Lupin and Other Potentially Cross-Reactive Allergens in Peanut Allergy

  • Maurizio Mennini
  • Lamia Dahdah
  • Oscar Mazzina
  • Alessandro Fiocchi
Food Allergy (T Green, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Food Allergy

Abstract

Purpose of Review

The presence of IgE cross-reactivity between peanut allergens and allergens from other legumes and tree nuts has been demonstrated, but the identification of the involved individual allergens is still limited. The aim of this review is to describe new allergenic findings, of potential relevance for cross-reactivity among peanut and lupin.

Recent Findings

Seventeen allergens of peanut have been included in the official allergen nomenclature database to date. Lupin sensitization has been observed in 15–20% of individuals with known peanut allergy, The majority of lupin seed proteins are comprised of α-conglutins (legumin-like) and β-conglutins (vicilin-like), and to a lesser extent γ-conglutins (vicilin-like) and δ-conglutins (2S albumins).

Summary

Several molecules may fuel peanut-lupin cross-reactivity. Awareness among physicians and general public could avoid unexpected allergic reactions. However, these do not appear frequent and no data suggest a precautionary labelling of lupin in foods.

Keywords

Peanut allergy Lupin Cross-reactivity Allergy Food labelling IgE 

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    Muraro A, Werfel T, Hoffmann-Sommergruber K, Roberts G, Beyer K, EAACI Food Allergy and Anaphylaxis Guidelines Group, et al. EAACI food allergy and anaphylaxis guidelines: diagnosis and management of food allergy. Allergy. 2014;69:1008–25.CrossRefPubMedGoogle Scholar
  2. 2.
    Kulis M, Wright BL, Jones SM, Burks AW. Diagnosis, management, and investigational therapies for food allergies. Gastroenterology. 2015;148:1132–42.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Branum AM, Lukacs SL. Food allergy among U.S. children: trends in prevalence and hospitalizations. NCHS Data Brief; 2008. p. 1–8.Google Scholar
  4. 4.
    Osborne NJ, Koplin JJ, Martin PE, Gurrin LC, Lowe AJ, Matheson MC, et al. Prevalence of challenge-proven IgE-mediated food allergy using population-based sampling and predetermined challenge criteria in infants. J Allergy Clin Immunol. 2011;127:668–76.CrossRefPubMedGoogle Scholar
  5. 5.
    Allen KJ. Food allergy: is there a rising prevalence and if so why? Med J Aust. 2011;195:5–7.CrossRefPubMedGoogle Scholar
  6. 6.
    Prescott S, Allen KJ. Food allergy: riding the second wave of the allergy epidemic. Pediatr Allergy Immunol. 2011;22:155–60.CrossRefPubMedGoogle Scholar
  7. 7.
    Perkin MR, Logan K, Tseng A, Raji B, Ayis S, Peacock J, et al. Randomized trial of introduction of allergenic foods in breast-fed infants. N Engl J Med. 2016;374:1733–43.CrossRefPubMedGoogle Scholar
  8. 8.
    Xepapadaki P, Fiocchi A, Grabenhenrich L, Roberts G, Grimshaw KE, Fiandor A, et al. Incidence and natural history of hen’s egg allergy in the first 2 years of life—the EuroPrevall birth cohort study. Allergy. 2016;71:350–7.CrossRefPubMedGoogle Scholar
  9. 9.
    Ferreira F, Hawranek T, Gruber P, Wopfner N, Mari A. Allergic cross-reactivity: from gene to the clinic. Allergy. 2004;59:243–67.CrossRefPubMedGoogle Scholar
  10. 10.
