Article

First case report of anaphylaxis to quinoa, a novel food in France

Authors:
To read the full-text of this research, you can request a copy directly from the authors.

Abstract

There are no previous reports of respiratory symptoms in patients with contact dermatitis to DMF like in our female patient, although we cannot confirm with patch-test the relation with DMF, she has no previous history of respiratory illness and improved when the armchairs were removed so the relation is quite probable. References 1. Darne´SDarne´S, Horne HL. Leather suite dermatitis. Br J Dermatol 2008;159: 262–264. 2. Williams JDL, Coulson LH, Susitaibal P, Winhoben SM. An outbreak of furniture dermatitis in the U.K. Br J Dermatol 2008;159:233–234. 3. Rantanen T. The cause of the Chinese sofa/chair dermatitis epidemic is likely to be contact allergy to dimethylfumarate a novel potent contact sensitizer. Br J Dermatol 2008;159: 218–221. 4. Yazdi MR, Mrowietz U. Fumaric acid esters. Clin Dermatol 2008;26: 522–526. 5. Hansson C, Tho¨rnebyTho¨rneby-Andersson K. Stereochemical considerations on concomitant allergic contact dermatitis to ester of the cis-trans isomeric compounds maleic acid and fumaric acid. Skin Pharmacol Appl Skin Physiol 2003;16: 117–122. 6. De Haan P, von Blomberg-van der Flier BME, de Groot J, Nieboer C, Bruynzeel DP. The risk of sensibilization and contact urticaria upon topical application of fumaric acid derivatives.

No full-text available

Request Full-text Paper PDF

To read the full-text of this research,
you can request a copy directly from the authors.

... They are consumed as a substitute to cereals by wheat-allergic or gluten-intolerant patients. Two cases of anaphylaxis after ingestion of quinoa have been reported [2,3]. ...
... It was reported that up to 25% of cases of adult asthma were due to occupational exposure [8] and that up to 20% of cases were induced by flour [9]. Quinoa seeds have previously been reported to be associated with anaphylaxis in France [2] and the United States [3] in persons eating quinoa. Highly soluble proteins of quinoa are reported to be associated with a heat-stable allergen [2]. ...
... Quinoa seeds have previously been reported to be associated with anaphylaxis in France [2] and the United States [3] in persons eating quinoa. Highly soluble proteins of quinoa are reported to be associated with a heat-stable allergen [2]. This is of particular interest in food allergy. ...
... Until now, the biomedical literature has recorded only one case of allergy to quinoa (Astier et al., 2009). This was reported in a 52-year old man who developed a serious systemic reaction, including dysphagia, dysphonia and generalized urticaria and angioedema following the ingestion of quinoa accompanied by fish and bread. ...
... Two heterogeneous groups of polypeptides in a range of 30-40 kDa (acid subunits) and 20-25 kDa (basic units), joined by disulfur bonds in teins (Brinegar and Goundan, 1993). Thus, the band close to the 35 kDa displayed using immunoblotting could belong to the chenopodin A acid subunit class -which is of particular interest for the development of functional foods based on highly soluble quinoa seed proteins (Astier et al., 2009). ...
Chapter
Full-text available
Quinoa (Chenopodium quinoa Willd.) is an amaranthaceous plant that has been recognized for centuries as an important food crop in the South American Andes. Its grains are highly nutritious; with a high protein and bioactive compound content that surpasses traditional cereal grains in terms of biological value. Quinoa is a nutritionally well-balanced food product with multiple functions associated with the reduction of chronic disease risk, thanks to its anti-oxidant, anti-inflammatory, immunomodulatory, anticarcinogenic and other properties. This chapter provides an up-to-date overview of the nutraceutical perspectives of quinoa, based on various scientific studies of its biological properties and functional applications beneficial to human health.
... Hasta ahora, la literatura biomédica registra sólo un caso de alergia a la quinua (Astier et al., 2009). Este caso fue reportado en un hombre de 52 años que desarrolló una seria reacción sistémica, incluyendo disfagia, disfonía, urticaria generalizada y angioedema después de la ingestión de quinua acompañada de pescado y pan. ...
... Dos grupos heterogéneos de poli péptidos en rango de 30-40 kDa (subunidades ácidas) y 20-25 kDa (unidades básicas) unidas por enlaces disulfuros en la proteína original caracterizan a las proteínas del tipo 11S (Brinegar y Goundan, 1993). De esta manera, la banda cercana a los 35 kDa evidenciada a través de inmunoblot podría pertenecer a la clase de la subunidad ácida de la chenopodina A, la cual es de particular interés en el desarrollo de alimentos funcionales a base a proteínas altamente solubles de semillas de quinua (Astier et al., 2009). ...
Chapter
Full-text available
La quínoa (Chenopodium quinoa Willd.) es una planta amarantácea que ha sido reconocida por siglos como un importante cultivo alimenticio en los Andes de Sudamérica. Sus granos son altamente nutritivos con una importante cantidad de proteínas y compuestos bioactivos superando en valor biológico a los tradicionales granos de cereales. De esta manera la quínoa representa un alimento nutricionalmente bien balanceado con múltiples propiedades funcionales relevantes para la reducción de factores de riesgo de enfermedades crónicas atribuibles a sus actividad anti-oxidante, anti-inflamatoria, inmunomodulatoria y anti-carcinogénica, entre otras. El presente capítulo entrega una visión global actualizada de las perspectivas nutracéuticas de la quínoa basada en diversas investigaciones que reportan sus propiedades biológicas y aplicaciones funcionales de beneficio a la salud humana.
... Yet, concerns have been raised regarding the high amount of saponins in quinoa, which inhere adjuvant capacity and may affect intestinal permeability [392]. Only few studies have investigated allergy to quinoa proteins, showing that quinoa may contain allergenic proteins [393][394][395][396]. However, no quinoa allergens are listed in the AllergenNomenclature [56]. ...
