23 resultados para Allergens

em Universidad Politécnica de Madrid


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La prevalencia de las alergias está aumentando desde mediados del siglo XX, y se estima que actualmente afectan a alrededor del 2-8 % de la población, pero las causas de este aumento aún no están claras. Encontrar el origen del mecanismo por el cual una proteína inofensiva se convierte en capaz de inducir una respuesta alérgica es de vital importancia para prevenir y tratar estas enfermedades. Aunque la caracterización de alérgenos relevantes ha ayudado a mejorar el manejo clínico y a aclarar los mecanismos básicos de las reacciones alérgicas, todavía queda un largo camino para establecer el origen de la alergenicidad y reactividad cruzada. El objetivo de esta tesis ha sido caracterizar las bases moleculares de la alergenicidad tomando como modelo dos familias de panalergenos (proteínas de transferencia de lípidos –LTPs- y taumatinas –TLPs-) y estudiando los mecanismos que median la sensibilización y la reactividad cruzada para mejorar tanto el diagnóstico como el tratamiento de la alergia. Para ello, se llevaron a cabo dos estrategias: estudiar la reactividad cruzada de miembros de familias de panalérgenos; y estudiar moléculas-co-adyuvantes que pudieran favorecer la capacidad alergénica de dichas proteínas. Para estudiar la reactividad cruzada entre miembros de la misma familia de proteínas, se seleccionaron LTPs y TLPs, descritas como alergenos, tomando como modelo la alergia a frutas. Por otra parte, se estudiaron los perfiles de sensibilización a alérgenos de trigo relacionados con el asma del panadero, la enfermedad ocupacional más relevante de origen alérgico. Estos estudios se llevaron a cabo estandarizando ensayos tipo microarrays con alérgenos y analizando los resultados por la teoría de grafos. En relación al estudiar moléculas-co-adyuvantes que pudieran favorecer la capacidad alergénica de dichas proteínas, se llevaron a cabo estudios sobre la interacción de los alérgenos alimentarios con células del sistema inmune humano y murino y el epitelio de las mucosas, analizando la importancia de moléculas co-transportadas con los alérgenos en el desarrollo de una respuesta Th2. Para ello, Pru p 3(LTP y alérgeno principal del melocotón) se selección como modelo para llevarlo a cabo. Por otra parte, se analizó el papel de moléculas activadoras del sistema inmune producidas por patógenos en la inducción de alergias alimentarias seleccionando el modelo kiwi-alternaria, y el papel de Alt a 1, alérgeno mayor de dicho hongo, en la sensibilización a Act d 2, alérgeno mayor de kiwi. En resumen, el presente trabajo presenta una investigación innovadora aportando resultados de gran utilidad tanto para la mejora del diagnóstico como para nuevas investigaciones sobre la alergia y el esclarecimiento final de los mecanismos que caracterizan esta enfermedad. ABSTRACT Allergies are increasing their prevalence from mid twentieth century, and they are currently estimated to affect around 2-8% of the population but the underlying causes of this increase remain still elusive. The understanding of the mechanism by which a harmless protein becomes capable of inducing an allergic response provides us the basis to prevent and treat these diseases. Although the characterization of relevant allergens has led to improved clinical management and has helped to clarify the basic mechanisms of allergic reactions, it seems justified in aspiring to molecularly dissecting these allergens to establish the structural basis of their allergenicity and cross-reactivity. The aim of this thesis was to characterize the molecular basis of the allergenicity of model proteins belonging to different families (Lipid Transfer Proteins –LTPs-, and Thaumatin-like Proteins –TLPs-) in order to identify mechanisms that mediate sensitization and cross reactivity for developing new strategies in the management of allergy, both diagnosis and treatment, in the near future. With this purpose, two strategies have been conducted: studies of cross-reactivity among panallergen families and molecular studies of the contribution of cofactors in the induction of the allergic response by these panallergens. Following the first strategy, we studied the cross-reactivity among members of two plant panallergens (LTPs , Lipid Transfer Proteins , and TLPs , Thaumatin-like Proteins) using the peach allergy as a model. Similarly, we characterized the sensitization profiles to wheat allergens in baker's asthma development, the most relevant occupational disease. These studies were performed using allergen microarrays and the graph theory for analyzing the results. Regarding the second approach, we analyzed the interaction of plant allergens with immune and epithelial cells. To perform these studies , we examined the importance of ligands and co-transported molecules of plant allergens in the development of Th2 responses. To this end, Pru p 3, nsLTP (non-specific Lipid Transfer Protein) and peach major allergen, was selected as a model to investigate its interaction with cells of the human and murine immune systems as well as with the intestinal epithelium and the contribution of its ligand in inducing an allergic response was studied. Moreover, we analyzed the role of pathogen associated molecules in the induction of food allergy. For that, we selected the kiwi- alternaria system as a model and the role of Alt a 1 , major allergen of the fungus, in the development of Act d 2-sensitization was studied. In summary, this work presents an innovative research providing useful results for improving diagnosis and leading to further research on allergy and the final clarification of the mechanisms that characterize this disease.

