Marker allergen

The determination of marker or major allergens allows the distinction between genuine sensitization and cross-reactivity. Only by detecting IgE reactivity to specific allergens is a balanced clinical interpretation of an allergological test result possible.

The following marker allergens are of particular interest for routine allergological assessment:

• Bet v 1- for birch pollen
• Ole e 1 for olive and ash pollen
• Pla a 1 for sycamore pollen
• Cup a 1 for cypress pollen
• Phl p 1, Phl p 2 , Phl p 5 , Phl p 6 , Phl p 11 for grass pollen
• Type v 1 for mugwort pollen
• Amb a 1 for ambrosia pollen
• Pla l 1 for ribwort
• Che a 1 for goosefoot

In pollen-allergic patients who have, for example, a serological and/or skin reactivity to different types of allergens, it is recommended to use a pollen test. This constellation can indicate a genuine sensitization or a cross-reactivity to so-called cross-reactive panallergens. Such panallergens are e.g.: Profiline (Bet v 2, Phl p 12, Amb a 8 and others) or Polcalcine (Bet v 4, Phl p 12 and others).

For example, proteins of the Bet v 1 family are widely distributed in the plant kingdom. They have a relevant allergenic significance. Sensitizations (mostly secondary sensitizations) to PR-10 proteins are mostly based on cross sensitizations due to their homology. Their primary sensitization is often birch pollen - triggered. Clinically, the sensitizations are associated with allergic reactions to pollen, fruit and vegetables.
Representatives of the Bet v 1 family are:

• Api G I Apium graveolens (Celery)
• Macaw h 8 Arachis hypogaea (peanut)
• Cor a 1 Corylus avellana (hazelnut)
• Fra a 1 Fragaria ananassa (strawberry)
• Mal d 1 Malus domestica (cultivated apple)
• Pru du 1 Almond (Prunus amydalus)

1. Jakob T et al (2015) Molecular allergy diagnostics in multiplex procedure. Allergo J Int 24: 42-54