Article
Cow’s milk-based infant formulas are the most common substitute to mother’s milk in infancy when breastfeeding is impossible or insufficient, as cow’s milk is a globally available source of mammalian proteins with high nutritional value. However, cow’s milk allergy (CMA) is the most prevalent type of food allergy among infants, affecting up to 3.8% of small children. Hypoallergenic infant formulas based on hydrolysed cow’s milk proteins are commercially available for the management of CMA. Yet, there is a growing demand for more options for infant feeding, both in general but especially for the prevention and management of CMA. Milk from other mammalian sources than the cow, such as goat, sheep, camel, donkey, and horse, has received some attention in the last decade due to the different protein composition profile and protein amino acid sequences, resulting in a potentially low cross-reactivity with cow’s milk proteins. Recently, proteins from plant sources, such as potato, lentil, chickpeas, quinoa, in addition to soy and rice, have gained increased interest due to their climate friendly and vegan status as well as potential lower allergenicity. In this review, we provide an overview of current and potential future infant formulas and their relevance in CMA prevention and management.
... They regulate lipid profile and help in weight management by controlling appetite due to slow gastric emptying. These diets reduce insulin resistance by improving blood glucose levels along with the risk of obesity, cardiovascular diseases, diabetes and certain types of cancers [10]. ...
Chapter
Full-text available
Quinoa has proteins of high biological value, carbohydrates of low glycemic index and phytosteroids with -3 and 6 fatty acids that provide health benefits. The main advantage of quinoa is that along with being a protein supplement in the flour industry, it meets the increasing international demand for gluten-free products in cakes, pastries, pasta and baked goods. Studies on glycemic index (GI) profiling of newly released quinoa varieties are lacking and so the present study was taken up to assess its GI. Cooked raw and germinated quinoa were given to 10 subjects, their blood glucose levels were determined every 15 min up to 60 min and again at 90 and 120 min respectively. The blood glucose levels after consumption of raw quinoa ranged from 78.30 to 120.20 mg/dl with an average fasting level of 96.51 mg/dl and for germinated quinoa ranged from 68.4 to 114.0 mg/dl with an average fasting level of 84.2 mg/dl. The glycemic index of raw quinoa of 70 g having 50 g of carbohydrates ranged from 51.28 to 78.25 with an average of 63.37 and the glycemic load was from 25.64 to 39.12 with an average of 31.68. The glycemic index of germinated quinoa of 75 g having 50 g of carbohydrates ranged from 51.2 to 64.7 with an average of 59.0 and the glycemic load was from 25.6 to 29.7 with an average of 29.54. Hence, this quinoa variety can be categorized as a medium glycemic index and high glycemic load food. These diets can reduce insulin resistance and the risk of life style diseases like CVD, diabetes and certain cancers.
... One of them was a 38-year-old female patient with eosinophilic esophagitis caused by quinoa and her skin princk test was pozitif forquinoa [46]. Others of them were a 29-year-old woman that has urticaria and angioedema in the lips after eating quinoa salad [47] and another case was a 52year-old male diagnosed with quinoa allergy reported [48]. ...
Article
Full-text available
Quinoa (Chenopodium Quinoa Willd.) is a psudocereal plant which has been consumedfor 5000 years. It has attracted the attention all over the world because ofits adaptability to all climate conditions and its biological, nutritional importance.The year of 2013 was declared international quinoa year due to the fact that it is anold plant that contributes to world food security. Quinoa has rich nutritional valuefrom protein, essential aminoacid, minerals and vitamins. Also it contains saponins,phytosterols, phytoecdysteroids, phenolics that provides its biological activities. Thesecomponents may positively affect on health such as metobolic, gastrointestinal andcardiac influences but nowadays there are limited studies on human health. In thisreview, the cardiovascular effects of quinoa will be mentioned.Key words: antioxidant–biological activities–cardiovascular effects–quinoa–nutritional value
... Amaranth seed is a staple food in some countries but in others it is used as a "grain" substitute for wheat, and has also been reported to cause anaphylaxis (79). Like amaranth and buckwheat, quinoa is not a cereal, but functions as a very popular cereal substitute, first reported as an anaphylaxis trigger in 2005 by Astier et al. (80). Another case from the United States of America concerned a 29-year-old woman who developed allergic symptoms including a sensation of choking, 5 min after eating a quinoa salad (81). ...
Article
Full-text available
Food anaphylaxis is on the increase, with those who have an allergy to peanuts, tree nuts, milk, and seafood at the highest risk of developing such a reaction. However, the diet in many societies is increasingly varied, much of the food consumed is prepared outside the home, and meals are often composed of many different ingredients. Anaphylaxis may occur to a composite food, and it may be unclear whether the reaction is due to contamination or to a culprit allergen present in an added ingredient. Composite foods can contain many allergic proteins present in small amounts, which do not always have to be labeled, unless they feature in European or US labeling regulations. These “hidden” allergens include mustard, celery, spices, lupine, pea, natural food colourings, and preservatives, but can occasionally include allergenic material from contaminants such as cereal mites. Hidden allergens can provoke severe reactions to seemingly unconnected foods which might then lead to a diagnosis of idiopathic anaphylaxis. The same problem can arise with two well-known types of food allergy; wheat-dependant exercise induced anaphylaxis and allergy to non-specific Lipid Transfer Protein allergens, both of which might only manifest when linked to a cofactor such as exercise. Many of these risk factors for food anaphylaxis have a common link; the public's engagement with popular concepts of health and fitness. This includes the development of a food and exercise culture involving the promotion and marketing of foods for their health-giving properties i.e., meat substitutes, wheat substitutes, supplements and alternative, or “natural” remedies for common ailments. Some of these foods have been reported as the cause of severe allergic reactions, but because they are often viewed as benign unlikely causes of severe allergic reactions, could be considered to be hidden allergens. The best resource to elicit the likelihood of a hidden allergen provoking an allergic reaction is to take a detailed history of the allergic reaction, presence of co-factors, foods suspected, type of food and where it was consumed. A good knowledge of commonly used ingredients, and list of potential hidden allergen suspects are essential tools for the food allergy detective.
