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t20 Mesquite

t20 Mesquite Scientific Information

Tipo:

Whole Allergen

Nome visualizzato:

Mesquite

Family:

Fabaceae

Latin Name:

Prosopis juliflora

Other Names:

Mesquite, Common mesquite, Prairie mesquite, Algarroba

Route of Exposure

Allergen Exposure

Mesquites belong to the Fabaceae (Legume) family. There are about 44 species of mesquite found throughout the world. They occur most frequently in warmer and semi-arid regions of North and South America (especially Argentina), Africa, India, and south-western Asia. Three of the most common mesquites are native and characteristic shrubs of the south-western US and Louisiana: honey mesquite (P. glandulosa), screwbean mesquite (P. pubescens), and velvet mesquite (P. velutina). (1, 2) Mesquite (P. juliflora) is native to Mexico, South America and the Caribbean. It has been introduced into Asia, Australia and elsewhere. All 4 are deciduous and have characteristic bean pods that have long been used by humans, wildlife and livestock as a food source.

Mesquite is a deciduous shrub or small tree typically reaching a height of 5-10 metres, and characterised by 22-centimetre bean-like pods. Mesquite bark is dull red and somewhat rough. The green-brown stem is sinuous and twisted, with axial thorns situated on both sides of the nodes and branches. The leaves are bi-pinnately compound and nearly hairless. The leaflets have short to non-existent stalks, and are dark green. Straight 2.5 cm spines arise in pairs from leaf axils. Seedpods are 10-22 cm long, yellow-green, flattened and narrowed between the seeds, ending in a point, and either straight or curved; they occur in drooping clusters. (2)

Mesquite flowers in early summer. Its flowers are small, green-yellowish spikes without any particular fragrance, and yet are attractive to bees. Honey mesquite’s flowers are creamy-yellowish to green and sweet-smelling. They are densely packed in cylindrical clusters. In India, P. juliflora flowers twice a year, in February-March and August-September. (3) Pollen may be produced in large quantities. Pollination is by both insects and wind.

Mesquite in several varieties (4) has been used for reclamation of desert lands and as a wood resource, with the end result that its easily dispersed and far-travelling pollen is an abundant and significant source of allergens. (5, 6, 7)

This tree can be found in warm climates in the desert, alongside desert washes and streams, on plains and hillsides, and often in thickets. Mesquites are widely used as ornamental shade trees throughout the south-west US because they need little or no watering and can survive on limited rainfall.

Mesquite wood is used chiefly for firewood. The wood is also used for fence posts, tool handles, furniture, and to create aromatic charcoal for barbecuing. Liquid smoke for meat flavouring is manufactured from honey mesquite sawdust. Honey mesquite provides an excellent source of nectar for honey bees. Native Americans used the seedpods, with or without the seeds, as flour, the root fibre for rope, and the wood for utensils, posts, and fuel. (2)

Clinical Relevance

Allergen Description

Mesquite pollen has been shown to contain at least 13 antigenic proteins. Early studies reported antigens varying from 10 to 81 kDa, with the most allergenic fraction being a 20 kDa protein. Other proteins of 13, 20, 27.5, 41, 55.5 and 81 kDa have been detected. (8, 9, 10, 11, 12, 13, 14, 15) Other authors, in evaluating pooled serum from 10 mesquite-allergic individuals, detected allergenic bands of 11, 16, 17, 18, 20, 27, 30, 36, 44, 56, 71, and 99 kDa. An additional IgE response by a 64 kDa band not present on the gel was detected on the blot, resulting in a total of 13 blot bands. The remaining kDa gel band produced only a slight image when blotted. (16) In an Indian study of 38 mesquite-sensitised individuals, the patients' pooled sera demonstrated 16 IgE binding components, with components of 24, 26, 29, 31, 35, 52, 58, 66 and 95 kDa recognised by more than 80% of individual patients' sera. (17)

To date, only one mesquite allergen has been partly characterised:

