Emerging and Novel Elicitors of Anaphylaxis: Collegium Internationale Allergologicum Update 2024.

BACKGROUND: Anaphylaxis represents the most severe end of the spectrum of allergic reactions. Frequent elicitors of anaphylaxis are insects, foods, and drugs. This paper summarizes recent development with regard to emerging and novel elicitors of anaphylaxis. SUMMARY: Food allergens on the rise include pulses (like pea, chickpea), seeds (hemp, chia), nuts (cashew), pseudograins (buckwheat, quinoa), fruits, and microalgae. Novel foods are foods that were not consumed to any significant extent in the European Union before May 1997, which includes four edible insects (mealworm, migratory locust, house cricket, and buffalo worm). Recent investigations have pointed out the risk of anaphylaxis associated with the consumption of yellow mealworm for people allergic to shellfish and house dust mites. In Europe, fire ants (mostly Solenopsis invicta) and Vespa velutina nigrithorax represent invasive species, which account for increasing numbers of anaphylactic reactions. Also, several new drugs, especially biologicals, have been associated with anaphylaxis. KEY MESSAGES: Elicitors of anaphylaxis are changing as a result of (i) increase in demand for plant-based food, (ii) introduction of novel foods, (iii) spreading of allergens by climate changes and globalization, or (iv) due to exposure to newly developed drugs.

Investigating Novel Food Sensitization: A Real-Life Prevalence Study of Cricket, Locust, and Mealworm IgE-Reactivity in Naïve allergic Individuals.

BACKGROUND AND OBJECTIVE: With the global population on the rise, edible insects are considered a potential solution to food security, although concerns about risks such as anaphylaxis exist. METHODS: 2,014 participants underwent testing with the Allergy Explorer-ALEX-2 including extracts of three novel foods: Acheta Domesticus (Ad), Locusta migratoria (Lm), and Tenebrio molitor (Tm). The IgE-mediated sensitization status was investigated in participants who had never knowingly consumed these insects. Data was recorded using an electronic database. RESULTS: 195 individuals (9.7% of all participants) were sensitized to insects. Tropomyosin was co-recognized by 34%, and 18.5% were positive for arginine kinases. Reactivity to Sarcoplasmic-CB, Troponin-C, Paramyosin, or Myosin-light-chain was found in less than 5% of the population, whereas 108 individuals (55.4%) did not show any reactivity to invertebrate panallergens. Additionally, 33 individuals (16.9%) exhibited monosensitization exclusively to insects. Multivariate analysis revealed an inverse association between arachnid reactivity and sensitization to insect allergens, while Mollusca, Blattoidea, and tropomyosin reactivity displayed a direct relationship. Furthermore, Myosin-light-chain reactivity correlated with Ad and Lm, and Troponin-C with Ad and Tm sensitization. CONCLUSION: Edible insect extract IgE sensitization was observed in individuals without prior exposure to such foods. Mites showed a low likelihood of being primary sensitizers due to their inverse association with insect reactivity. Conversely, the direct association of insect sensitization with mollusk and cockroach extract reactivity suggests their potential as primary sensitizers in these participants. Tropomyosin consistently exhibited a positive association with reactivity to all studied insects, supporting its role as a primary sensitizer.

Addressing the safety of new food sources and production systems.

New food sources and production systems (NFPS) are garnering much attention, driven by international trade, changing consumer preferences, potential sustainability benefits, and innovations in climate-resilient food production systems. However, NFPS can introduce new challenges for food safety agencies and food manufacturers. Most food safety hazards linked to new foods have been identified in traditional foods. However, there can be some food safety challenges that are unique to new foods. New food ingredients, inputs, and processes can introduce unexpected contaminants. To realize the full potential of NFPS, there is a need for stakeholders from governments, the food industry, and the research community to collectively work to address and communicate the safety of NFPS products. This review outlines known food safety hazards associated with select NFPS products on the market, namely, plant-derived proteins, seaweeds, jellyfish, insects, microbial proteins, as well as foods derived from cell-based food production, precision fermentation, vertical farming, and 3D food printing. We identify common elements in emerging NFPS regulatory frameworks in various countries/regions. Furthermore, we highlight current efforts in harmonization of terminologies, use of recent scientific tools to fill in food safety knowledge gaps, and international multi-stakeholder collaborations to tackle safety challenges. Although there cannot be a one-size-fits-all approach when it comes to the regulatory oversight for ensuring the safety of NFPS, there is a need to develop consensus-based structured protocols or workflows among stakeholders to facilitate comprehensive, robust, and internationally harmonized approaches. These efforts increase consumers' confidence in the safety of new foods and contribute toward fair practices in the international trade of such foods.

