Absence of modification of endogenous soy allergens.
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Allergens↗
Biomedical subjects
G Kanny
Publications and source records attributed to G Kanny.
Ultrastructural changes in the duodenal mucosa induced by ingested histamine in patients with chronic urticaria.
Histamine in food may be responsible for some cases of food intolerance. We previously demonstrated disturbances in the metabolism of ingested histamine in patients with chronic urticaria (CU) and proposed that this could be related to increased intestinal permeability to histamine. The present study was undertaken to look for ultrastructural changes in the intestinal tract that might explain this abnormality. We examined duodenal biopsies from seven patients with CU before and after intraduodenal administration of histamine (120 mg). Five subjects had clinical symptoms (diarrhea, urticaria, headache, accelerated heart rate, and drop in blood pressure) within 1 h of duodenal histamine challenge (DHC). Ultrastructural changes, including edema of the interstitial tissue, enlargement of the basal intercellular spaces, slight congestion of the endothelial cells, and pericapillary edema, were observed in six subjects 45 min after DHC. In all the biopsies, the epithelium was normal, and the tight junctions were not modified by DHC. This morphologic study demonstrates that histamine can induce edema in the basal intercellular spaces of the duodenal mucosa and in the submucosa without evident change in the integrity of intercellular junctions. The most plausible route for histamine to have taken would appear to be an intracellular one.
Administration, Oral↗
Airborne eczema due to mould allergy.
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Adult↗
Allergic rhinitis to thuja pollen.
Allergy to pollen of Cupressaceae has been linked to pollens of Cupressus, Juniper and Cryptomeria. The authors report 2 cases of rhinitis and conjunctivitis induced by thuja, another member of the Cupressaceae family. Monosensitization to thuja pollen has been identified as the causal agent: (1) of a long-standing springtime rhinitis in 1 patient with negative skin tests and specific IgE titers to the main inhalants (specificity of the prick test and nasal provocation with the thuja extract was confirmed by a positive RAST) and (2) in a 2nd patient without former history of allergy, who consulted for conjunctivitis following acquisition of a dog; the standard battery of skin tests, and Phadiotop were all negative. After controls, only the thuja extract gave significant skin test response. The level of total IgE was low, and RAST was negative. Sensitization and pollen provocation were produced by the intermediary of the dog, carrying thuja pollens on its fur. The immunoprint and the crossed radioimmunoelectrophoresis revealed common antigenicity between cypress and thuja extracts.
Adult↗
Identification of a masked allergen, alpha-lactalbumin, in baby-food cereal flour guaranteed free of cow's milk protein.
We report on a baby food, cereal flour P (CFP), which, although guaranteed free of cow's milk protein, caused failure to thrive and diarrhea, vomiting, and coughing fits in a 22-month-old child. The purpose of this study was to identify the allergen involved. The investigation used prick tests, RAST, and the RAST inhibition method. Specific IgE was elevated to 100 kU/l for cow's milk and to 15.3 kU/l for alpha-lactalbumin (2.5 kU/l for casein, 0.7 kU/l for beta-lactoglobulin). Antibovine IgG IgEs were associated. RAST inhibition experiments demonstrated the presence of alpha-lactalbumin in "food-quality" lactose used in this flour, at a dose of 1-5 micrograms/g of CFP. The daily intake of alpha-lactalbumin was found to be less than 70 micrograms. This exquisite clinical sensitization was attributed to the intestinal hyperpermeability (IH) which favors the access of milk allergen to the blood, leading to an ever-growing state of hypersensitivity. It could have been due to egg- and mustard-associated allergies as well as to giardiasis and intestinal candidosis. This work underlines the risk of masked food allergens and the need of thoroughly informative labeling.
Allergens↗
Sesame seed and sesame seed oil contain masked allergens of growing importance.