  • Pro j 20kD, a 20 kDa protein. (10, 11, 13, 18)
  • Pro j 66kD, a 66 kDa protein. (19)

Using serum IgE of mesquite-allergic individuals, 59 and 66 kDa proteins were isolated from the pollen, wood and wood smoke of mesquite. The authors commented that more allergens of mesquite pollen were present but did not give further descriptions. (20)

A more recent study purified a 66 kDa protein from mesquite pollen extract, which was shown to be recognised by 90% of mesquite-sensitised patients in skin test and ELISA, as well as to induce significant histamine release in allergic patients' blood. (19)

Potential Cross Reactivity

Cross-reactivity among members of the legume family (Fabaceae) may be expected, but has not yet been investigated. Significant cross-reactivity between members of the genus is probable. (21)

Cross-inhibition assays have shown a close relationship between Mesquite pollen, Ailanthus excelsaCassia siamea, Holoptelea integrifolia, Putranjiva roxburghii and Salvadora persica. IgE binding components of 14, 41, 52 and 66 kDa were shared allergens, whereas those of 26 and 29 kDa were specific to P. juliflora. (17, 22)

In a study investigating cross-reactivity of mesquite tree pollen with plant-derived foods, in vitro cross-reactivity of mesquite pollen with Lima bean was evaluated. Of 110 patients with asthma, rhinitis or both who were tested intradermally, 20 showed marked positive reactions with mesquite pollen extract. Of these, 12 patients showed elevated IgE antibodies to mesquite pollen extract alone, and 4 to both Lima bean and the pollen extract. Lima bean extract could inhibit IgE binding to mesquite in a dose-dependent manner. Immunoblot and immunoblot inhibition demonstrated the presence of 20, 26, 35, 66 and 72 kDa shared IgE-binding components between the 2 extracts. Histamine release, peripheral blood mononuclear cell proliferation, and interleukin IL-4 levels also suggested allergenic cross-reactivity. (23) Whether Mesquite is cross-reactive with other Phaseolus species was not investigated.

A 66-kDa protein isolate from mesquite pollen extract was shown in inhibition assays to have a close allergenic relationship with Ailanthus excelsaCassia siameaSalvadora persica pollen and Phaseolus lunatus (lima bean). (19)

Molecular Aspects

Clinical Experience

IgE-mediated reactions

Mesquite pollen may induce asthma, rhinitis and conjunctivitis in sensitised individuals. (6, 24, 25, 26)

Mesquite is a major cause of allergic disease in the south-western United States, (4, 6, 16, 24, 27) Mexico, (16, 28, 29) Saudi Arabia, (30, 31, 32, 33, 34) Namibia and South Africa, (35) Kuwait, (5, 36, 37) the United Arab Emirates (UAE), (38, 39) and India. (17, 40, 41, 42)

Mesquite pollen is a potent allergen capable of evoking immediate hypersensitivity reactions in a susceptible population remote from the plant source. One study reports that 62% of 100 consecutive patients attending an allergy clinic were shown to be positive to mesquite pollen, as confirmed by IgE antibody tests, despite the absence of the plant within a 50-mile (80-kilometre) radius. (6) Asthmatics may experience a dual response: an acute immediate (IgE-mediated) response as well as a late response. (43)

In Tucson, Arizona, a city that has a high prevalence of allergic rhinitis and asthma, pollen from the mesquite tree has been noted to be among the major causes. (24) In a report on sensitisation to mesquite pollen in Charleston, South Carolina, USA, 1 598 out of 4 361 patients were said to be sensitised to mesquite pollen, even though most of them had no known direct exposure to mesquite. (16) A Texas study compared serum-specific IgE testing to skin-prick testing for 53 inhalant allergens using subjects > or = 18 years old with chronic rhinitis and who had at least 1 positive skin-prick test to a 53-inhalant allergen panel. Skin-prick test was positive in 34% for mesquite, compared to 19% for serum-specific IgE. (44) In another study, the lead author examined aeroallergen sensitisation rates in military children in Texas undergoing skin testing for rhinitis. Twenty-nine per cent were positive for mesquite pollen. (45)

