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Title
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Exploring the diagnosis and profile of cannabis allergy
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Author
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Abstract
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| Background Cannabis allergy (CA) has mainly been attributed to Can s 3, the nonspecific lipid transfer protein (nsLTP) of Cannabis sativa. Nevertheless, standardized diagnostic tests are lacking and research on CA is scarce. Objective To explore the performance of 5 cannabis diagnostic tests and the phenotypic profile of CA. Methods A total of 120 patients with CA were included and stratified according to the nature of their cannabis-related symptoms; 62 healthy and 189 atopic controls were included. Specific IgE (sIgE) hemp, sIgE and basophil activation test (BAT) with a recombinant Can s 3 protein from Cannabis sativa (rCan s 3), BAT with a crude cannabis extract, and a skin prick test (SPT) with an nCan s 3-rich cannabis extract were performed. Clinical information was based on patient history and a standardized questionnaire. Results First, up to 72% of CA reporting likely-anaphylaxis (CA-A) are Can s 3 sensitized. Actually, the Can s 3-based diagnostic tests show the best combination of positive and negative predictive values, 80% and 60%, respectively. sIgE hemp displays 82% sensitivity but only 32% specificity. Secondly, Can s 3+CA reported significantly more cofactor-mediated reactions and displayed significantly more sensitizations to other nsLTPs than Can s 3-CA. Finally, the highest prevalence of systemic reactions to plant-derived foods was seen in CA-A, namely 72%. Conclusions The most effective and practical tests to confirm CA are the SPT with an nCan s 3-rich extract and the sIgE rCan s 3. Can s 3 sensitization entails a risk of systemic reactions to plant-derived foods and cofactor-mediated reactions. However, as Can s 3 sensitization is not absolute, other cannabis allergens probably play a role. |
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Language
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English
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Source (journal)
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The journal of allergy and clinical immunology. In practice. - New York, NY, 2013, currens
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Publication
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New York, NY
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Elsevier Inc
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2019
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ISSN
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2213-2198
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DOI
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10.1016/J.JAIP.2018.09.017
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Volume/pages
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7
:3
(2019)
, p. 983-+
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ISI
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000460123700026
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Pubmed ID
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30273677
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Full text (Publisher's DOI)
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Full text (open access)
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Full text (publisher's version - intranet only)
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