Article

Legume: Cross-reactivity

Servicio de Alergia del Hospital Niño Jesús, Madrid. Spain.
Allergologia et Immunopathologia (Impact Factor: 1.74). 05/2003; 31(3):151-61.
Source: PubMed

ABSTRACT

Legumes are dicotyledonous plants belonging to the Fabales order. The main distinctive characteristic of which is their fruit (legumen, seeds contained in pods). This botanical order is formed by three families: Mimosaceae, Caesalpiniaceae and Papilionaceae or Fabacea. The Papilionaceae family includes the most important allergenic species: Lens culinaris (lentil), Cicer arietinum (chick-pea), Pisum sátivum (pea), Arachis hipogea (peanut), Phaseolus vulgaris (bean) y Glycine max (soy). Legumes are an important ingredient in the Mediterranean diet. Among Spanish children, sensitivity to legumes is the fifth most prevalent food allergy. Lentil and chick-pea are the most frequent cause of allergic reactions to legumes in Spanish children. Legumes could be involved in severe allergic symptoms. The different legumes have structurally homologous proteins, but they are not all equally allergenic, thus making it difficult to distinguish in vitro and in vivo cross-reactivity. We have demonstrated by skin tests and CAP that most of the patients are sensitised to more than one species. We have demonstrated a great degree of cross-reactivity among lentil, chick-pea, pea and peanut by ELISA inhibition (> 50 % max. inhibition). Unlike the Anglo-Saxons population, this phenomenon implies clinical sensitisation for many Spanish children. The majority of our patients have had symptoms with more than one legume (median 3 legumes). Thirty-nine patients were challenged (open or simple blind) with two or more legumes and 32 (82 %) reacted to two or more legumes: 43,5 % to 3, 25,6 % to 2, 13 % to 4 legumes. Seventy three per cent of the patients challenged with lentil and pea had positive challenge to both, 69,4 % to lentil and chick-pea, 60 % to chick-pea and 64,3 % to lentil, chick-pea and pea simultaneously. Peanut allergy peanut can be associated to allergy to lentil, chick-pea and pea but less frequently. Contrarily, white bean and overall green bean and soy are well tolerated by children allergic to other legumes. In our study, 82 % of the children allergic to legumes had a sensitisation to pollen. Pea and bean are the legumes with more in vitro cross-reactivity with Lolium perenne, Olea europea and Betula alba. This cross-reactivity could be because of common antigenic determinants or due to the coexistence of pollen and legume allergy. Panallergens implication seems to be less probable. It is important to emphasize that in spite of an evident clinical and immunological cross-reactivity, the diagnosis of legume allergy should not be based only on specific IgE tests. The decision to eliminate one legume from the diet should be based on a positive oral food challenge.

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    • "The prevalence of food allergic diseases in childhood is around 3% with a range between 1.4-4% for common allergens [1,2]. The Papilionaceae family includes several legumes, such as lentils, chickpeas, green-beans, peanuts and soy, that are an important component of the European Diet and are among the five classes of food majorly responsible for IgE mediated allergicreactions [3,4]. Among these legumes, lentils seem to be the most common legume implicated in pediatric allergic reactions in the Mediterranean area and India [5-8], and usually they start early in life, below 4 years of age. "
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    ABSTRACT: Background Among legumes, lentils seem to be the most common legume implicated in pediatric allergic reactions in the Mediterranean area and India, and usually they start early in life, below 4 years of age. Case report A 22 -month-old child was admitted to our Pediatric Department for anaphylaxis and urticaria. At the age of 9 months she presented a first episode of angioedema and laryngeal obstruction, due to a second assumption of lentils in her diet. At admission we performed routine analyses that were all in the normal range, except for the dosage of specific IgE, that revealed a positive result for lentils. Prick tests too were positive for lentils, while they were all negative for other main food allergens. The child also performed a prick by prick that gave the same positive result (with a wheal of 8 mm of diameter). The child had not previously eaten lentils and other legumes, but her pathological anamnesis highlighted that the allergic reaction appeared soon after the inhalation of cooking lentil vapours when the child entered the kitchen Therefore a diagnosis of lentils vapours allergy was made. Conclusions Our case shows the peculiarity of a very early onset. In literature there are no data on episodes of anaphylaxis in so young children, considering that our child was already on lentils exclusion diet. Therefore a diet of exclusion does not absolutely preserve patients from allergic reactions, that can develop also after their cooking steams inhalation.
    Full-text · Article · Dec 2012 · Italian Journal of Pediatrics
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    • "The name " legume or pod " derives from the fruit, which is composed from two symmetrical valves enclosing the seeds [2]. Several legumes were used as food, such as the kidney bean (Phaseolus vulgaris), pea (Pisum sativum), broad bean (Vicia faba), lupin (Lupinus albus), chick pea (Cicer arietinum), peanut (Arachis hypogaea), soy bean (Glycine max), and lentil (Lens culinaris) [3]. Immunological cross-reactivity has been widely reported in this family but the clinical cross-reactivity is rare [4] [5]. "
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    ABSTRACT: The IgE-mediated allergic reactions to food are caused, generally, by ingestion. However, they can be rarely induced by exposure to airborne food particles through the handling or the cooking. Vicia faba is a vegetable which belongs to Legumes or Fabaceae family, Fabales order. Allergic reactions after ingestion of legumes and cases of asthma after exposure to the cooking vapors have been reported in the literature. A paper assessed the volatile substances (insect repellents) released by V. faba. The authors demonstrated that this plant produces several chemical substances, such as small quantities of methyl salicylate. We describe a case of occupational allergy, induced by handling during picking up of fresh broad beans, in a farmer with history of adverse reaction after eating the cooked and raw vegetable.
    Full-text · Article · Jun 2011 · Journal of Allergy
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    • "The name " legume or pod " derives from the fruit, which is composed from two symmetrical valves enclosing the seeds [2]. Several legumes were used as food, such as the kidney bean (Phaseolus vulgaris), pea (Pisum sativum), broad bean (Vicia faba), lupin (Lupinus albus), chick pea (Cicer arietinum), peanut (Arachis hypogaea), soy bean (Glycine max), and lentil (Lens culinaris) [3]. Immunological cross-reactivity has been widely reported in this family but the clinical cross-reactivity is rare [4] [5]. "
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    ABSTRACT: The IgE-mediated allergic reactions to food are caused, generally, by ingestion. However, they can be rarely induced by exposure to airborne food particles through the handling or the cooking. Vicia faba is a vegetable which belongs to Legumes or Fabaceae family, Fabales order. Allergic reactions after ingestion of legumes and cases of asthma after exposure to the cooking vapors have been reported in the literature. A paper assessed the volatile substances (insect repellents) released by V. faba. The authors demonstrated that this plant produces several chemical substances, such as small quantities of methyl salicylate. We describe a case of occupational allergy, induced by handling during picking up of fresh broad beans, in a farmer with history of adverse reaction after eating the cooked and raw vegetable.
    Full-text · Article · Jan 2011
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