Consumption of edible insects and insect-based foods: A systematic review of sensory properties and evoked emotional response.

Low consumer acceptance of edible insects and insect-based products is one of the main barriers to the successful implementation of entomophagy in Western countries. This rejection is mainly caused by consumers' negative emotional responses, psychological/personality traits, and attitudes toward food choices. However, as the role of intrinsic product characteristics on such food choices has not been adequately studied, a systematic review was conducted following the PRISMA method, to analyze studies that have assessed hedonic evaluations, sensory profiling, or emotional responses to edible insects or insect-based products. The majority of studies performed with whole insects and insect flour highlight that insect-based products are more negatively evaluated than control products. Although the sensory properties of insects are affected by species and processing conditions, they are generally negative across sensory dimensions. In particular, insects and insect-based products are generally associated with odor and flavor/taste attributes that are related to old/spoiled food. These negative attributes can be linked to the fat fraction of edible insects, with insect oils being very negatively evaluated by consumers. On the other hand, defatted fractions and deodorized oils are not associated with these negative attributes, further supporting the hypothesis that the fat fraction is responsible for the negative odor and flavor/taste attributes. However, there is still a lack of studies assessing the sensory profile of edible insects and insect-based products, as well as consumers' emotional responses to their consumption. Future studies should focus on the effects of different processing conditions, products incorporating insect fractions (namely protein concentrates/isolates and defatted fractions), and evaluation by target consumer groups.

[Impact of black soldier fly (Hermetia illucens) larvae biomass on the immune status of rats].

The improvement of the novel foods' safety assessment algorithms is currently one of the food hygiene significant areas. Within the studying of Hermetia illucens insects' effect, the standard in vivo allergological research integrated in the protocol of medical and biological evaluation of genetically modified food has been used. The protocol was supplemented with cytokine profile indicators and pathomorphologic characteristics of immunocompetent organs' lymphoid tissue. The purpose of the research was to study the effect of black soldier fly (Hermetia illucens) larvae biomass on the rats' immune status in the experiment on the induced anaphylactic shock model. Material and methods. The effect of black soldier fly (Hermetia illucens) larvae biomass was studied in a 29-day experiment on growing (43-72 days of life) male Wistar rats fed with Hermetia illucens biomass - main group (n=29) and semi-synthetic casein diet - control group (n=29). The complex assessment of allergenic potential of Hermetia illucens biomass was carried out in the experiment on the induced anaphylactic shock model in Wistar rats. An expanded pool of immune status indicators was studied including active anaphylactic shock severity (lethality, number of severe anaphylaxis reactions, anaphylactic index); cytokine profile (content of proinflammatory and anti-inflammatory cytokines, as well as regulators of cellular and humoral immune response); IgG1 and IgG4 level before and after administration of ovalbumin permissive dose (4 mg/kg b.w.). In addition to this pathomorphologic characteristics of lymphoid tissue of the main immunocompetent organs (thymus, spleen, Payer's patches) have been obtained. Results. The significant systemic anaphylaxis reaction decrease in the main group has been shown. Comparative assessment of the serum cytokines (GM-CSF, IFN-γ, IL-10, IL-12(p70), IL-13, IL-1α, IL-1ß, IL-2, IL-4, IL-5, IL-6, TNF-α) as well as the level of immunoglobulins of the IgG1, IgG4 class before and after administration of ovalbumin permissive dose did not reveal significant differences in rats of the control and main groups. In the main group, there was a decrease in blood serum proallergic cytokines: the level of IL-4 reduced by 1.3 fold, IL-10 - 1.1 and IL-13 - 1.2 fold (p>0.05), and in animals with mild anaphylactic reaction - by 1.8, 1.4 and 1.4 times, respectively (p>0.05). The morphologic studies of the immune system organs showed no intergroup differences. Conclusion. Thus, allergological studies of black soldier fly (Hermetia illucens) larvae in the experiment with the use of systemic anaphylaxis rat model and determination of immune status indicators (anaphylactic shock severity, cytokine profile, IgG1 and IgG4 level, morphologic structure of immunocompetent organs) did not reveal any allergenic effect of the studied product.

Food allergen detection by mass spectrometry: From common to novel protein ingredients.

