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Allergen in soy oils
Allergy
... Widyarani et al. (2014) developed biorefinery methods for separation of proteins and oil fractions from rubber seed kernel. Furthermore, some different protocols were reported to extract proteins from the oils, such as low-temperature acetone precipitation (Paschke et al., 2001), phosphate buffered saline (PBS) extraction (Errahali et al., 2002), bicarbonate extraction (Olszewski et al., 1998), borate extraction (Rigby et al., 2011), and cold acetone extraction (Li et al., 2013). However, it is still expected for more and more simple, efficient, and green methods using in protein extraction and enrichment from oil, which can provide researchers more new options. ...
This study aimed to develop the extraction method of protein from edible oil for rapid detection. Firstly, aqueous biphasic systems (ABS) based on six hydrophilic ionic liquids (ILs) and three salts were developed and the phase diagram was drawn by turbidimetric point method. The binodal curves were fitted to the Merchuk equation. On this basis, the ABS composed of IL and salt were applied to extract protein from edible oil. The type of IL or salt, IL concentration, salt concentration, oil mass, extraction pH, and temperature on the extraction efficiency of protein from oil were investigated. The results showed that the optimum conditions for the extraction of protein from edible oil with ABS were as follows: 50% (w/v) K3PO4, 20% (w/v) [Bmim]Cl at 35 ℃, and pH 9.0. Under the optimal conditions, the protein extraction efficiency was almost 100%. Also, the extraction mechanism was studied and the main driving factors of protein extraction may be the hydrophobicity, electrostatic interaction, and salting-out between molecules. Finally, the method was used to detect the commercial edible oils from different sources. The results showed that the ABS could also be used to extract protein from other edible oils. In conclusion, the IL-based ABS method is simple and rapid for protein extraction from edible oil, and will highlight novel possibilities in the large-scale separation and purification of protein from oily solution.
... Since isotretinoin is solubilized in refined soybean oil, the manufacturers discourage prescription in patients with soybean or peanut allergy according to the package leaflet [13]. However, refined soybean oil contains only very low amounts of soy proteins and minimal IgEbinding is to be expected [14]. ...
Background:
Peanut and soybean allergies are listed as contraindication in the package leaflet of isotretinoin, a widely used treatment of acne vulgaris. Cross-reactivity between PR10-proteins in peanut, tree nuts, and soybean is particularly common in patients with birch pollinosis and may lead to anaphylactic reactions in sensitized patients after intake of soybean oil containing isotretinoin capsules.
Case presentation:
Here, we describe a young man with hazelnut and birch pollen allergy, who experienced exercise-induced anaphylaxis after isotretinoin intake on the third day of treatment. A complete allergy work-up was carried out, and sensitization to both peanut and soybean PR10-proteins was confirmed. However, oral provocation with isotretinoin remained negative in the absence of intense physical activity and longterm treatment was well tolerated.
Conclusion:
To our knowledge, this is the first report of an exercise-induced anaphylaxis due to isotretinoin therapy. Our literature review to assess tolerability of isotretinoin in patients allergic to peanut, tree nuts or soybean revealed only one other case of anaphylaxis in a cashew-nut allergic patient sensitized to soybean PR10-protein Gly m 4. While there are no reports on soybean allergic patients treated with isotretinoin, the vast majority of peanut or tree nut allergic patients tolerated isotretinoin. Therefore, we conclude that sensitization to soybean, peanut or tree nuts should not preclude isotretinoin therapy. Particular caution is however warranted in patients with soybean sensitization. Pre-treatment oral challenges with isotretinoin may be recommended and physicians should be aware of the potential role of cofactors.
... The myofibrillar protein tropomyosin (TM) is a cross-reacting allergen among crustaceans and has been shown to be the main allergen in species like shrimp, lobster, crab, and Antarctic krill (Nakano, Yoshinuma, & Yamada, 2008;Reese, Ayuso, & Lehrer, 1999). As reviewed by Hidalgo and Zamora (2006) proteins and peptides may be found in many crude and refined plant oils and several studies have shown that allergenic proteins may be found in oils extracted from peanuts (Ramazzotti et al., 2008), soybeans (Errahali et al., 2002), sunflower seeds (Zitouni et al., 2000), and gourmet nuts (Teuber, Brown, & Haapanen, 1997). Very few studies have however been carried out on the allergenicity of fish oils (Mark, Beaty, & Slavin, 2008) and to the best of our knowledge, the presence of allergens in oils from crustaceans has not been reported. ...
Tropomyosin is known to be the main allergen in crustaceans and the objective of this study was to investigate if this protein could be detected in commercial crustacean oils from Antarctic krill (Euphausia superba) and the zooplankton Calanus finmarchicus. We also examined the possibility of determining the protein content in the oils by direct amino acid analysis. Western blotting showed that a commercial antibody against shrimp tropomyosin cross-reacted with a protein of similar size in Antarctic krill and C. finmarchicus. The protein tentatively identified as tropomyosin, was also detected in krill oil products, but not in oils from C. finmarchicus. The acetone-heptane method used for extracting proteins in the oils is however not optimal. Other extraction methods should therefore be considered when investigating the presence of allergenic proteins in oils. Direct amino acid analysis on oils should be further explored as a method for determining the total amount of proteins present.
