Assessment of the tolerance to lupine-enriched pasta in peanut-allergic children

Summary Background Reports of allergy to lupine derivatives (as de novo sensitization or cross‐reactivity in subjects allergic to peanut) are increasing as their use in food products increases. Objectives The aim of this study was to assess: (1) lupine tolerance in a group of children allergic to pe...

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Bibliographic Details
Published in:	Clinical and experimental allergy Vol. 39; no. 7; pp. 1045 - 1051
Main Authors:	Fiocchi, A., Sarratud, P., Terracciano, L., Vacca, E., Bernardini, R., Fuggetta, D., Ballabio, C., Duranti, M., Magni, C., Restani, P.
Format:	Journal Article
Language:	English
Published:	Oxford, UK Blackwell Publishing Ltd 01-07-2009 Blackwell
Subjects:	Adolescent Allergic diseases Arachis - adverse effects Arachis - immunology Arachis hypogaea Biological and medical sciences Child Child, Preschool cross-reactivity Dietary Proteins Digestive allergic diseases Dose-Response Relationship, Immunologic Double-Blind Method Female food allergy Food, Fortified Fundamental and applied biological sciences. Psychology Fundamental immunology Humans Immunoglobulin E - immunology Immunopathology lupine allergy Lupinus - adverse effects Lupinus - immunology Male Medical sciences peanut allergy Peanut Hypersensitivity - immunology Sensitivity and Specificity Skin Tests technological treatments Human Immunopathology Food allergy Peanut Tolerance cross-reactivity lupine allergy peanut allergy Immunology Treatment Cross reaction Digestive diseases technological treatments Child
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Summary:	Summary Background Reports of allergy to lupine derivatives (as de novo sensitization or cross‐reactivity in subjects allergic to peanut) are increasing as their use in food products increases. Objectives The aim of this study was to assess: (1) lupine tolerance in a group of children allergic to peanut, using lupine enriched‐pasta instead of raw flour as has been done in previous clinical studies; (2) whether technological treatments of lupine modify its cross‐reactivity or co‐sensitization with peanut; (3) the role of lupine seed proteins in sensitization, and (4) to identify the eliciting doses (EDs) by using double‐blind, placebo‐controlled food challenges (DBPCFC). Methods Twelve patients with a history of clinical allergic reactions to peanut were evaluated by skin prick tests (SPTs), the ImmunoCAP® test, immunoblotting, and DBPCFC. The 12 selected subjects were included in a trial where lupine‐enriched pasta and placebo pasta were administered in a DBPCFC protocol. Results Positive clinical reactions were observed in two children, the EDs being 0.2 and 6.4 g of pasta, corresponding to 50 mg and 1.6 g of lupine proteins, respectively. β‐conglutin was the protein most involved in SPT positivity. Conclusion Lupine‐enriched pasta can be tolerated by most subjects suffering from peanut allergy, but a sizeable minority (2/12 of them in this case) can develop potentially dangerous clinical reactions. Information about possible reactions to lupine derivatives by those allergic to peanuts must be included in the labelling of lupine‐enriched products to protect consumers at risk.
Bibliography:	ArticleID:CEA3199 ark:/67375/WNG-L612FXLH-S istex:7832170E2984D095248C45E343458A2DADEB2FD4 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Article-2 ObjectType-Feature-1
ISSN:	0954-7894 1365-2222
DOI:	10.1111/j.1365-2222.2009.03199.x