Wall pellitory (judaica)

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Code: w21
Latin name: Parietaria judaica
Source material: Pollen
Family: Urticaceae
Common names: Wall Pellitory, Pellitory-of-the-Wall, Parietaire, Spreading Pellitory, Asthma weed, Sticky-weed

See also: Wall Pellitory w19 (Parietaria officinalis).

Allergen Exposure

Wall Pellitory is a common weed around the Mediterranean and along the West coast of Europe as far north as central England. It is found in Spain, Greece, Italy and Israel, and has been introduced in other parts of Western Europe and in Australia and Argentina. Two closely related species are found in the US and one in Brazil.

The genus Parietaria has about 10 species, which are highly cross-reactive to each other. Parietaria pollen allergens (officinalis, judaica, lusitanica, creatica) are one of the most common causes of pollinosis in areas where the plants grow. A close correlation exists between the species P. judaica and P. officinalis. In some geographical areas one species may dominate, and IgE antibodies to only one of the species can be found in sensitised individuals.

Parietaria judaica is a sprawling, many-branched, bushy perennial weed, with brittle, reddish stems. It grows from 30 to 100 cm. The leaves are 3 to 12 cm long and oval in shape, with hairs on the veins on the lower surface. The leaves of P. judaica (w21) are about 5cm shorter than those of P. officinalis (w19).

The inconspicuous green stalkless flowers are clustered in the leaf axils. They are dioecious (individual flowers are either male or female, but only one sex is to be found on any one plant). In many countries the Wall Pellitory flowers all year round but with distinct peaks in spring and around November. In some areas, Wall Pellitory may flower only from early summer to late fall. This plant is pollinated by wind.

The plant lives preferably on walls (hence the name), rocks, banks, and hedgebanks. Wall Pellitory may be used for medicinal purposes.

Allergen Description

The following allergens have been characterised:

Par j 1, a 12 kDa lipid transfer protein (.1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29)

Par j 2, a 9 kDa lipid transfer protein. (1, 4, 5, 6, 7, 8, 11, 17, 26, 28,  29, 30, 31, 32, 33, 34, 35)

Par j 3, a 14 kDa profilin. (1, 5, 36, 37, 38, 39)

Par j 4, a calcium binding protein. (1, 26,40, 41)

A glucanase has been isolated from P. judaica pollen. (42)

Par j 1 and Par j 2 are major allergens, both considered as non-specific Lipid Transfer Proteins. (4, 5, 6)

Two isoforms of Par j 1.0101 have been isolated and named Par j 1.0102 (a 14,7 kDa protein) and Par j 1.0201 (a 10,7 kDa protein). These proteins represent isoallergenic forms of the major allergen Par j 1.0101. These isoform allergens demonstrated a 98% and 89% amino acid sequence homology, respectively, with Par j 1.0101. (19) The epitope of the major allergen Par j 1.010 is also present on the Par j 2.0101 major allergen, representing a common IgE epitope. It is an immunodominant epitope, since it was capable of inhibiting 30% of all specific IgE against the Parietaria judaica major allergens. (18)

Par j 1, a major allergen, induces IgE responses in 95% of P. judaica-allergic patients. (2)

Par j 2.0101, a major allergen of Parietaria judaica, has been characterised and binds with IgE of 82% of P. judaica-allergic individuals. (3)

A profilin has also been detected in Parietaria judaica pollen, but the allergen has not been fully characterised. (43)

The IgE-binding epitopes of rPar j 2, a major allergen of Parietaria judaica pollen, are heterogeneously recognised among allergic subjects. At least four putative IgE-binding epitopes were identified.  (34)

Potential Cross-Reactivity

An extensive cross-reactivity among the different individual species of the genus could be expected, as well as to a certain degree among members of the family Urticaceae. (44) However, for Parietaria crossreactivity with other family members of different genera does not appear to be the case in general. RAST-inhibition demonstrated the absence of cross-reactivity between Parietaria and Urtica. (45, 46) Also, utilising an ELISA inhibition test, no cross-reactivity could be demonstrated between Ramie (Boehmeria nivea), a member of the Urticaceae family, a weed widely distributed throughout Japan and Southeast Asia, and Parietaria (P. officinalis and P. judaica). (47)