... They regulate lipid profile and help in weight management by controlling appetite due to slow gastric emptying. These diets reduce insulin resistance by improving blood glucose levels along with the risk of obesity, cardiovascular diseases, diabetes and certain types of cancers [3]. ...
Article
Full-text available
Quinoa has potential health benefits and exceptional nutritional value like high concentration of protein, unsaturated fatty acids and low glycemic index (35-53). Studies on glycemic index (GI) profile of germinated quinoa are lacking, so the present study was carried out to assess the glycemic index of germinated quinoa. Quinoa was germinated, cooked and was given to the subjects, blood glucose levels were examined for every 15mins upto 120mins. The mean fasting blood glucose level was 84.2 mg/dl and blood glucose levels after consumption of germinated quinoa was ranged from 114 to 68.4 mg/dl. The glycemic index of 75gm of germinated quinoa (having 50g of carbohydrates) ranged from 51.2 –64.7 with an average of 59. The glycemic load of germinated quinoa was ranged from 25.6 to 29.7 with an average of 29.54.Hence, concluded that germinated quinoa can be categorized into medium GI and high Glycemic Load (GL) food (9) Glycemic Index Profiling of Quinoa (Chenopodium quinoa Willd) Variety. Available from: https://www.researchgate.net/publication/324079819_Glycemic_Index_Profiling_of_Quinoa_Chenopodium_quinoa_Willd_Variety [accessed May 03 2018].
... They regulate lipid profile and help in weight management by controlling appetite due to slow gastric emptying. These diets reduce insulin resistance by improving blood glucose levels along with the risk of obesity, cardiovascular diseases, diabetes and certain types of cancers [3]. ...
Article
Full-text available
Quinoa has proteins of high biological value, carbohydrates of low glycemic index and phytosteroids with  - 3 and 6 fatty acids that provide health benefits. The main advantage of quinoa is that along with being a protein supplement in the flour industry, it meets the increasing international demand for gluten-free products in cakes, pastries, pasta and baked goods. Studies on glycemic index (GI) profiling of newly released quinoa varieties are lacking and so the present study was taken up to assess its GI. Cooked quinoa was given to the 10 subjects, their blood glucose levels were determined every 15 min up to 60 min and again at 90 and 120 min respectively. The blood glucose levels after consumption of quinoa ranged from 78.30 to 120.20 mg/dl with an average fasting level of 96.51 mg/dl. The glycemic index of quinoa ranged from 51.28 to 78.25 with an average of 63.37 and the glycemic load was from 25.64 to 39.12 with an average of 31.68. Hence, this quinoa variety can be categorized as a medium glycemic index and high glycemic load food.
... Sin embargo, pocos han sido los hallazgos que confirman reacciones alérgicas. La literatura describe casos muy puntuales o aislados asociados a la principal proteína de almacenamiento termoestable tipo globulinas, chenopodina 110,111 . ...
Article
Full-text available
The design of functional foods from well-known vegetables products such as soybean (Glycine max [L.] Merr.) and the enhancement of ancestral products like quinoa (Chenopodium quinoa Willd.) are feasible strategies to combat worldwide malnutrition. The aim of this review is to describe the agroecological, compositional, nutritional and technological features of these two different vegetable species (leguminous and pseudo-cereal) based on prior publications. In order to reach this goal, a review was performed using databases (Scopus, Web of Science, Scielo) and complemented with a subsequent manual search on Google Scholar and websites of recognized institutions. The included studies (n=117) in this review show that soybean adapts better to low altitudes (∼1,000 m a. s. l.), while quinoa does it in a range of higher altitudes (500-4,000 m a. s. l.) with a high tolerance to frost. Both are a source of high quality proteic given that supply the suggested requirements of essential aminoacids for children and adults with no significant differences, particularly tryptophan and lysine, and due to the high percentages of digestibility (>70%). Their low concentrations of prolamins and reasonable levels of Fe, Zn, Ca, daidzein and genistein make of them interesting products for food industry.
... Allergic individuals have Th2 skewing of their immune responses and studies in animal models suggest that tolerance involves T regulatory (Tregs) cells and the secretion of specific cytokines, in particular IL-10. To date, scarce data support the allergic potential of pseudocereals; however, some case reports of anaphylaxis to quinoa in France (Astier et al., 2009), Rajgira seed flour (Amaranthus paniculatus) in India (Kasera et al., 2013) and buckwheat in Asia (Lee et al., 2013) can be found in the literature. Immunoadjuvant activity of quinoa (Chenopodium quinoa) saponins on the humoral and cellular immune response(s) of mice immunized with ovalbumin have been suggested (Verza et al., 2012). ...
Chapter
Nutritional and health implications of pseudocereals (amaranth, quinoa, buckwheat, etc.) were reviewed. Diets that contain pseudocereals have been associated with low innate and adaptive immunological alterations caused by gluten proteins, hypocholesterolemic effects, antioxidant and antitumor activities, reducing blood glucose levels and improving hypertension and anaemia. Dietary fibre alone does not fully explain the frequent association between greater intake of whole grains and the reduced risk of disease in observational studies. Future research should be directed towards epidemiological studies and towards consolidating the mechanisms of action, especially in the human body.
