Art v 1
Summary
Art v 1 is one of the major allergens of mugwort (Artemisia vulgaris) with a reported prevalence among mugwort-allergic patients to be up to 95% depending on the geographical location. It is a defensin-like glycoprotein linked to polyproline-rich region with molecular weight varying between 24 and 28 kDa. Mugwort-allergic patients sensitized to Art v 1 can trigger allergic respiratory symptoms like allergic rhino-conjunctivitis and asthma. Such patients can also exhibit pollen-food-allergy symptoms like oral allergy syndrome, urticaria, angioedema and anaphylaxis. However, no significant difference has been found in their sensitization among food-allergic or food-tolerant patients. Further, native Art v 1 is shown to have higher reactivity than the recombinant Art v 1. Mugwort and ragweed exhibit substantial cross-reactivity among pollen allergic patients, may be due to cross-reactivity among Art v 1 and Amb a 4. Besides, Art v 1 is also responsible for cross-reactivity of mugwort with sunflower and chamomile. Importantly, Art v 1 may act as a prominent diagnostic marker for sensitization to mugwort pollen.
Epidemiology
Worldwide distribution
Artemisia vulgaris (mugwort) is a perennial weed widely distributed across Europe, North America, and Asia Inhalation of the pollen grains of mugwort can trigger type I allergic reactions.
In Europe, mugwort pollens are a major cause of allergy. The sensitization rates among suspected allergy patients are between 10 % (Southern Europe) and 15 % (Northern Europe). Depending on the geographical region, up to 95 % of mugwort-allergic patients are sensitized to the major allergen Art v 1. In a study in Spain, sensitization to Art v 1 was found in 75% of 24 mugwort-sensitized patients based on skin prick test (SPT), specific IgE, and the nasal provocation test. Further, in 100 pediatric mugwort-allergic patients (1-19 years) from Germany, 79% were found to be sensitized to native Art v 1 (nArt v 1). Among 35 summer or spring pollinosis patients (sera samples) in Strasbourg, France, 17.6% were sensitized to mugwort-pollen allergen, Art v 1.
Art v 1 was also the most commonly detected (81%; ranging from 53%‐93%) mugwort allergen among 240 patients (3-66 years), allergic to Artemisia pollen in a study conducted in different provinces of China (Shanxi, Shandong, Yunnan Province).
Clinical Relevance
Cross-reactive Molecules
Mugwort and ragweed (Ambrosia artemisiifolia) exhibit substantial cross-reactivity among pollinosis patients. A study conducted on sera of patients allergic to ragweed and mugwort from Canada (8 sera), Italy (81 sera) and Austria (74 sera) found about 42% Art v 1 sensitized patients to be reactive with Amb a 4. This shows considerable cross-reactivity among Art v 1 and Amb a 4.
Sunflower co-allergy in patients sensitized to mugwort may be due to cross-reactivity between Art v 1 and its homologous proteins in sunflower, Hel a 1 and Hel a 2. Mugwort-chamomile cross-reactivity was also reported and the possible cross-reactive allergen identified was Art v 1.
Disease severity
A study conducted in Austria using sera of approximately 600 mugwort pollen allergic patients found Art v 1 serum specific Immunoglobulin E (sIgE)-reactivity on immunoblots in >95% patients. In a study conducted in China, 81.1% of 148 mugwort-allergic patients showed a positive reaction to sIgE of Art v 1. All these patients showed respiratory symptoms like allergic rhino-conjunctivitis and asthma in addition to food allergy symptoms like oral allergy syndrome, urticaria, angioedema and anaphylaxis. The Art v 1-sIgE levels were significantly correlated with whole mugwort pollen sIgE (correlation coefficient, r=0.802, p<0.01). However, no significant difference was found between Art v 1-sIgE levels in mugwort-allergic patients who were either allergic or tolerant to food.
Art v 1 can induce strong T-cell responses in the peripheral blood mononuclear cells (PBMCs) of mugwort allergic patients. Further, a study on 51 white mugwort-allergic patients has suggested Art v 1 to be a potential target for peptide immunotherapy owing to its consistent T-cell response and association with HLA-DRB1*01 phenotype.
Diagnostics
Disease Severity
Art v 1 acts as a prominent diagnostic marker for sensitization to mugwort pollen.
A study was conducted in Germany to differentiate the reactivity of nArt v 1 and recombinant Art v 1 (rArt v 1) on 32 mugwort-allergic and 10 control patients. The results revealed a significant correlation among both the forms in terms of positive reaction to SPT (p<0.001). However, the size of wheals produced was significantly less with rArt v 1 than nArt v 1 (p<0.05). Similar results were obtained for the nasal provocation test (difference in threshold levels, p<0.05) indicating low sensitivity and higher allergen requirement for rArt v 1 than nArt v 1. This difference may be attributed to the involvement of carbohydrate-specific antibodies in epitope recognition.
Cross-reactivity
Art v 1 cannot play a role in identifying pollen-food-allergy syndrome as cross-reactive structures between food and mugwort pollens have not been found.
Cross-Reactivity
The mono-β-arabinosylated hydroxyprolines of Art v 1 are said to have cross-reactive carbohydrate determinants. Both cross-reactivity and IgE recognition essentially involves xylose and fucose residues.
Mugwort and ragweed are highly cross-reactive due to the presence of common allergenic structures on their pollens. The Art v 1 homologue protein with a defensin-like domain found in ragweed was reported to be Amb a 4. However, the proline-rich region of Amb a 4 differs from Art v 1 which affects the IgE binding in respective allergic patients.
Pollens from Asteraceae weeds that are botanically related [such as Artemisia absinthium (wormwood) and Helianthus annuus (sunflower)] possess Art v 1 cross-reactive structures, especially polypeptide and carbohydrate structures. Further, Hel a 1 and Hel a 4 are reported to be the homologous protein to Art v 1 in sunflower.
References
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