Allergy caused by ingestion of persimmon (Diospyros kaki):: Detection of specific IgE and cross-reactivity to profilin and carbohydrate determinants

Background: Allergy to persimmon (Diospyros kaki) is very rare and not yet confirmed by means of double-blind, placebo-controlled, food-challenge (DBPCFC), Thus far, specific IgE to this fruit and cross-reactivity to pollen and other foods has not been determined. Objective: The objective was to confirm allergy to persimmon in 3 patients with an according personal history and to characterize allergens and cross-reactivity of specific IgE antibodies to pollen and food allergens, One patient reacted with pruritus, penis edema, urticaria, and asthma; the second reacted with nausea and vomitus; and the third reacted with rhinoconjunctivitis, asthma, and stomachache after ingestion of persimmon. Methods: Patients underwent skin prick testing with routine allergens, latex, persimmon, and other foods. Allergy to persimmon was confirmed by means of a DBPCFC, Specific serum IgE levels were measured with CAP-FEIA and the enzyme allergosorbent test (EAST) method, EAST and immunoblot inhibitions were carried out with persimmon; birch, grass, and ragweed pollen; latex; and N-glycans as inhibitors. Results: All patients had positive skin test responses, DBPCFC and specific IgE assays to persimmon, Blot and EAST inhibition assays revealed IgE to cross-reactive profilin in one patient and IgE to cross-reacting carbohydrate determinants in all patients. Conclusions: This is the first report on 3 cases of allergy to persimmon verified by means of DBPCFC and detection of specific IgE, The sensitization is due to cross-reactive profilin and carbohydrate determinants.