Heterogeneity of banana allergy: characterization of allergens in banana-allergic patients

Grob, Martin; Reindl, Jürgen; Vieths, S.; Wüthrich, B; Ballmer‐Weber, Barbara

doi:10.1016/s1081-1206(10)62090-x

Cited by 30 publications

(22 citation statements)

References 17 publications

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“…Sera from patients with pollen allergy sensitized to profilin show IgE cross-reactivity with fruits and vegetables. Profilin has been implicated in the birch-Rosaceae fruit and the birch-mugwort-celery-spice syndrome [11, 12], and several studies concluded that this protein can also play a role in patients allergic to a variety of other foods [6, 11, 13, 14, 15, 16, 17, 18, 19, 20, 21]. Results of recent studies suggest that IgE antibodies to profilin in foods have little or no clinical relevance [22, 23, 24].…”

Section: Introductionmentioning

confidence: 99%

Severe Allergy to Sharon Fruit Caused by Birch Pollen

Bolhaar

Ree

et al. 2005

Int Arch Allergy Immunol

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Background: Allergy to sharon fruit (persimmon) has been only rarely reported. Cross-reactivity with pollen (profilin and Bet v 6) appeared to be involved, but Bet v 1 has not been implicated previously. Objective: It is our aim to identify whether Bet v 1 sensitization is linked to sharon fruit allergy. Methods: Two patients with a reaction upon first exposure to sharon fruit were included in the study, as well as 7 patients with birch-pollen-related apple allergy. Sensitivity was assessed by skin prick testing (SPT), a radio-allergosorbent test (RAST) and immunoblotting. RAST analysis was performed for Bet v 1, Bet v 2 and Bet v 6. Cross-reactivity was evaluated by RAST and immunoblot inhibitions. Biological activity of IgE was measured by basophil histamine release. Sharon fruit allergy was evaluated by double-blind placebo-controlled food challenge (DBPCFC) or open challenge (OC). Results: Both sharon-fruit-allergic patients demonstrated positive reactions in the RAST (8.6 and 6.2 IU/ml, respectively) and SPT (wheal area 37 and 36 mm²). Sharon fruit allergy was confirmed by DBPCFC in 1 patient. The second patient refused a challenge because of the severe initial reaction. Sera from both patients were reactive to Bet v 1 and Bet v 6, which was cross-reactive with sharon fruit by inhibition assays. The patient with the severest reactions was reactive to profilin on immunoblotting. However, profilin did not induce significant histamine release, nor did Bet v 6. Bet v 1 induce approximately 60% histamine release. An OC with sharon fruit in 7 patients allergic to birch pollen and apple, who had not eaten sharon fruit previously, was positive in 6/7 cases. Conclusions: Birch-pollen-related allergy to sharon fruit is mediated by the known cross-reactive pollen allergens including Bet v 1 and may become more of a problem should sharon fruit consumption increase.

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Section: Introductionmentioning

confidence: 99%

Severe Allergy to Sharon Fruit Caused by Birch Pollen

Bolhaar

Ree

et al. 2005

Int Arch Allergy Immunol

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“…Based on our immunoblot findings it is possible to hypothesize that the same also holds true for the other three vegetable foods studied here. In effect, in previous studies, Grob et al [39] did not detect any LTP-allergic subject among patients with clinical allergy to banana not sensitized to natural rubber latex, no patient allergic to melon, watermelon and other members of the gourd family without clinical pollinosis have been observed so far [40,41,42,43], and no LTP hypersensitivity has been observed in potato-allergic children [44]. Since LTPs are generally located in the epidermal layers of plant-derived foods we might not ingest LTP in banana, melon and potato as these foods are usually consumed in peeled form.…”