Sesame seed and sesame seed oil have been thought of as rare causes of food allergy, representing less than 1% of all food allergy cases. We now report nine cases of IgE-dependent allergy to sesame seed and/or sesame seed oil, six of which were diagnosed in 1995 alone. Our skin test results draw attention to the poor quality of a commercial sesame seed extract and the good sensitivity of skin prick tests made with a freshly prepared sesame seed flour extract. The diagnosis of this food allergy was established by double-blind oral provocation tests, with doses of sesame seed flour ranging from 100 mg to 10 g. Allergy to sesame seed oil was also demonstrated in some cases. The sensitivity of the Pharmacia Phadebas CAP System for the detection of sesame seed-specific IgE was only mediocre. We draw attention to the important use of sesame seed in modern cooking, a fact which may explain the growing frequency of this allergy. We underline the particular risk with sesame seed oil. Sesame seed should also be considered a cause of allergic reactions to drug products and cosmetics.
Adolescent↗
alpha-Amylase contained in bread can induce food allergy.
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Adult↗
[Food-induced anaphylaxis. A new French multicenter survey].
The frequency of food-induced anaphylactic shocks (FIAS) has been investigated beside 46 emergency departments, 29 departments of Dermatology, and 19 departments of Intern Medicine or Pneumology. 794 A.S. have been reported. FIAS represent 10.2% of the etiologies. More than a third of them are relapsing anaphylaxis. Food allergy had been previously identified in 23.4% of cases. The allergen was present as a hidden allergen or inadvertently consumed in 30.8% of FIAS. 9.9% of the patients were asthmatic. An enhancing factor was heightened in 25.9% of cases: alcohol, exercise, simultaneous intake of aspirin, beta-blockers, conversion enzyme inhibitors. Other factors predisposing to food anaphylaxis were a cross-reactivity shared by pollens and fruit, latex and exotic fruit, house dust mites and snails, or mastocytosis. More than 15 allergens were detected: egg (11.6%), fish (10.4%), crustaceans (10.4%), milk (6.5%), fruit-latex group (6.5%), peanut and other leguminosae (soy, peas, lentils, guar gum...), celery, garlic, etc... The food allergen still remained unknown in 25% of cases. However, the rate of efficiency of the diagnosis reached 94% in the Allergy Units. In addition 10.2% of A.S. were considered idiopathic, raising the hypothesis of allergy to masked food allergens. Compared to a previous study from the 1982's, this survey shows a striking increased prevalence of FIAS.(ABSTRACT TRUNCATED AT 250 WORDS)
Allergens↗
Food anaphylaxis following ingestion of carmine.
BACKGROUND: The risk of sensitization to reactive dyes is well established. The clinical situation is caused most often by synthetic azo dyes and triphenylmethane derivatives but natural dyes such as carmine extracted from dried female insects, Coccus cacti (cochineal), have been incriminated. OBJECTIVE: Study of a case of anaphylaxis after ingestion of yogurt to establish the responsibility of carmine. METHOD: Case report of a patient who received skin prick test and leukocyte histamine release test with carmine and yogurt. CONCLUSIONS: This case provided evidence of an IgE-dependent mechanism and draws attention to the triggering dose of carmine (1 mg) although the acceptable daily intake is up to 5.0 mg per kg of body weight.
Adult↗
Anaphylaxis to mustard as a masked allergen in "chicken dips".
BACKGROUND: Masked allergens in processed foods are sometimes responsible for "idiopathic" anaphylaxis because of the lack of full ingredient labeling. Patients, even if they are aware of a specific hypersensitivity, may be unaware of trace amounts of the offending allergen(s) that are present in these products. METHODS: We report a case of severe anaphylaxis to mustard masked in "chicken dips." A 38-year-old woman had an anaphylactic reaction beginning 20 minutes after eating "chicken dips" in a fast food restaurant. She was treated successfully in an emergency room and then referred to us for evaluation. We performed skin prick tests, IgE antibody, and inhibition assays to identify allergens in foods eaten just prior to the anaphylactic reaction. RESULTS: She had a history of allergy to mustard. Skin prick tests revealed sensitivity to mustard, coriander, and curry powder, which contains mustard. She had 56.3 KU/L mustard-specific serum IgE antibody in a Phadebas CAP RAST assay (Pharmacia, Sweden). The mustard RAST was inhibited with an extract of "chicken dips," confirming the presence of mustard in "chicken dips." CONCLUSIONS: This case points out the risk of masked allergens in modern food products and the value of the RAST inhibition assay for the identification of such hidden allergens.
