Hypersensitivities to sesame and other common edible seeds

Abstract

Several seeds have been increasingly incorporated in various food items, with consequent risk of hypersensitivity reactions that are often severe. Identification of the specific seed as the culprit is often not explored or is difficult to verify. In this article, we reviewed the English literature from January 1930 to March 2016 using PubMed and Google Scholar searching for publications relevant to hypersensitivity to common edible seeds, namely sesame, sunflower seed, poppy seed, pumpkin seed, flaxseed, and mustard seed. Considering the worldwide consumption of those seeds, the number of published articles on the subject was relatively small and was mainly as case reports rather than large series. Allergy to sesame was more reported than to other seeds, with an estimated prevalence of 0.1-0.2%. In this review, we summarize the information relevant to each of the six seeds and their oils regarding the manifestations, routes of exposure, identified major allergens, and cross-reactivity with other seeds or other foods. We also addressed the important role of a thorough history taking in suspecting seed allergy, the limited reliability of routine diagnostic procedures, and the importance of verification by appropriate challenge tests. At present, management is basically dietary avoidance and the use of symptomatic medications that may include epinephrine auto-injectors. We did not encounter any well-designed studies on immunotherapy for seed allergy, but it is hoped that such a gap be filled by the development of safe effective protocols in the near future.With the growing trend of incorporating seeds in diet, hypersensitivity reactions have been increasingly occurring but are rarely suspected. The problem is compounded by the difficulty in identifying the culprit and the apparent underreporting. MethodsIn this article, we review the English literature from January 1930 to March 2016 using PubMed and Google Scholar. Special attention was directed to hypersensitivity reactions to commonly consumed seeds, namely sesame, sunflower, poppy, flaxseed, and pumpkin seed, and their respective oils. We also summarize the studies on the identified allergens and the cross-reactivities among these seeds and with other foods.

A patient‐specific approach to develop an exclusion diet to manage food allergy in infants and children

“…38 Of these, sesame and mustard are included in the list of 14 major allergens in the EU, but not on the US FALCPA list, where sesame and mustard may be hidden ingredients on product labels. The most commonly eaten seeds are sesame, sunflower seed, poppy seed, pumpkin seed, flaxseed and mustard seed.…”

“…The most commonly eaten seeds are sesame, sunflower seed, poppy seed, pumpkin seed, flaxseed and mustard seed. 38 Of these, sesame and mustard are included in the list of 14 major allergens in the EU, but not on the US FALCPA list, where sesame and mustard may be hidden ingredients on product labels. 39 BOX 2 Important points regarding the management of nut and lupin allergy Nut avoidance strategies…”

Medicinal bioactivites and allergenic properties of pumpkin seeds: review upon a pediatric food anaphylaxis case report

“…Pumpkin (58,59). Cupins (7S vicilins and 11S legumins) have been identified in sesame seed, and 2S albumin storage proteins in both sesame and sunflower seed (60). The important sequential and structural homology of storage proteins of different origins may be responsible for cross-reactivity between different edible seeds, peanuts and tree nuts (58)(59)(60).…”

Ever Increasing Allergies to the Edible Seeds in Recent Years: Sesame Allergy

“…Susam, ay çiçeği, haşhaş, balkabağı, hardal ve keten gibi yenilebilir tohumların günlük beslenme programımızda kullanımının artmasıyla birlikte tohumlarla ilgili hipersensitivite reaksiyonları giderek artmaktadır. Çocuk olgularda da birçok yiyeceğe tohumların katılması ve kutanöz maruziyet nedeniyle tohum alerjisinin arttığı bildirilmektedir (1) .…”

“…Susam (Sesameum indicum), pedalium ailesine (Pedaliaceae) mensuptur ve özellikle Asya mutfağında yemeklerin hazırlanmasında kullanılır. Susam alerjisi, diyet alışkanlıklarının küreselleşmesi ve vejetaryen/vegan yaşam tarzlarına yönelik genel eğilimin artmasıyla hekimlerin günlük rutininde giderek daha fazla önem kazanmaktadır (1) . Susam, önemli allerjenitesi ve hipersensitivitesi ile diğer tohum allerjilerinden daha sık görülmekte olup, prevalansı %0,1-0,2 olarak tahmin edilmektedir (1,2) .…”