... % has been found by a report dependent on feeding habits and exposure [107]. Among sensitive children, 6 % are affected with soy allergy [108]. The threshold levels that is required for eliciting allergenic response vary from 0.0013 to 500 mg as reported by Becker et al. in 2004 [107]. ...
Legumes belonging to Fabaceae family of the order Fabales are a rich and important source of proteins and many essential elements. Due to its nutritious elements, these are preferably included in human diet in most part of the world. But, unfortunately, IgE binding proteins have been identified in majority of legumes, and allergenic response to these legumes may range from mild skin reactions to life-threatening anaphylactic reaction. Overall, allergenicity due to consumption of legumes in decreasing order may be peanut, soybean, lentil, chickpea, pea, mung bean, and red gram. So far, several allergens from different legumes have been identified and characterized. Most of identified allergens belong to storage proteins family, profilins, or the pathogenesis-related proteins. Legumes also have property of immunological cross-reactivity among themselves and from other sources that also increases the severity of allergenic response to a particular legume. This review summarizes the currently available knowledge on legume allergy and describes the allergenic problems associated with different legumes. It also tries to explore about the legume allergens identified so far by different scientific groups. The culmination of knowledge about identification and characterization of allergens from different legumes will be helpful in diagnosis and treatment of allergy, for development of novel therapeutic strategies, for strict avoidance of particular legume in diet by susceptible individual and also to produce hypoallergenic cultivars of leguminous crop through conventional breeding or genetic modification.
... % has been found by a report dependent on feeding habits and exposure [107]. Among sensitive children, 6 % are affected with soy allergy [108]. The threshold levels that is required for eliciting allergenic response vary from 0.0013 to 500 mg as reported by Becker et al. in 2004 [107]. ...
... The increasing use of isolated food proteins (lysozyme, casein, gliadin, soya protein etc.) is at risk of modified allergenicity by production processes [16][17][18] . Finally, the allergenicity of residual proteins in staple food vegetable oils (peanut, sunflower, sesame and soya oil) seems higher than believed [19][20][21][22][23] . ...
The prevalence of food allergies increases, relating to diet modifications. The consumption of new foods--exotic foods or foods originally used for animal feed, new proteins, neo allergens due to the use of new technologies and soon, Genetically Modified Foods--are in the spotlight.
It is essential to develop a system of food allergy vigilance encompassing the full range of foods being consumed. Understanding this imperative leads logically to the suggestion of developing an allergy vigilance network taking advantage of the ongoing experience of allergists "on the ground".
The French Allergy Vigilance Network is subscribed to by 302 allergologists (267 of whom are French). The aims of the Network are to record cases of severe anaphylaxis, to establish an epidemiological data bank from prospective multicenter studies, and to monitor the allergic risk from novel foods.
In 2002, 107 cases of severe anaphylaxis were recorded: anaphylactic shock--59.8% (one fatal), systemic reaction--18.7%, laryngeal angio-edema--15.9%, acute severe asthma--5.6% (one fatal). The main allergens identified were peanuts, nuts, shellfish, lupine flour and wheat flour. Action has been taken as a result: information by industry on inadequate labeling, withdrawal of wrongly labeled batches, and university hospital centers have been encouraged to establish the allergenic safety of their catering services.
Setting up such a network in other countries would lead to a significant advance in knowledge of the peculiarities of allergies relating to a wide variety of eating habits.
... ,28]. Several IgE-binding bands have been detected in sunflower and soy oils [25,26,29]. A recombinant peanut oleosin obtained from baculovirus was shown to be an allergen contained in peanut oil [30]. ...
The purpose of this review is to bring the reader up to date on the importance of assessing a food's lowest observed adverse-effect level (LOAEL) with two aims. Firstly, to help industry choose tests with a level of sensitivity capable of detecting food allergens hidden in industrial products. Secondly, to specify protective measures for highly allergic individuals in order to prevent recurrent severe anaphylaxis. The review also seeks to highlight the present issues and unsolved questions.
Thanks to standardized oral-provocation tests (double-blind placebo-controlled food challenges), LOAELs have been identified for many IgE-dependent food allergies. Most studies concern the pediatric population. Data is available for milk, egg, peanut, wheat flour, and sesame. The LOAELs are commonly in the range of 1-2 mg of natural foods, representing a few hundred micrograms of protein. These minimal reactive doses characterize about 1% of people allergic to milk, egg, or peanut. The level at which no observed adverse effect is seen might be a few tens of micrograms of protein for peanut. At the present time, allergy to oil seems to be restricted to unrefined cold-pressed oils.
Concerning IgE-dependent food allergies, the threshold dose inducing symptoms is now known to vary a great deal according to the individual. A reactive dose of less than 65 mg characterizes 16 and 18% of patients allergic to egg or peanut. Less than 30 mg of milk proteins characterizes 5% of those allergic to milk. For milk, egg, and peanut, 1% of patients have a very low threshold, about 1 mg. Such data emphasize the necessity of using detection tests with a sensitivity better than 10 parts per million. The modifications of allergenicity undergone by protein ingredients that are now commonly introduced into industrially made products are not yet sufficiently known. A better knowledge of the reactive doses of these proteins is needed.