... Allergic individuals have Th2 skewing of their immune responses and studies in animal models suggest that tolerance involves T regulatory (Tregs) cells and the secretion of specific cytokines, in particular IL-10. To date, scarce data support the allergic potential of pseudocereals; however, some case reports of anaphylaxis to quinoa in France (Astier et al., 2009), Rajgira seed flour (Amaranthus paniculatus) in India (Kasera et al., 2013) and buckwheat in Asia (Lee et al., 2013) can be found in the literature. Immunoadjuvant activity of quinoa (Chenopodium quinoa) saponins on the humoral and cellular immune response(s) of mice immunized with ovalbumin have been suggested (Verza et al., 2012). ...
Chapter
Pseudocereals are currently emerging as healthy alternatives to gluten-containing grains in the gluten-free diet. They make modern and innovative baked goods. They are naturally gluten free and high in a wide range of nutrients. Pseudocereal-based food products containing amaranth, quinoa and buckwheat as composites with wheat flour are already available commercially (pasta, noodles, breakfast cereals, biscuits, and breads) but few of these products are gluten free. Pseudocereals are considered as reasonably well balanced foods with functional properties that have been shown to provide medicinal benefits. This chapter summarizes recent research reporting several different beneficial effects of psudocereals consumption and the molecular mechanisms by which these pseudocereals exert their beneficial effects of pseudocereals.
... However, Astier and others reported a case of anaphylaxis to quinoa in France: a 52 year old man developed a systemic reaction consisting of dysphagia, dysphonia, urticaria and angioedema after the ingestion of quinoa with fish and bread. They tested samples of the ingested food, and only quinoa showed Immunoglobulin E (IgE) reactivity in the patient's serum [60]. ...
Article
Full-text available
Chenopodium quinoa Willd, known as quinoa, has been cultivated and consumed by humans for the last 5,000-7,000 years. Quinoa was important to pre-Columbian Andean civilizations, as the Incas considered it a gift from their gods. Quinoa has potential health benefits and exceptional nutritional value: a high concentration of protein (all essential amino acids highly bioavailable), unsaturated fatty acids, a low glycemic index; vitamins, minerals and other beneficial compounds; it is also gluten-free; furthermore, quinoa is a sustainable food, as plants exhibit a carbon and water food print that is between 30 and 60 times lower than that of beef. Quinoa is easy to cook, has versatility in preparation, and could be cultivated in different environments. For these reasons, quinoa, previously considered a food of low social prestige, is now the focus of attention of many countries worldwide. However, few studies exist on quinoa or quinoa compounds, in vitro, in vivo and clinical trials, for assessing its potential clinical applications supported by strong scientific evidence; thus, there is a need for well-designed clinical trials and increased scientific research in this field.
... This was the first case report regarding quinoa allergy in the USA (Hong et al., 2013). In addition, another case with a 52-year-old male patient from France diagnosed with quinoa allergy was reported (Astier et al., 2009). ...
... Allergies to eggs and dairy are also problematic, particularly in children, with approximately 1-3% of children being allergic to eggs and cow's milk (Sicherer & Sampson, 2006;Crisafulli et al., 2012). Allergic reactions to quinoa have been reported (Yotaro, 2002;Astier et al., 2009); however, these appear to be extremely rare. ...
Article
The objectives of this study were to determine pasting properties of non-roasted (NR) and roasted quinoa (RQ) and to investigate the effect of RQ on consumer acceptance and physicochemical properties of an allergen-free, gluten-free cake formulation. Quinoa seeds were roasted at 177 °C for 15 (R15), 30 (R30) and 45 min (R45), and flours were analysed for pasting properties. Five cakes including a commercial chocolate cake (CCC) and cakes made with NR and RQ flours were evaluated for preference by fifty panelists. Quality parameters included colour, water activity, moisture content, firmness, weight and height. Peak and final viscosity increased with roasting time. The NR cake had the highest sensory scores for appearance, colour and texture. On flavour and overall acceptability, CCC was the highest. Regarding quality data, CCC, NR and R15 cakes had similar L* values, while CCC had the lowest a*, b*, aw, moisture content and firmness values.
... Upon sequencing two of the plasmids and comparing with other genes in the GenBank, both plasmids were found to be homologous to legumin family of seed storage proteins. The nucleotide sequences of two legumin cDNAs (accession number EU113051 and EU113052 in the GenBank database) from pecan and their corresponding deduced amino acid sequences are shown in (Thorpe et al., 1988), and quinoa (Astier et al., 2009) have been implicated to cause allergic reactions in sensitive individuals. The predicted cleavage site separating the acidic and basic subunit of pecan legumin is between residue 316 and 317 (indicated by an arrow in Fig 3.1B). ...
