Objective:To investigate the clinical characteristics and major allergens of patients with pollen-food allergy syndrome（PFAS） and their correlation with the severity of symptoms, and to provide a basis for identifying high-risk patients, optimizing the allergen testing process and developing individualized dietary management strategies. Methods:The clinical data of 166 patients with PFAS admitted to our hospital from January 2021 to July 2023 were retrospectively analyzed. The clinical symptoms, pollen types and food allergy of the patients were analyzed by questionnaire survey and serum specific IgE detection. phi coefficient, Apriori algorithm modeling and multivariate logistic regression analysis were used to evaluate the association between allergen and symptom severity. Results:Artemisia pollen was the most common allergen in this area, with a positive rate of 96.39%. Peach and mango were the most common food allergens, which caused allergic reactions in 24.10% and 22.89% of patients, respectively. Oral mucosal symptoms were the main symptoms. Correlation analysis showed that there was a correlation between pollen allergens and allergenic food. Association rule analysis showed that when the patient was allergic to the combination of peanuts and trees, the probability of high severity of symptoms was 82.35%. Multivariate analysis showed that ragweed allergy was significantly positively correlated with the severity of PFAS symptoms. Conclusion:Artemisia pollen and related food allergens play an important role in the pathogenesis of PFAS. Association rule mining and network map analysis revealed direct associations between peanut and tree combination allergy and symptom severity, as well as potential links between other inhaled allergens and specific food allergies. Ragweed and peach allergy are independent risk factors for the aggravation of PFAS symptoms, which can be used as early warning indicators. These results help to improve the screening of high-risk patients and the construction of regional allergen databases.
Humans ; Food Hypersensitivity/immunology* ; Allergens/immunology* ; Retrospective Studies ; Pollen/immunology* ; Cross Reactions ; Immunoglobulin E/blood* ; Rhinitis, Allergic, Seasonal/immunology* ; Artemisia/immunology* ; Male ; Female ; Adult ; Prunus persica/immunology* ; Arachis/immunology* ; Middle Aged ; Surveys and Questionnaires ; Oral Allergy Syndrome

Peanut, a major economic and oil crop known for the high protein and oil content, is extensively cultivated in China. Peanut plants have the ability to form nodules with rhizobia, where the nitrogenase converts atmospheric nitrogen into ammonia nitrogen that can be utilized by the plants. Analysis of nodule fixation is of positive significance for avoiding overapplication of chemical fertilizer and developing sustainable agriculture. In this study, AhNIGT1.2, a member of the NIGT family predominantly expressed in peanut nodules, was identified by bioinformatics analysis. Subsequent spatiotemporal expression analysis revealed that AhNIGT1.2 was highly expressed in nodules and showed significant responses to high nitrogen, low nitrogen, high phosphorus, low phosphorus, and rhizobia treatments. Histochemical staining indicated that the gene was primarily expressed in developing nodules and at the connection region between mature nodules and peanut roots. The fusion protein AhNIGT1.2-GFP was located in the nucleus of tobacco epidermal cells. The AhNIGT1.2-OE significantly increased the number of peanut nodules, while AhNIGT1.2-RNAi reduced the number of nodules, which suggested a positive regulatory role of AhNIGT1.2 in peanut nodulation. The AhNIGT1.2-OE in roots down-regulated the expression levels of NRT1.2, NRT2.4, NLP1, and NLP7, which indicated that AhNIGT1.2 influenced peanut nodulation by modulating nitrate transport and the expression of NLP genes. The transcriptome analysis of AhNIGT1.2-OE and control roots revealed that overexpressing AhNIGT1.2 significantly enriched the differentially expressed genes associated with nitrate response, nodulation factor pathway, enzymes for triterpene biosynthesis, and carotenoid biosynthesis. These findings suggest that AhNIGT1.2 play a key role in peanut nodulation by regulating nitrate transport and response and other related pathways. This study gives insights into the molecular mechanisms of nitrogen and phosphorus in regulating legume nodulation and nitrogen fixation, and sheds light on the development of legume crops that can efficiently fix nitrogen in high nitrogen environments.
Arachis/physiology* ; Nitrates/metabolism* ; Plant Proteins/physiology* ; Transcription Factors/metabolism* ; Plant Root Nodulation/physiology* ; Gene Expression Regulation, Plant ; Root Nodules, Plant/metabolism* ; Nitrogen Fixation