Extensive cross-reactivity occurs in the Parietaria genus. Par o 1 (13.5 kDa) and Par j 1 (12 kDa), the major allergens from Parietaria, are highly cross-reactive, and a high homology has been shown between P. judaica (Par j 1), P. officinalis (Par o 1), P. lusitanica and P. mauritanica (Par m 1). (20, 48)

Par j 1, a LPT, is expected to result in cross-reactivity with other lipid transfer protein containing foods and pollens. However, a recent investigation confirmed cross-inhibition (cross-reactivity) between food LTP allergens but no cross-reactivity between food LPT allergens and Ole e 7 (Olive tree pollen) and Par j 1, or between the LTP allergens from olive tree pollen and Parietaria pollen. (27)

Although a profilin has not been characterised in Parietaria plants, by inference they must contain profilin. (43) Significant but low antigenic cross-reactivity has been demonstrated among Mercurialis annua, Olea europaea, Fraxinus elatior, Ricinus communis, Salsola kali, Parietaria judaica and Artemisia vulgaris by several in vitro techniques. (49) Parietaria profilin shows only limited cross-reactivity with Birch and grass profilins. Less than 50% of patients sensitized to Birch and grass profilin cross-react to Parietaria profilin. (37)

Sera from subjects sensitised to White Cypress, Pine, Italian Cypress, Ryegrass or Birch pollen were shown to have IgE antibodies that reacted with pollen from these and from Cocksfoot, Couch Grass, Lamb's Quarter, Wall Pellitory, Olive, Plantain and Ragweed. The authors conclude that the presence of pollen-reactive IgE antibodies may not necessarily be a true reflection of sensitising pollen species. (50)

The recombinant Juniperus oxycedrus pollen allergen rJun o 2 (Cupressaceae family) has a significant sequence similarity to the calcium-binding proteins called calmodulins, and immunoblotting inhibition tests demonstrated that J. oxycedrus, J. ashei, Cupressus arizonica, C. sempervirens, Parietaria judaica, Olea europaea, and Lolium perenne pollen extracts were able to inhibit IgE binding to blotted rJun o 2. (51) The inference is that that if close cross-reactivity occurs between Juniperus oxycedrus, other members of the Cupressaceae, and Parietaria judaica, then the possibility exists that these pollens may affect individuals sensitised to Pareitaria judaica (and Pareitaria officinalis).

Sensitisation to pistachio is common in Parietaria allergy. (52)

Clinical Experience

IgE mediated reactions

Wall Pellitory pollen has been recognized as an important allergen, causing symptoms of asthma, allergic rhinitis and allergic conjunctivitis. (53, 54, 55, 56, 57, 58, 59, 60, 61) Allergy to Parietaria has been increasing. (62)

Rhinoconjunctivitis and bronchial asthma, alone or in association, represent the most common clinical manifestations of this allergy. The season in which patients experience clinical symptoms is prevalently spring. However, many people show a multiseasonal pattern. Studies have indicated that many Parietaria-allergic patients are monosensitised. (63, 64)

In children, sensitisation to Parietaria is low, but becomes the most frequent cause of sensitivity as individuals grow older. (57, 59)

In some parts of the world, e.g., Catalonia, Spain, and the Balearic Islands, this pollen is present practically all year round. (57, 59)

Parietaria allergy is strongly associated with Mediterranean countries, and in particular with Greece and Italy. (65, 66)

Various studies from Italy have recorded a high prevalence of sensitisation to Parietaria pollen. Parietaria is responsible for 60% to 65% of hay fever pollinosis in Italy: approximately 8% in Northern Italy, 32% in Central Italy, and up to 70% in Liguria. (67, 68, 69 )In Rome, 39.8% of 1612 subjects with respiratory allergy were shown to be sensitised to Parietaria. (70)

Allergen-Specific IgE determination in 2,934 consecutive outpatients with respiratory pathology of suspected allergic origin in 21 centres across Italy showed that 28.2% were positive to at least one of the pollens in the panel tested for, which included Parietaria, and that the prevalence of individual pollen species was related to geographical area. (71)