Article
Tree nut allergies affect up to 0.2% young children and 0.5% adults in the US. The current investigation focused on two tree nuts (pecan and Brazil nut), with four specific aims: (i) to clone and characterize 2S albumin, a major allergen in pecan, (ii) to clone and characterize 11S legumin, a major allergen in pecan, (iii) to develop a sensitive and robust competitive ELISA for Brazil nut detection, and (iv) to purify and characterize BN seed allergens. Pecan cDNA expression library was constructed to meet specific aims (i) and (ii). The genes corresponding to 2S albumin and 11S legumin in pecan was amplified and expressed as fusion proteins. The fusion proteins were screened for IgE-binding with pecan allergic human sera. The corresponding native protein in pecan was identified using proteomic tools and inhibition immunoblots. The cross-reactivity of fusion protein with corresponding walnut allergen was also assessed. Overlapping synthetic peptides were used to determine the linear epitopes. Homology modeling of pecan allergens was done to obtain the structural insight and compare with known epitopes of corresponding allergens in other tree nuts. Of the 28 patients’ serum IgE tested by dotblot, 22 (79%) bound to 2S albumin (Car i 1) and 16 (57%) bound to 11S legumin (Car i 4). The native pecan 2S albumin is ~16 kDa composed of a large subunit (~12 kDa) linked to small subunit (~4 kDa) by disulfide bond. The native pecan 11S legumin is a hexameric protein, each monomer composed of ~33 kDa acidic subunit linked via disulfide bond to ~20-22 kDa basic subunit. IgE inhibition immunoblots suggested Car i 1 and Car i 4 to be cross-reactive with corresponding walnut allergens Jug r 1 and Jug r 4, respectively. Linear epitope mapping of Car i 1 indicated weak, moderate, and strong reactivity of serum pools against 12, 7, and 5 peptides, respectively. Of the 11 peptides recognized by all 3 serum pools, 5 peptides were strongly reactive. These strongly reactive polypeptides were located in 3 discrete regions of the Car i 1 sequence (residues 43-57, 67-78, and 106-120). Epitope mapping results of Car i 4 revealed weak, moderate, and strong reactivity of serum pools against 10, 5, and 4 peptides, respectively. Seven peptides were recognized by all 3 sera pools, of which 2 were strongly reactive. The strongly reactive peptides were located in 3 discrete regions of the Car i 4 acidic subunit sequence (residues 118-132, 208-219, and 238-249). Homology modeling of Car i 1 and Car i 4 revealed significant overlapping regions shared in common with other tree nuts. Rabbit anti-Brazil nut polyclonal antibodies were used to develop the inhibition ELISA for specific aim (iii). The assay was evaluated for cross-reactivity and robustness. The developed ELISA was sensitive (IC50 = 23.2 ± 9 ng/ml, n=76). Among the 66 tested foods/ingredients, only cinnamon exhibited detectable interference (1.36%). The ELISA could detect Brazil nut seed proteins over a pH range of 5-12, with optimal pH range of 7-10. Exposing Brazil nut seeds to processing did not adversely affect the nut seed protein detection using the assay. Brazil nut seed protein recovery from 100 mg of foods spiked with 10 and 1 μg of soluble Brazil nut proteins or 100 and 10 μg of defatted Brazil nut flour exhibited a wide recovery range, 63-315%, indicating protein-food matrix interaction. Brazil nut storage proteins were purified using column chromatography to meet specific aim (iv). Analytical ultracentrifugation of the purified Brazil nut albumin, vicilin and legumin proteins registered sedimentation coefficients of 1.8S, 7.1S and 11.8S, respectively. Under reducing conditions, the major polypeptide bands in 2S albumin were observed at 6.4, 10-11, and 15.2 kDa. The 7S vicilin was composed of one 12.6 kDa, two ~38-42 kDa, and two ~54-57 kDa polypeptides, while 11S globulin contained two major classes of polypeptides: ~30-32 kDa and ~20-21 kDa. The 7S vicilin is a glycoprotein. The estimated molecular mass and Stokes’ radius for 2S albumin and 7S and 11S globulins were (19.2 kDa, 20.1 Å), (114.8 kDa, 41.1 Å), and (289.4 kDa, 56.6 Å), respectively. Circular dichroism spectroscopic analysis indicated the secondary structure of the 3 proteins to be mainly -sheets and turns. Emission fluorescence spectra of the native proteins registered a λmax at 337, 345, and 328 nm for 2S albumin and 7S and 11S globulin, respectively. When probed with rabbit anti-Brazil nut polyclonal antibodies, 7S vicilin exhibited higher immunoreactivity than 2S albumin and 11S globulin.
... Relevant allergy studies on millet include those by Bohle et al (2003) and Rombold et al (2008). Finally, Astier et al (2009) reported a study on quinoa allergy. ...
Article
There are a growing number of individuals diagnosed with food allergies and intolerances. Gluten, in particular, is avoided by many individuals because of celiac disease, gluten intolerance, and gluten ataxia. Individuals with allergies, intolerances, or both follow strict diets, but there is concern that these individuals may be at risk of several nutrient deficiencies, including decreased calcium, iron. B vitamins, and fiber. To prevent deficiencies, alternative sources of these nutrients must be provided. Gluten-free cereals and pseudocereals such as amaranth, buckwheat, corn, millet, rice, sorghum, and quinoa can be excellent sources of vitamins, minerals, fiber, and other important nutrients. Germination of these edible seeds has been shown to further increase nutrient content and to reduce antinutrients. Their use to naturally fortify and enrich gluten-free foods has great potential. Although there are many benefits to germinated seeds in food, more research must be done to improve texture and sensory properties to gain wider consumer acceptance. A review of germination of gluten-free cereals and pseudocereals and its effect on their nutritional profile is presented.
... 16 Newly recognized food triggers include quinoa, fish gelatin, and seal and whale meat eaten by indigenous peoples. [17][18][19] Medication triggers include b-lactam and other antibiotics; aspirin, ibuprofen, and other analgesics 20 ; and newly recognized agents such as oversulfated chondroitin sulfate (OSCS)-contaminated heparin, 21 as well as seemingly innocuous substances such as folic acid contained in vitamins and supplements. 22 Biologic agents that trigger anaphylaxis include mAbs such as cetuximab, 23 infliximab, 24 and omalizumab 25 ; allergens used in immunotherapy 26 ; and, rarely, vaccines to prevent infectious diseases. ...