    • Canonica GW, Ansotegui IJ, Pawankar R, Schmid-Grendelmeier P, van Hage M, Baena-Cagnani CE, et al. A WAO-ARIA-GA2LEN consensus document on molecular-based allergy diagnostics. World Allergy Organ J. 2013;6:17. The official consensus of the World Allergy Organization emphasizes the role of molecular diagnostics in allergy food and its complex effects on the expression of clinical allergy.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Nwaru B, Hickstein L, Panesar S, Muraro A, Werfel T, Cardona V, et al. The epidemiology of food allergy in Europe: a systematic review and meta-analysis. Allergy. 2014;69:62–75.CrossRefPubMedGoogle Scholar
  12. 12.
    Nwaru B, Hickstein L, Panesar S, Roberts G, Muraro A, Sheikh A. Prevalence of common food allergies in Europe: a systematic review and meta-analysis. Allergy. 2014;69:992–1007.CrossRefPubMedGoogle Scholar
  13. 13.
    Urisu A, Ebisawa M, Ito K, Aihara Y, Ito S, Mayumi M, et al. Japanese guideline for food allergy 2014. Allergol Int. 2014;63:399e419.CrossRefGoogle Scholar
  14. 14.
    Ebisawa M, Nishima S, Ohnishi H, Kondo N. Pediatric allergy and immunology in Japan. Pediatr Allergy Immunol. 2013;24:704e14.CrossRefGoogle Scholar
  15. 15.
    • Gupta RS, Springston EE, Warrier MR, Smith B, Kumar R, Pongracic J, et al. The prevalence, severity, and distribution of childhood food allergy in the United States. Pediatrics. 2011;128:e9e17. The data show a steady increase in food allergies in the United States, by making people understand the social importance of the issue.CrossRefGoogle Scholar
  16. 16.
    Verma AK, Kumar S, Das M, Dwivedi PD. A comprehensive review of legume allergy. Clin Rev Allergy Immunol. 2013;45:30–46.CrossRefPubMedGoogle Scholar
  17. 17.
    Ballabio C, Peñas E, Uberti F, Fiocchi A, Duranti M, Magni C, et al. Characterization of the sensitization profile to lupin in peanut-allergic children and assessment of cross-reactivity risk. Pediatr Allergy Immunol. 2013;24:270–5.CrossRefPubMedGoogle Scholar
  18. 18.
    Sebei K, Gnouma A, Herchi W, Sakouhi F, Boukhchina S. Lipids, proteins, phenolic composition, antioxidant and antibacterial activities of seeds of peanuts (Arachis hypogaea l) cultivated in Tunisia. Biol Res. 2013;46:257–63.CrossRefPubMedGoogle Scholar
  19. 19.
    Koppelman SJ, Vlooswijk RA, Knippels LM, Hessing M, Knol EF, van Reijsen FC, et al. Quantification of major peanut allergens Ara h 1 and Ara h 2 in the peanut varieties Runner, Spanish, Virginia, and Valencia, bred in different parts of the world. Allergy. 2001;56:132–7.CrossRefPubMedGoogle Scholar
  20. 20.
    Hebling CM, Ross MM, Callahan JH, McFarland MA. Size-selective fractionation and visual mapping of allergen protein chemistry in Arachis hypogaea. J Proteome Res. 2012;11:5384–95.CrossRefPubMedGoogle Scholar
  21. 21.
    Pawankar R, Canonica GW, Holgate ST, Lockey RF, editors. WAO White Book on Allergy; available at http://www.worldallergy.org/definingthespecialty/white_book.php. Accessed 29 Sept 2016.
  22. 22.
    Grimshaw KE, Bryant T, Oliver EM, Martin J, Maskell J, Kemp T, et al. Incidence and risk factors for food hypersensitivity in UK infants: results from a birth cohort study. Clin Transl Allergy. 2016;6:1.CrossRefPubMedGoogle Scholar
  23. 23.
