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Tables of pollen cross-reactivities for formulating allergen immunotherapy*designated as a recommended representative for allergen immunotherapy (WeberRW, Guidelines for using pollen cross-reactivity in formulating allergen immunotherapy, JACI, July 2008)General Patterns of Allergenic Cross-ReactivityBotany taxonomic ranks: kingdom>phylum>class>order>family>subfamily>tribe>genus>speciesSame tribe or genusClosely-related compositions and protein structuresStrong cross-reactionsSame family or subfamilySimilar compositions with different/unique structuresModerate cross-reactionsDifferent subfamilies or familiesDistinct compositions/structures, minimal similaritiesLow/no cross-reactionsWeedsFamilyGenusCommon name and speciesNotesAsteraceaeArtemisiaMugwort (A. vulgaris)*Common/giant sagebrush (A. tridentata)*WormwoodCross-react within genusMay evaluate and treat with one member; use mugwortin Europe and eastern US, sagebrush in midwestern and western USAmbrosiaShort ragweed (A. artemisiifolia)*Giant ragweed (A. trifida)*False ragweed (A. acanthicarpa)*Western ragweed (A. psilostachya)*Cross-react within genus May treat with one member, but common to treat with both short and giant ragweeds due to possible unique major/minor allergensAmbrosia, Xanthium, and Ivain same family and may cross-react, some authors recommend using limited number of allergens from cross-reactive groupsSouthern ragweedSlender ragweedDo not cross-react well with other ragweeds, consider treating separatelyIvaBurweed marshelder (I. xanthifolia)*Rough marshelder (I. ciliata)Poverty weedCross-react within genus, choose one (usually burweed marshelder)XanthiumCocklebur (X. communis)*Consider treating separatelyAmaranthaceaeAtriplex(“saltbush”)Redroot pigweed (A. retroflexus)*PigweedAmaranthCross-react within genus, choose one (usually redroot pigweed)AmaranthusWingscale(A. canescens)*Cross-react within genus, choose one (usually wingscale)Chenopodioiddeae subfamily (formerly known as Chenopodiaceae family)SalsolaRussian thistle (S. pestifer= S. kali)*May possess unique allergens, treat separatelyKochiaBurning bush (K. scoparia)*May possess unique allergens, treat separatelyChenopodiumLamb’s quarters(C. album)Mexican teaCross-react within genusLamb’s quarter has strong cross-reactivity with Salsola(e.g. Russian thistle) and Kochia(e.g. burning bush) sppUrticaceaeUrticaNettle (U. dioica)*Nettle and pellitory with unique allergens, treat separatelyParietariaPellitory (P. judaica)*PlantaginaceaePlantagoEnglish plantain (P. lanceolota)Treat separatelyPolygonaceaeRumexSheep’s sorrel (R. acetosella)DockCross-react within genusGrassesFamilyCommon name and genus/speciesNotesPooideaeTimothy (Phleum pratense)*Sweet vernalMeadow fescueRyeJuneKentucky blueOrchardRed topVelvetCanaryCereal grains (e.g. wheat, rye, barley)Cross-react within familyTimothy and sweet vernal may have unique allergensTreat with one member (usually timothy) but consider addition of sweet vernal if neededChloridoideaeBermuda (Cynodon dactylis)*LovegrassPrairie grasses including salt, buffalo, gramaCross-react within family, choose one (usually bermuda)PanicoideaeJohnson (Sorghum halepense)*BahiaCornSugarcaneCross-react within familyEvaluate bahia and johnson separatelyMay treat with one member(usually johnson) but consider treating bahia and johnson separately
*designated as a recommended representative for allergen immunotherapy (WeberRW, Guidelines for using pollen cross-reactivity in formulating allergen immunotherapy, JACI, July 2008)ReferencesWeberRW, Guidelines for using pollen cross-reactivity in formulating allergen immunotherapy, JACI, 7/2008Cox et al, Allergen immunotherapy: A practice parameter thirdupdate, JACI, 1/2011WeberRW, Patterns of pollen cross-allergenicity, JACI, 8/2003WeberRW, Cross-reactivity of Plant and Animal Allergens, Clin Rev in All and Imm, 2001Esch RE, Portnoy J, Allergen Immunotherapy, Curr All Asthma Reports, 2001TreesFamily and subfamilyCommon name and genus/speciesNotesCupressaceaeMountain cedar (Juniperus ashe)*Other juniper, cedar treesCypressCross-react within family(except Taxodioideae)May evaluate and treat with one member, usually mountaincedarTaxodioideaeJapanese red cedar (Cryptomeria japonica)*Not a truecedar; evaluate and treat separatelyfrom other CupressaceaeJapanese red cedar is the only species in this genusPinaceaeWhite pine (Pinus strobus)*Other pine treesSpruceCross-react within family, choose one (usually white pine)FabaceaeMimosaLocustMesquiteCross-react within familyBetulaceaeSilver birch (Betula verrucosa)*European alder (Alnus glutinosa)*HazelnutHornbeamCross-react within family, and between Betulaceae/Fagaceae familiesThe use of one locally prevalent member adequate (usually birch, alder, or oak)FagaceaeWhite oak (Quercus alba)*Red oakBeechChestnutJuglandaceaeCaryaPecan (C. illinoensis)HickoryCross-react within familyJuglansBlack walnut (J. nigra)OleaceaeAsh (Fraxinus excelsior)*European olive (Olea europaea)*PrivetLilacCross-react within family, choose one locally prevalent member (usually ash in N. America)SalicaceaePopulusEastern cottonwoodPoplarAspenCross-react within genusand family, cottonwoodand willowin particularSalixWillowSapindaceaeAcerRed maple (A. rubrum)*Cross-react within genus but box elder may have unique allergens, evaluate and treat box elder separatelyBox elder (A. negundo)*UlmaceaeUlmusAmerican elm Chinese elm Siberian elm Cross-react within genusMoraceaeWhite mulberry(Morus alba)Paper mulberry(Morus papyrifera)Cross-react within genusPlatanaceaeAmerican sycamore(Platanus occidentalis)Cross-react within genusAltingiaceaeAmerican sweetgum(Liquidambar styraciflua)Cross-react within genusArthropodsGenusCommon name and speciesNotesDermatophagoidesDust mite (D. pteronyssinus, D. farinae)Cross-react but also have significant unique allergens, if treating with both decrease dose of eachBlatellaGerman cockroach(B. germanica)Unique allergens, treat with both at full doseAlthough, German cockroaches are most likely to occur in American homes, an equal mixture of German and American is appropriatePeriplaneta American cockroach(P. americana)AedesMosquito (A. aegyptii)Treat separately