Soy is a hotly debated and widely discussed topic in the field of nutrition. However, health practitioners may be ill-equipped to counsel clients and patients about the use of soyfoods because of the enormous, and often contradictory, amount of research that has been published over the past 30 years. As interest in plant-based diets increases, there will be increased pressure for practitioners to gain a working knowledge of this area. The purpose of this review is to provide concise literature summaries (400–500 words) along with a short perspective on the current state of knowledge of a wide range of topics related to soy, from the cholesterol-lowering effects of soy protein to the impact of isoflavones on breast cancer risk. In addition to the literature summaries, general background information on soyfoods, soy protein, and isoflavones is provided. This analysis can serve as a tool for health professionals to be used when discussing soyfoods with their clients and patients.
BACKGROUND
Soybean is among the ‘big eight’ allergenic foods, and β‐conglycinin, the main antigenic protein of soybean, has high levels of antigenic activity. Why the antigenic activity of soybean β‐conglycinin is not eliminated by enzymatic hydrolysis is not clear. In this study, changes in the molecular composition and antigenicity of β‐conglycinin hydrolyzed by pepsin were analyzed and it was determined whether complete sequential epitopes exist in the resulting hydrolysates. The nature and antigenic activity of protein subunits obtained after β‐conglycinin hydrolysis were also assessed by sodium dodecyl sulfate‐polyacrylamide gel electrophoresis and competitive enzyme‐linked immunosorbent assay, respectively.
RESULTS
The residual antigenic activity of β‐conglycinin was 52%, α′‐ and α‐subunits completely disappeared, the 49 kDa fraction partially disappeared, and peptides measuring 27 and 23 kDa were newly formed after 60 min of enzymatic hydrolysis. Prolonged enzymatic hydrolysis did not result in remarkable changes in these peptides; thus, the peptides show some resistance to enzymatic hydrolysis. The amino acid sequences of the peptide chains were analyzed by matrix‐assisted laser desorption / ionization‐time of flight mass spectrometry and aligned with the related sequences in the corresponding protein and antigen databases. Ten complete sequential epitopes were identified in the residual 49 kDa fraction, of these epitopes, two were from α‐subunits and eight were from β‐subunits.
CONCLUSION
The presence of complete sequential epitopes in hydrolysates obtained from the enzymatic hydrolysis of soybean is an important reason for the incomplete disappearance of the antigenic activity of β‐conglycinin. © 2020 Society of Chemical Industry
Alden et al assert isotretinoin and alitretinoin are contraindicated in nut allergic patients unless tested using the proposed protocol. We feel this is an unsupported step, limiting treatment options for adolescents with two very common conditions: nut allergy and acne.
The index case’s eye and lip swelling occurring very late (12 hours) after isotretinoin, do not automatically represent drug allergy and are inconsistent with IgE‐mediated mechanisms as seen in peanut allergy.
Cette thèse actualise les connaissances de l'évaluation de l'allergénicité des aliments et son application au diagnostic de l'allergie alimentaire. Après la définition, les caractéristiques et la classification des allergènes alimentaires, les phénomènes physico-chimiques modifiant l'allergénicité des aliments ainsi que les réactivités croisées sont décrites. Ainsi sont introduits les outils cliniques et biologiques utiles au diagnostic de l'allergie alimentaire et à la détection des traces d'allergènes alimentaires. Une collaboration étroite entre cliniciens et chercheurs biologistes, permet d'optimiser la prise en charge diagnostique et thérapeutique de l'allergie alimentaire. Cette démarche se concrétise par la mise à disposition et l'utilisation de divers outils (développement d'allergènes recombinants, dosage de contaminants alimentaires dans des médicaments ou aliments, ...) et est illustrée par diverses mises en situation clinique réelles.
Soya‐derived products, including refined soya oil and lecithin, are common excipients in many medicines and nutritional supplements. The European Medicines Agency (EMA) currently advises that all medicines containing soya‐derived excipients should be labelled as contraindicated in peanut‐allergic individuals.³ This was following a Swedish report of 4 deaths in peanut‐allergic children attributed to inadvertent high‐level soya consumption in children previously tolerant to soya, although it has been suggested that these fatalities might have in fact been due to peanut contamination.¹ Of note, soya is an uncommon trigger for fatal anaphylaxis, and there have been no further deaths reported due to soya in Sweden since the original case report.
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Soybean is one of the most important sources of edible vegetable oil and protein. However, soybean is considered as an allergenic food, particularly in western countries. At least 16 IgE-reactive proteins have been identified in soybean, among which Gly m Bd 30K, Gly m Bd 28K and Gly m Bd 60K appeared to be major allergens. These allergens account for less than 1% of total soybean protein. Soybean germplasm selection, breeding and genetic modification have been applied to develop soybean with low- or non-allergenicity. This chapter addresses the characterization of soybean allergens and possible approaches towards developing hypoallergenic soybean cultivars.
Allergy to soybean is rare, whereas the latest data from the allergovigilence network show that soybeans are one of the principal emerging allergens. The clinical manifestations are essentially IgE mediated, with a risk of severe anaphylaxis mainly in patients allergic to peanut or to birch pollen; association with allergy to cow's milk proteins appears to be less frequent. One special feature of soybean allergy is that the threshold for triggering symptoms is often elevated. Characterization of the major allergens and the recent availability of specific IgE assays for nGly m 5, nGly m6 and nGly m 4 provide a better basis for understanding soybean-induced anaphylaxis.