Food allergens are molecules, mainly proteins, that trigger immune responses in susceptible individuals upon consumption even when they would otherwise be harmless. Symptoms of a food allergy can range from mild to acute; this last effect is a severe and potentially life-threatening reaction. The European Union (EU) has identified 14 common food allergens, but new allergens are likely to emerge with constantly changing food habits. Mass spectrometry (MS) is a promising alternative to traditional antibody-based assays for quantifying multiple allergenic proteins in complex matrices with high sensitivity and selectivity. Here, the main allergenic proteins and the advantages and drawbacks of some MS acquisition protocols, such as multiple reaction monitoring (MRM) and data-dependent analysis (DDA) for identifying and quantifying common allergenic proteins in processed foodstuffs are summarized. Sections dedicated to novel foods like microalgae and insects as new sources of allergenic proteins are included, emphasizing the significance of establishing stable marker peptides and validated methods using database searches. The discussion involves the in-silico digestion of allergenic proteins, providing insights into their potential impact on immunogenicity. Finally, case studies focussing on microalgae highlight the value of MS as an effective analytical tool for ensuring regulatory compliance throughout the food control chain.

Consumer acceptability of plant-, seaweed-, and insect-based foods as alternatives to meat: a critical compilation of a decade of research.

There is a growing criticism of meat-based products over environment, animal welfare, and public health. Meat lovers are keeping and adapting their habits, while other consumers are increasingly shifting toward meat alternatives considered as healthier and more sustainable options to replace the animal-based products. This transition gives room in the market to plant-, seaweed-, and insect-based meat products alternatives. Nevertheless, these emerging markets are still facing the challenge of consumers' acceptance and the uncertainty in terms of preferences. This paper focuses on in-depth understanding of consumer perception and acceptability of plant-, seaweed-, and insect-based meat products to get insights on their current situation and future implementation. The main factors and motives influencing the consumer perceptions toward meat alternative products are reported. Further, the consumers' motives and drivers to consume alternative products were highlighted. This review, provides a better understanding of motives and drivers of consumers' acceptance to improve the acceptability of meat alternatives, considering product and country origin of the consumers of meat alternative foods.Supplemental data for this article is available online at https://doi.org/10.1080/10408398.2022.2036096.

The Clinical Promise of Microalgae in Rheumatoid Arthritis: From Natural Compounds to Recombinant Therapeutics.

Rheumatoid arthritis (RA) is an invalidating chronic autoimmune disorder characterized by joint inflammation and progressive bone damage. Dietary intervention is an important component in the treatment of RA to mitigate oxidative stress, a major pathogenic driver of the disease. Alongside traditional sources of antioxidants, microalgae-a diverse group of photosynthetic prokaryotes and eukaryotes-are emerging as anti-inflammatory and immunomodulatory food supplements. Several species accumulate therapeutic metabolites-mainly lipids and pigments-which interfere in the pro-inflammatory pathways involved in RA and other chronic inflammatory conditions. The advancement of the clinical uses of microalgae requires the continuous exploration of phytoplankton biodiversity and chemodiversity, followed by the domestication of wild strains into reliable producers of said metabolites. In addition, the tractability of microalgal genomes offers unprecedented possibilities to establish photosynthetic microbes as light-driven biofactories of heterologous immunotherapeutics. Here, we review the evidence-based anti-inflammatory mechanisms of microalgal metabolites and provide a detailed coverage of the genetic engineering strategies to enhance the yields of endogenous compounds and to develop innovative bioproducts.

Risk Assessment of Chlorogenic and Isochlorogenic Acids in Coffee By-Products.

Chlorogenic and isochlorogenic acids are naturally occurring antioxidant dietary polyphenolic compounds found in high concentrations in plants, fruits, vegetables, coffee, and coffee by-products. The objective of this review was to assess the potential health risks associated with the oral consumption of coffee by-products containing chlorogenic and isochlorogenic acids, considering both acute and chronic exposure. An electronic literature search was conducted, revealing that 5-caffeoylquinic acid (5-CQA) and 3,5-dicaffeoylquinic acid (3,5-DCQA) are the major chlorogenic acids found in coffee by-products. Toxicological, pharmacokinetic, and clinical data from animal and human studies were available for the assessment, which indicated no significant evidence of toxic or adverse effects following acute oral exposure. The current state of knowledge suggests that long-term exposure to chlorogenic and isochlorogenic acids by daily consumption does not appear to pose a risk to human health when observed at doses within the normal range of dietary exposure. As a result, the intake of CQAs from coffee by-products can be considered reasonably safe.

