Probable gastrointestinal reaction to soybean

Soy and Isoflavone Consumption and Multiple Health Outcomes: Umbrella Review of Systematic Reviews and Meta-Analyses of Observational Studies and Randomized Trials in Humans

SCOPE

To assess the existing evidence of associations between consumption of soy and isoflavone and multiple health outcomes.

METHODS AND RESULTS

This is an umbrella review of meta-analyses and systematic reviews of randomized trials and observational studies in humans. 114 Meta-analyses and systematic reviews are identified with 43 unique outcomes. Soy and isoflavone consumption seems more beneficial than harmful for a series of health outcomes. Beneficial associations are identified for cancers, cardiovascular disease, gynecological, metabolic, musculoskeletal, endocrine, neurological, and renal outcomes, particularly in perimenopausal women. Harmful association is only found for gastric cancer (RR: 1.17, 95% CI: 1.02-1.36) for high intake of miso soup (1-5 cups per day) in male.

CONCLUSION

Generally, soy and isoflavone consumption is more beneficial than harmful. The results herein support promoting soy intake as part of a healthy diet. Randomized controlled trials are necessary to confirm this finding.

Targeting a cross-reactive Gly m 5 soy peptide as responsible for hypersensitivity reactions in a milk allergy mouse model

Background

Cross-reactivity between soybean allergens and bovine caseins has been previously reported. In this study we aimed to map epitopes of the major soybean allergen Gly m 5 that are co-recognized by casein specific antibodies, and to identify a peptide responsible for the cross-reactivity.

Methods

Cow's milk protein (CMP)-specific antibodies were used in different immunoassays (immunoblotting, ELISA, ELISA inhibition test) to evaluate the in vitro recognition of soybean proteins (SP). Recombinant Gly m 5 (α), a truncated fragment containing the C-terminal domain (α-T) and peptides of α-T were obtained and epitope mapping was performed with an overlapping peptide assay. Bioinformatics tools were used for epitope prediction by sequence alignment, and for modelling the cross-recognized soy proteins and peptides. The binding of SP to a monoclonal antibody was studied by surface Plasmon resonance (SPR). Finally, the in vivo cross-recognition of SP was assessed in a mouse model of milk allergy.

Results

Both α and α-T reacted with the different CMP-specific antibodies. α-T contains IgG and IgE epitopes in several peptides, particularly in the peptide named PA. Besides, we found similar values of association and dissociation constants between the α-casein specific mAb and the different milk and soy components. The food allergy mouse model showed that SP and PA contain the cross-reactive B and T epitopes, which triggered hypersensitivity reactions and a Th2-mediated response on CMP-sensitized mice.

Conclusions

Gly m 5 is a cross-reactive soy allergen and the α-T portion of the molecule contains IgG and IgE immunodominant epitopes, confined to PA, a region with enough conformation to be bound by antibodies. These findings contribute to explain the intolerance to SP observed in IgE-mediated CMA patients, primarily not sensitised to SP, as well as it sets the basis to propose a mucosal immunotherapy for milk allergy using this soy peptide.

Use of soy protein-based formulas in infant feeding

Soy protein-based formulas have been available for almost 100 years. Since the first use of soy formula as a milk substitute for an infant unable to tolerate a cow milk protein-based formula, the formulation has changed to the current soy protein isolate. Despite very limited indications for its use, soy protein-based formulas in the United States may account for nearly 25% of the formula market. This report reviews the limited indications and contraindications of soy formulas. It will also review the potential harmful effects of soy protein-based formulas and the phytoestrogens contained in these formulas.

Implications of antinutritional components in soybean foods

There are a number of components present in soybeans that exert a negative impact on the nutritional quality of the protein. Among those factors that are destroyed by heat treatment are the protease inhibitors and lectins. Protease inhibitors exert their antinutritional effect by causing pancreatic hypertrophy/hyperplasia, which ultimately results in an inhibition of growth. The lectin, by virtue of its ability to bind to glycoprotein receptors on the epithelial cells lining the intestinal mucosa, inhibits growth by interfering with the absorption of nutrients. Of lesser significance are the antinutritional effects produced by relatively heat stable factors, such as goitrogens, tannins, phytoestrogens, flatus-producing oligosaccharides, phytate, and saponins. Other diverse but ill-defined factors appear to increase the requirements for vitamins A, B12, D, and E. The processing of soybeans under severe alkaline conditions leads to the formation of lysinoalanine, which has been shown to damage the kidneys of rats. This is not generally true, however, for edible soy protein that has been produced under milder alkaline conditions. Also meriting consideration is the allergenic response that may sometimes occur in humans, as well as calves and piglets, on dietary exposure to soybeans.

