A Comprehensive Review on Kiwifruit Allergy: Pathogenesis, Diagnosis, Management, and Potential Modification of Allergens Through Processing

Abstract

Kiwifruit is rich in bioactive components including dietary fibers, carbohydrates, natural sugars, vitamins, minerals, omega‐3 fatty acids, and antioxidants. These components are beneficial to boost the human immune system and prevent cancer and heart diseases. However, kiwifruit is emerging as one of the most common elicitors of food allergies worldwide. Kiwifruit allergy results from an abnormal immune response to kiwifruit proteins and occur after consuming this fruit. Symptoms range from the oral allergy syndrome (OAS) to the life‐threatening anaphylaxis. Thirteen different allergens have been identified in green kiwifruit and, among these allergens, Act d 1, Act d 2, Act d 8, Act d 11, and Act d 12 are defined as the “major allergens.” Act d 1 and Act d 2 are ripening‐related allergens and are found in abundance in fully ripe kiwifruit. Structures of several kiwifruit allergens may be altered under high temperatures or strong acidic conditions. This review discusses the pathogenesis, clinical features, and diagnosis of kiwifruit allergy and evaluates food processing methods including thermal, ultrasound, and chemical processing which may be used to reduce the allergenicity of kiwifruit. Management and medical treatments for kiwifruit allergy are also summarized.

Linking cross-reactivity clusters of food and respiratory allergens in PAMD@ to asthma and duration of allergy

“…So far cross-reactivity between kiwi fruits and a variety of fruits, vegetables, nuts and seeds has been reported. 25 We found no previous report about an association between Act d 1 and Gal d 3. However, about 119 similar and 65 identical positions between these two proteins were found according to UniProt database.…”

Influence of high-intensity ultrasound on the IgE binding capacity of Act d 2 allergen, secondary structure, and In-vitro digestibility of kiwifruit proteins

“…In 2004, the Food and Drug Administration (FDA) of the United States required labeling of products containing the “Big Eight” allergenic food items, including milk, eggs, fish, shellfish, tree nuts, peanuts, wheat, and soybeans [3] . Currently, kiwifruit is considered to cause the most common plant-based food allergies among fruits worldwide after the “Big Eight” [1] , [4] . In Turkey, allergic reactions triggered by kiwifruit is ranked fourth among children aged 6 to 9 years old [5] .…”

“…In addition, many studies have found that pollen such as birch and ragweed pollen, and other fruits and vegetables showed cross-reactivity with kiwifruit since they contain similar allergenic epitopes in their proteins [9] , [10] , [11] , [12] , [13] . To date, 20–40% of the population around the world are allergic to pollen [4] . Thus, the number of people susceptible to kiwifruit allergens is increasing.…”

“…However, thermal processing negatively affected the color attributes, flavor, and bioactive compounds (e.g., ascorbic acid and phenolics) present in fruit samples. Thus, novel non-thermal processing techniques are needed [4] .…”

Effect of Instant Controlled Pressure Drop (DIC) Treatment on the Detection of Nut Allergens by Real Time PCR

“…Foods, including tree nuts, are frequently submitted to thermal and non-thermal processing in the food industry, to improve their organoleptic properties or ensure their safety [13]. Roasting, boiling, baking or frying are common thermal treatments applied in the food industry.…”