Article
The incidence rate of anaphylaxis is increasing, particularly during the first 2 decades of life. Common triggers include foods, medications, and insect stings. Clinical diagnosis is based on a meticulous history of an exposure or event preceding characteristic symptoms and signs, sometimes but not always supported by a laboratory test such as an elevated serum total tryptase level. Physician-initiated investigation of patients with anaphylaxis whose symptoms and signs are atypical sometimes leads to important insights into previously unrecognized triggers and mechanisms. In idiopathic anaphylaxis, in which no trigger can be confirmed by means of skin testing or measurement of specific IgE, the possibility of mastocytosis or a clonal mast cell disorder must be considered in addition to the possibility of a previously unrecognized trigger. Long-term risk reduction in patients with anaphylaxis focuses on optimal management of relevant comorbidities such as asthma and other respiratory diseases, cardiovascular disease, and mastocytosis or a clonal mast cell disorder; avoidance of the relevant confirmed allergen trigger; and relevant immunomodulation such as medication desensitization, venom immunotherapy, and possibly in the future, immunotherapy with food. Emergency preparedness for recurrence of anaphylaxis in community settings includes having epinephrine (adrenaline) autoinjectors available, knowing when and how to use them, and having a written, personalized anaphylaxis emergency action plan and up-to-date medical identification. Randomized controlled trials of the pharmacologic interventions used in an acute anaphylaxis episode are needed.
Chapter
As global population increases, food crops, which at a particular time appeared to be neglected or lesser known, begins to gain recognition. Chenopodium quinoa (Willd.) (quinoa) belongs to the family Amaranthaceae; it is regarded as a pseudocereal that is a natural to the Andean regions and is adaptable to diverse soil types and climatic conditions. Its high nutritional composition has stirred up enormous attention from the scientific community. Quinoa is very rich in dietary fiber, proteins, vitamins, unsaturated fats, and minerals, having an astonishing equilibrium of very essential amino acids, similarly branded as being a gluten-free grain, which permits its usage in the nutrition of celiac patients. Saponins, protease, and phytic acid inhibitors are among the utmost antinutrients found in quinoa seeds. Saponins happen to be the most dominant and are present in the exterior coating of the seeds, where they are responsible for the seed’s characteristic bitter taste. However, several researchers have tried to develop methods of saponin removal in seeds without altering the nutrient composition of the seeds significantly; this includes washing the seeds in cold water. Research shows that consumption of quinoa gave positive results against the antibodies of wheat proteins, thus suggesting that people with wheat protein allergies could consume quinoa. As a product of significance with regard to its mineral composition and phytochemicals, it is pertinent that more research should be carried out to come up with appropriate methods of propagation, distribution, and preparation to help solve the issue of malnutrition worldwide, especially in Africa and Asia where the production of food is constantly being threatened by environmental stress and global climate change.
Article
Résumé Introduction Les graines sont de plus en plus utilisées dans l’alimentation moderne pour leurs effets bénéfiques sur la santé. Elles sont, cependant, principalement responsables d’allergies alimentaires IgE médiées. Méthode Une revue de la littérature, concernant les graines de sésame, tournesol, courge, lin, pavot, amarante, chia, chanvre, millet, sarrasin, nigelle et quinoa, a été réalisée. Résultats La description des allergies aux graines dans la littérature est limitée à des cas sporadiques rapportés à travers le monde. Seul le sésame a été le plus étudié. En Israël, l’allergie au sésame est le 2e allergène le plus fréquent responsable d’allergie alimentaire chez l’enfant et le 3e en Arabie Saoudite. Le Réseau d’Allergo-Vigilance français rapporte des cas d’anaphylaxie, de grade 2 et 3 selon la classification de Ring et Messmer, chez l’enfant et chez l’adulte pour les graines de tournesol, courge, lin, amarante, millet, sarrasin et quinoa. Les huiles de sésame et de tournesol ont été incriminées dans certaines réactions. Certaines graines présentent des réactivités croisées avec d’autres allergènes qu’il est nécessaire de rechercher lors du bilan allergologique. Les IgE spécifiques sont toutes disponibles sauf pour l’amarante, le chia et le chanvre. Conclusion Les réactions allergiques aux graines sont sévères, car les protéines mises en jeu sont des protéines de stockage et des LTP. Les seules graines à déclaration obligatoire au niveau des étiquetages des produits industriels sont les graines de sésame. Les cliniciens doivent tenir compte de ces allergies alimentaires émergentes et devront les rechercher systématiquement dans l’exploration allergologique.
Chapter
Exposure to an allergen to which the patient has been previously sensitised is necessary for anaphylaxis. Sensitisation involves the formation of IgE to epitopes on the allergen at initial exposure. B cells are responsible for the secretion of IgE, which is then bound by receptors for IgE (known as FcεRI receptors) with high affinity. These receptors are found on the outer membrane of mast cells and basophils [1–5]. When an allergen is represented, IgE binds and this causes FcεRI receptors to come close to each other and cross-link. Following cross-linkage, a number of tyrosine kinases (e.g. Lyn, syk, fyn) become active intracellularly, allowing both up- and down-regulation of the signalling cascade [3, 4]. The degranulation function of mast cells is dependent upon the influx of calcium to the cell, a process which can be facilitated or inhibited through intracellular signalling mechanisms [3, 6, 7]. Both mast cells and basophils form chemical signalling molecules in advance which can then be released upon demand. These stored molecules include histamine, heparin, tryptase, chymase, and tumour necrosis factor alpha (TNFα). The cells can also secrete inflammatory mediator substances such as platelet-activating factor, nitric oxide, TNFα, the products of the arachidonic acid cycle involving cyclo-oxygenase (PGD2), and those involving lipoxygenase (in particular the leukotrienes LTC4, LTD4, and LTE4), but these are freshly synthesised rather than stored. Interleukins 4, 5, 13 plus GM-CSF may continue to be manufactured by the cell for some hours following exposure [6, 8].