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Scope: Today, about 2–8% of the population of Western countries exhibits some type of food allergy whose impact ranges from localized symptoms confined to the oral mucosa to severe anaphylactic reactions. Consumed worldwide, lettuce is a Compositae family vegetable that can elicit allergic reactions. To date, however, only one lipid transfer protein has been described in allergic reaction to lettuce. The aim of this study was to identify potential new allergens involved in lettuce allergy. Methods and results: Sera from 42 Spanish lettuce-allergic patients were obtained from pa-tients recruited at the outpatient clinic. IgE-binding proteins were detected by SDS-PAGE and immunoblotting. Molecular characterization of IgE-binding bands was performed by MS. Thaumatin was purified using the Agilent 3100 OFFGEL system. The IgE-binding bands recognized in the sera of more than 50% of patients were identified as lipid transfer protein (9 kDa), a thaumatin-like protein (26 kDa), and an aspartyl protease (35 and 45 kDa). ELISA inhibition studies were performed to confirm the IgE reactivity of the purified allergen. Conclusion: Two new major lettuce allergens—a thaumatin-like protein and an aspartyl protease—have been identified and characterized. These allergens may be used to improve both diagnosis and treatment of lettuce-allergic patients.

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The prevalence of exotic pet allergies has been increasing over the last decade. Years ago, the main allergy-causing domestic animals were dogs and cats, although nowadays there is an increasing number of allergic diseases related to insects, rodents, amphibians, fish, and birds, among others. The current socio-economic situation, in which more and more people have to live in small apartments, might be related to this tendency. The main allergic symptoms related to exotic pets are the same as those described for dog and cat allergy: respiratory symptoms. Animal allergens are therefore, important sensitizing agents and an important risk factor for asthma. There are three main protein families implicated in these allergies, which are the lipocalin superfamily, serum albumin family, and secretoglobin superfamily. Detailed knowledge of the characteristics of allergens is crucial to improvement treatment of uncommon-pet allergies.

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International Comparative Medicine Symposium. Allergology. Revisión de métodos computacionales para determinar propiedades de alergenos alimentarios de plantas

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Tree nut allergies are considered an important health issue in developed countries. To comply with the regulations on food labeling, reliable allergen detection methods are required. In this work we isolated almond-specific recombinant antibody fragments (scFv) from a commercial phage display library bypassing the use of live animals, hence being consistent with the latest policies on animal welfare. To this end an iterative selection procedure employing the Tomlinson I phage display library and a crude almond protein extract was carried out. Two different almond-specific scFv (named PD1F6 and PD2C9) were isolated after two rounds of biopanning, and an indirect phage ELISA was implemented to detect the presence of almond protein in foodstuffs. The isolated scFvs demonstrated to be highly specific and allowed detection of 40 ng mL?1 and 100 ng mL?1 of raw and roasted almond protein, respectively. The practical detection limit of the assay in almond spiked food products was 0.1 mg g?1 (110e120 ppm). The developed indirect phage ELISA was validated by analysis of 92 commercial food products, showing good correlation with the results obtained by a previously developed real-time PCR method for the detection of almond in foodstuffs. The selected phage clones can be affinity maturated to improve their sensitivity and genetically engineered to be employed in different assay formats.

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Food allergy is recognized as a major public health issue, especially in early childhood. It has been hypothesized that early sensitization to food allergens maybe due to their ingestion as components dissolved in the milk during the breastfeeding, explaining reaction to a food, which has never been taken before. Thus, the aim of this work has been to detect the presence of the food allergens in breast milk by microarray technology. We produced a homemade microarray with antibodies produced against major food allergens. The antibody microarray was incubated with breast milk from 14 women collected from Fundación Jiménez Díaz Hospital. In this way, we demonstrated the presence of major foods allergens in breast milk. The analysis of allergens presented in breast milk could be a useful tool in allergy prevention and could provide us a key data on the role of this feeding in tolerance induction or sensitization in children.