Australians' experience, barriers and willingness towards consuming edible insects as an emerging protein source.

Increasing global populations and limitations on the natural resources required in food production such as land and water will place further pressure on an already strained food production system. To meet the future food production requirements, it is essential to find viable alternatives to current food sources, without the high resource challenges. Protein production is of particular concern and insects are a nutritious and sustainable source yet, despite a rich history in parts of the world, Australians have been reluctant to adopt the practice as a societal norm. This study aimed to explore Australian consumers' experiences with edible insects, identify barriers to consumption, and explore possible factors that may motivate Australians to consume insects. A total of 601 participants (23.8% male, 76.2% female), completed an online survey using a variety of open-ended questions; 5- or 7-point Likert scales and check-all-that-apply questions. Consumer willingness was measured through self-reporting willingness-to-try insects or insect-based foods. Results indicated 35.4% of participants had previously consumed insects, with Orthoptera (crickets, grasshoppers) the most commonly consumed order (60.1%). Participants with no previous experience consuming insects cited 'lack of opportunity' as the main reason (57.2%). 'Increased accessibility' (56.6%) and 'increased nutrition knowledge' (56.6%) were identified as major factors that may increase the likelihood of future insect consumption. Participants reporting that they were willing to try insects were most likely to accept 'insect-based flour' (65.6%) and 'chocolate-covered ants' (52.1%). By providing increased opportunity, accessibility and education of insect-based food products, a higher proportion of Australians may be willing to eat insects, particularly if presented in indistinguishable forms (i.e. flour). This may lead to a greater acceptance of insects as an alternative, more sustainable protein source than previously anticipated.

Curious to eat insects? Curiosity as a Key Predictor of Willingness to try novel food.

Entomophagy - the consumption of insects - is often rejected by Western society despite its benefits over traditional animal-based proteins. While several factors have been identified as potential predictors of people's willingness to try insect foods, this study introduced an under-explored factor: curiosity, which is a powerful motivator of behaviour that can overcome negative emotions and motivate us to seek new experiences. In two experiments (Ns = 240 and 248), participants (all UK residents, 99.6% British citizens) rated a number of food dishes, half of which contained insects, on a number of factors including curiosity and willingness to try the dish. Across both studies, curiosity predicted willingness to try both insect and non-insect foods above and beyond other factors. Furthermore, we unexpectedly (but consistently) observed a "curiosity-boosting effect" in which curiosity positively interacted with other predictors, increasing their effect on willingness to try insect foods, but not familiar foods. These findings suggest that curiosity promotes the willingness to try insect food in two different manners: A direct effect (above and beyond other factors) and a boosting effect.

EWHETA (Eat Well for a HEalthy Third Age) Project: novel foods to improve the nutrition in the elderly people.

Cardiovascular diseases (CVD) are the leading cause of mortality. However, by treating modifiable cardiovascular risk factors and following a healthy diet as the Mediterranean diet, we have opportunity to prevent CVD. In the EWHETA (Eat Well for a HEalthy Third Age) Project, our goal has been to develop novel foods ("Mediterranean Lasagne", MLs) in versions all nutritionally complete and well balanced in terms of calories, whole carbohydrates, fibers, source of vegetable proteins, and vegetable fats. MLs can be easy prepared at home (inexpensively) and used as fresh food or can be pre-prepared and used in residences for elderly people or in health care residencies. The project has saw the alliance between nutritionists and food and sensor scientists and the active involvement of older people in tasting the novel foods to achieve the final tasty versions of the MLs. We think that the nutritional components of these novel foods and its well-accepted taste, insert in a healthy diet and life style (fundamental aspects at every age), and could contribute to improve diet in the elderly people and prevent malnutrition.

Observations of Toddlers' sensory-based exploratory behaviors with a novel food.

