, Hong Zhang, Yun Sun, Guoping Li, Jianxin Su, Dongming Huang, Ting Chen, Jinni Chen, Huashou Ke, Xiangping Ma, Bing Wan should be considered co-first authors.}}, Chunhua Wei ^f,^{^{1
Wenting Luo, Xianhui Zheng, Jiale Zhang, Aoli Li, Jing Wu, Jinhai Ma, Yan Zhao, Xin Sun, Chunhua Wei, Huali Ren, Siqin Wang, Hong Zhang, Yun Sun, Guoping Li, Jianxin Su, Dongming Huang, Ting Chen, Jinni Chen, Huashou Ke, Xiangping Ma, Bing Wan should be considered co-first authors.}}, Huali Ren ^g,^{^{1
Wenting Luo, Xianhui Zheng, Jiale Zhang, Aoli Li, Jing Wu, Jinhai Ma, Yan Zhao, Xin Sun, Chunhua Wei, Huali Ren, Siqin Wang, Hong Zhang, Yun Sun, Guoping Li, Jianxin Su, Dongming Huang, Ting Chen, Jinni Chen, Huashou Ke, Xiangping Ma, Bing Wan should be considered co-first authors.}}, Siqin Wang ^h,^{^{1
Wenting Luo, Xianhui Zheng, Jiale Zhang, Aoli Li, Jing Wu, Jinhai Ma, Yan Zhao, Xin Sun, Chunhua Wei, Huali Ren, Siqin Wang, Hong Zhang, Yun Sun, Guoping Li, Jianxin Su, Dongming Huang, Ting Chen, Jinni Chen, Huashou Ke, Xiangping Ma, Bing Wan should be considered co-first authors.}}, Hong Zhang ^i,^{^{1
Wenting Luo, Xianhui Zheng, Jiale Zhang, Aoli Li, Jing Wu, Jinhai Ma, Yan Zhao, Xin Sun, Chunhua Wei, Huali Ren, Siqin Wang, Hong Zhang, Yun Sun, Guoping Li, Jianxin Su, Dongming Huang, Ting Chen, Jinni Chen, Huashou Ke, Xiangping Ma, Bing Wan should be considered co-first authors.}}, Yun Sun ^j,^{^{1
Wenting Luo, Xianhui Zheng, Jiale Zhang, Aoli Li, Jing Wu, Jinhai Ma, Yan Zhao, Xin Sun, Chunhua Wei, Huali Ren, Siqin Wang, Hong Zhang, Yun Sun, Guoping Li, Jianxin Su, Dongming Huang, Ting Chen, Jinni Chen, Huashou Ke, Xiangping Ma, Bing Wan should be considered co-first authors.}}, Guoping Li ^k,^{^{1
Wenting Luo, Xianhui Zheng, Jiale Zhang, Aoli Li, Jing Wu, Jinhai Ma, Yan Zhao, Xin Sun, Chunhua Wei, Huali Ren, Siqin Wang, Hong Zhang, Yun Sun, Guoping Li, Jianxin Su, Dongming Huang, Ting Chen, Jinni Chen, Huashou Ke, Xiangping Ma, Bing Wan should be considered co-first authors.}}, Jianxin Sun ^l,^{^{1
Wenting Luo, Xianhui Zheng, Jiale Zhang, Aoli Li, Jing Wu, Jinhai Ma, Yan Zhao, Xin Sun, Chunhua Wei, Huali Ren, Siqin Wang, Hong Zhang, Yun Sun, Guoping Li, Jianxin Su, Dongming Huang, Ting Chen, Jinni Chen, Huashou Ke, Xiangping Ma, Bing Wan should be considered co-first authors.}}, Dongming Huang ^m,^{^{1
Wenting Luo, Xianhui Zheng, Jiale Zhang, Aoli Li, Jing Wu, Jinhai Ma, Yan Zhao, Xin Sun, Chunhua Wei, Huali Ren, Siqin Wang, Hong Zhang, Yun Sun, Guoping Li, Jianxin Su, Dongming Huang, Ting Chen, Jinni Chen, Huashou Ke, Xiangping Ma, Bing Wan should be considered co-first authors.}}, Ting Chen ^n,^{^{1
Wenting Luo, Xianhui Zheng, Jiale Zhang, Aoli Li, Jing Wu, Jinhai Ma, Yan Zhao, Xin Sun, Chunhua Wei, Huali Ren, Siqin Wang, Hong Zhang, Yun Sun, Guoping Li, Jianxin Su, Dongming Huang, Ting Chen, Jinni Chen, Huashou Ke, Xiangping Ma, Bing Wan should be considered co-first authors.}}, Jinni Chen ^o,^{^{1