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IgE-mediated allergy to wheat proteins can be caused by exposure through ingestion, inhalation, or skin/mucosal contact, and can affect various populations and age groups. Respiratory allergy to wheat proteins is commonly observed in adult patients occupationally exposed to flour, whereas wheat food allergy is more common in children. Wheat allergy is of growing importance for patients with recurrent anaphylaxis, especially when exercise related. The diagnosis of wheat allergy relies on a consistent clinical history, skin prick testing with well-characterized extracts and specific IgE tests. The accuracy of wheat allergy diagnosis may be improved by measuring IgE responses to several wheat components. However, a high degree of heterogeneity has been found in the recognition pattern of allergens among patient groups with different clinical profiles, as well as within each group. Thus, oral provocation with wheat or the implicated cereal is the reference test for the definitive diagnosis of ingested wheat/cereal allergy.

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We conclude that Bet v 1 and Bos d 5 not only structurally mimic human LCN2, but also functionally by their ability to bind iron via siderophores. The apo-forms promote Th2 cells, whereas the holo-forms appear to be immunosuppressive. These results provide for the first time a functional understanding on the principle of allergenicity of major allergens from entirely independent sources, like birch and milk.

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The study of cross-reactivity in allergy is key to both understanding. the allergic response of many patients and providing them with a rational treatment In the present study, protein microarrays and a co-sensitization graph approach were used in conjunction with an allergen microarray immunoassay. This enabled us to include a wide number of proteins and a large number of patients, and to study sensitization profiles among members of the LTP family. Fourteen LTPs from the most frequent plant food-induced allergies in the geographical area studied were printed into a microarray specifically designed for this research. 212 patients with fruit allergy and 117 food-tolerant pollen allergic subjects were recruited from seven regions of Spain with different pollen profiles, and their sera were tested with allergen microarray. This approach has proven itself to be a good tool to study cross-reactivity between members of LTP family, and could become a useful strategy to analyze other families of allergens.

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Cross-reactivity of plant foods is an important phenomenon in allergy, with geographical variations with respect to the number and prevalence of the allergens involved in this process, whose complexity requires detailed studies. We have addressed the role of thaumatin-like proteins (TLPs) in cross-reactivity between fruit and pollen allergies. A representative panel of 16 purified TLPs was printed onto an allergen microarray. The proteins selected belonged to the sources most frequently associated with peach allergy in representative regions of Spain. Sera from two groups of well characterized patients, one with allergy to Rosaceae fruit (FAG) and another against pollens but tolerant to food-plant allergens (PAG), were obtained from seven geographical areas with different environmental pollen profiles. Cross-reactivity between members of this family was demonstrated by inhibition assays. Only 6 out of 16 purified TLPs showed noticeable allergenic activity in the studied populations. Pru p 2.0201, the peach TLP (41%), chestnut TLP (24%) and plane pollen TLP (22%) proved to be allergens of probable relevance to fruit allergy, being mainly associated with pollen sensitization, and strongly linked to specific geographical areas such as Barcelona, Bilbao, the Canary Islands and Madrid. The patients exhibited mayor que50% positive response to Pru p 2.0201 and to chestnut TLP in these specific areas. Therefore, their recognition patterns were associated with the geographical area, suggesting a role for pollen in the sensitization of these allergens. Finally, the co-sensitizations of patients considering pairs of TLP allergens were analyzed by using the co-sensitization graph associated with an allergen microarray immunoassay. Our data indicate that TLPs are significant allergens in plant food allergy and should be considered when diagnosing and treating pollen-food allergy.

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Wood is a natural material that is able to trigger rhinitis and asthma in exposed subjects in occupational settings. This has been described with both soft and hard woods.1,2 Involvement of both low- and high-molecular-weight allergens has been reported, and the relevance of these is related with the wood type.1 There are cases where protein may be the responsible allergen. Crossreactivity between obeche and ramin woods3 and between obeche and latex4 has been shown. However, to the best of our knowledge, this is the first report of a multiple IgE-mediated sensitization to different woods that caused occupational respiratory symptoms in the same worker.