Although sensitisation to Parietaria is less prevalent in children, it is still significant. In a survey of 600 atopic children (3 to 12 years old) in Naples, 9.9% were sensitive to the pollen of P. officinalis, compared to 30.8% of 1,400 atopic adults. (72) This study is also relevant because of the high degree of cross-reactivity between this plant and P. judaica. In a study of 507 asthmatic atopic children in the Chieti-Pescara area of Italy, allergen-specific IgE investigation for 12 common aeroallergens found that 23% of 507 patients were positive to Parietaria. (73) In Naples, allergy to Parietaria as an isolated allergen or in association with other allergens was recorded in 82.02% of pollen-allergic patients. (74) In San Remo, 41.8% of 5,481 patients where shown to be clinically sensitised to P. officinalis pollen, (75) and by inference, probably to P. judaica. In Parietaria-polysensitised patients, Gramineae were the most frequently associated allergens (84.8%), followed by Olea Europaea (41.1%), Dermatophagoides farinae (37.4%) and Dermatophagoides pteronyssinus (36.2%). (59)

Parietaria pollen is also the most common weed pollen in the Aegean region of Turkey; 52% of 132 patients with allergic rhinitis were positive to Parietaria on specific IgE testing; seven of these (10%) were monosensitised. Fifty-six out of 69 patients (81%) had serum IgE antibodies to Parietaria pollen. (76)

Studies from Spain have produced similar findings. In Catalonia and the Balearic Islands, Parietaria pollen is present throughout the year. Sensitisation to Parietaria in children is reported to be low, but becomes the most frequent cause of sensitivity as the patients grow older. (57) In a survey, allergy to Parietaria allergy was detected in 25% of a group of allergic patients. (56) Patients exclusively sensitive to this pollen have been described, indicating high allergenic specificity of Parietaria. (77). High amounts of Parietaria pollen have also been recorded in aerobiological studies in Salamanca (78) and in Bilbao. (79)

In the southern part of Switzerland (Canton Ticino), 18% of 503 consecutive patients with hay fever were shown to be sensitised to Parietaria using specific IgE tests. (80) The south of France also has a high prevalence of allergy to Parietaria. (81)

Parietaria pollen sensitisation is high in Split, Croatia. (82) Sensitisation to P. officinalis pollen alone was found in 52.5% of hay fever pollinosis patients, whereas 12.5% of patients were allergic to both P. officinalis and grass pollen. Thus, over 65% of this population of hay fever pollinosis patients are allergic to P. officinalis pollen. Further studies in Croatia have recorded that of 4,116 atopic patients with respiratory symptoms, 38.8% were allergic to various pollen allergens, and that of these, 62.5% were sensitised to Parietaria pollen. (64) In Dubrovnik, the far south of Croatia, P. officinalis sensitisation is as high as 92.3% of atopic patients, (83) but this decreases towards the north of the Adriatic, reaching 35.1% in Istria. (84)

Parietaria judaica, although native to the UK, has not usually been considered to be of any clinical importance. Holgate et al. demonstrated, using IgE antibody tests, that 8 of 62 patients with a clinical history of summer seasonal respiratory symptoms were sensitised to this plant. Five of these 8 had never visited the Mediterranean area, and therefore it is possible that sensitisation occurred in the U.K. (85)

Similarly in the USA, 8% of 100 grass-sensitive patients who suffered from seasonal respiratory allergy were found by IgE antibody tests to be sensitised to P. judaica and P. officinalis. (86)

The antibody response to the major allergen from the pollen of Parietaria on the part of allergic patients from three European populations was shown to be associated with HLA-DRB1*1101 and/or 1104. The data suggested that this association is stronger in subjects monosensitised to Parietaria. (87, 88, 89)

The measurement of serum-specific IgE has been shown to be specific and reliable in determining sensitisation to Parietaria. (90, 91)

Other reactions

Although the allergens in pollen may generally be different from those of the rest of the plant, in the case of Parietaria judaica and Dactylis glomerata plants, the allergenic components are present throughout most of the plant: most highly concentrated in the pollen but present in the leaves and in trace amounts in the stems. (92)

Compiled by Dr Harris Steinman, harris@allergyadvisor.com

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As in all diagnostic testing, the diagnosis is made by the physican based on both test results and the patient history.