Wenting Luo, Xianhui Zheng, Jiale Zhang, Aoli Li, Jing Wu, Jinhai Ma, Yan Zhao, Xin Sun, Chunhua Wei, Huali Ren, Siqin Wang, Hong Zhang, Yun Sun, Guoping Li, Jianxin Su, Dongming Huang, Ting Chen, Jinni Chen, Huashou Ke, Xiangping Ma, Bing Wan should be considered co-first authors.}}, Huashou Ke ^p,^{^{1
Wenting Luo, Xianhui Zheng, Jiale Zhang, Aoli Li, Jing Wu, Jinhai Ma, Yan Zhao, Xin Sun, Chunhua Wei, Huali Ren, Siqin Wang, Hong Zhang, Yun Sun, Guoping Li, Jianxin Su, Dongming Huang, Ting Chen, Jinni Chen, Huashou Ke, Xiangping Ma, Bing Wan should be considered co-first authors.}}, Xiangping Ma ^q,^{^{1
Wenting Luo, Xianhui Zheng, Jiale Zhang, Aoli Li, Jing Wu, Jinhai Ma, Yan Zhao, Xin Sun, Chunhua Wei, Huali Ren, Siqin Wang, Hong Zhang, Yun Sun, Guoping Li, Jianxin Su, Dongming Huang, Ting Chen, Jinni Chen, Huashou Ke, Xiangping Ma, Bing Wan should be considered co-first authors.}}, Bing Wan ^r,^{^{1
Wenting Luo, Xianhui Zheng, Jiale Zhang, Aoli Li, Jing Wu, Jinhai Ma, Yan Zhao, Xin Sun, Chunhua Wei, Huali Ren, Siqin Wang, Hong Zhang, Yun Sun, Guoping Li, Jianxin Su, Dongming Huang, Ting Chen, Jinni Chen, Huashou Ke, Xiangping Ma, Bing Wan should be considered co-first authors.}}, Baoqing Sun ^a,^⁎
^a Department of Allergy and Clinical Immunology, Department of Laboratory, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
^b Department of Allergy and Clinical Immunology, Inner Mongolia Cancer Hospital, Inner Mongolia, China
^c Ningxia Medical University General Hospital, Yinchuan, China
^d Department of Allergy, The First Affiliated Hospital, Harbin Medical University, Harbin, China
^e Department of Pediatrics, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
^f Weifang Weien Hospital, Weifang, China
^g Department of Allergy, State Grid Beijing Electric Power Hospital, Capital Medical University Electric Power Teaching Hospital, Beijing, China
^h Henan Provincial People's Hospital, Zhengzhou, China
ⁱ Department of Pediatrics, Gansu Provincial Hospital, Lanzhou, China
^j Department of Pediatrics, Yinchuan Maternal and Child Health Care Hospital, Yinchuan, China
^k Laboratory of Allergy and Precision Medicine, Department of Pulmonary and Critical Care Medicine, Chengdu Institute of Respiratory Health, Chengdu Third People's Hospital Branch of National Clinical Research Center for Respiratory Disease, Chengdu, China
^l The Second People's Hospital of Zhaoqing, China
^m Department of Pediatrics, Boai Hospital of Zhongshan City, Zhongshan, China
ⁿ Shengli Clinical Medical College of Fujian Medical University, Department of Otorhinolaryngology Head and Neck Surgery, Fujian Provincial Hospital, Fuzhou, China
^o Hainan Maternal and Children's Medical Center, Haikou, China
^p Maoming Maternal and Child Health Hospital, Maoming, China
^q First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
^r Department of Pulmonary and Critical Care Medicine, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China