An earlier study conducted in Tucson assessed the incidence and remittance of positive skin-test reactions to individual allergens in 828 children aged 6-11 years, and the remittance rates for individual allergens were high and variable (19-49%). The perennial allergens Bermuda and Alternaria were early sensitisers and had low remittance rates. For mesquite, the percentage of positive skin-prick tests at 6 years of age was 11%, and 24% at 11 years of age. (46)

In a study in Comarca Lagunera, Mexico, skin-prick tests on 101 patients with asthma reported sensitisation to mesquite tree in 57%.  (29) A study of the prevalence of aeroallergen sensitisation in 181 atopic asthmatic adults in Guadalajara and Veracruz, Mexico, reported that 20% were sensitised to mesquite tree pollen. (47) In a study aimed at describing the skin-prick test sensitivity patterns in the different climatic zones in Mexico, 13-24% were sensitised to mesquite. (48)

The practices that ‘green’ the desert have some unintended consequences, including the promotion of allergen sensitisation to imported plants. In a study from Kuwait on 706 patients aged 6 to 64 years who had allergic rhinitis, specific IgE to mesquite tree was found in 50.3%. (37) In a study of 553 asthmatics in Kuwait with sensitisation to common aeroallergens, as measured by serum-specific IgE, it was found that the 3 most prevalent sensitising pollens were from Chenopodium (70.7%), Bermuda grass (63%), and mesquite tree (63%), all of which are horticultural plants imported for the purpose of ‘greening’ the desert. (7)

In a Saudi Arabian study of 473 allergic patients suffering from bronchial asthma in 4 geographical regions, a total of 76% in Qassim, 37.5% in Gizan, 29% in Abha, and 11% in Hofuf reacted positively to mesquite pollen extract. (5) In a study in Saudi Arabia of 84 children with allergic rhinitis, skin testing with common allergens found that cat fur, Bermuda grass and mesquite were the most common allergens. Symptoms of recurrent rhinosinusitis, otitis media with effusion, and tonsil and adenoid infection were commonly noticed among them. (32) Similarly, in a study in the Eastern Province of Saudi Arabia of 1 159 patients with positive skin-prick tests to inhalants, 46% of natives and 32% of North American expatriates were positive to this allergen. (33) Mesquite tree pollen may also be carried in sandstorm dust, as demonstrated in a study conducted in Riyadh, Saudi Arabia, which reported that mesquite tree pollen was one of the most abundant aeroallergens. (31) Among 263 United Arab Emirates nationals with a respiratory disease suspected of being of allergic origin, 23.5% were sensitised to pollen from mesquite trees. (39) In a study of 327 adult patients with respiratory, dermatologic and ophthalmologic diseases of suspected allergic origin who attended a hospital based in the United Arab Emirates, and who were evaluated for aeroallergen sensitisation, skin-prick testing showed that 45.5% were sensitised to mesquite. (38) A more recent study found mesquite to be the most prevalent sensitisation in patients in the Riyadh region of the Kingdom of Saudi Arabia, (49) with skin-prick tests being positive in 72%. (50)

A study conducted in the Kingdom of Saudi Arabia (KSA), the United Arab Emirates, and Sudan, evaluated 492 consecutive patients, mean age 30 years. Indigenous raw material for pollen grains was collected from the desert near the capital city of Riyadh, KSA. The highest sensitisation to indigenous pollens was detected to Chenopodium murale (32%) in Khartoum (Sudan) and Salsola imbricata (30%) and P. juliflora (24%) in the Riyadh region. (49)

In Oman, an evaluation of the records of 689 patients who had undergone an allergy skin-prick test with a diagnosis of asthma, allergic rhinitis or rhinoconjunctivitis found that 36% were sensitised to mesquite (P. glandulosa). (51)