In vitro allergenicity of cows' milk substitutes

There are numerous alternatives to cows' milk formula for allergic children. We have investigated the allergenicity of several of these using RAST and RAST inhibition on serum from 16 patients with a known history of cows' milk protein intolerance (CMPI) and 16 atopic controls. A RAST grade of > or = 3 for cows' milk was present in all those with CMPI, whilst all the controls gave RAST of < or = 1. Modified cows' milk formula, goats' infant formula, sheep and goats' milk produced similar results to cows' milk. Only two patients had RAST > or = 3 for soya milk and the soy/beef hydrolysate gave positive results in only three patients. One had positive RAST to Nutramigen and two to Pregestimil. Of the whey hydrolysates investigated, Pepti-junior gave seven positive RASTs whilst we were unable to bind Alfare to the sepharose in sufficient quantities to interpret the results which were negative in all cases. RAST inhibition data on pooled sera from the same patients agreed with the RAST results. The inhibition curves showed high inhibition with goats', sheep, modified cows' milk formula and the casein formula, AL110 (50%). Soy and soy/beef hydrolysate showed a much lower inhibition pattern. Casein hydrolysates showed low inhibition while the whey hydrolysate produced higher inhibition. We have shown that despite claims of low allergenicity, some of these alternative formulae are antigenically recognized in vitro by some cows' milk intolerant patients.

Immediate and late onset asthma from occupational exposure to soybean dust

Most patients sensitive to soybean experience gastrointentinal symptoms, urticaria, angioedema, and asthma after ingestion. However, we report here a previously non-allergic patient who developed immediate and late onset asthma after breathing soybean flour used in the manufacture of food supplements. She exhibited positive immediate and late skin test sensitivity as well as a positive bronchial challenge to a soybean flour extract. In contrast to another patient with an anaphylactic response after soybean ingestion, the radioallergosorbent test (RAST) to soybean antigen was negative in our patient.

The effect of different feeds, including those containing soya-bean products, on the passage of digesta from the abomasum of the preruminant calf

1. The effects of various factors on rates of flow and composition of digesta leaving the abomasum of preruminant calves were studied. The possible relation of some of these effects to the development of serum antibodies to certain dietary constituents has also been examined. Two situations were distinguished: (a) unsensitized responses, shown by calves receiving milk protein or soya-bean products for the first one or two occasions; (b) sensitized responses, shown by calves receiving certain soya-bean products, after a number of these feeds had been given. 2. For unsensitized calves, the rate of flow of total digesta from the abomasum was greater in the first few hours after a feed consisting of a mineral solution was given, than after cow's milk was given. This difference wasapparently due to differences in the composition of digesta entering the duodenum. Total digesta flows after giving synthetic milk feeds, prepared from different protein sources, were similar to those after cow's milk was given. 3. For sensitized calves, rates of flow of total digesta from the abomasum were greatly affected by the nature of the protein source used in the diet. Soya-bean flour (heated or unheated) generally caused inhibition of flow for some hours after feeding; a soya-bean protein isolate (isoelectric) had a similar but smaller effect, but a soya-bean concentrate (prepared by alcohol extraction of a soya-bean flour) and milk protein had little or no effect. The inhibition, believed to be a sign of more general disorders, appeared to be caused by a factor entering the duodenum which induced a change in the way in which the calf responded, probably as the result of a gastrointestinal allergy. 4. Calves given soya-bean flour or a soya-bean protein isolate (isoelectric) in their diets for several weeks, showed respectively high and low titres of serum antibodies to an antigen prepared from soya-bean flour. Calves given alcohol-extracted soya-bean concentrate had no similar antibodies. 5. In addition to variations in total digesta flow, dietary nitrogen compounds were held up in the abomasum to different extents after different feeds. After a whole-milk feed or a synthetic feed prepared from casein, a slow, steady release of N occurred over at least 9 h. N hold-up after giving soya-bean-containing feeds was slight for the soya-bean flour, but extremely marked for the soya-bean protein isolate (isoelectric). The latter hold-up was followed after several hours by a rapid outflow of N from the abomasum.