Adult↗
The use of two multitests fx5 and fx10 in the diagnosis of food allergy in children: regarding 42 cases.
The multitests Cap RAST fx5 and fx10 (Pharmacia, Cap System) are used for a rapid biological diagnosis of food allergy. These tests were assessed in 29 children who presented 42 food allergies (FA) documented by prick tests, specific IgE and labial or oral provocation tests (single blind placebo controlled food challenges). When the multitests were positive, the search for specific IgE to the corresponding allergens was performed (Cap RAST, Pharmacia). The theoretical coverage of FA could be estimated according to the frequency of food allergens involved in the children. It reaches 85% for Cap RAST fx5 and 29% for Cap RAST fx10. The sensitivity of Cap RAST fx5 is 89% and 50% for Cap RAST fx10. Even in the case when the child had a single food allergy, the detail of specific IgE showed multiple positivities to several allergens included in the multitest. Consequently, the positive predictive value of Cap RAST was only 32%. Prick tests to the same allergens were more rarely positive, gaining thus a better positive predictive value. The authors propose the use of Cap RAST fx5, eventually completed by a Cap RAST to beef for the first approach of food allergy in children. They stress the point that prick tests have to be carried on subsequently, in order to select properly allergens responsible for food allergy.
Adolescent↗
[Food-induced anaphylaxis. A new French multicenter study].
The frequency of food-induced anaphylactic shocks (FIAS) has been investigated beside 46 emergency departments, 29 departments of Dermatology, and 19 departments of Intern Medicine or Pneumology. 794 A.S. have been reported. FIAS represent 10.2% of the etiologies. More than a third of them are relapsing anaphylaxis. Food allergy had been previously identified in 23.4% of cases. The allergen was present as a hidden allergen or inadvertently consumed in 30.8% of FIAS. 9.9% of the patients were asthmatic. An enhancing factor was heightened in 25.9% of cases: alcohol, exercise, simultaneous intake of aspirin, beta-blockers, conversion enzyme inhibitors. Other factors predisposing to food anaphylaxis were a cross-reactivity shared by pollens and fruit, latex and exotic fruit, house dust mites and snails, or mastocytosis. More than 15 allergens were detected: egg (11.6%), fish (10.4%), crustaceans (10.4%), milk (6.5%), fruit-latex group (6.5%), peanut and other legumes (soy, peas, lentils, guar gum...), celery, garlic, etc... The food allergen still remained unknown in 25% of cases. However, the rate of efficiency of the diagnosis reached 94% in the Allergy Units. In addition 10.2% of A.S. were considered idiopathic, raising the hypothesis of allergy to masked food allergens. Compared to a previous study from the 1982's, this survey shows a striking increased prevalence of FIAS. The frequency of recurrent anaphylaxis, occurring in one-third of cases, is also highlighted and makes plausible once more the role of masked food allergens. The authors insist upon the need of a thorough allergologic investigation in all the cases of A.S. An informative labelling about the presence or absence of food proteins which are mostly allergenic should be recommended. The need of a thorough allergologic investigation is supported not only by the incidence of FIAS but also by the incidence of idiopathic anaphylaxis: 10.2%.
Anaphylaxis↗
[Occupational asthma caused by organic substances].