The prevalence of food allergy in the French population is estimated to be 3.24%. The constant increase in this prevalence is related to environmental factors: drugs, tobacco, new foods, new food ingredients and new food technology, all leading to increased allergenicity of ingredients. We decided that it was necessary to develop a system of food allergy vigilance to provide a continuous flow of information about the risk of allergy to new foods and data on the incidence of serious food-induced anaphylaxis. Therefore, a French Allergy Vigilance Network was set up in 2001; it now involves 250 French allergists. One hundred and seven cases of severe anaphylaxis (including two deaths) in 33 children and 74 adults were reported in 2002. Anaphylactic shock was reported in 59.8% of the cases involved (one fatal, to peanut); 18.7% were other systemic reactions, including 15.9% with laryngeal angioedema, 5.6% with serious acute asthma (one fatal, to soy). The most frequent allergens were peanut (14 cases), other nuts (16 cases), shellfish (nine cases), the latex-fruit group (nine cases), lupine flour (seven cases), wheat flour (seven cases), celery (five cases) and snails (five cases). The seriousness of these reactions was underestimated, as epinephrine was administered in only 59% of the cases. Several public interest measures should now be taken: communicate information about the new risk factors to the food industry, advise them to improve labelling, and encourage hospital catering services to set up guidelines for food safety. Setting up the same sort of network in other European countries could lead to a significant advance in knowledge with regard to the peculiarities of allergies relating to a wide variety of eating habits. Data that would be obtained by allergy networks similar to ours would be useful to French and other European health agencies responsible for making decisions concerning the safety of foods.
Background: The increasing prevalence of food allergies could be linked to the use of new technologies using more and more proteic ingredients, as well as to environmental causes such as a growing intake of drugs promoting clinical severity. There is a need to have a continuous flow of information about the risks of new foods, and the frequency of serious forms of allergies. Methods/data base: A French Allergy Vigilance Network taking advantage of the ongoing experience of allergists "on the ground" was set up in 2001 and is subscribed to by 260 members, 232 of whom are French. The aims are to record cases of severe anaphylaxis, to establish a data bank from prospective multicenter studies, and to monitor the allergic risk from novel foods. Results/conclusion: 107 cases were reported in 2002, in 33 children and 74 adults. 59.8% were cases of anaphylactic shock (one fatal, to peanut), 18.7% systemic reactions, 15,9% laryngeal angio-edema, 5.6% serious acute asthma (one fatal, to soy). The most frequent allergens were peanut (14), nuts (16), shellfish (9), latex group fruit (9), lupine flour (7), wheat (7), celery (5), and snails (5). The gravity was underestimated since epinephrine was only administered in 59% of cases. Several public interest measures could be taken, to communicate information to food industries, to improve labelling, to encourage hospital catering services to set up advised procedures to review the safety of meals. Setting up networks such as the French Allergy Vigilance Network in other countries or in Europe would lead to a significant advance in knowledge with regard to the peculiarities of allergies relating to a wide variety of eating habits. National and European health and safety provisions should provide a basic policy for food allergy vigilance ensuing from the epidemiological data supplied by allergologists.
La prévalence de l’allergie alimentaire est de 3,24 % dans la population française. Des facteurs environnementaux doivent être pris en compte dans l’augmentation régulière de fréquence : médicaments, tabac, nouveaux aliments, nouveaux ingrédients et nouvelles technologies. Un système d’allergovigilance informant des risques nouveaux et de la fréquence des formes sévères d’anaphylaxie alimentaire est nécessaire. Le réseau d’allergovigilance, créé en 2001 comporte actuellement 250 allergologues français. Cent sept cas d’anaphylaxie sévère, dont deux mots, ont été rapportés en 2002 chez 33 enfants et 74 adultes. Les accidents cliniques enregistrés sont le choc anaphylactique : 59,8 % (un cas mortel à l’arachide), des réactions systémiques sérieuses : 18,7 %, un angi-œdème laryngé : 15,9 %, un asthme aigu grave : 5,6 % (un cas mortel au soja). Les allergènes les plus fréquents sont l’arachide (14), l’ensemble des noix (16), les crustacés (9), les fruits du groupe latex (9), la farine de lupin (7), la farine de blé (7), le céleri (5), les escargots (5). Une sous-estimation de la gravité, avec absence d’utilisation d’adrénaline est observée dans 59 % des cas. Plusieurs mesures d’intérêt public devraient être prises : communication des risques nouveaux aux industries agro-alimentaires, conseils d’amélioration d’étiquetage, directives de procédures de sécurité alimentaire pour les unités culinaires des hôpitaux. La création de tels réseaux dans d’autres pays européens pourrait contribuer à une avancée significative des connaissances quant aux particularités des allergies alimentaires liées aux habitudes alimentaires diverses. Les données de réseaux d’allergologues similaires au réseau national d’allergovigilance seraient un support important aux décisions autorités sanitaires françaises et européennes en matière de sécurité alimentaire.
