[The allergenic significance of legumes]

Anaphylaxis due to green beans (Phaseolus vulgaris): a new phenotype?

BACKGROUND

Anaphylaxis is a severe allergic reaction with increasing incidence in Europe. It is often caused by food, insect venom, and drugs. White, red, and green beans (Phaseolus vulgaris) are legumes of the Fabaceae family consumed worldwide. In Spain, beans are the third most consumed legume species after chickpeas and lentils. Allergy to different legumes is very frequent in children and represents the fifth cause of food allergy.

OBJECTIVE

Demonstrate a new phenotype in patients with green bean anaphylaxis.

MATERIAL AND METHODS

We report a 20-year-old woman who experienced anaphylaxis after consuming cooked green beans and required emergency treatment. There were no associated cofactors such as medications, alcohol, or physical exercise. After the episode, she tolerated well nuts, garlic, chickpeas, peas, and soy. Prick-prick with raw and cooked green bean, ISAC, SDS-PAGE and IgE-Western blot were performed.

RESULTS

The prick+prick test with raw and cooked green beans was positive. The sodium dodecyl sulfate-polyacrylamide gel electrophoresis-immunoglobulin E (SDS-PAGE/IgE)-western blot analysis with white and red beans as well as cooked and raw green beans showed identification of several proteins with a molecular weight of 25-75 kDa in the extract of raw beans. Only one protein with a molecular weight of approximately 10 kDa was recognized in cooked beans.

CONCLUSION

We present a case of anaphylaxis induced by green beans (Phaseolus vulgaris) because of a 10-kDa protein and tolerance to other legumes, which suggests a new phenotype.

Leguminosas como causa infrecuente de alergia alimentaria en Colombia: reporte de dos casos y revisión de la literatura

La alergia alimentaria se ha venido incrementando a nivel mundial, afectando alrededor del 1,5 % a 2,5 % de los adultos y 6 % de los niños, y tiene un gran impacto en la calidad de vida de los pacientes y sus cuidadores, debido a las dietas de restricción. Los alérgenos más prevalentes son la leche, el huevo, el trigo, la soja, los frutos secos, el maní, el pescado y los mariscos. Las leguminosas mejor estudiadas son el maní y la soja; otras leguminosas como las lentejas, garbanzos y arvejas representan la quinta causa de alergia alimentaria en el área mediterránea, en Turquía y en la India, siendo menos prevalentes en otras áreas geográficas. La alergia a las leguminosas es una entidad infrecuente en Colombia, se desconoce la prevalencia en el país. Describimos los primeros dos casos de anafilaxia por lentejas reportados en el país. Ambos pacientes menores de 18 años, con reacciones adversas tras la ingesta de leguminosas, en las cuales se demuestra alergia mediada por IgE a las lentejas y además sensibilización en el primer caso a las arvejas y garbanzos, y en el segundo caso a los frijoles. Diferentes datos sobre la prevalencia se han descrito en varias áreas geográficas, siendo mayor en países con dietas mediterráneas. Las reacciones mediadas por IgE suelen aparecer incluso con el alimento altamente cocido, debido a la termo-estabilidad de las proteínas. La reactividad cruzada más frecuente se relaciona con los garbanzos y las arvejas.

Clinical phenotypes of childhood food allergies based on immune mechanisms: A multicenter study

