By Randy J. Horwitz MD, PhD, Robert F. Lemanske Jr. MD (auth.), Phil Lieberman MD, John A. Anderson MD (eds.)
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Additional resources for Allergic Diseases: Diagnosis and Treatment
The pollen wall is composed of three layers: an outer exine (composed of external sexine and internal nexine) and an inner intine. The sexine has many micropores, but also larger pores or furrows through which the pollen tube emerges during successful pollination. Allergenic proteins stored in the sexine or intine dissolve through these pores onto mucosal surfaces, allowing hypersensitivity reactions. Many of these proteins have been purified and studied in detail. The major allergens are named with the first three letters of the genus and then the first letter of the species name followed by a group designation, for example Que a 1 (Quercus alba-white oak), Amb a 1 (Ambrosia artemisiifolia-ragweed), and Lol p 1 (Lolium perenne-ryegrass).
The most commonly used method is class scores, usually ranging from 0 to 4-6. Class 0 indicated undetectable IgE, whereas classes 1-4 or 6 represent increasing quantities of IgE. Some laboratories also report a class 0/1 or Chapter 3 I Diagnostic Tests 33 B A 'I( )l o c '1(= Human IgE antibody I( = Labeled anti-human IgE antibody Fig. I. Schematic presentation of an immunosorbent assay for allergen-specific IgE antibody. (A) Allergen represented by small circles and squares has been bound to solid phase.
Allergenic proteins are found in the spores and in other fungal elements that may become airborne. Many of the allergenic proteins produced by these fungi have been characterized at the molecular level, such as Alt a 1 (Alternaria alternata) and CIa h 2 (Cladosporium herbarium). In general, temperate grasslands are a strong source of Alternaria, Cladosporium, Helminthosporium-Drechslera, and Epicoccum species. Outdoor fungal particle levels peak in the midsummer in most temperate regions, but large daily variations are superimposed on this trend.