In the United States, the prevalence of adults with food allergies is approximately 2% to 3%. Theoretically, any food can cause an allergic reaction; however, some foods are clearly more allergenic than others. In adults, peanuts, tree nuts, finned fish, crustaceans, fruit, and vegetables account for 85% of the food-allergic reactions. Currently, the only ways to manage food allergies are to avoid the allergen and initiate therapy for an allergic reaction if ingestion does occur. The presence of homologous proteins among animal or plant foods and between foods and certain airborne allergens may account for cross-sensitization that may be clinically relevant. For inpatients or outpatients with food allergies, nutrient and fluid requirements are the same as for individuals without food allergies. Since patients with adverse reactions to food may self-restrict intake or have been counseled on food avoidance, it is particularly important to determine dietary adequacy and to provide patients with appropriate food substitutions to provide nutrients that may be missing from a patient’s diet. This is of particular concern for individuals with multiple food allergies. Eating away from home and traveling also pose special problems for those with food allergies.
The α subunit of β-conglycinin is a major allergen in soybean. The objective of this study was to predict and identify the linear immunoglobulin (Ig)E epitopes of the soybean α subunit of β-conglycinin. Three immunoinformatics tools were used to predict the potential epitopes and were confirmed by dot-blot inhibition using sera from soybean allergic subjects. As a result, 15 peptides were predicted and assembled by solid-phase synthesis. Eleven epitopes were identified by the dot-blot inhibition test. Moreover, peptide 3 had IgE binding capability with all sera(5/5) tested, while peptide 1, 4, 6, 8 and12 could bind to 4/5 of the sera samples. Secondary structure prediction of peptide 3 and circular dichroism test validated that the structure of peptide 3 was a random coil.
Atopic dermatitis (AD) is one of the first manifestations of the atopic march. The natural history of food allergies (FA) is closely related to AD. Sensitivity to food is demonstrated with cutaneous tests (prick-tests and atopy patch-tests) or the presence of IgE specific to food. A true allergy to a foodstuff is revealed by oral provocation tests (OPT) or by improvement during an avoidance diet. Ingestion of the food allergen during OPT can provoke an onset of eczema, an immediate reaction (urticaria, oedema) or involve other target organs (digestive disorders, rhinitis, asthma or anaphylactic shock). Seven allergens are responsible for around 90 p. 100 of FA: milk, eggs, wheat, peanuts, nuts, soy and fish. The fundamental knowledge acquired demonstrates the implication of food allergens in the physiopathogenesis of AD. The assessment of the efficacy of avoidance diets is difficult to demonstrate in standardised double-blind studies. Their efficacy is demonstrated compared with the natural history of AD. A diagnostic algorythm of FA during AD is proposed. An avoidance diet can be prescribed on 3 levels: primary, secondary and tertiary prevention. Diagnostic dietetics are aimed at initiating a hypoallergenic diet over a short period of 15 to 21 days when AD is severe and does not permit an allergy assessment. This diet is followed by an allergy assessment and OPT to determine the foodstuff responsible. Therapeutic dietetics consists in initiating an avoidance diet based on the results of the allergy assessment: positive predictive value of specific IgE, positivity of oral provocation tests or the re-introduction of the foodstuff for one week. Preventive dietetics is aimed at preventing the onset of AD: a consensus has been established by the American and European Academies of Paediatrics. In conclusion, present knowledge demonstrates that FA is a triggering factor for AD and that the avoidance diets based on allergy assessments are an essential tool in the treatment of AD. Understanding the triggering mechanisms of oral tolerance will permit the development of strategies for the prevention and cure of food allergies.
Oilseeds are rich in bioactive compounds. However, a major portion of these components is not present in the refined oils because either they are not extracted or they are lost during refining. Nowadays, new processing trends are being explored to increase the nutritional value of edible oils. These procedures are increasing the contents of bioactive compounds, but they are also modifying the contents of other minor components. Among them, peptides and proteins are usually not considered. This review discusses the different types of peptides and proteins characterized in edible oils, the standardized and validated methodology existing for their determination, and the advantages and risks of increasing their contents in the edible oils in relation to oil stability and allergenicity.
A method has been developed to determine residual protein in refined oils, a potential trigger of allergic reactions. High-pH bicarbonate or borate buffers were found to be the most effective extractants, residual oil protein comprising a mixture of proteins of M(r) 6000-100000. Extracted protein could be quantified with superior precision using 3-(4-carboxybenzoyl)quinolone-2-carboxaldehyde (CBQCA). Residual protein content determined in a set of oils using the borate extraction-CBQCA assay was positively correlated with contents determined using a bicarbonate-total amino acid analysis method. Oil refining substantially reduced the oil protein content determined by the borate-CBQCA assay with neutralized/refined, bleached, and deodorized (fully refined) oils containing 62-265 ng/g oil, whereas crude un-degummed oils contained 86000-87900 ng/g of protein. These analyses and published data on cumulative threshold doses for soybean suggest that even the most sensitive individuals would need to consume at least 50 g of highly refined oil to experience subjective symptoms.
The prevalence of food anaphylaxis due to masked allergens has increased within the last 10 years. Contamination of manufactured products by food allergens is a key concern for food industries.
To determine quantities eliciting reactions in patients who have an IgE-dependent food allergy, thanks to standardized oral provocation tests. To evaluate the subsequent levels of sensitivity required for the detection tests of allergens for egg, peanut, milk and sesame.
