New Food Allergies in a European Non-Mediterranean Region: Is <b><i>Cannabis sativa</i></b> to Blame?

Abstract

Background: Allergy to fruit and vegetables exhibit geographic variation regarding the severity of symptoms and depending on the sensitization profile of the patient. These sensitization profiles and routes remain incompletely understood. Cannabis is a very popular drug and derived from Cannabis sativa, a plant containing lipid transfer proteins (LTP) also known as important allergens in plant and fruit allergies. In this study we sought to elucidate a potential connection between C. sativa allergy and plant food allergies. Methods: A case-control study involving 21 patients consulting for plant food allergies. Twelve patients were cannabis allergic and 9 had a pollen or latex allergy without cannabis allergy. Testing for cannabis IgE implied measurement of specific IgE, skin testing and basophil activation tests. Allergen component analysis was performed with a microarray technique. Results: Plant food allergy in patients with documented cannabis allergy had more severe reactions than patients without cannabis allergy and frequently implied fruits and vegetables that are not observed in a (birch) pollen-related food syndrome. With the exception of 1 patient with cannabis allergy, all were sensitized to nonspecific (ns)-LTP. Conclusion: Our data suggest that illicit cannabis abuse can result in cannabis allergy with sensitization to ns-LTP. This sensitization might result in various plant-food allergies. Additional collaborative studies in different geographical areas are needed to further elucidate on this hypothesis.

Cannabis Allergy: What do We Know Anno 2015

“…Consequently, sensitization to Can s 3 could be an explanation for the high variety of secondary plant-derived food allergies seen in European patients with a cannabis allergy. This, sometimes extensive, cross-reactivity between cannabis and plant-derived food has been described by Ebo et al (2013) and was recently designated as the ''cannabis-fruit/vegetable syndrome'' by Van Gasse et al (2014). In our case-control series (Ebo et al 2013), 10/12 patients with a documented cannabis allergy were sensitized to different ns-LTPs including Pru p 3, the ns-LTP of peach (Prunus persica).…”

“…This, sometimes extensive, cross-reactivity between cannabis and plant-derived food has been described by Ebo et al (2013) and was recently designated as the ''cannabis-fruit/vegetable syndrome'' by Van Gasse et al (2014). In our case-control series (Ebo et al 2013), 10/12 patients with a documented cannabis allergy were sensitized to different ns-LTPs including Pru p 3, the ns-LTP of peach (Prunus persica). The food allergies most commonly implicated in the cannabis-fruit/vegetable syndrome were allergies to peach, banana, apple, cherry, nuts, tomato and occasionally citrus fruits such as orange and grapefruit.…”

“…Furthermore, young children may be exposed to cannabis allergens, e.g. through smoking by parents and/or siblings (Ebo et al 2013).…”

“…First, respiratory reactions like rhinoconjunctivitis, asthma and palpebral angioedema have been described. These reactions predominantly occur when cannabis is consumed by smoking or vaporizing (Ebo et al 2013;Swerts et al 2014;Van Gasse et al 2014). Respiratory symptoms may also arise from passive exposure to cannabis smoke by proxy or inhalation of C. sativa pollen (Ebo et al 2013;Mayoral et al 2008;Prasad et al 2009;Singh and Shahi 2008;Stokes et al 2000;Torre et al 2007).…”

“…Presently, sensitization and allergy to cannabis are almost exclusively studied or documented by prick-prick skin testing. Prick-prick skin tests use a broad variety of raw materials such as macerated C. sativa leaves, buds and flowers de Larramendi et al 2008;Ebo et al 2013;Gamboa et al 2007;Larramendi et al 2013;Metz-Favre et al 2011;Nayak et al 2013;Stadtmauer et al 2003;Tessmer et al 2012). Needless to say, this approach is virtually impossible to standardize, mainly because of unpredictable variations in composition and potential contaminations with other allergens of the raw material.…”