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Background Obeche wood dust is a known cause of occupational asthma where an IgE-mediated mechanism has been demonstrated. Objective To characterize the allergenic profile of obeche wood dust and evaluate the reactivity of the proteins by in vitro, ex vivo and in vivo assays in carpenters with confirmed rhinitis and/or asthma Materials and methods An in-house obeche extract was obtained, and two IgE binding bands were purified (24 and 12 kDa) and sequenced by N-terminal identity. Specific IgE and IgG, basophil activation tests and skin prick tests (SPTs) were performed with whole extract and purified proteins. CCD binding was analyzed by ELISA inhibition studies. Results Sixty-two subjects participated: 12 with confirmed occupational asthma/rhinitis (ORA+), 40 asymptomatic exposed (ORA−), and 10 controls. Of the confirmed subjects, 83% had a positive SPT to obeche. There was a 100% recognition by ELISA in symptomatic subjects vs. 30% and 10% in asymptomatic exposed subjects and controls respectively (p<0.05). Two new proteins were purified, a 24 kDa protein identified as a putative thaumatin-like protein and a 12 kDa gamma-expansin. Both showed allergenic activity in vitro, with the putative thaumatin being the most active, with 92% recognition by ELISA and 100% by basophil activation test in ORA+ subjects. Cross-reactivity due to CCD was ruled out in 82% of cases. Conclusions Two proteins of obeche wood were identified and were recognized by a high percentage of symptomatic subjects and by a small proportion of asymptomatic exposed subjects. Further studies are required to evaluate cross reactivity with other plant allergens.

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Over 30 wheat allergens have been associated to baker’s asthma and much of them have been also implied in food allergy. Few of them have rendered as major allergens. Tri a 14, wheat LTP, has been associated to baker’s asthma as major allergen in patients that can consume peach and wheat derived foodstuffs. In Spanish baker’s asthma patients, 60% showed positive response to Tri a 14 and 45% to Pru p 3. However, the cross-reactivity between peach and wheat has been unusual in allergic population (1,8). Moreover, wheat allergy is not so often as should be attending to the high consume.