Prick-in-prick tests, Cap system RAST, and single or double-blind placebo-controlled food challenges (SBPCFC or DBPCFC) were performed. The doses of natural food were gradually increased from 5 to 5000 mg for solid food and from 1 to 30 mL for peanut oil, sunflower oil, soy oil and sesame oil.
Data from 125 positive oral challenges to egg, 103 to peanut, 59 to milk and 12 to sesame seeds were analysed. Haemodynamic modifications were observed in 2%, 3%, 1.7%, and 8% of the oral challenges (OCs) to egg, peanut, milk and sesame, respectively. Respiratory symptoms were observed in 12%, 20%, 10% and 42% of egg, peanut milk and sesame allergies, respectively. A cumulative reactive dose inferior or equal to 65 mg of solid food or 0.8 mL of milk characterized 16%, 18%, 5% and 8% of egg, peanut, milk and sesame allergies, respectively. 0.8% of egg allergies, 3.9% of peanut allergies, and 1.7% of milk allergies reacted to 10 mg or less of solid food or to 0.1 mL for milk. The lowest reactive threshold has been observed at less than 2 mg of egg; 5 mg of peanut, 0.1 mL of milk and 30 mg of sesame seed. Ten out of 29 OC with peanut oil, two out of two OC with soy oil and three out of six OC with sunflower oil were positive. Five out six OC with sesame oil were positive: 1 and 5 mL induced an anaphylactic shock.
The risk of asthma and anaphylactic shock to sesame and peanut is confirmed. Minimal reactive quantities show that, in order to guarantee a 95% safety for patients who are allergic to egg, peanut and milk, and on the basis of consumption of 100 g of food, the detection tests should ensure a sensitivity of 10 p.p.m. for egg, 24 p.p.m. for peanut and 30 p.p.m. for milk proteins. Oil allergies being considered, the limit of sensitivity should fall to 5 p.p.m.
Spices are the most attractive ingredients to confer an authentic taste to food. As they are derived from plants, they harbour allergenic potency and can induce symptoms ranging from mild local to severe systemic reactions. Due to the content of pharmacologically active substances of spices, the diagnosis of allergy and the differentiation from intolerance reactions may be difficult. Association with inhalative allergies via IgE cross-reactivity, but also direct gastrointestinal sensitization plays a role. This article is a botanical and allergological overview of the most important spices and molecules responsible for eliciting IgE-mediated reactions or cross-reactions. As no curative treatments are known at present, strict avoidance is recommended and, therefore, accurate labelling of pre-packed food is necessary.
Atopic dermatitis (AD) is one of the first manifestations of the atopic march. The natural history of food allergies (FA) is closely related to AD. Sensitivity to food is demonstrated with cutaneous tests (prick-tests and atopy patch-tests) or the presence of IgE specific to food. A true allergy to a foodstuff is revealed by oral provocation tests (OPT) or by improvement during an avoidance diet. Ingestion of the food allergen during OPT can provoke an onset of eczema, an immediate reaction (urticaria, oedema) or involve other target organs (digestive disorders, rhinitis, asthma or anaphylactic shock). Seven allergens are responsible for around 90 p. 100 of FA: milk, eggs, wheat, peanuts, nuts, soy and fish. The fundamental knowledge acquired demonstrates the implication of food allergens in the physiopathogenesis of AD. The assessment of the efficacy of avoidance diets is difficult to demonstrate in standardised double-blind studies. Their efficacy is demonstrated compared with the natural history of AD. A diagnostic algorythm of FA during AD is proposed. An avoidance diet can be prescribed on 3 levels: primary, secondary and tertiary prevention. Diagnostic dietetics are aimed at initiating a hypoallergenic diet over a short period of 15 to 21 days when AD is severe and does not permit an allergy assessment. This diet is followed by an allergy assessment and OPT to determine the foodstuff responsible. Therapeutic dietetics consists in initiating an avoidance diet based on the results of the allergy assessment: positive predictive value of specific IgE, positivity of oral provocation tests or the re-introduction of the foodstuff for one week. Preventive dietetics is aimed at preventing the onset of AD: a consensus has been established by the American and European Academies of Paediatrics. In conclusion, present knowledge demonstrates that FA is a triggering factor for AD and that the avoidance diets based on allergy assessments are an essential tool in the treatment of AD. Understanding the triggering mechanisms of oral tolerance will permit the development of strategies for the prevention and cure of food allergies.
Soybean is considered one of the "big eight" foods that are believed to be responsible for 90% of all allergenic reactions. Soy allergy is of particular importance, because soybeans are widely used in processed foods and, therefore, represent a particularly insidious source of hidden allergens. Although significant advances have been made in the identification and characterization of soybean allergens, scientists are not completely certain about which proteins in soy cause allergic reactions. At least 16 allergens have been identified. Most of them, as with other plant food allergens, have a metabolic, storage, or protective function. These allergens belong to protein families which have conserved structural features in relation with their biological activity, which explains the wide immunochemical cross-recognition observed among members of the legume family. Detailed analysis of the structure-allergenicity relationships has been hampered by the complexity and heterogeneity of soybean proteins. A variety of technological approaches have been attempted to decrease soybean allergenicity. This paper provides a comprehensive review of the current body of knowledge on the identification and characterization of soybean allergens, as well as an update on current hypoallergenization techniques.
