Asthma and rhinitis induced by exposure to raw green beans and chards

Do Foods Cause Rhinitis?

Rhinitis is a frequent inflammatory disease, that implies various etiopathogenetic mechanisms. The most relevant are IgE- and non-IgE-mediated cellular infiltration, and different causal substances. Foods may cause of rhinitis in some patients. Rhinitis by foods, or food rhinitis (FR) as a isolate condition, is infrequent and usually associated with other allergic or nonallergic disorders. Food Rhinitis may depend on different pathogenetic mechanisms, including IgE-mediated, type 2 non-allergic inflammation, and hyperreactivity reactions. FR also may dependent on professional exposure, which is a type of occupational rhinitis (OR).

Exploring a Potential Causal Link Between Dietary Intake and Chronic Obstructive Pulmonary Disease: A Two-Sample Mendelian Randomization Study

Background

Chronic Obstructive Pulmonary Disease (COPD), the most prevalent chronic respiratory condition, significantly impairs patients' quality of life. The pivotal element in disease management lies in prevention, underscoring the paramount importance of employing a scientific approach to investigate early prevention strategies for COPD.

Methods

This study delved into the causal link between 28 dietary intakes and COPD employing two-sample Mendelian randomization. We primarily utilized the Inverse Variance Weighted (IVW) method as the main outcome, complemented by Weighted Median (WM), MR-Egger method, along with several sensitivity analysis techniques, all accompanied by visual representations.

Results

We identified higher odds of COPD following exposure to green beans (OR=1.381, 95% CI=1.119-1.704, P=0.003) and pork intake (OR=2.657, 95% CI=1.203-5.868, P=0.016). In contrast, the odds of developing COPD were lower following exposure to dried fruit (OR=0.481, 95% CI=0.283-0.819, P=0.007), cereal (OR=0.560, 95% CI=0.356-0.880, P=0.012), and whole egg consumption (OR=0.700, 95% CI=0.504-0.972, P=0.033).

Conclusion

In light of our study's findings, we anticipate that strategically modifying dietary choices may offer an avenue for early COPD prevention in the future.

Association between Food-Specific Immunoglobulin G4 Antibodies in Adults with Self-Reported Signs and Symptoms Attributed to Adverse Reactions to Foodstuffs

Signs and symptoms attributed to adverse reactions to foodstuffs (ARFS) need tools for research and evaluation in clinical practice. The objectives of this study were (a) to evaluate the most frequent self-reported signs and symptoms attributed to ARFS in Spanish adults, (b) to determine the prevalence of food-specific IgG4 antibody reactions (AbRs), and (c) to investigate the association between self-reported ARFS symptomatology and food-specific IgG4 AbRs. Food-specific IgG4 AbRs against 57 common food and beverages (AESKUCARE-T2FA® in vitro point-of-care test kit, Aesku.Diagnostics GmbH, Germany) were determined in capillary blood samples of 205 volunteers living in the Region of Madrid (Spain). The most frequent self-reported signs and symptoms were related to skin (43%), digestive (41%), and nervous system (NS, 33%) problems. The prevalence of food-specific IgG4 AbRs was cow's milk (73%), sheep's milk (70%), casein (66%), and goat's milk (56.10%). Positive IgG4 AbRs against tomato had a profile consisting of 3/4 of skin problems, more than half of digestive, and 2/5 of NS self-reported signs and symptoms. In conclusion, at least 1/3 of the studied sample reported skin, digestive, and NS signs and symptoms. The most frequent food-specific IgG4 AbRs were related to dairy. Skin problems were more frequent in positive tomato IgG4 AbRs.

Legumes steam allergy in childhood: Update of the reported cases

In the past few decades, the prevalence of allergic diseases has deeply increased, with a key role played by food allergies. Legumes seem to play a major role towards the overall increase in the scenario of food allergy, since they are an appreciated source, consumed worldwide, due to their high protein content, variable amounts of lipids and for the presence of vitamins. In literature there are numerous descriptions of adverse reactions after ingestion of uncooked and cooked legumes. Nevertheless, cases of allergic reactions induced by inhaling vapours from cooking legumes have rarely been described. Herein the authors report an update of the literature data on allergic reactions caused by legume steam inhalation, underlying the possible pathogenic mechanism of these atopic events and the knowledge of literature data in paediatric age. The importance of this review is the focus on the clinical aspects concerning legume vapour allergy, referring to literature data in childhood.

Impact of thermal processing on legume allergens

Food induced allergic manifestations are reported from several parts of the world. Food proteins exert their allergenic potential by absorption through the gastrointestinal tract and can even induce life threatening anaphylaxis reactions. Among all food allergens, legume allergens play an important role in induction of allergy because legumes are a major source of protein for vegetarians. Most of the legumes are cooked either by boiling, roasting or frying before consumption, which can be considered a form of thermal treatment. Thermal processing may also include autoclaving, microwave heating, blanching, pasteurization, canning, or steaming. Thermal processing of legumes may reduce, eliminate or enhance the allergenic potential of a respective legume. In most of the cases, minimization of allergenic potential on thermal treatment has generally been reported. Thus, thermal processing can be considered an important tool by indirectly prevent allergenicity in susceptible individuals, thereby reducing treatment costs and reducing industry/office/school absence in case of working population/school going children. The present review attempts to explore various possibilities of reducing or eliminating allergenicity of leguminous food using different methods of thermal processing. Further, this review summarizes different methods of food processing, major legumes and their predominant allergenic proteins, thermal treatment and its relation with antigenicity, effect of thermal processing on legume allergens; also suggests a path that may be taken for future research to reduce the allergenicity using conventional/nonconventional methods.