    •• Du Toit G, Roberts G, Sayre PH, LEAP Study Team, et al. Randomized trial of peanut consumption in infants at risk for peanut allergy. N Engl J Med. 2015;372:803–13. Recent RCT which conclude that the early introduction of peanuts significantly decreased the frequency of the development of peanut allergy among children at high risk for this allergy and modulated immune responses to peanuts.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Nettleton S, Woods B, Burrows R, Kerr A. Food allergy and food intolerance: towards a sociological agenda. Health (London). 2009;13:647–64.CrossRefGoogle Scholar
  25. 25.
    •• Waggoner MR. Parsing the peanut panic: the social life of a contested food allergy epidemic. Soc Sci Med. 2013;90:49–55. This analysis compares medical literature to other textual sources, including media reports, legislation, and advocacy between 1980 and 2010 in order to examine how peanut allergies transformed from a rare medical malady into a contemporary public health problem. The authors argue that the peanut allergy epidemic was co-constructed through interactions between experts, publics, biomedical categories, and institutions, while social reactions to the putative epidemic expanded the sphere of surveillance and awareness of peanut allergy risk.CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Christakis NA. This allergies hysteria is just nuts. BMJ. 2008;337:a2880.CrossRefPubMedGoogle Scholar
  27. 27.
    Sicherer SH, Sampson HA. Peanut allergy: emerging concepts and approaches for an apparent epidemic. J Allergy Clin Immunol. 2007;120:491–503.CrossRefPubMedGoogle Scholar
  28. 28.
    • Sicherer SH, Wood RA. Advances in diagnosing peanut allergy. J Allergy Clin Immunol Pract. 2013;1:1–13. The authors review the utility of currently available tests and provide suggestions on how to best use them to accurately predict peanut allergy. Still, the physician-supervised oral food challenge remains the most definitive test available.CrossRefPubMedGoogle Scholar
  29. 29.
    Kapoor S, Roberts G, Bynoe Y, Gaughan M, Habibi P, Lack G. Influence of a multidisciplinary paediatric allergy clinic on parental knowledge and rate of subsequent allergic reactions. Allergy. 2004;59:185–91.CrossRefPubMedGoogle Scholar
  30. 30.
    Ewan PW, Clark AT. Long-term prospective observational study of patients with peanut and nut allergy after participation in a management plan. Lancet. 2001;357:111–5.CrossRefPubMedGoogle Scholar
  31. 31.
    Shreffler WG, Beyer K, Chu TH, Burks AW, Sampson HA. Microarray immunoassay: association of clinical history, in vitro IgE function, and heterogeneity of allergenic peanut epitopes. J Allergy Clin Immunol. 2004;113:776–82.CrossRefPubMedGoogle Scholar
  32. 32.
    Radauer C, Lackner P, Breiteneder H. The Bet v 1 fold: an ancient, versatile scaffold for binding of large, hydrophobic ligands. BMC Evol Biol. 2008;8:286.CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Edstam MM, Viitanen L, Salminen TA, Edqvist J. Evolutionary history of the non-specific lipid transfer proteins. Mol Plant. 2011;4:947–64.CrossRefPubMedGoogle Scholar
  34. 34.
    Peeters KA, Koppelman SJ, Penninks AH, Lebens A, Bruijnzeel-Koomen CA, Hefle SL, et al. Clinical relevance of sensitization to lupine in peanut-sensitized adults. Allergy. 2009;64:549–55.CrossRefPubMedGoogle Scholar
  35. 35.
    Sicherer SH, Muñoz-Furlong A, Sampson HA. Prevalence of peanut and tree nut allergy in the United States determined by means of a random digit dial telephone survey: a 5-year follow-up study. J Allergy Clin Immunol. 2003;112:1203–7.CrossRefPubMedGoogle Scholar
  36. 36.