Five methods using aqueous/organic solvents for the separation of proteins from oils were compared. The extraction with acetone-hexane followed by amino acid analysis was found to be the most suitable method for isolation and quantification of proteins from oils. The detection limit of the method was 0.18 mg protein/kg oil, and the quantification limit was 0.6 mg protein/kg. The relative repeatability limit for samples containing 1-5 mg protein/kg sample was 27%. The protein recovery ranged between 68 and 133%. Using this method, the protein content of 14 refined and nonrefined oils was determined. In none of the refined oils were proteins detected, whereas the protein content of the unrefined oils ranged between undetectable in extra virgin olive oil to 11 mg/kg in rapeseed oil. With sodium dodecyl sulfate-polyacrylamide gel electrophoresis in combination with silver staining, many protein bands were visible in the unrefined soy, olive, peanut, and rapeseed oil samples. Proteins bands were not obtained from the refined fish oil. In the other refined oil samples, a few proteins bands could be visualized. Two protein bands with apparent molecular molecular masses of 58 and 64 kDa were always observed in these oils.
To determine the prevalence of soy allergy in IgE-associated cow's milk allergy (CMA).
Children <3.5 years with documented IgE-associated CMA (n = 93) were evaluated for soy allergy by double-blind, placebo-controlled food challenge, open challenge, or convincing previous history of an anaphylactic reaction to soy. Children tolerant to soy at entry received soy formula and were followed up for 1 year.
Of this IgE-associated CMA cohort (ages 3 to 41 months), 14% (95% CI = 7. 7%-22.7%) were determined to have soy allergy, 12 definitely at entry and 1 possibly after 1 year of soy ingestion. The latter child experienced severe failure to thrive at enrollment and exhibited improved growth while receiving soy during follow-up but was diagnosed with eosinophilic esophagitis at study completion. Improved growth (P <.05) occurred in the non-soy-allergic cohort ingesting soy formula (579 31 mL/d) during the year of follow-up.
Soy allergy occurs in only a small minority of young children with IgE-associated CMA. As such, soy formula may provide a safe and growth-promoting alternative for the majority of children with IgE-associated CMA shown to be soy tolerant at the time of introduction of soy formula.
This report has been prepared by an EAACI task force representing the five EAACI Sections and the EAACI Executive Committee composed of specialists that reflect the broad opinion on allergy expressed by various clinical and basic specialties dealing with allergy. The aim of this report is to propose a revised nomenclature for allergic and related reactions that can be used independently of target organ or patient age group. The nomenclature is based on the present knowledge of the mechanisms which initiate and mediate allergic reactions. However, the intention has not been to revise the nomenclature of nonallergic hypersensitivity.
Although soy is considered a major food allergen (along with milk, egg, peanut, fish, and wheat), the prevalence of soy allergy in the pediatric population is not well defined.
To determine the prevalence of soy allergy in atopic children attending the Allergy Clinic at the Pediatric Department of Milan University.
Seven hundred four patients with allergic signs and symptoms, aged 1 month to 18 years, were recruited between December, 1991 and April, 1992. The subjects with positive skin prick tests to soy were tested using a DBPCFC with powdered soy formula in fruit juice, and rice or corn flour as placebo. In children who refused the liquid challenge, capsules containing dehydrated soy flour or talcum powder as placebo were administered. An age-matched and sex-matched group of subjects with negative skin prick tests to soy were tested using an open challenge with soy formula.
A positive skin prick test to soy was found in 148/704 patients (21%); 131 out of 148 children with positive skin prick test (group A) and 131 out of 556 children with negative skin prick test to soy (group B) were challenged with soy: 8/131 (6%) in group A had a positive soy challenge while no clinical reactions were observed in children in group B. A younger median age, a positive past and current personal history of cow milk allergy, and a previous history of soy allergy were found most often in children with positive soy skin prick test and positive soy challenge than in children with positive skin prick test and negative soy challenge. The eight soy-allergic children reacted to the soy challenge mostly with cutaneous and gastrointestinal symptoms; symptoms were immediate in six and late in two children. The eliciting dose of soy was very small in the immediate reaction; higher and repeated doses were necessary for the onset of late reactions.
The prevalence of clinical soy allergy in our children with positive skin prick tests to soy is 6.1% (8/131), while none of 131 children with negative skin prick test to soy reacted to the challenge.
Macrolides are known to have relatively few side effects and are prescribed in cases of allergic reaction to penicillin. The new macrolides, for example Azithromycin and Roxithromycin, are increasingly preferred over erythromycin at the ear, nose, and throat out-patient department due to improved oral reabsorption (acid resistance), better penetration into tissue, prolonged half-life, extended antibacterial activity, modest side effects, and better pharmacokinetics. There are only few case reports concerning side effects of macrolides. We report on the appearance of a Churg Strauss-Syndrome (CSS) in a patient following intake of the macrolide antibiotic azithromycin and roxithromycin.