Occupational asthma (OA) to organic substances is frequently related to IgE-dependent hypersensitivity. New etiological agents are latex and vegetal gums, in health care personnel as in carpet-making manufactures. Bakers are exposed to numerous allergens: wheat and cereal flours, sesame and other seed proteins, alpha-amylase and other enzymes. Alpha-amylase extracted from Aspergillus orizae is a potent allergen. Plant derived materials have been identified as allergens in the floral industry (Ficus, Ginseng, Gypsophila, etc). The accurate diagnosis relies upon a thorough history, completed by measurements of peak expiratory flows during the work. Sensitization can be confirmed by prick tests and immuno assays for IgE antibodies. Bronchial provocation tests documenting OA are advisable. The early detection of OA might be evaluated by skin tests to occupational allergens repeated yearly. The prevention of OA relies on air sampling technologies controlling the allergenic density of the atmosphere and removing asthmatics from exposed areas. There are no scientific grounds for discarding atopics from occupations at risk for OA.
Asthma↗
High risk of sensitization to latex in children with spina bifida.
The risk of per-operative anaphylactic shock in response to latex is established in children with spina bifida. This study focuses on 30 children with spina bifida and aims at evaluating the value of predictive tests (skin tests and RAST). No patient had shown a preoperative accident. Hypersensitivity to latex, sometimes suspected by questioning of the patient, was detected 12 times out of 30 (40%). 10 children of the 12 were atopic (83%). The incidence of atopy is significantly higher than that of the general pediatric population (14 out of 30; 46%). This study demonstrates the frequency of the latent hypersensitivity to latex and the subsequent potential risk of per-operative anaphylactic shock. This sensitization can be partly explained by multiple contacts with latex; urinary catheterization several times a day, daily use of latex gloves for routine care, repetitive surgery (more than 8 operations per child). However, atopy increases the risk of sensitization to latex. The authors underline the importance of taking preventive measures for these children such as the use of PVC, silicone or polyurethane catheters and of synthetic rubber. Hypoallergenic gloves are under investigation. A questionnaire and systematic preventive cutaneous assessment before each operation are strongly advised.
Anaphylaxis↗
Incidence and risk factors for latent sensitization to chymopapain: predictive skin-prick tests in 700 candidates for chemonucleolysis.
Seven hundred patients were investigated prospectively before undergoing chemonucleolysis. A past history of allergy and/or previous exposure to papain, either in food, beverages or drugs, was sought, and a skin-prick test with chymopapain was performed. Based on the results obtained, the subjects were classified into four groups: Group I--225 non-atopic non-papain-exposed subjects; Group II--285 non-atopic papain-exposed subjects; Group III--69 atopic non-papain-exposed subjects; and Group IV--121 atopic papain-exposed subjects. Latent sensitization to papain was observed in 0.4% of subjects in Group I, 3.16% in Group II, 5.8% in Group III and 7.4% in Group IV. The odds ratios were 13.8 for atopy and 7.3 for exposure to papain. Interaction between atopy and papain exposure did not result in a significantly greater risk. Neither sex nor age nor a history of a previous drug reaction were risk factors. Only one patient out of the 23 who were sensitive to papain had no risk factor. The 677 skin-test negative patients then underwent chemonucleolysis and none of them had an anaphylactic reaction. This was significantly less frequent: (P = 0.04) than the incidence in a random population (0.45%). Prick tests performed 6 weeks and 6 months after chemonucleolysis revealed newly acquired sensitization in 36% of the patients. Atopy was not a risk factor for this event.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
Food allergy to sunflower oil in a patient sensitized to mugwort pollen.
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Adult↗
Risks of milk formulas containing peanut oil contaminated with peanut allergens in infants with atopic dermatitis.
Four cases of infants with atopic dermatitis are reported. In all cases, a sensitization to peanut is demonstrated. Any ingestion of peanuts can be excluded, with the exception of a daily consumption of peanut oil, contained in milk formulas. Oral challenges with peanut oil induce a rash, and elimination of these brands is followed by the disappearance of eczematous lesions. The presence of residual allergenic proteins in peanut oil is thus suspected. Owing to the growing incidence of peanut hypersensitivity, the elimination of peanut oil from all milk formulas, food for babies, and ointments, seems to be highly advisable.
Allergens↗