A study reviewing perennial and seasonal aeroallergen trends in the Middle East, and their effect on military personnel serving in the area, reported that most of the countries have significant grass and weed pollen seasons, and that mesquite tree is as relevant among these personnel as it is in the USA. (52)

In India, where the mesquite tree is common, (53) a Delhi study reported that mesquite pollen was the most significant pollen sensitising agent, with 35% of patients being sensitised to it. Of the 166 patients who skin-tested positive for mesquite, 50 sera were evaluated for serum-specific IgE for mesquite, of which 60% were positive. (54) An earlier study employed intradermal tests with mesquite pollen extract on respiratory allergy patients from the Bikaner (arid) and Delhi (semi-arid) areas in India, and elicited positive skin reactions in 71/220 of the patients. (17) In a recent study of 331 Indian patients with nasal allergy, nasal polyps, allergic conjunctivitis and allergic asthma, 321 patients showed significant positive results to skin-prick tests. Dust and pollen allergens were positive in most of the patients, compared with insect antigens. Among the pollen antigens tested, those of Parthenium hysterophorus were found to be the most common (30%), followed by mesquite (25%). (55) An earlier study evaluating sensitisation to Nile trumpet tree (Dolichandrone platycalyx) was investigated in all patients with allergic rhinitis and asthma attending a tertiary care centre in South India, and found that of 317 subjects, 18% were sensitised to mesquite pollen. (56) In100 patients attending a clinic in Jaipur, India, who were skin-prick tested, 16% were positive for mesquite. (57)

A study cautioned that when commercial mesquite tree pollen extract results in an isolated positive skin test result, this may be a false positive result, and that in some patients the allergen extract apparently has the ability to cause direct mast cell degranulation. (58)

Immunotherapy for mesquite pollen allergy has not been extensively evaluated to date. (59)

Other reactions

Individuals with marked hypersensitivity to mesquite pollen should be aware that honey might contain mesquite pollen, as demonstrated by a report of a patient who was extremely sensitive to mesquite pollen and experienced anaphylaxis after ingesting honey containing this pollen. (60)

Mesquite wood charcoal has been widely promoted for the unique taste it imparts to broiled food. In a study comparing 13 mesquite charcoal cooks with 17 gas-flame broiler cooks, the prevalence of respiratory symptoms among workers exposed to mesquite charcoal smoke was greater to a statistically significant degree. Unidentified high-molecular-weight saturated and unsaturated aliphatic hydrocarbons were present in air samples from the environments of the mesquite broiler cooks, but not in air samples from the environments of the gas-flame broiler cooks. (61)

Compiled By

Last reviewed: June 2022.