    de Leon MP, Glaspole IN, Drew AC, Rolland JM, O’Hehir RE, Suphioglu C. Immunological analysis of allergenic cross-reactivity between peanut and tree nuts. Clin Exp Allergy. 2003;33:1273–80.CrossRefPubMedGoogle Scholar
  37. 37.
    Lee YP, Mori TA, Sipsas S, Barden A, Puddey IB, Burke V, et al. Lupin-enriched bread increases satiety and reduces energy intake acutely. Am J Clin Nutr. 2006;84:975–80.PubMedGoogle Scholar
  38. 38.
    Fiocchi A, Sarratud P, Terracciano L, Vacca E, Bernardini R, Fuggetta D, et al. Assessment of the tolerance to lupine-enriched pasta in peanut-allergic children. Clin Exp Allergy. 2009;39:1045–51.CrossRefPubMedGoogle Scholar
  39. 39.
    Shaw J, Roberts G, Grimshaw K, White S, Hourihane J. Lupin allergy in peanut-allergic children and teenagers. Allergy. 2008;63:370–3.CrossRefPubMedGoogle Scholar
  40. 40.
    Peeters KA, Nordlee JA, Penninks AH, Chen L, Goodman RE, Bruijnzeel-Koomen CA, et al. Lupine allergy: not simply cross-reactivity with peanut or soy. J Allergy Clin Immunol. 2007;120:647–53.CrossRefPubMedGoogle Scholar
  41. 41.
    Burks AW, Williams LW, Helm RM, Connaughton C, Cockrell G, O’Brien T. Identification of a major peanut allergen, Ara h I, in patients with atopic dermatitis and positive peanut challenges. J Allergy Clin Immunol. 1991;88:172–9.CrossRefPubMedGoogle Scholar
  42. 42.
    Burks AW, Williams LW, Connaughton C, Cockrell G, O’Brien TJ, Helm RM. Identification and characterization of a second major peanut allergen, Ara h II, with use of the sera of patients with atopic dermatitis and positive peanut challenge. J Allergy Clin Immunol. 1992;90:962–9.CrossRefPubMedGoogle Scholar
  43. 43.
    Rabjohn P, Helm EM, Stanley JS, West CM, Sampson HA, Burks AW, et al. Molecular cloning and epitope analysis of the peanut allergen Ara h 3. J Clin Invest. 1999;103:535–42.CrossRefPubMedPubMedCentralGoogle Scholar
  44. 44.
    Shewry PR. Plant storage proteins. Biol Rev Camb Philos Soc. 1995;70:375–426.CrossRefPubMedGoogle Scholar
  45. 45.
    Stavy L, Treves AJ, Feldman M. Effect of concanavalin A on lymphocyte-mediated cytotoxicity. Nature. 1971;232:56–8.CrossRefPubMedGoogle Scholar
  46. 46.
    Ju SY, Park JH, Kwak TK, Kim KE. Attitudes and preferences of consumers toward food allergy labeling practices by diagnosis of food allergies. Nutr Res Pract. 2015;9:517–22.CrossRefPubMedPubMedCentralGoogle Scholar
  47. 47.
    Hefle SL, Furlong TJ, Niemann L, Lemon-Mule H, Sicherer S, Taylor SL. Consumer attitudes and risks associated with packaged foods having advisory labeling regarding the presence of peanuts. J Allergy Clin Immunol. 2007;120:171–6.CrossRefPubMedGoogle Scholar
  48. 48.
    Fiocchi A, Dahdah L, Riccardi C, Mazzina O, Fierro V. Precautionary labelling of cross-reactive foods: the case of rapeseed. Asthma Research and Practice. 2016. doi:10.1186/s40733-016-0028-4.
  49. 49.
    Businco L, Bellanti J, Catassi C, Cavagni G, Corrias A, Fiocchi A, et al. Food Allergy in childhood. Hypersensitivity to cow's milk allergens. Clin Experim Allergy. 1993;23:481–83.Google Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Maurizio Mennini
    • 1
  • Lamia Dahdah
    • 1
  • Oscar Mazzina
    • 1
  • Alessandro Fiocchi
    • 1
  1. 1.Division of Allergy, University Department of PediatricsPediatric Hospital Bambino GesùVatican CityItaly

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