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El sector porcino ibérico es un sector típicamente español. La imagen que asocia el consumidor a los productos ibéricos es la correspondiente a los productos elaborados a partir de cerdos ibéricos en explotaciones extensivas, (dehesas), y cebados en montanera. Sin embargo, según los datos publicados por el Ministerio de Agricultura, Alimentación y Medio Ambiente, más de un 70 por ciento de los cerdos ibéricos que se producen en España son criados en granjas intensivas. El sector porcino ibérico está en pleno proceso de cambio, tanto por las variaciones que se derivan de la crisis que sufre el sector, como por las modificaciones que se esperan en la norma de calidad, recientemente acordadas. En este entorno en el que existe una reducción importante de los márgenes comerciales en todos los eslabones de la cadena de valor del jamón ibérico de bellota, adquiere importancia el estudio de su estructura y funcionamiento, la determinación de los aspectos que mejoran la eficiencia económica a lo largo de la misma y su concordancia a lo largo de ella. Así mismo, un sector de los consumidores comienza a buscar productos de calidad, se interesa por productos con determinados etiquetados que garantizan la calidad o unas determinadas prácticas de producción y elaboración, como sucede con los productos ecológicos. Existen numerosos estudios sobre distintos aspectos del sector porcino ibérico, realizados por distintas instituciones, como universidades, instituciones privadas y proyectos europeos. En general, se centran en la mejora de la producción de los cerdos ibéricos o en la mejora de la elaboración de los jamones. La novedad de la investigación realizada en la presente Tesis Doctoral reside en el estudio de los aspectos que determinan la mayor eficiencia económica de la cadena de valor del jamón ibérico de bellota de la denominación de origen de Guijuelo, y en las características que aporta al jamón ibérico de bellota la producción ecológica frente a la convencional. Resumen Los objetivos planteados en esta investigación son la mejora de la cadena de valor del jamón ibérico de bellota de la denominación de origen de Guijuelo, mediante el estudio de la problemática estructural y de funcionamiento de la misma. Como objetivos específicos se proponen la mejora de la eficiencia económica en las relaciones comerciales entre los distintos eslabones de la cadena de valor, y el impulso de la oferta de los productos ecológicos de ibérico, mediante el estudio comparativo de las producciones convencionales y ecológicas. Para alcanzar estos objetivos la metodología utilizada es la cadena de valor agroalimentaria, utilizando como herramientas de análisis el método Delphi y la realización de un análisis DAFO del sector porcino ibérico. Las fuentes de información primarias utilizadas proceden por una parte de la colaboración realizada en el proyecto europeo Q-Porkchains, coordinado por el Dr. Jacques H. Trienekens, y por otra parte de los cuestionarios especialmente diseñados para el análisis Delphi realizado. Las fuentes de información secundarias proceden de artículos académicos publicados, de artículos de revistas especializadas en el sector y de informes y estadísticas publicados por el Ministerio de Agricultura, Alimentación y Medio Ambiente. Las conclusiones de la investigación son las siguientes. Las relaciones comerciales de la cadena de valor estudiada están gestionadas, ya que se otorga gran valor a las relaciones comerciales basadas en la confianza, tanto en el aprovisionamiento de productos como en la venta de los mismos en cada eslabón. Sin embargo, no se gestiona adecuadamente la gama de productos que se oferta a lo largo de la cadena de valor, puesto que los eslabones de la misma obtienen diferente eficiencia económica para el mismo producto. Por otra parte, aunque la denominación de origen de Guijuelo es una marca conocida por el consumidor, el esfuerzo por tener una marca colectiva de calidad no ha sido totalmente satisfactorio, en especial para el eslabón de la distribución. Por esta razón, es importante resaltar que es recomendable la creación de una marca propia que cuide la calidad con especial atención, modificando incluso las empresas integrantes de la cadena de valor si el objetivo de calidad no coincide. Es importante garantizar la calidad del producto al consumidor, mediante la trasmisión la información generada por los informes de inspección y certificación realizados por las entidades correspondientes en relación a la norma de calidad de los productos de cerdo ibérico y por el Consejo Regulador de Guijuelo. Se requiere un estudio detallado de los posibles nichos de mercado para llegar a los clientes que buscan un producto de calidad diferenciada como es el jamón ibérico de denominación de origen de Guijuelo. Dentro de los posibles clientes debe tenerse en consideración al colectivo de personas alérgicas, ya que no se encuentran con facilidad en el mercado productos cárnicos de cerdo libres de alérgenos. Por último, la innovación es muy importante en este sector, y pueden ofertarse nuevos productos que ayuden al acortamiento de la cadena de valor, como podría ser la carne fresca de cerdo ibérico de bellota. La producción ecológica de porcino ibérico, en la actualidad no es significativa. El manejo que se realiza de los cerdos ibéricos convencionales de bellota es muy similar al manejo que se realiza de los cerdos ecológicos, salvo en la alimentación que reciben los cerdos ibéricos antes del cebo en montanera y en los medicamentos permitidos en ambas producciones. La producción de porcino ecológico de bellota puede ser interesante para la exportación. Los jamones ibéricos de bellota dispondrían de un sello que garantiza un manejo tradicional –como se realiza en muchas explotaciones extensivas de cerdos ibéricos de bellota-, y que es apreciado por los consumidores de otros países, dispuestos a pagar por productos de calidad diferenciada. Este tipo de producción quizá podría solventar la limitación al ámbito nacional de la norma de calidad de los productos de cerdo ibérico. La falta de claridad y unanimidad en el sector sobre la calidad de los productos de ibéricos que se percibe en los cambios previstos en la legislación, y el interés del eslabón de la industria elaboradora de jamones en calidades no ligadas a producciones extensivas sino intensivas, por su mayor volumen de ventas y sus mejores rendimientos, mueven a los productores de “ibérico puro de bellota” a desmarcarse del sector “ibérico”, donde el peso del producto ibérico cruzado de pienso tiene mucho peso en las decisiones que se toman. The Iberian pork industry is a typically Spanish industry. The associated image by the consumer to these products corresponds to products made from Iberian pigs in extensive farms (meadows), and fattened in open range. However, according to data released by the Ministry of Agriculture, Food and Environment, more than 70 percent of the Iberian pigs produced in Spain are raised on factory farms. The Iberian pork industry is in process of change, both by modifications resulting from the crisis in the sector, and the expected ones in the quality standard, recently agreed. In this environment where there is a significant reduction in trade margins in all links of the value chain of Iberian ham, becomes important to study its structure and operation, identifying the aspects that improve economic efficiency along the value chain and their concordance along it. Likewise, part of the consumers begins searching for quality products, they are interested in certain products that guarantee some sort of quality or production and processing practices, like organic products. There are several studies on various aspects of the Iberian pork industry, made by different institutions, such as universities, private institutions and some European projects. In general, their goal is focused on improving the Iberian hog production or on improving the elaboration of hams. The novelty of the research conducted in this PhD thesis lies in the study of the aspects that determine the economic efficiency of the value chain of Iberian ham from Guijuelo designation of origin, and the comparison between the features that organic or conventional production of Iberian ham brings to it. The objectives propound in this research are the improvement of the value chain of Iberian ham from Guijuelo designation of origin, through the study of its structural and operational problematic. The proposed specific objectives are the improvement of the economic efficiency Resumen in trade relations between the different links in the value chain, and the promotion of the supply of Iberian organic pork products, through the comparative study of conventional and organic productions. In order to achieve these objectives, the used methodology is the agrifood value chain, using as analysis tools the Delphi method, and a SWOT analysis of the Iberian pork industry. The primary sources of information come partly from the collaboration in the European project Q-Porkchains, coordinated by Dr. Jacques Trienekens, and partly from the questionnaires specially designed for the Delphi analysis performed. The secondary sources come from published academic papers, specialized journal articles and reports published by the Ministry of Agriculture, Food and Environment. The research conclusions are as follows. Trade relations in the studied value chain are managed, as it is granted a great value to business relationships based on trust, both in the supply of products and in the sale in each link. However, the portfolio that is offered throughout the value chain is not properly managed, since the economic efficiency obtained for the same product is different in each link. Moreover, although the designation of origin of Guijuelo is a well-known brand, the effort made to acquire a collective quality trademark has not been entirely satisfactory, especially in the distribution link. Due to it, it is important to highlight that it is recommended to create a brand focused on quality, and indeed to change the firms integrating the vale chain, if the goal is not shared by all the companies. It is essential to ensure the quality of the product to the consumer, through the transmission of the available information related to the quality standard of Iberian pork products and of the Guijuelo Regulating Council. A detailed study of potential niche markets is required, in order to reach customers looking for a differentiated quality product as Iberian ham of Guijuelo designation of origin. It should be taken into consideration the group of allergy sufferers as potential customers, as they do not easily find pork products in the market free of allergens. Innovation is very important in this industry, and new products could be commercialized that help to shorten the value chain, as fresh acorn Iberian pork. Nowadays, the organic production of Iberian pork products is not significant. The operation is very similar in both conventional and organic production of Iberian pork products, except in the food received by Iberian hogs and the sort of medicinal treatments allowed in each production. The organic acorn Iberian pork production could be interesting for export. Acorn Iberian hams would have a well-known hallmark, which guarantees a traditional production, -as it is done in many extensive holdings of Iberian acorn-pigs-, and that is appreciated by consumers in other countries This niche of consumers could pay for differentiated quality products. Perhaps, this sort of production could solve the limitation to national scope of the quality standard of Iberian pork products. The lack of clarity and unanimity in the industry on the quality of Iberian pork products has been perceived in the agreed changes of the legislation as well as the interest of the processing industry in hams of quality categories which are not linked to extensive but intensive productions, due to their higher sales volume and better yields. This situation pushed "acorn pure Iberian " pigs farmers to split from the Iberian industry, where the importance of cross Iberian pig from intensive farms is growing so high that they can influence the negotiations and decisions taken inside and outside the industry.