^⁎Corresponding author. Department of Allergy and Clinical Immunology, Department of Laboratory, National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiangxi Road, Guangzhou, Guangdong, 510120, China.Department of Allergy and Clinical ImmunologyDepartment of LaboratoryNational Center for Respiratory MedicineNational Clinical Research Center for Respiratory DiseaseState Key Laboratory of Respiratory DiseaseGuangzhou Institute of Respiratory Health First Affiliated Hospital of Guangzhou Medical University151 Yanjiangxi RoadGuangzhouGuangdong510120China

Abstract

Purpose

Nut sensitization in China remains insufficiently characterized. Component-resolved diagnosis (CRD) technology offers the ability to distinguish true food allergies from pollen-induced cross-sensitizations while avoiding the risks of oral food challenge (OFC) tests. This study aims to explore and validate the major allergenic components and patterns of cross-reactivity between nuts and pollens in patients with pollen-food allergy syndrome (PFAS).

Methods

This study evaluated the sensitization profiles of 104 patients with self-reported PFAS, focusing on crude extracts and major allergenic components of pollen and nuts. In addition, the presence of cross-reactive carbohydrate determinants (CCDs) was tested to determine if the specific immunoglobulin E (sIgE) detection of these plant allergens was influenced by non-specific reactions causing false positives. Furthermore, we conducted serum inhibition assays to explore the cross-reactivity between pollen and nut allergens.

Results

The majority of PFAS patients were from northern China, where sensitization to weed pollen, particularly mugwort, was more prevalent than to tree pollen or grass pollens. Hazelnut and walnut were identified as the most frequently sensitizing nut allergens, whereas sensitization rates to other nuts were markedly lower. CRD combined with serum inhibition assays demonstrated a common cross-sensitization between pollen and nut allergens. Notably, the hazelnut component Cor a 1-sIgE was significantly inhibited by birch pollen and its component Bet v 1, while Cor a 8-sIgE showed effective inhibition by mugwort pollen and its component Art v 3.

Conclusions

This is the first study to comprehensively evaluate nut sensitization and its key allergenic components in Chinese PFAS patients, confirming substantial cross-sensitization with pollen allergens. Specifically, birch and mugwort pollen significantly inhibited IgE binding to hazelnut. These findings provide component-resolved insights into the prevalence and mechanisms of nut allergies in China, enhancing our understanding of the allergenic landscape and informing clinical diagnosis and management strategies.

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Graphical abstract

Image 1

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Highlights

•	This study fills a knowledge gap regarding nut sensitization in Chinese patients with pollen-food allergy syndrome.
•	This study links exposure to mugwort and birch pollen with nut sensitization in clinical settings.
•	This study demonstrates cross-reactivity and the major components between pollen and nut allergens through component-resolved diagnostics.
•	This study supports tailored approaches for allergy diagnosis and management in regions with high pollen exposure.

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Keywords : Pollen-food allergy syndrome, Nut sensitization, Component-resolved diagnosis, Cross-reactivity, Inhibition test

Plan

Introduction

Methods

Study design

Blood sample collection and testing

Allergen sIgE inhibition test

Statistical analysis

Results

Clinical characteristics of PFAS patients

sIgE sensitization to crude extracts of plant-derived allergens

sIgE sensitization to allergen components

Co-sensitization patterns and correlations between nut and pollen allergens

sIgE inhibition test of pollen allergen proteins on nut sensitization

sIgE inhibition test of pollen and components proteins on hazelnut sensitization components

Discussion

CRediT authorship contribution statement

Informed consent statement

Institutional review board statement

Data availability statement

Funding source

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Article 108365- novembre 2025 Retour au numéro

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Component-resolved diagnostics study on nut sensitization and cross-reactivity in China - 22/10/25

Abstract

Purpose

Methods

Results

Conclusions

Graphical abstract

Highlights

Plan

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