Section: Discussionmentioning

confidence: 95%

Detection of Some Safe Plant-Derived Foods for LTP-Allergic Patients

Asero

Mistrello

Roncarolo

et al. 2007

Int Arch Allergy Immunol

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Background: Lipid transfer protein (LTP) is a widely cross-reacting plant pan-allergen. Adverse reactions to Rosaceae, tree nuts, peanut, beer, maize, mustard, asparagus, grapes, mulberry, cabbage, dates, orange, fig, kiwi, lupine, fennel, celery, tomato, eggplant, lettuce, chestnut and pineapple have been recorded. Objective: To detect vegetable foods to be regarded as safe for LTP-allergic patients. Methods: Tolerance/intolerance to a large spectrum of vegetable foods other than Rosaceae, tree nuts and peanut was assessed by interview in 49 subjects monosensitized to LTP and in three distinct groups of controls monosensitized to Bet v 1 (n = 24) or Bet v 2 (n = 18), or sensitized to both LTP and birch pollen (n = 16), all with a history of vegetable food allergy. Patients and controls underwent skin prick test (SPT) with a large spectrum of vegetable foods. The absence of IgE reactivity to foods that were negative in both clinical history and SPT was confirmed by immunoblot analysis and their clinical tolerance was finally assessed by open oral challenge (50 g per food). Results: All patients reported tolerance and showed negative SPT to carrot, potato, banana and melon; these foods scored positive in SPT and elicited clinical symptoms in a significant proportion of patients from all three control groups. All patients tolerated these four foods on oral challenge. Immunoblot analysis confirmed the lack of IgE reactivity to these foods by LTP-allergic patients. Conclusion: Carrot, potato, banana and melon seem safe for LTP-allergic patients. This finding may be helpful for a better management of allergy to LTP.

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“…8 However, there are few reports of this condition. 9,10 The immunoglobulin E (IgE) binding epitopes in allergens contribute to allergenicity and are seen as a prediction of clinical severity and the development of tolerance. 11,12 Food allergens are classified into (i) Class I food allergen and (ii) Class II food allergens.…”

Section: Discussionmentioning

confidence: 99%

Tolerance to Baked Banana in Adult with Banana Anaphylaxis: A Case Report

Wongsa

Intapiboon

Dechapaphapeaktak

et al. 2017

bkkmedj

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F ood allergy is defined as "an adverse reaction to food in which immunological mechanisms have been demonstrated." 1 The increae in the prevalence of food allergy was reported as about 3.5%-5% of the general population 2 and 8% of the paediatric population. 3 The characteristic of food-induced allergic disorders have been defined as IgE-mediated, cell-mediated and mixed (IgE and cell-mediated). 2 Prevalence of adverse reactions to fruits was reported in 2.2-11.5% of children and 0.4-6.6% of adults. 4 Among fresh fruit, banana is not a common cause of fruit allergy, but it can cause life-threatening symptoms. Banana allergy is characterized as banana hypersensitivity, cross reaction to birch tree or pollen known as oral allergy syndrome and the latex-fruit syndrome which often occurs in patients sensitive to latex. Here we reported a case of a patient who experienced banana anaphylaxis without latex or pollen allergy and can tolerate baked banana. Case ReportA case of 59-year-old Thai woman with generalized pruritic urticarial rash, rhinorrhea, nasal obstruction and shortness of breath after 30 minutes following the ingestion of two pieces of raw Pisang awak banana (glûay-nám-wáa) ( Figure 1) together with paracetamol 1,000 mg. At the emergency room, blood pressure 160/90 mmHg, pulse rate 80/min, respiratory rate 15/min, body temperature 37.2°C. The physical examination revealed good consciousness, end expiratory rhonchi both lungs, nasal swelling, angioedema both eyelids with generalized urticarial rash, and organ presented within normal limits. Food-induced anaphylaxis was diagnosed and adrenaline (1:1,000) 0.5 mL intramuscular was given to her immediately with the rapid response of her clinical syptoms within an hour. Unfortunately, a late phase reaction occurred 3 hours later. She was then admitted as an inpatient for a day and discharged with self-epinephrine auto injection. Serum tryptase 2 hours after the onset of reaction revealed 19.10 ug/L (1.9-13.5). AbstractBananas are one of the most consumed fruits in the world with enriched nutrients. Although allergy to banana is rare, it can occur in both children and adults with varying clinical presentation ranging from oral allergy syndrome to anaphylaxis.Banana is a complex allergen including both heat labile and heat stable parts of proteins. As far as known, the heat stable allergen or linear epitope in their molecular structure usually plays a significant role in a case of anaphylaxis.Here we report 59-year-old woman who experienced anaphylaxis following the ingestion of raw Pisang awak banana (glûay-nám-wáa). Interestingly, this patient shows substantial evidence of immunoglobulin E (IgE) reactivity to the banana but can tolerate baked banana.

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Heterogeneity of banana allergy: characterization of allergens in banana-allergic patients

Cited by 30 publications

References 17 publications

Severe Allergy to Sharon Fruit Caused by Birch Pollen

Severe Allergy to Sharon Fruit Caused by Birch Pollen

Detection of Some Safe Plant-Derived Foods for LTP-Allergic Patients

Tolerance to Baked Banana in Adult with Banana Anaphylaxis: A Case Report

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