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Grain-induced asthma is a frequent occupational allergic disease mainly caused by inhalation of cereal flour or powder. The main professions affected are bakers, confectioners, pastry factory workers, millers, farmers, and cereal handlers. This disorder is usually due to an IgE-mediated allergic response to inhalation of cereal flour proteins. The major causative allergens of grain-related asthma are proteins derived from wheat, rye and barley flour, although baking additives, such as fungal α-amylase are also important. This review deals with the current diagnosis and treatment of grain-induced asthma, emphasizing the role of cereal allergens as molecular tools to enhance diagnosis and management of this disorder. Asthma-like symptoms caused by endotoxin exposure among grain workers are beyond the scope of this review. Progress is being made in the characterization of grain and bakery allergens, particularly cereal-derived allergens, as well as in the standardization of allergy tests. Salt-soluble proteins (albumins plus globulins), particularly members of the α-amylase/trypsin inhibitor family, thioredoxins, peroxidase, lipid transfer protein and other soluble enzymes show the strongest IgE reactivities in wheat flour. In addition, prolamins (not extractable by salt solutions) have also been claimed as potential allergens. However, the large variability of IgE-binding patterns of cereal proteins among patients with grain-induced asthma, together with the great differences in the concentrations of potential allergens observed in commercial cereal extracts used for diagnosis, highlight the necessity to standardize and improve the diagnostic tools. Removal from exposure to the offending agents is the cornerstone of the management of grain-induced asthma. The availability of purified allergens should be very helpful for a more refined diagnosis, and new immunomodulatory treatments, including allergen immunotherapy and biological drugs, should aid in the management of patients with this disorder.