References
  1. Simpson BJ. A field guide to Texas trees. Houston, Gulf Publishing Co. 1999:243-7.
  2. Weber RW. On the cover. Mesquite. Ann Allergy Asthma Immunol 2007;98(4):A4.
  3. AgroForestryTree Database. Prosopis juliflora. http://www.worldagroforestry.org/SEA/Products/AFDbases/AF/asp/SpeciesInfo.asp?SpID=1354. Accessed March 2013.
  4. Bieberdorf FW, Swinny B. Mesquite and related plants in allergy. Ann Allergy 1952;10(6):720-4.
  5. Al-Frayh A, Hasnain SM, Gad-El-Rab MO, Al-Turki T, Al-Mobeireek K, Al-Sedairy ST. Human sensitization to Prosopis juliflora antigen in Saudi Arabia. Ann Saudi Med 1999;19(4):331-6.
  6. Novey HS, Roth M, Wells ID. Mesquite pollen--an aeroallergen in asthma and allergic rhinitis. J Allergy Clin Immunol 1977;59(5):359-63.
  7. Ezeamuzie CI, Thomson MS, Al-Ali S, Dowaisan A, Khan M, Hijazi Z. Asthma in the desert: spectrum of the sensitizing aeroallergens. Allergy 2000;55(2):157-62.
  8. Sridhara S, Singh BP, Arora N, Verma J, Gangal SV. A study on antigenic and allergenic changes during storage in three different biological extracts. Asian Pac J Allergy Immunol 1992;10(1):33-8.
  9. Thakur IS, Kamal, Mishra S. Fractionation and immunological characterization of allergens and allergoids of Prosopis juliflora pollen. Asian Pac J Allergy Immunol 1991;9(1):57-62.
  10. Thakur IS. Isolation and characterization of two antigenic glycoproteins from the pollen of Prosopis juliflora. Biochem Int 1991;23(5):969-78.
  11. Thakur IS. Purification and characterization of the glycoprotein allergen from Prosopis juliflora pollen. Biochem Int 1991;23(3):449-59.
  12. Thakur IS. Isolation of allergenically active glycoprotein from Prosopis juliflora pollen. Biochem Int 1989;18(3):605-13.
  13. Thakur IS. Fractionation and immunochemical characterization of Prosopis juliflora pollen allergen. Biochem Int 1986;13(6):951-60.
  14. Thakur IS. Prosopis juliflora pollen allergen induced hypersensitivity and anaphylaxis studies in guinea pigs. Biochem Int 1986;13(5):915-25.
  15. Thakur IS, Sharma JD. Isolation and characterization of allergens of Prosopis juliflora pollen grains. Biochem Int 1985;11(6):903-12.
  16. Killian S, McMichael J. The human allergens of mesquite (Prosopis juliflora). Clin Mol Allergy 2004;2(1):8.
  17. Dhyani A, Arora N, Gaur SN, Jain VK, Sridhara S, Singh BP. Analysis of IgE binding proteins of mesquite (Prosopis juliflora) pollen and cross-reactivity with predominant tree pollens. Immunobiology 2006;211(9):733-40.
  18. Thakur IS. Fractionation and analysis of allergenicity of allergens from Prosopis juliflora pollen. Int Arch Allergy Appl Immunol 1989;90(2):124-9.
  19. Dhyani A, Singh BP, Arora N, Jain VK, Sridhara S. A clinically relevant major cross-reactive allergen from mesquite tree pollen. Eur J Clin Invest 2008;38(10):774-81.
  20. More D, Whisman LB, Jordan-Wagner D. Identification of specific IgE to mesquite wood smoke in individuals with mesquite pollen allergy. [Letter] J Allergy Clin Immunol 2002;110(5):814-6.
  21. Yman L. Botanical relations and immunological cross-reactions in pollen allergy. Pharmacia Diagnostics AB. Uppsala. Sweden. 1978: ISBN 91-7260-511-1.
  22. Singh BP, Sinha S, Arora N. Cross reactive allergens: status and their clinical implications. Indian J Allergy Asthma Immunol 2008;22(2):105-18.
  23. Dhyani A, Arora N, Jain VK, Sridhara S, Singh BP. Immunoglobulin E (IgE)-mediated cross-reactivity between mesquite pollen proteins and lima bean, an edible legume. Clin Exp Immunol 2007;149(3):517-24.
