Type I sensitization profiles in patients with spice syndromes

Abstract Background Allergies to spices have not been adequately researched to date, but they are becoming increasingly important in allergology. The clinical spectrum ranges from mild symptoms to anaphylaxis. Spice allergies can occur as cross-reactions in the form of spice syndromes if type I sensitization to herb pollen is present. The aim of this study was to precisely characterize cross-reactive spice syndromes and their sensitization profiles. Particular attention was paid to the manifestation of mugwort–(celery)–spice syndrome, mugwort–tropical fruit syndrome, and latex–tropical fruit syndrome. Methods We performed a retrospective evaluation of 64 patients who were examined for spice syndromes at the University Dermatology Clinic in Tübingen between 2019 and 2024. Diagnoses and cutaneous and serological evidence of specific IgE antibodies were recorded. Results Patients with mugwort–(celery)–spice syndrome in our cohort were characterized by frequent sensitization to aeroallergens, especially ragweed and mugwort. Serological sensitization to PR10 homologues was common, while sensitization to profilins and to the mugwort major allergen Art v 1 (PR12) was less common. In patients with mugwort–tropical fruit syndrome, sensitization to herbs was particularly common, with all patients testing positive for the mugwort major allergen Art v 1. There was more frequent cutaneously detectable sensitization to labiate plants in mugwort–(celery)–spice syndrome compared to mugwort–tropical fruit syndrome, while sensitization to umbelliferous plants and other spices occurred with similar frequency in both groups. Only one patient had latex–tropical fruit syndrome. Conclusion The results highlight the complex immunological cross-reactivities between pollen and plant allergens and may contribute to a more comprehensive understanding of spice syndromes.