Vicia faba Hypersensitivity and ASA Intolerance in a Farmer: A Case Report

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.

Green bean (Phaseolus vulgaris): a new source of IgE-binding lipid transfer protein

Green beans belong to the Fabaceae family, which includes widely consumed species, such as beans, peanuts, and soybeans. In the literature, few cases have described allergic reactions upon the exposure to green bean boiling steam or ingestion. Here, we describe five patients reporting documented adverse reactions upon the ingestion of cooked green beans, and we characterize the responsible allergen. Fresh and cooked green beans were tested by a prick + prick technique. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis and IgE immunoblotting were performed with boiled vegetable extract, and the N-terminal sequence of the immunoreactive protein was obtained by analyzing the excised band in a protein sequencer. Immunoblotting inhibition of cooked green bean with in-house-purified peach lipid transfer protein (LTP) Pru p 3 was performed. An interesting green bean protein was chromatographically purified, tested with a pool serum, and inhibited with Pru p 3. Moreover, its molecular mass was determined by mass spectrometry. Prick + prick tests with raw and cooked green beans were positive for all of the patients. IgE immunoblotting showed that all of the patients reacted toward a unique IgE-binding protein at about 9 kDa. The obtained N-terminal sequence revealed the following amino acids: Ala-Ile-Ser-X-Gly-Qln-Val-Thr-Ser-Ser-Leu-Ala, corresponding to an LTP. A complete inhibition of the IgE binding to this protein, in both raw and purified extract, was obtained by purified peach Pru p 3, confirming previous IgE immunoblotting results.

Allergic reactions to foods by inhalation

Although allergic reactions to foods occur most commonly after ingestion, inhalation of foods can also be an underlying cause of these reactions. For example, published reports have highlighted the inhalation of allergens from fish, shellfish, seeds, soybeans, cereal grains, hen's egg, cow's milk, and many other foods in allergic reactions. Symptoms have typically included respiratory manifestations such as rhinoconjunctivitis, coughing, wheezing, dyspnea, and asthma. In some cases, anaphylaxis has been observed. In addition, there have been many investigations of occupational asthma following the inhalation of relevant food allergens. This report reviews the current literature focusing on allergic reactions to foods by inhalation.

Angioedema induced by inhalation of vapours from cooked white bean in a child

BACKGROUND

There are few references of allergic reaction to beans in childhood. We report the case of a seven years old boy who suffered from angioedema associated to inhalation of vapours from cooked white bean.

METHODS

skin prick tests (SPT) were performed by prick-by-prick with cooked white bean and legumes. It was also determined total IgE and specific IgE antibodies to bean and legumes with the use of the CAP enzymo-immunoassay. Subsequently, a oral challenge test was carried out with white bean.

RESULTS

The prick-by-prick with white bean was positive in our case, and negative in ten controls patients. Specific IgE in patient serum, assayed by CAP was positive for white bean and green bean. The patient developed angioedema after ingestion cooked white bean.

CONCLUSION

we demonstrated a type I hypersensitivity to white bean in a seven years old child by SPT, specific IgE antibodies and challenge test.

Links between rhinitis and asthma

There is compelling evidence of a close relationship between the upper and lower airways in asthma and rhinitis. Rhinitis is present in the majority of patients with asthma, and a significant minority of patients with rhinitis have concomitant asthma. Similarities between the two conditions occur in the nature of the inflammation present in the target tissues. A common initiating step in the inflammatory process of allergic airways disease is the presence of immunoglobulin E providing an adaptor molecule between the offending allergen and inflammatory cell activation and mediator release. Differences in the two conditions arise largely from the structural differences between the nose and the lungs. In an asthmatic, concomitant allergic rhinitis increases healthcare costs and further impairs quality of life. The presence of rhinitis should always be investigated in children and young adults with asthma. Subjects with allergic rhinitis have an increased risk of developing asthma and may form a suitable population for secondary intervention to interrupt the 'allergic march'.

Relevance of inhalational exposure to food allergens

PURPOSE OF REVIEW

This review discusses the inhalational route as a clinically important route of exposure to food allergens.

RECENT FINDINGS

In childhood, we have recently demonstrated that food allergens can induce both early and late phase bronchial reactions within blinded, placebo-controlled challenges. Additionally, clinically important levels of food allergens have been measured in environmental air samples.

SUMMARY

It is well known that the ingestion of food allergens frequently causes respiratory symptoms and that the mechanism of death in fatal anaphylaxis is usually profound bronchospasm. The mechanism by which ingested food allergens induce bronchial reactions is unclear. There are many case reports of bronchial reactions to aerosolized food allergens. Within the food industry the problems have been examined more systematically. From such work it is possible to gain an impression of the potential prevalence of the problem. With 10% of adult asthma being occupational and 10% of occupational asthma being induced by aerosolized food, inhalational exposure to food allergens plays a major role in at least 1% of adult asthma. For a patient with co-existent food allergy and asthma it is important that both dietary and environmental avoidance be practised. The similar pathophysiology of allergic and occupational asthma and the ability of inhaled food allergens to cause the latter raises the question as to whether aerosolized food could play a role in the pathogenesis of childhood asthma.