BACKGROUND: Food neophobia hinders the acceptance of healthy foods in young children, and may be overcome by repeated food exposure. Prevalent literature states that children exhibit five sensory-based exploratory behaviors (SBEBs): smelling, licking, spitting, manipulating and/or swallowing as they progress towards accepting a novel food, yet there is a paucity of research on these behaviors. This study aimed to use direct observations of SBEBs across first-time exposures to hummus to (1) determine the prevalence of five SBEBs (smelling, licking, spitting, manipulating and swallowing) in 12-35 month olds, (2) quantify the psychometric properties of the SBEB assessment; and (3) examine the association of SBEBs with parent-assessed food fussiness, and consumption of the novel food. METHODS: Direct observations of SBEBs during a 15-20 min snack time were conducted by trained staff members for 55 hummus-naïve toddlers ages 12-35 months, across 16 exposures to a novel food (hummus). Parents completed the child eating behavior questionnaire. Hummus consumption was measured using digital plate waste method. RESULTS: Very low base rates of spitting (0.06%), smelling (0.97%) and licking (1.95%) were observed but manipulation (26.36%) and swallowing (62.15%) were more prevalent. Observation data on two behaviors over 16 occasions gave rise to a reliability coefficient from our G study portion of our generalizability analyses of Eρ2 = 0.65. SBEBs did not significantly associate with parent-assessed food fussiness, nor hummus consumption. CONCLUSIONS: Although literature refers to the prevalence of SBEBs, we did not observe this for three proposed behaviors. We did observe manipulation, but more research is needed to determine if there are additional SBEBs not noted in the literature, and to better delineate the process that leads to acceptance/rejection of novel food.

The Large Jellyfish Rhizostoma luteum as Sustainable a Resource for Antioxidant Properties, Nutraceutical Value and Biomedical Applications.

Jellyfish is a compartment in the marine food web that often achieves high increases of biomass and that it is starting to be explored for several human potential uses. In this paper, a recently rediscovered large jellyfish, Rhizostoma luteum, is studied for the first time to describe its organic compounds for the isolation and production of bioactive compounds in several fields of food, cosmetics, or biomedical industries. The biogeochemical composition (Carbon, Nitrogen and Sulfur content), protein and phenols content, together with their antioxidant activity, and the analysis of lipid content (identifying each of the fatty acids presented) was analyzed. The results presented here suggested this jellyfish has the highest antioxidant activity ever measured in a jellyfish, but also with high content in polyunsaturated fatty acids (PUFAs), including the essential fatty acid linoleic. The large natural biomass of Rhizostoma luteum in nature, the wide geographical spread, the fact that already its life cycle has been completed in captivity, establishes a promising positive association of this giant jellyfish species and the isolation of bioactive compounds for future use in marine biotechnology.

The Safety and Regulatory Process for Amino Acids in Europe and the United States.

The safety of long-term, high-dose amino acid consumption marketed as dietary supplements or functional or medical foods requires regulatory clearance in the European Union through the novel food process or through the Dietary Supplement Health and Education Act or the GRAS (Generally Recognized As Safe) route in the United States. The safety assessment of high daily doses of amino acids for bodybuilding or other health benefits is expected to require human studies to support tolerability and safety. The need for human studies is based on the fact that there is little or no evidence of toxicity from the conduct of animal toxicity studies and because standard animal testing would be inappropriate because of the large dosages required to provide a suitable margin of safety when extrapolating from animals to humans. Furthermore, the large dosages in animals required to provide a substantial margin of safety could lead to nutritional and physiologic imbalances, potentially confounding an amino acid safety assessment.

Consumer acceptance of insect-based foods in the Netherlands: Academic and commercial implications.

Despite growing interest in the use of insects as food, uptake of insect-based foods in Europe is low. Existing research into Western consumer acceptance of insects as food tends to emphasise the role of individual cognition in food choice at the expense of social or contextual factors, and typically frames consumer acceptance as a general issue, rather than relevant only for relatively few early adopters. This paper outlines empirical work, theoretically and methodologically informed by a critical appraisal of previous research, with consumers of insect-based convenience foods in the Netherlands. Reported initial motivations for trying insect foods are shown to be substantially different from factors - such as price, taste, availability, and 'fit' with established eating practices - which affect repeat consumption. Such factors are congruent with those affecting routine consumption of more conventional foods, indicating that insect foods should be analysed according to similar criteria and should be designed with more practical considerations in mind. Further, a reorientation of consumer acceptance research is proposed. Research should shift from attempts to forecast acceptance and engage with 'actual' examples of insect consumption; social, practical and contextual factors affecting food consumption should be emphasised; and - following work on the establishment of other novel foods - early adopters, rather than general populations, should receive greater analytic attention.

Analysis of personal and cultural values as key determinants of novel food acceptance. Application to an ethnic product.