ACC oxidase (ACO) is one of the key enzymes that catalyze the synthesis of ethylene. Ethylene is involved in salt stress response in plants, and salt stress seriously affects the yield of peanut. In this study, AhACO genes were cloned and their functions were investigated with the aim to explore the biological function of AhACOs in salt stress response, and to provide genetic resources for the breeding of salt-tolerant varieties of peanut. AhACO1 and AhACO2 were amplified from the cDNA of salt-tolerant peanut mutant M29, respectively, and cloned into the plant expression vector pCAMBIA super1300. The recombinant plasmid was transformed into Huayu22 by pollen tube injection mediated by Agrobacterium tumefaciens. After harvest, the small slice cotyledon was separated from the kernel, and the positive seeds were screened by PCR. The expression of AhACO genes was analyzed by qRT-PCR, and the ethylene release was detected by capillary column gas chromatography. Transgenic seeds were sowed and then irrigated with NaCl solution, and the phenotypic changes of 21-day-seedings were recorded. The results showed that the growth of transgenic plants were better than that of the control group Huayu 22 upon salt stress, and the relative content of chlorophyll SPAD value and net photosynthetic rate (Pn) of transgenic peanuts were higher than those of the control group. In addition, the ethylene production of AhACO1 and AhACO2 transgenic plants were 2.79 and 1.87 times higher than that of control peanut, respectively. These results showed that AhACO1 and AhACO2 could significantly improve the salt stress tolerance of transgenic peanut.
Salt Tolerance/genetics* ; Arachis/genetics* ; Plant Breeding ; Ethylenes/metabolism* ; Plants, Genetically Modified/genetics* ; Gene Expression Regulation, Plant ; Plant Proteins/genetics*

To study the molecular mechanism of salt stress response of peanut small GTP binding protein gene AhRabG3f, a 1 914 bp promoter fragment upstream of the start codon of AhRabG3f gene (3f-P) from peanut was cloned. Subsequently, five truncated fragments (3f-P1-3f-P5) with lengths of 1 729, 1 379, 666, 510 and 179 bp were obtained through deletion at the 5' end, respectively. Plant expression vectors where these six promoter fragments were fused with the gus gene were constructed and transformed into tobacco by Agrobacterium-mediated method, respectively. GUS expression in transgenic tobacco and activity analysis were conducted. The gus gene expression can be detected in the transgenic tobacco harboring each promoter segment, among which the driving activity of the full-length promoter 3f-P was the weakest, while the driving activity of the promoter segment 3f-P3 was the strongest. Upon exposure of the transgenic tobacco to salt stress, the GUS activity driven by 3f-P, 3f-P1, 3f-P2 and 3f-P3 was 3.3, 1.2, 1.9 and 1.2 times compared to that of the transgenic plants without salt treatment. This suggests that the AhRabG3f promoter was salt-inducible and there might be positive regulatory elements between 3f-P and 3f-P3 in response to salt stress. The results of GUS activity driven by promoter fragments after salt treatment showed that elements included MYB and GT1 between 1 930 bp and 1 745 bp. Moreover, a TC-rich repeat between 682 bp and 526 bp might be positive cis-elements responsible for salt stress, and an MYC element between 1 395 bp and 682 bp might be a negative cis-element responsible for salt stress. This study may facilitate using the induced promoter to regulate the salt resistance of peanut.
Arachis/genetics* ; Fabaceae/genetics* ; GTP-Binding Proteins/metabolism* ; Gene Expression Regulation, Plant ; Glucuronidase/metabolism* ; Plant Proteins/metabolism* ; Plants, Genetically Modified/genetics* ; Salt Stress ; Stress, Physiological/genetics* ; Tobacco/genetics*

BACKGROUND: The prevalence of peanut allergy (PA) among children has increased significantly over the past decade. Even though the prevalence of PA in Singapore is considered low, peanut is the top trigger for food-induced anaphylaxis in Singaporean children.OBJECTIVE: To describe the demographic characteristics and clinical features of children with PA.METHODS: This is a 5-year retrospective review of children diagnosed with PA based on clinical history coupled with a positive skin prick test to peanut or positive oral food challenge results.RESULTS: There were 269 patients (53.9% males) with a clinical diagnosis of PA. The median age at first allergic presentation for the PA group was 24 months old, with interquartile range of 13–39 months. The most common form of peanut introduced was roasted peanut. The rate of peanut anaphylaxis was 7.1%. Concomitant tree nut sensitization was found in 32.3% of this cohort, predominantly to cashew nut. Majority of them have a personal history of atopy – 75.8% with eczema, 63.6% with allergic rhinitis, and 19.7% with asthma.CONCLUSION: This is the first large review of peanut-allergic children in Singapore. Prospective population-based studies are needed to establish the true prevalence and risk factors associated with the development of this potentially life-threatening condition.
Anacardium ; Anaphylaxis ; Arachis ; Asia ; Asthma ; Child ; Cohort Studies ; Diagnosis ; Eczema ; Humans ; Nuts ; Peanut Hypersensitivity ; Prevalence ; Prospective Studies ; Retrospective Studies ; Rhinitis, Allergic ; Risk Factors ; Singapore ; Skin ; Trees