  24. Sneller MR, Hayes HD, Pinnas JL. Pollen changes during five decades of urbanization in Tucson, Arizona. Ann Allergy 1993;71(6):519-24.
  25. Sharma SD, Vyas MS, Singh M. Role of Prosopis juliflora and house-dust with reference to spring catarrh. Indian J Med Res 1975;63(11):1652-5.
  26. Shivpuri DN, Parkash D. A study in allergy to prosopis juliflora tree (Hindi name: Kabuli Keekar). Ann Allergy 1967;25(11):643-8.
  27. Calhoun KH. Patterns of mold sensitivity in the subtropical Gulf Coast. Otolaryngol Head Neck Surg 2004;130(3):306-11.
  28. Bessega C, Ferreyra L, Vilardi JC, Saidman BO. Unexpected low genetic differentiation among allopatric species of section Algarobia of Prosopis (leguminosae). Genetica 2000;109(3):255-66.
  29. Martínez Ordaz VA, Rincón Castañeda CB, López Campos C, Velasco Rodríguez VM. Cutaneous hypersensitivity in patients with bronchial asthma in La Comarca Lagunera. [Spanish] Rev Alerg Mex 1997;44(6):142-5.
  30. Abdulrahman Al-Frayh et al. Human sensitization to Prosopis juliflora antigen in Saudi Arabia Ann Saudi Med 1999;19(4):331-6.
  31. Kwaasi AA, Parhar RS, al-Mohanna FA, Harfi HA, Collison KS, al-Sedairy ST. Aeroallergens and viable microbes in sandstorm dust. Potential triggers of allergic and nonallergic respiratory ailments. Allergy 1998;53(3):255-65.
  32. al Anazy FH, Zakzouk SM. The impact of social and environmental changes on allergic rhinitis among Saudi children. A clinical and allergological study. Int J Pediatr Otorhinolaryngol 1997;42(1):1-9.
  33. Suliaman FA, Holmes WF, Kwick S, Khouri F, Ratard R. Pattern of immediate type hypersensitivity reactions in the Eastern Province, Saudi Arabia. Ann Allergy Asthma Immunol 1997;78(4):415-8.
  34. Hasnain SM, Fatima K, Al-Frayh A, Al-Sedairy ST. One-Year pollen and spore calendars of Saudi Arabia Al-Khobar, Abha and Hofuf. Aerobiologia 2005;21(3):241-7.
  35. Ordman D. The prosopis tree as a cause of seasonal hay fever and asthma j South West Africa and South Africa. S Afr Med J 1959;33(1):12-4.
  36. Davies RR. Spore concentrations in the atmosphere at Ahmadi, a new town in Kuwait. J Gen Microbiol 1969;55(3):425-32.
  37. Dowaisan A, Al-Ali S, Khan M, Hijazi Z, Thomson MS, Ezeamuzie CI. Sensitization to aeroallergens among patients with allergic rhinitis in a desert environment. Ann Allergy Asthma Immunol 2000;84(4):433-8.
  38. Bener A, Safa W, Abdulhalik S, Lestringant GG. An analysis of skin prick test reactions in asthmatics in a hot climate and desert environment. Allerg Immunol (Paris) 2002;34(8):281-6.
  39. Lestringant GG, Bener A, Frossard PM, Abdulkhalik S, Bouix G. A clinical study of airborne allergens in the United Arab Emirates. Allerg Immunol (Paris) 1999;31(8):263-7.
  40. Singh AB, Kumar P. Aeroallergens in clinical practice of allergy in India. An overview. Ann Agric Environ Med 2003;10(2):131-6.
  41. Singh AB, Kumar P. Common environmental allergens causing respiratory allergy in India. Indian J Pediatr 2002;69(3):245-50.
  42. Singh AB, Shahi S. Aeroallergens in clinical practice of allergy in India- ARIA Asia Pacific Workshop report. Asian Pac J Allergy Immunol 2008;26(4):245-56.
  43. Menon MP, Das AK, Singh AB. Dual asthmatic responses to prosopis juliflora. Ann Allergy 1977;39(5):351-4.
  44. Calabria CW, Dietrich J, Hagan L. Comparison of serum-specific IgE (ImmunoCAP) and skin-prick test results for 53 inhalant allergens in patients with chronic rhinitis. Allergy Asthma Proc 2009;30(4):386-96.
