Article

Oral allergy syndrome to watermelon and melon

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Abstract

Oral allergy syndrome (OAS) usually presents as an immediate swelling and itching sensation of the mouth and throat after ingestion of a food allergen. OAS may be the most common food allergy-related manifestation. Watermelon and melon belong to the Cucurbitaceae family and often show allergenic cross reactivity. Profilin is a 13 kda protein that is identified as a relevant pollen allergen in airborne pollen and related plant food allergies. Profilin is found in both watermelon and melon. Here we report a case of OAS to watermelon and melon in an 11 year-old boy. He was positive to the skin prick test, patch test and oral challenge test with watermelon and melon.

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... Moreover, various Korean foods are reportedly implicated in diverse clinical manifestations of PFAS; e.g., bronchospasm and urticaria caused by shiso leaf (Perilla frutescens), 21 anaphylaxis by Chinese bellflower root, 22 crown daisy-dependent exercise-induced anaphylaxis, 23 and PFAS caused by celery, lettuce, chicory, radish sprouts, ginseng, mango, kiwi, tomato, crown daisy and perilla leaf. [24][25][26][27] Cross-allergenicity between foods and pollen allergens is linked to the pathogenesis of PFAS. 28 The major allergen of birch pollen, Bet v 1, exhibits cross-reactivity with many food allergens, particularly the Rosaceae family (e.g., apple, peach, pear, cherry, plum and apricot). ...
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Purpose: Pollen-food allergy syndrome (PFAS) is an immunoglobulin E (IgE)-mediated allergy in pollinosis patients caused by raw fruits and vegetables and is the most common food allergy in adults. However, there has been no nationwide study on PFAS in Korea. In this study, we investigated the prevalence and clinical characteristics of PFAS in Korea. Methods: Twenty-two investigators participated in this study, in which patients with allergic rhinoconjunctivitis and/or bronchial asthma with pollen allergy were enrolled. The questionnaires included demographic characteristics, a list of fruits and vegetables, and clinical manifestations of food allergy. Pollen allergy was diagnosed by skin prick test and/or measurement of the serum level of specific IgE. Results: A total of 648 pollinosis patients were enrolled. The prevalence of PFAS was 41.7% (n = 270). PFAS patients exhibited cutaneous (43.0%), respiratory (20.0%), cardiovascular (3.7%) or neurologic symptoms (4.8%) in addition to oropharyngeal symptoms. Anaphylaxis was noted in 8.9% of the PFAS patients. Seventy types of foods were linked to PFAS; e.g., peach (48.5%), apple (46.7%), kiwi (30.4%), peanut (17.4%), plum (16.3%), chestnut (14.8%), pineapple (13.7%), walnut (14.1%), Korean melon (12.6%), tomato (11.9%), melon (11.5%) and apricot (10.7%). Korean foods such as taro/taro stem (8.9%), ginseong (8.2%), perilla leaf (4.4%), bellflower root (4.4%), crown daisy (3.0%), deodeok (3.3%), kudzu root (3.0%) and lotus root (2.6%) were also linked to PFAS. Conclusions: This was the first nationwide study of PFAS in Korea. The prevalence of PFAS was 41.7%, and 8.9% of the PFAS patients had anaphylaxis. These results will provide clinically useful information to physicians.
Article
Oral allergy syndrome (OAS), an immediate swelling and itching sensation of the mouth and throat after ingestion of a food allergen, is the most common food allergy-related manifestation. It can be present either in isolation or in association to systemic symptoms, and may even result in anaphylaxis. We report a case of a 5-year-old child who suffered from an oral allergy syndrome after eating perilla seeds. We obtained a positive open oral challenge with crude perilla seeds.
Article
Watermelon is a worldwide consumed Cucurbitaceae fruit that can elicit allergic reactions. However, the major allergens of watermelon are not known. The aim of this study is to identify and characterize major allergens in watermelon. Twenty-three patients allergic to watermelon took part in the study. The diagnosis was based on a history of symptoms and positive skin prick-prick tests to watermelon, confirmed by positive open oral challenge testing to watermelon pulp. Allergenic components were detected by SDS-PAGE and immunoblotting. Molecular characterization of IgE-binding bands was performed by N-terminal amino acid sequencing and mass spectrometry. Allergens were purified combining several chromatographic steps. Several IgE binding bands (8-120 kDa) were detected in watermelon extract. Three major allergens were identified as malate dehydrogenase (36 kDa), triose phosphate isomerase (28 kDa) and profilin (13 kDa). Purified allergens individually inhibited IgE binding to the whole watermelon extract. All in all these results indicate that malate dehydrogenase, triose phosphate isomerase and profilin are major allergens involved in watermelon allergy.
Article
Melon allergy has been documented by means of double-blind, placebo-controlled food challenges. The most common clinical feature associated with melon allergy is oral allergy syndrome (OAS). However, no relevant allergens of melon have been identified to date. We sought to identify melon allergens and analyze their digestibility in human saliva and simulated gastric fluid (SGF) to provide a rationale for the OAS. Melon, zucchini, cucumber, and watermelon allergens were identified by means of IgE immunoblotting of sera from 21 patients with OAS after melon ingestion confirmed by means of double-blind, placebo-controlled food challenge. Further characterization was performed with rabbit antisera against sunflower pollen profilin and anticomplex glycans. Lability of allergens was assayed by incubation of melon extract in human saliva and SGF. Several IgE-binding components between 15 and 60 kd and a main reactive band of 13 kd were detected in melon extract with the pooled sera from patients with melon allergy. As in melon, 13-kd components of zucchini, cucumber, and watermelon extracts were strongly recognized by the IgE antibodies of the patients with melon allergy and were identified as profilins. Putative cross-reacting carbohydrate determinants were also detected. Sera from 71% of patients recognized the melon profilin, and therefore profilin is considered a major allergen. Melon allergens were unaffected by crude human saliva. In contrast, most melon proteins, predominantly the 13-kd component (profilin), were quickly digested in the SGF. In patients with OAS, a 13-kd protein identified as a profilin is a major melon allergen highly susceptible to pepsin digestion.
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