BACKGROUND: Peanut allergy is an increasing problem in Singapore and strict avoidance is difficult as peanut is ubiquitous in Asian cuisine. OBJECTIVE: We aimed to assess the efficacy and safety of peanut oral immunotherapy (OIT) in children with obvious peanut allergy in Singapore. METHODS: This was an open-label study of peanut OIT in children living in Singapore, with 2 weekly dose escalation until final maintenance dose of 3,000 mg of peanut protein and a maintenance phase of 12 months. An oral food challenge was performed at 6 months to assess for desensitisation and at 4 weeks after discontinuation of OIT having completed 12 months of maintenance therapy to assess for possible sustained unresponsiveness. The adverse events were monitored using the symptom diaries. RESULTS: Nine subjects were started on OIT, with 7 managing to complete maintenance phase of therapy. Of these 7, all were able to tolerate at least 3,000 mg of peanut protein by 6 months of maintenance therapy, showing that the OIT was effective. Of these 7, 3 patients complied with the 4-week abstinence period after completion of OIT before another peanut challenge; 2 of the 3 subjects showed a significant decrease from the initial ability to tolerate 3,000 mg of peanut protein. Side effects were mainly gastrointestinal in nature and were more common during the updosing phase than the maintenance phase. No episodes of anaphylaxis were observed in this study. CONCLUSION: Peanut OIT seemed to be effective and safe in our cohort of Singaporean children.
Anaphylaxis ; Arachis ; Asian Continental Ancestry Group ; Child ; Cohort Studies ; Humans ; Hypersensitivity ; Immunotherapy ; Peanut Hypersensitivity ; Pilot Projects ; Probiotics ; Singapore

BACKGROUND: The predictive decision points for both peanut skin prick test (SPT) wheal size and serum IgE concentrations, in peanut-sensitized children, have not been evaluated in Singapore. OBJECTIVE: We aim to derive clinically useful predictive decision points to be used for risk stratification of oral food challenge (OFC) in peanut-sensitized patients. METHODS: Patients with a positive SPT to peanut, performed during a 4-year period between 2012 and 2016, were included in a retrospective chart review. The patients were assessed for their peanut allergy status based on a convincing clinical history. Their first SPT and serum IgE results done at presentation to our centre were used. RESULTS: There were 269 patients with a clinical diagnosis of peanut allergy based on recent immediate reaction to peanut and 59 patients whom were tolerating peanuts regularly. There were 251 patients sensitized to peanut, without prior known peanut exposure. A wheal size of ≥8 mm and a peanut-specific IgE of ≥6 kU/L each provided for a 95% positive predictive value of clinical reaction to peanuts; the larger the wheal size on SPT, the higher the probability. CONCLUSION: The cutoff values derived in this study can help clinicians in the risk assessment of OFC in peanut-sensitized patients. Prospective studies using OFCs for the diagnosis of peanut allergy are needed to confirm the diagnostic performance of these tests in predicting OFC outcomes.
Arachis ; Child ; Diagnosis ; Humans ; Immunoglobulin E ; Peanut Hypersensitivity ; Prospective Studies ; Retrospective Studies ; Risk Assessment ; Singapore ; Skin