This paper sets out to analyse whether the complexity and the type of benefits and values pursued in the consumer choice process for a novel food product (couscous) varies with the consumer's ethnic origin (Spanish and Arab). A qualitative study was used to explore these issues in an application of the "means-end chain" theory. The hierarchical value maps obtained point to the presence of an important emotional dimension in the consumption of the selected product, particularly Arab consumers, suggesting that greater familiarity with the product results in a more complex choice process. Some cross-cultural variation can also be observed. Arab consumers attach more importance to issues such as the geographic origin of the product, cultural identification, and fulfilment of family duty. Spanish couscous consumers, meanwhile, claim that it is a way to follow the latest trends, and be more cosmopolitan and more successful within their environment.

The Bright Side of Gelatinous Blooms: Nutraceutical Value and Antioxidant Properties of Three Mediterranean Jellyfish (Scyphozoa).

Jellyfish are recorded with increasing frequency and magnitude in many coastal areas and several species display biological features comparable to the most popular Asiatic edible jellyfish. The biochemical and antioxidant properties of wild gelatinous biomasses, in terms of nutritional and nutraceutical values, are still largely unexplored. In this paper, three of the most abundant and commonly recorded jellyfish species (Aurelia sp.1, Cotylorhiza tuberculata and Rhizostoma pulmo) in the Mediterranean Sea were subject to investigation. A sequential enzymatic hydrolysis of jellyfish proteins was set up by pepsin and collagenase treatments of jellyfish samples after aqueous or hydroalcoholic protein extraction. The content and composition of proteins, amino acids, phenolics, and fatty acids of the three species were recorded and compared. Protein content (mainly represented by collagen) up to 40% of jellyfish dry weight were found in two of the three jellyfish species (C. tuberculata and R. pulmo), whereas the presence of ω-3 and ω-6 polyunsaturated fatty acids (PUFAs) was significantly higher in the zooxanthellate jellyfish C. tuberculata only. Remarkable antioxidant ability was also recorded from both proteinaceous and non proteinaceous extracts and the hydrolyzed protein fractions in all the three species. The abundance of collagen, peptides and other bioactive molecules make these Mediterranean gelatinous biomasses a largely untapped source of natural compounds of nutraceutical, cosmeceutical and pharmacological interest.

Safety of isomaltulose syrup (dried) as a novel food pursuant to Regulation (EU) 2015/2283.

Following a request from the European Commission, the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) was asked to deliver an opinion on isomaltulose syrup (dried) as a novel food (NF) pursuant to Regulation (EU) 2015/2283. The NF consists of a mixture of mono- and disaccharides in powder form, mainly composed of isomaltulose (≥ 75%) and trehalulose (< 13%). The applicant intends to use the NF as a replacement for sucrose already on the market. The information provided on the manufacturing process, composition and specifications of the NF is sufficient and does not raise safety concerns. No absorption, distribution, metabolism and excretion (ADME) or toxicological data were provided for the NF. Instead, the safety of the NF was assessed based on literature data available on isomaltulose and mixtures of isomaltulose and trehalulose. In addition, considering the nature, compositional characterisation and production process of the NF, the Panel considered that such data were sufficient to conclude that the NF is as safe as sucrose.

Spirulina (Arthrospira platensis): Antiallergic Agent or Hidden Allergen? A Literature Review.

Presently, there has been an increase in the consumption of the blue-green microalga-spirulina (Arthrospira species), which dominates 99.5% of the total world production of microalgae. Primarily sold as a dietary supplement, it is also incorporated into snacks, pasta, cookies, and bread. Owing to its nutrient abundance, spirulina has a variety of potential applications. Extensive studies have been conducted on the health benefits of spirulina, but its safety in terms of allergy has received limited attention. Therefore, to bridge this knowledge deficit, this review aimed to evaluate the allergenic and antiallergic potential of spirulina. In the PubMed and Scopus databases using words related to allergy, we attempted to detect papers on hypersensitivity to spirulina. A total of 128 records were identified, of which 49 were screened. Ultimately, in this review, we analyzed four case studies, encompassing a total of five patients with allergies to spirulina. We assessed the severity of allergic reactions following World Allergy Organization (WAO) Anaphylaxis Guidance 2020, which varied from mild (grade 2) to severe (grade 4) based on the patient's symptoms. Additionally, our findings indicate that allergy to spirulina is not commonly reported or diagnosed. However, most of the described cases (four of five) regarding allergy to spirulina according to WAO Anaphylaxis Guidance 2020 were classified as anaphylaxis. Furthermore, it is noteworthy that spirulina also possesses antiallergic properties, as evidenced by research studies. Our article delves into both the allergic and antiallergic potential of spirulina.