Background: Food allergies (FA) are an important public health concern that place a major burden on the lives of children and their families. The complex pathogenesis of FAs results in multisystemic and heterogenous clinical presentations. Objective: To evaluate, according to immune mechanisms, the characteristics and risk factors of childhood FA in Turkey. Methods: This descriptive multicenter study included 1248 children with FA, aged < 18 years,, who were evaluated by pediatric allergists in 26 different centers. Results: Immune mechanisms of FA were immunoglobulin E (IgE) mediated in 71.8%, non-IgE mediated in 15.5%, and mixed IgE/non-IgE mediated in 12.7% of the patients. An episode of anaphylaxis had occurred in 17.6% of IgE-mediated FA. The most common food allergens were classified into five categories (in order of decreasing frequency): cow's milk, egg, tree nuts and/or peanut, wheat, and seafood. Allergies to cow's milk and egg declined significantly with age, whereas tree nuts and/or peanut allergies increased with age. The 0-2 year age group accounted for 62.5% of the cases. The most frequent cause of FA and food anaphylaxis was cow's milk before age 13 years and tree nuts and/or peanut during adolescence (ages 13-18 years). Compared with other phenotypes, male sex (odds ratio [OR] 1.486; p = 0.032), sibling(s) (OR 1.581; p = 0.021), and maternal atopy (OR 1.531; p = 0.045) increased the likelihood of IgE-mediated FA, whereas high household income (OR 1.862; p = 0.026) increased the likelihood of non-IgE-mediated FA in multivariate regression analysis. Conclusion: This study showed that the clinical findings of FA were highly variable, depending on age and underlying immune mechanism. Knowing the population characteristics will enable better management of FA in children.

Food Allergy and Food Poisoning

Taken into account data from which is considered a product not safe, estimate the safe level of a contaminant on food, for example, always have many unavoidable uncertainties. It cannot be overemphasized enough, that this also happens as in any other human activity. In most cases, we hope, to define as clearly as possible the eventual risk associated with particular conditions of exposure to a given substance in food. There are numerous toxic compounds that reside naturally in certain foods that unable these to be consumed above certain limits or even are fully prohibited in some other countries. Chapter starts with a clear explanation of differences and relationships between food allergy and food poisoning, continued with main allergens in food and main toxics. Finally, authors summarize different origins of toxins and allergens (natural from foods, from additives, pollutants and food processing).

Food Allergy and Food Poisoning

Taken into account data from which is considered a product not safe, estimate the safe level of a contaminant on food, for example, always have many unavoidable uncertainties. It cannot be overemphasized enough, that this also happens as in any other human activity. In most cases, we hope, to define as clearly as possible the eventual risk associated with particular conditions of exposure to a given substance in food. There are numerous toxic compounds that reside naturally in certain foods that unable these to be consumed above certain limits or even are fully prohibited in some other countries. Chapter starts with a clear explanation of differences and relationships between food allergy and food poisoning, continued with main allergens in food and main toxics. Finally, authors summarize different origins of toxins and allergens (natural from foods, from additives, pollutants and food processing).

Legumes steam allergy in childhood: Update of the reported cases

In the past few decades, the prevalence of allergic diseases has deeply increased, with a key role played by food allergies. Legumes seem to play a major role towards the overall increase in the scenario of food allergy, since they are an appreciated source, consumed worldwide, due to their high protein content, variable amounts of lipids and for the presence of vitamins. In literature there are numerous descriptions of adverse reactions after ingestion of uncooked and cooked legumes. Nevertheless, cases of allergic reactions induced by inhaling vapours from cooking legumes have rarely been described. Herein the authors report an update of the literature data on allergic reactions caused by legume steam inhalation, underlying the possible pathogenic mechanism of these atopic events and the knowledge of literature data in paediatric age. The importance of this review is the focus on the clinical aspects concerning legume vapour allergy, referring to literature data in childhood.

Purification and immunobiochemical characterization of a 31 kDa cross-reactive allergen from Phaseolus vulgaris (kidney bean)

Background

Legumes are a rich source of proteins but are also potential elicitors of IgE-mediated food allergy. This study aimed to isolate and characterize a major allergen of Phaseolus vulgaris (kidney bean) and determine its allergenicity.

Methodology

Kidney bean allergen was purified using Q Sepharose column (anion exchanger) and eluates with high intensity were pooled to purify protein using Superdex 75 (gel filtration) and C₁₈ column (RP-HPLC). Patients with history of kidney bean allergy were skin prick tested (SPT) with crude kidney bean extract and the purified protein. Specific IgE was estimated in sera by enzyme-linked immunosorbent assay (ELISA). Characterization of purified protein and its cross-reactivity was investigated by immunobiochemical methods. Identification of purified protein was carried out by tandem mass spectrometry.