A 50-year-old patient with asthma for three years presented with arthritis and mononeuritis multiplex. Laboratory and radiological investigations revealed eosinophilia (64%), eosinophilic infiltrations of bone marrow, raised IgE-level, and transient pulmonary infiltrates. THERAPY AND DEVELOPMENT: Intravenous steroid therapy was started and resulted in normalization of eosinophilia, IgE-level, and asthmatic symptoms. The neurologic deficits showed only a weak tendency for improvement.
The diagnosis of CSS was established on the basis of clinical criterias and laboratory investigations. The diagnosis was supported by the fact that a similar course of the disease was observed one year ago following administration of azithromycin, another macrolide.
Because of a fatal case of soy anaphylaxis occurring in Sweden in 1992, a study was started the following year in which all physicians were asked to report fatal and life-threatening reactions caused by food. The results of the first 3 years of the study are reported here, including results from another ongoing study on deaths from asthma during the same period.
In 1993-6, 61 cases of severe reactions to food were reported, five of them fatal. Peanut, soy, and tree nuts seemed to have caused 45 of the 61 reactions, and four of them were fatal. If two cases occurring less than a year before our study started are included, we are aware of two deaths caused by peanuts and four deaths caused by soy. All four youngsters who died from soy anaphylaxis with asthma were severely allergic to peanuts but had no previously known allergy to soy. In most cases, there was a rather symptom-free period for 30-90 min between early mild symptoms and severe and rapidly deteriorating asthma.
Soy has probably been underestimated as a cause of food anaphylaxis. Those at risk seem to be young people with asthma and peanut allergy so severe that they notice symptoms after indirect contact.
We previously reported eight patients who developed Churg-Strauss syndrome in association with zafirlukast treatment for asthma and postulated that the syndrome resulted from unmasking of a previously existing condition due to corticosteroid withdrawal and not from a direct drug effect. The availability of montelukast, a new leukotriene receptor antagonist with a different molecular structure, permitted us to test this hypothesis. Our goals were to ascertain whether the Churg-Strauss syndrome developed in patients taking montelukast and other novel asthma medications, and to describe potential mechanisms for the syndrome.
Case series.
Outpatient and hospital practices of pulmonologists in the United States and Belgium.
Four adults (one man, three women) who received montelukast as treatment for asthma; two women who received salmeterol/fluticasone therapy, but not montelukast.
Churg-Strauss syndrome developed in the four asthmatic patients who received montelukast. In each case, there was a long history of difficult-to-control asthma characterized by multiple exacerbations that had required frequent courses of oral systemic corticosteroids or high doses of inhaled corticosteroids for control. Two other asthmatics who received fluticasone and salmeterol but not montelukast therapy developed the same syndrome with tapering doses of oral or high doses of inhaled corticosteroids.
The occurrence of Churg-Strauss syndrome in asthmatic patients receiving leukotriene modifiers appears to be related to unmasking of an underlying vasculitic syndrome that is initially clinically recognized as moderate to severe asthma and treated with corticosteroids. Montelukast does not appear to directly cause the syndrome in these patients.
Pigeon fanciers' lung (PFL) is a form of extrinsic allergic alveolitis caused by exposure to avian antigens. Although the mechanisms involved in the pathogenesis of PFL are unclear it has been suggested that immune complexes formed on the alveolar epithelial surface of the lung initiate the symptoms of the acute stages of discase. Pigeon intestinal mucin has been implicated as an important antigen in the pathogenesis of PFL, and affected fanciers have very high antibody titres against this antigen. In this study we investigated the IgG and IgG subclass responses to both intact and papain digested mucin in 250 pigeon fanciers classified according to the presence of absence of precipitating antibodies and clinical status. Sera were screened by quantitative ELISA for IgG and IgG subclass activity to these antigens. There was no significant difference in the median IgG titre to pigeon mucin in individuals with PFL and asymptomatic antibody positive individuals. IgG1 and IgG2 were the major antibody subclasses against pigeon intestinal mucin with lower titres of IgG3 and negligible IgG4. Patients with PFL had significantly higher titres of anti-mucin IgG1 than asymptomatic antibody positive individuals (p = 0.0019) whilst there was no significant differences in IgG2, IgG3 and IgG4 titres between these two groups. Papain digestion of mucin resulted in a 600 fold decrease in IgG3 titres whilst IgG1 and IgG2 titres were essentially unaffected as compared to undigested mucin. This suggests that both IgG1 and IgG2 are directed against the O-linked oligosaccharides in the papain resistant regions of mucin whilst the majority of IgG3 is directed against papain sensitive protein epitopes (or possibly N-Iinked sugars in the sparsely glycosylated regions). - The difference between symptomatic and asymptomatic sera in the IgG subclass profiles to pigeon intestinal mucin together with the very high titres of anti-mucin antibody in all individuals with PFL confirm pigeon mucin as a major antigen in disease. Differences in antibody subclass profiles are likely to affect the composition and properties of the immune complexes, with consequences for the developmcnt of disease.
In the present study refined and non-refined soybean oils as well as soy lecithins were investigated for residual allergenicity and compared with extracts from native soybeans. By means of immunoblotting and EAST inhibition experiments no IgE-binding activity was detectable in refined soybean oils, which is probably due to thermal treatment during the refining. The investigated non-refined oils and soy lecithins showed a residual IgE-binding activity. In addition in the lecithin extracts a new IgE-binding structure with a molecular mass of approximately 16 kDa was detectable.
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