BACKGROUND: Anaphylaxis is increasing in young children. The aim of the present study was to analyze the clinical characteristics of anaphylaxis in Korean infants, with a focus on food triggers. METHODS: The study analyzed the medical records of infants aged 0 to 2 years old who had been diagnosed with anaphylaxis in 23 secondary or tertiary hospitals in Korea. RESULTS: We identified 363 cases of infantile anaphylaxis (66.9% male). Cutaneous symptoms were most prevalent (98.6%), followed by respiratory (83.2%), gastrointestinal (29.8%), and neurologic (11.6%) symptoms. Cardiovascular symptoms were noted in 7.7% of the cases. Most of the cases of anaphylaxis (338; 93.1%) were induced by foods. The most common trigger food was cow's milk and cow's milk products (43.8%), followed by hen's eggs (21.9%), walnuts (8.3%), wheat (7.7%), peanuts (4.8%), other nuts (3.0%), and fish (2.1%). In cow's milk-induced anaphylaxis cases, more than half the cases had cow's milk specific immunoglobulin E (sIgE) levels that were lower than the diagnostic decision points (DDPs), which is 5 kUA/L for those under the age of 1 and 15 kUA/L for those over the age of 1. In anaphylaxis induced by hen's egg, most of the cases (91.8%) had hen's egg sIgE levels that were higher than the DDP, which is 2 kUA/L for those under the age of 2 and 7 kUA/L for those over the age of 2. Of the infantile anaphylaxis cases, 46.8% had been treated with epinephrine, and 25.1% had been prescribed an epinephrine auto-injector. CONCLUSION: Cow's milk is the most frequent trigger food of anaphylaxis in Korean infants. However, we found no significant correlation between the sIgE level and clinical severity. Education is required regarding the importance of epinephrine as the first line therapy for anaphylaxis and on properly prescribing epinephrine for infants with a history of anaphylaxis.
Anaphylaxis ; Arachis ; Child ; Education ; Eggs ; Epinephrine ; Humans ; Immunoglobulin E ; Immunoglobulins ; Infant ; Juglans ; Korea ; Medical Records ; Milk ; Nuts ; Ovum ; Retrospective Studies ; Tertiary Care Centers ; Triticum

PURPOSE: Many studies have reported that pollen-food allergy syndrome (PFAS) can cause anaphylaxis. No comprehensive investigations into anaphylaxis in PFAS have been conducted, however. In this study, we investigated the clinical manifestations and risk factors for anaphylaxis in PFAS in Korean patients with pollinosis. MATERIALS AND METHODS: Data were obtained from a nationwide cross-sectional study that previously reported on PFAS in Korean patients with pollinosis. Data from 273 patients with PFAS were collected, including demographics, list of culprit fruits and vegetables, and clinical manifestations of food allergy. We analyzed 27 anaphylaxis patients and compared them with patients with PFAS with oropharyngeal symptoms only (n=130). RESULTS: The most common cause of anaphylaxis in PFAS was peanut (33.3%), apple (22.2%), walnut (22.2%), pine nut (18.5%), peach (14.8%), and ginseng (14.8%). Anaphylaxis was significantly associated with the strength of sensitization to alder, hazel, willow, poplar, timothy, and ragweed (p<0.05, respectively). Multivariable analysis revealed that the presence of atopic dermatitis [odds ratio (OR), 3.58; 95% confidence interval (CI), 1.25–10.23; p=0.017]; sensitization to hazel (OR, 5.27; 95% CI, 1.79–15.53; p=0.003), timothy (OR, 11.8; 95% CI, 2.70–51.64; p=0.001), or ragweed (OR, 3.18; 95% CI, 1.03–9.87; p=0.045); and the number of culprit foods (OR, 1.25; 95% CI, 1.15–1.37; p<0.001) were related to the development of anaphylaxis in PFAS. CONCLUSION: The most common culprit foods causing anaphylaxis in PFAS were peanut and apple. The presence of atopic dermatitis; sensitization to hazel, timothy, or ragweed; and a greater number of culprit foods were risk factors for anaphylaxis in PFAS.
Alnus ; Ambrosia ; Anaphylaxis ; Arachis ; Cross-Sectional Studies ; Demography ; Dermatitis, Atopic ; Food Hypersensitivity ; Fruit ; Humans ; Hypersensitivity ; Juglans ; Nuts ; Panax ; Pollen ; Prunus persica ; Rhinitis, Allergic, Seasonal ; Risk Factors ; Salix ; Vegetables

PURPOSE: Egg is the most common food allergen in infants. However, the natural course of egg allergy has not been fully elucidated. This study aimed to describe clinical characteristics and to identify prognostic factors associated with tolerance acquisition of immunoglobulin E (IgE)-mediated egg allergy in children.
Arachis ; Child ; Dermatitis, Atopic ; Diagnosis ; Egg Hypersensitivity ; Egg White ; Follow-Up Studies ; Food Hypersensitivity ; Humans ; Hypersensitivity ; Immunoglobulin E ; Immunoglobulins ; Infant ; Ovum ; Triticum