Article
An allergy is an abnormal, inappropriate, exaggerated reaction of the immune system to contact with a foreign protein. These foreign proteins, usually well tolerated by the healthy population, are known as allergens. The term "hypersensitivity" is often used as a synonym for allergy. This chapter explores the various nuts and seeds that have induced allergies in people. Food-induced allergy may present with various symptoms. In 90% of reactions the skin is involved, with either acute urticaria or angioedema. These symptoms usually appear within minutes of ingesting the triggering food. Conjunctival and nasal symptoms are also common in acute systemic food reactions. Allergic reactions needs rapid and efficient management to avoid a potential fatality. Peanuts and tree nuts are responsible for severe food-induced reactions. Peanut allergy has an impact on socialization and affects the quality of life not only of allergic patients but also of their families, who live in constant fear of a reaction. Hazelnuts can elicit more severe symptoms and a full-blown anaphylactic reaction. Together with peanuts, hazelnuts account for 90% of fatalities due to food allergy. Sesame allergy occurs in individuals of all ages, from infancy to adulthood. Symptoms vary from subject to subject and include all allergic patterns, although there is a predominance of IgE-mediated symptoms. No definite treatment is yet available for nut and seed allergies.
Article
Objectives: Celiac disease is an enteropathy triggered by dietary gluten found in wheat, rye, and barley. Treatment involves a strict gluten-free diet (GFD). Quinoa is a highly nutritive plant from the Andes that has been recommended as part of a GFD. However, in-vitro data suggested that quinoa prolamins can stimulate innate and adaptive immune responses in celiac patients. Therefore, we aimed to evaluate the in-vivo effects of eating quinoa in adult celiac patients. Methods: Nineteen treated celiac patients consumed 50 g of quinoa every day for 6 weeks as part of their usual GFD. We evaluated diet, serology, and gastrointestinal parameters. Furthermore, we carried out detail histological assessment of 10 patients before and after eating quinoa. Results: Gastrointestinal parameters were normal. The ratio of villus height to crypt depth improved from slightly below normal values (2.8:1) to normal levels (3:1), surface-enterocyte cell height improved from 28.76 to 29.77 μm and the number of intra-epithelial lymphocytes per 100 enterocytes decreased from 30.3 to 29.7. Median values for all the blood tests remained within normal ranges, although total cholesterol (n=19) decreased from 4.6 to 4.3 mmol/l, low-density lipoprotein decreased from 2.46 to 2.45 mmol/l, high-density lipoprotein decreased from 1.8 to 1.68 mmol/l and triglycerides decreased from 0.80 to 0.79 mmol/l. Conclusions: Addition of quinoa to the GFD of celiac patients was well tolerated and did not exacerbate the condition. There was a positive trend toward improved histological and serological parameters, particularly a mild hypocholesterolemic effect. Overall, this is the first clinical data suggesting that daily 50 g of quinoa for 6 weeks can be safely tolerated by celiac patients. However, further studies are needed to determine the long-term effects of quinoa consumption.
Article
The wealth of allergology news continues to thrive year by year. The most important subjects remain allergens and food allergies, asthma which is difficult to treat, pollen allergies and anaphylaxis. The latter are still underestimated by doctors whatever their domain of involvement, both general practitioners and emergency physicians.
Article
There are always many new developments in allergy. Nevertheless, rhinitis, asthma and food allergies remain the three most important themes. The latter are the object of this present review. My comments are addressed, of course, to allergists, but also to pediatricians, pulmonary specialists, dermatologists, otolaryngologists and to all other physicians interested in food allergies.
Article
Among tree nut allergens, pecan allergens remain to be identified and characterized. The objective was to demonstrate the IgE-binding ability of pecan 11S legumin and characterize its sequential IgE-binding epitopes. The 11S legumin gene was amplified from a pecan cDNA library and expressed as a fusion protein in Escherichia coli. The native 11S legumin in pecan extract was identified by mass spectrometry/mass spectrometry (MS/MS). Sequential epitopes were determined by probing the overlapping peptides with three serum pools prepared from different patients' sera. A three-dimensional model was generated using almond legumin as a template and compared with known sequential epitopes on other allergenic tree nut homologues. Of 28 patients tested by dot blot, 16 (57%) bound to 11S legumin, designated Car i 4. MS/MS sequencing of native 11S legumin identified 33 kDa acidic and 20-22 kDa basic subunits. Both pecan and walnut seed protein extracts inhibited IgE binding to recombinant Car i 4, suggesting cross-reactivity with Jug r 4. Sequential epitope mapping results of Car i 4 revealed weak, moderate, and strong reactivity of serum pools against 10, 5, and 4 peptides, respectively. Seven peptides were recognized by all three serum pools, of which two were strongly reactive. The strongly reactive peptides were located in three discrete regions of the Car i 4 acidic subunit sequence (residues 118-132, 208-219, and 238-249). Homology modeling of Car i 4 revealed significant overlapping regions shared in common with other tree nut legumins.
Article
Anaphylaxis occurs commonly in community settings. The rate of occurrence is increasing, especially in young people. Understanding potential triggers, mechanisms, and patient-specific risk factors for severity and fatality is the key to performing appropriate risk assessment in those who have previously experienced an acute anaphylactic episode. The diagnosis of anaphylaxis is based primarily on clinical criteria and is valid even if the results of laboratory tests, such as serum total tryptase levels, are within normal limits. Positive skin test results or increased serum specific IgE levels to potential triggering allergens confirm sensitization but do not confirm the diagnosis of anaphylaxis because asymptomatic sensitization is common in the general population. Important patient-related risk factors for severity and fatality include age, concomitant diseases, and concurrent medications, as well as other less well-defined factors, such as defects in mediator degradation pathways, fever, acute infection, menses, emotional stress, and disruption of routine. Prevention of anaphylaxis depends primarily on optimal management of patient-related risk factors, strict avoidance of confirmed relevant allergen or other triggers, and, where indicated, immunomodulation (eg, subcutaneous venom immunotherapy to prevent Hymenoptera sting-triggered anaphylaxis, an underused, potentially curative treatment). The benefits and risks of immunomodulation to prevent food-triggered anaphylaxis are still being defined. Epinephrine (adrenaline) is the medication of first choice in the treatment of anaphylaxis. All patients at risk for recurrence in the community should be equipped with 1 or more epinephrine autoinjectors; a written, personalized anaphylaxis emergency action plan; and up-to-date medical identification. Improvements in the design of epinephrine autoinjectors will help to optimize ease of use and safety. Randomized controlled trials of pharmacologic agents, such as antihistamines and glucocorticoids, are needed to strengthen the evidence base for treatment of acute anaphylactic episodes.
