Diagnostic utility of the basophil activation test in natto-induced hypersensitivity

Fukuda, Ryoko; O‐Uchi, Toshiaki; Asahina, Yasuhiko; Shiiya, Chihiro; Takeuchi, Sakiko; Yasuda-Sekiguchi, Fumiyo; Iriki, Hisato; Kouno, Michiyoshi; Takahashi, Shinichi; Tanikawa, Akiko; Amagai, Masayuki; Takahashi, Hayato

doi:10.1016/j.alit.2021.07.010

Cited by 3 publications

(2 citation statements)

References 21 publications

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“…Two very recent articles have focused on the use of BATs in the diagnosis of soy allergy. However, in both cases, the authors used only a total soy extract (soymilk proteins for one and natto extracts and soybean extract for the other, respectively) ( 28 , 29 ). Although they both concluded that the BAT was of interest in this indication, their test method cannot distinguish between the two types of soy allergy at a molecular level and so does not seem to us to be able to answer all the questions raised by the diagnosis of soy allergy.…”

Section: Discussionmentioning

confidence: 99%

Utility of the Basophil Activation Test Using Gly m 4, Gly m 5 and Gly m 6 Molecular Allergens for Characterizing Anaphylactic Reactions to Soy

Evrard

Cosme

Raveau³

et al. 2022

Front. Allergy

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There are two major clinically described forms of IgE-dependent soy allergy: (i) a primary dietary form, linked to sensitization against soy storage proteins Gly m 5 and Glym 6, and (ii) a form included in birch-soy syndromes linked to Gly m 4, a PR-10-like allergen. This second form sometimes causes severe systemic reactions, even anaphylaxis, especially on consuming certain forms of soy such as soymilks or smoothies. Skin prick tests and specific IgE assays against soy whole extracts lack sensitivity. Assays of anti-Gly m 4, Gly m 5 and Gly m 6 specific IgEs have been developed to overcome this obstacle, but they unfortunately lack specificity, especially for anti-Gly m 4. We hypothesized that the basophil activation test (BAT) using molecular soy allergens Gly m 4, Gly m 5 and Gly m 6 would both remedy the lack of sensitivity of other tests and offer, through its mechanistic contribution, greater specificity than the assay of anti-Gly m 4 specific IgEs. This would enable the two types of soy allergy to be separately identified. In a characteristic clinical example of PR-10-induced anaphylactic reaction after consuming soymilk, we report preliminary results of Gly m 4-exclusive positivity of BAT supporting our hypothesis. It will be necessary to confirm these results on more patients in subsequent studies, and to specify the place of the BAT in an overall diagnostic strategy. Meanwhile, soy BAT using molecular allergens is a promising diagnostic tool for soy allergy and probably also for follow-up in specific immunotherapies.

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Section: Discussionmentioning

confidence: 99%

Utility of the Basophil Activation Test Using Gly m 4, Gly m 5 and Gly m 6 Molecular Allergens for Characterizing Anaphylactic Reactions to Soy

Evrard

Cosme

Raveau³

et al. 2022

Front. Allergy

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“…Natto, tempeh, miso and soy sauce are associated with numerous health benefits, thought to be due to the fermentation process increasing the amount of isoflavones which may protect against allergic inflammation [48]. The case reports usually describe Japanese adults who can tolerate soy products but have had anaphylactic reactions to natto, which is soybeans in a mucilage [49,50]. One allergen identified is poly- c -glutamic acid (PGA) in the mucilage, a substance also produced by jellyfish,, meaning surfers and other regular sea bathers may be at a risk of developing reactions to natto if they become sensitised to PGA through jellyfish stings [51].…”

Section: Legumesmentioning

confidence: 99%

New arrivals in anaphylaxis to foods

Olivieri

Skypala

2023

Current Opinion in Allergy &Amp; Clinical Immunology

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Purpose of review More people are excluding wheat from their diet, or turning to a more sustainable diet in which includes meat substitutes or is mainly or wholly plant-based. This increases the availability of new foods and with it the increasing likelihood of novel allergens. Recent findings There is a growing body of evidence which suggests that allergies to seeds and legumes are increasing potentially due to their use in concentrated form in vegan or health foods. Insects can be a sustainable source of protein, but mealworm could provoke symptoms in individuals sensitized or allergic to shellfish or house dust mite. Novel plant food allergens such as gibberellin-regulated proteins and thaumatin-like proteins are increasingly being reported as significant causes of severe reactions to fruits. Summary these findings make it even more imperative to take a full dietary history to ensure apparent idiopathic anaphylaxis is not in reality due to a novel food, especially in cases where other forms of the food are tolerated. Given the lack of diagnostic tests for these novel foods, a prick-to-prick skin prick test should be performed with the suspected food. There is currently more work needed to define and sequence many of the allergens involved.

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Nattokinase (Bac s 1), a subtilisin family serine protease, is a novel allergen contained in the traditional Japanese fermented food natto

Suzuki¹,

Nakamura²,

Sato³

et al. 2023

Allergology International

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Diagnostic utility of the basophil activation test in natto-induced hypersensitivity

Cited by 3 publications

References 21 publications

Utility of the Basophil Activation Test Using Gly m 4, Gly m 5 and Gly m 6 Molecular Allergens for Characterizing Anaphylactic Reactions to Soy

Utility of the Basophil Activation Test Using Gly m 4, Gly m 5 and Gly m 6 Molecular Allergens for Characterizing Anaphylactic Reactions to Soy

New arrivals in anaphylaxis to foods

Nattokinase (Bac s 1), a subtilisin family serine protease, is a novel allergen contained in the traditional Japanese fermented food natto

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