Principal Findings

Purified protein appeared as a single band at 31 kDa on SDS-PAGE and showed IgE binding to 88% patients’ sera by ELISA and immunoblotting. SPT with purified protein identified 78% hypersensitive patients of kidney bean. Significant release of histamine from sensitized basophils was observed after challenge with purified protein. PAS staining suggested it to be a glycoprotein, but no change in IgE binding was observed after periodate oxidation. The 31 kDa protein remained stable for 60 min on incubation with pepsin. The purified protein had high allergenic potential since it required only 102 ng of self protein for 50% IgE inhibition. Mass spectrometric analysis identified it as Phytohemagglutinin. It also showed hemagglutination with human RBCs. Cross-reactivity was observed with peanut and black gram with IC₅₀ of 185 and 228 ng respectively.

Conclusion/Significance

A 31 kDa major allergen of kidney bean was purified and identified as phytohemagglutinin with cross-reactivity to peanut and black gram.

Characterization of potential allergens in fenugreek (Trigonella foenum-graecum) using patient sera and MS-based proteomic analysis

BACKGROUND

Fenugreek is a legume plant used as an ingredient of curry spice. Incidents of IgE-mediated food allergy to fenugreek have been reported. Coincidence with allergy to peanut, a major food allergen, seems to be common suggesting a rather high rate of cross-reactivity.

OBJECTIVE

Characterization of fenugreek allergens using patient sera and mass spectrometry-based proteomic analysis.

METHODS

Allergenic fenugreek proteins were detected by immunoblotting, using sera from 13 patients with specific IgE to peanut and fenugreek. IgE-binding proteins were analyzed by peptide mass fingerprinting and peptide sequencing.

RESULTS

A fenugreek protein quintet in the range from 50 kDa to 66 kDa showed high IgE-affinity, the protein at 50 kDa reaching the strongest signals in all patients. Proteomic analyses allowed the classification of several fenugreek proteins to a number of allergen families. Fenugreek 7S-vicilin and 11S-legumin were partly sequenced and revealed considerable homologies to peanut Ara h 1 and Ara h 3, respectively. The presence of a fenugreek 2S albumin and pathogenesis-related (PR-10) plant pollen protein was assumed by database searching results.

CONCLUSION

In this study, individual fenugreek proteins were characterised for the first time. Observed homologies to major peanut allergens provide a molecular explanation for clinical cross-reactivity.

Angioedema induced by inhalation of vapours from cooked white bean in a child

BACKGROUND

There are few references of allergic reaction to beans in childhood. We report the case of a seven years old boy who suffered from angioedema associated to inhalation of vapours from cooked white bean.

METHODS

skin prick tests (SPT) were performed by prick-by-prick with cooked white bean and legumes. It was also determined total IgE and specific IgE antibodies to bean and legumes with the use of the CAP enzymo-immunoassay. Subsequently, a oral challenge test was carried out with white bean.

RESULTS

The prick-by-prick with white bean was positive in our case, and negative in ten controls patients. Specific IgE in patient serum, assayed by CAP was positive for white bean and green bean. The patient developed angioedema after ingestion cooked white bean.

CONCLUSION

we demonstrated a type I hypersensitivity to white bean in a seven years old child by SPT, specific IgE antibodies and challenge test.

Enteromorpha compressa (L.) Greville an edible green alga as a source of antiallergic principle (S)

Enteromorpha compressa a marine green algal species grows extensively in North coastal Andhra Pradesh. Besides its nutritional importance it has also been identified as source of anti-anaphylactic compound(s).E. compressa extracts alleviated the IgE levels raised against ovalbumin and other allergens in mice. Further,Enteromorpha extract also significantly down regulated the serum IgE levels in different murine models irrespective of their genetic background. The results obtained in this study suggest thatE. compressa extract has compound(s), which inhibit IgE immune response and may have potential in curing various types of allergies.