Article
Quinoa (Chenopodium quinoa), a seed crop from the Andes region of South America, has been reported to have an exceptional seed protein amino acid composition. The purpose of this study was to isolate and characterize a major seed storage protein of quinoa, an US-type globulin called chenopodin. Extraction of quinoa seed protein was optimized with regard to extraction time, salt concentration, and buffer volumes. Extraction with 0.5 M NaCl solubilized polypeptides having molecuiar weights of 8000-9000,22 000-23 000,32 000-39 000, and 50 000. Enrichment of the chenopodin polypeptides (the A subunit group at 32 000-39 000 and the B subunit group at 22 000-23 000) was achieved by acid precipitation of the extract at pH 5.O. Gel filtration was necessary to purify the native (320 000) chenopodin. The disulfide-bonded A (acidic) and B (basic) polypeptides were separated by denaturation, reduction, and alkylation followed by ion-exchange chromatography. The amino acid compositions of the A and B polypeptides were similar to those of the acidic and basic subunits from other US seed globulins. The N-terminal sequence of one of the B polypeptides (GLEETICSARLSENIDDPSKA) was highly homologous to the basic subunits of several other 1 IS storage proteins, especially to rapeseed cruciferin.
Article
Quinoa (Chenopodium quinoa), a seed crop from the Andes region of South America, has been reported to have an exceptional seed protein amino acid composition. The purpose of this study was to isolate and characterize a major seed storage protein of quinoa, an 11S-type globulin called chenopodin. Extraction of quinoa seed protein was optimized with regard to extraction time, salt concentration, and buffer volumes. Extraction with 0.5 M NaCl solubilized polypeptides having molecular weights of 8000-9000, 22000-23000, 32000-39000, and 50 000. Enrichment of the chenopodin polypeptides (the A subunit group at 32 000-39 000 and the B subunit group at 22 000-23 000) was achieved by acid precipitation of the extract at pH 5.0. Gel filtration was necessary to purify the native (320 000) chenopodin. The disulfide-bonded A (acidic) and B (basic) polypeptides were separated by denaturation, reduction, and alkylation followed by ion-exchange chromatography. The amino acid compositions of the A and B polypeptides were similar to those of the acidic and basic subunits from other 11S seed globulins. The N-terminal sequence of one of the B polypeptides (GLEETICSARLSENIDDPSKA) was highly homologous to the basic subunits of several other 11S storage proteins, especially to rapeseed cruciferin.
Article
The nutritional quality of protein in quinoa seeds has been determined by amino acid assay and by animal feeding experiments. The amino acid composition of the protein in raw quinoa and washed quinoa show similar pattern. The first limiting amino acids were the aromatic amino acids thyrosine + phenylalanine giving a chemical score of 86 for protein in raw quinoa and 85 for protein in washed quinoa. Threonine was the next limiting amino acid followed by lysine. The amount of lysine and sulfur amino acids (methionine + cystine) was relatively high. In general, the content of essential amino acids in quinoa is higher than in common cereals. The animal experiments showed NPU values of 75.7, BV of 82.6 and TD value of 91.7 for the protein in raw quinoa. Results of the in-vitro enzymatic methods showed that the digestibility of the protein in quinoa is comparable to that of other high quality food proteins. The corresponding experiments carried out with samples of guinoa seeds, which have been processed to remove the saponins, showed that, the saponins do not exert any negative effect on the nutritive quality of the protein.
Article
Diagnosis of exercise-induced anaphylaxis is based on conjunction between a specific factor: a specific or nonspecific food allergy and exercise. The authors report observation of a patient who presented with exercise-induced anaphylaxis associated with food allergy to spinach, but also with a cross reaction with latex.
Article
The amino acid composition and the physicochemical and functional properties of quinoa protein isolates were evaluated. Protein isolates were prepared from quinoa seed by alkaline solubilization (at pH 9, called Q9, and at pH 11, called Q11) followed by isoelectric precipitation and spray drying. Q9 and Q11 had high levels of essential amino acids, with high levels of lysine. Both isolates showed similar patterns in native/SDS-PAGE and SEM. The pH effect on fluorescence measurements showed decreasing fluorescence intensity and a shift in the maximum of emission of both isolates. Q9 showed an endotherm with a denaturation temperature of 98.1 degrees C and a denaturation enthalpy of 12.7 J/g, while Q11 showed no endotherm. The protein solubility of Q11 was lower than that of Q9 at pH above 5.0 but similar at the pH range 3.0-4.0. The water holding capacity (WHC) was similar in both isolates and was not affected by pH. The water imbibing capacity (WIC) was double for Q11 (3.5 mL of water/g isolate). Analysis of DSC, fluorescence, and solubility data suggests that there is apparently denaturation due to pH. Some differences were found that could be attributed to the extreme pH treatments in protein isolates and the nature of quinoa proteins. Q9 and Q11 can be used as a valuable source of nutrition for infants and children. Q9 may be used as an ingredient in nutritive beverages, and Q11 may be used as an ingredient in sauces, sausages, and soups.