  45. Calabria CW, Dice J. Aeroallergen sensitization rates in military children with rhinitis symptoms. Ann Allergy Asthma Immunol 2007;99(2):161-9.
  46. Stern DA, Lohman IC, Wright AL, Taussig LM, Martinez FD, Halonen M. Dynamic changes in sensitization to specific aeroallergens in children raised in a desert environment. Clin Exp Allergy 2004;34(10):1563-669.
  47. Bedolla-Barajas M, Hernández-Colín DD, Sainz-Hernández J, Morales-Romero J. Allergen sensitization in Mexican adults with asthma: Experience at a teaching hospital. [Spanish] Rev Alerg Mex 2011;58(3):133-41.
  48. Larenas-Linnemann DE, Fogelbach GA, Alatorre AM, Cruz AA, Colín DD, Pech JA, Hernández AM, Imperial DA, del Prado ML, Zapién FJ, Huerta RE, Martell JA. Patterns of skin prick test positivity in allergic patients: usefulness of a nationwide SPT chart review. Allergol Immunopathol (Madr ) 2011;39(6):330-6.
  49. Hasnain SM, Al-Frayh AR, Subiza JL, Fernández-Caldas E, Casanovas M, Geith T, Gad-El-Rab MO, Koshak E, Al-Mehdar H, Al-Sowaidi S, Al-Matar H, Khouqeer R, Al-Abbad K, Al-Yamani M, Alaqi E, Musa OA, Al-Sedairy S. Sensitization to indigenous pollen and molds and other outdoor and indoor allergens in allergic patients from Saudi Arabia, United Arab Emirates, and Sudan. World Allergy Organ J 2012;5(6):59-65.
  50. Almogren A. Airway allergy and skin reactivity to aeroallergens in Riyadh. Saudi Med J 2009 Mar;30(3):392-6.
  51. Al-Tamemi SH, Al-Shidhani AN, Al-Abri RK, Jothi B, Al-Rawas OA, Al-Riyami BM. The pattern of sensitisation to inhalant allergens in Omani patients with asthma, allergic rhinitis and rhinoconjunctivitis. Sultan Qaboos Univ Med J 2008;8(3):319-24.
  52. Waibel KH. Allergic rhinitis in the Middle East. Mil Med 2005;170(12):1026-8.
  53. Anand P. Commonest Allergens: Indian Scenario. (Poster) 2nd Int Symp Molecular Allergol, Rome, Italy, 22-24 April 2007.
  54. Sharma S, Kathuria PC, Gupta CK, Nordling K, Ghosh B, Singh AB. Total serum immunoglobulin E levels in a case-control study in asthmatic/allergic patients, their family members, and healthy subjects from India. Clin Exp Allergy 2006;36(8):1019-27.
  55. Lal A, Sunaina Waghray S, Nand Kishore NN. Skin prick testing and immunotherapy in nasobronchial allergy: our experience. Indian J Otolaryngol Head Neck Surg 2011;63(2):132-5.
  56. Mridula PA, Mahesh PA, Abraham JN, Amrutha DH, Agashe SN, Sitesh R, Vedanthan PK. Dolichandrone platycalyx: New entomophilous pollen--A report on pollen sensitization in allergic individuals. Am J Rhinol Allergy 2011;25(1):e34-8.
  57. Goyal M, Parikh R, Goyal N. Identification of common allergens by skin prick test associated with common respiratory allergic disorders in the city of Jaipur. Rajasthan. Indian J Allergy Asthma Immunol 2010;24(1):1-6.
  58. Kelso JM. Interpretation of isolated positive skin test results for mesquite tree pollen. J Allergy Clin Immunol 2004;114(2):452-4.
  59. Parasuramalu BG, Gangaboraiah R, Balaji R, Someswara GM. Assessment of quality of life among patients with respiratory allergy, receiving sublingual and subcutaneous immunotherapy. Indian J Allergy Asthma Immunol 2011;25(1):21-7.
  60. Mansfield LE, Goldstein GB. Anaphylactic reaction after ingestion of local bee pollen. Ann Allergy 1981;47(3):154-6.
  61. Johns RE Jr, Lee JS, Agahian B, Gibbons HL, Reading JC. Respiratory effects of Mesquite broiling. J Occup Med 1986;28(11):1181-4.