Serologic and skin test diagnosis of birch pollen allergy with recombinant Bet v 1, the chief allergen of birch

Background: Type I allergy represents a severe health problem in industrialized countries where up to 20% of the population suffers from allergic rhinitis, conjunctivitis and allergic asthma bronchiale and in severe cases from anaphylaxis, leading to death.

Objective: The aim of this study was to evaluate recombinant Bet v 1, the major birch pollen allergen for in vivo and in vitro diagnosis of birch pollen allergy.

Methods: A group of 51 birch pollen allergic patients and eight non-allergic control individuals were tested for birch pollen allergy by skin-prick and intradermal testing, comparing commercial birch pollen extracts with recombinant Bet v 1. Quantitative and qualitative serological testing was done with natural and recombinant allergens by radioallergosorbent test (RAST), enzyme-linked immunosorbent assay (ELISA) and immunoblotting.

Results: Recombinant Bet v 1 allowed accurate in vivo and in vitro diagnosis of tree pollen allergy in 49/51 patients tested. No false positive results were obtained in any in vitro assay system (ELISA, Westernblot) or by skin testing (skin-prick, intradermal test) with recombinant Bet v 1.

Conclusions: Our results document that recombinant Bet v 1 produced in bacterial expression systems allows accurate in vitro and in vivo diagnosis of birch pollen allergy in > 95% of birch pollen allergic patients.