Fruit allergy and anaphylaxis in children: Culprit fruits and clinical findings.

Background: Fruit allergy usually presents with mild-to-moderate symptoms but serious systemic reactions, e.g., anaphylaxis, may also occur. Objective: This study aimed to examine the clinical and laboratory characteristics of patients with fruit allergy and fruit-induced anaphylaxis. Methods: Patients diagnosed with fruit allergy at Diskapi Hematology and Oncology Hospital and Bilkent City Hospital between January 2017 and January 2023 were included in the study. The diagnosis of anaphylaxis was made according to the European Allergy and Clinical Immunology Anaphylaxis Guideline. Results: During the study period, skin-prick tests with food allergens were performed on 9432 patients in our clinic, and fruit allergy was detected in 78 patients (0.82%). Five patients with inaccessible medical records were excluded from the study. 40 (54.8%) were boys. The median (interquartile range) age at the onset of symptoms was 72 months (12.5-144 months). Sixty-eight of the patients (93.2%) had a concomitant allergic disease, the most common of which was allergic rhinitis (n = 48 [65.8%]). The 73 patients had a history of reaction to 126 fruits. Twenty-five patients (19.8%) were allergic to multiple fruits. The most common fruit allergen was banana (22/126 [17.4%]), followed by peach (18/126 [14.2%]) and kiwi (17/126 [13.5%]). Mucocutaneous findings were observed most frequently after fruit consumption (120/126 [95.2%]). Anaphylaxis occurred in 17 patients (23.2%) with 21 fruits.The fruits most commonly associated with anaphylaxis were banana (6/21 [28.6%]) and kiwi (6/21 [28.6%]). Conclusion: Fruit allergy generally presents with mild symptoms, e.g., oral allergy syndrome, but severe systemic symptoms, e.g., anaphylaxis, can also be observed. Kiwi and banana are the fruits that most commonly cause anaphylaxis. Although more comprehensive studies are needed to comment on the development of tolerance, especially in patients with anaphylaxis, responsible fruit avoidance is still the most important strategy.

Fruit flavors in electronic cigarettes (ECIGs) are associated with nocturnal dry cough: A population longitudinal analysis.

Evidence from in vitro and animal models has identified the pulmonary toxicity of flavors in electronic cigarettes (ECIGs); however, less is known from epidemiological studies about the effects of flavors in the respiratory health. This study examined the longitudinal association between exposure to ECIGs flavors and nocturnal dry cough among ECIGs users. A secondary analysis of data from the Population Assessment of Tobacco and Health Study (2014-2019) was conducted. The study population included adults who provided information (n = 18,925) for a total of 38,638 observations. Weighted-incidence estimates and weighted- generalized estimating equation models were performed to assess unadjusted and adjusted associations. The weighted incidence proportion (WIP) of nocturnal dry cough was significantly higher among current (WIP:16.6%; 95%CI 10.5, 21.2) and former fruit flavored ECIGs users (WIP:16.6%; 95%CI 11.3, 21.9) as compared to non-ECIGs users (WIP:11.1%; 95%CI 10.6, 11.6). Current ECIGs users of fruit flavors showed 40% higher risk of reporting cough than non-ECIGs users (aRR:1.40, 95%CI 1.01, 1.94). Former ECIGs users of multiple flavors and other flavors had 300% and 66% higher risk to develop cough, respectively (aRR:3.33, 95%CI 1.51, 7.34 and aRR:1.66, 95%CI 1.0.9, 2.51), relative to non-ECIGs users. We observed a significantly higher risk of developing nocturnal dry cough in the past 12 months in current and former ECIGs users of fruit flavors and in former ECIGs users of multiple flavors. To the extent that cough may serve as an early indicator of respiratory inflammation and potential disease risk, the association between ECIGs use and cough raises potential concerns.

Alergia alimentaria: importancia de los cofactores / Food allergy: the importance of cofactors

Las LTP (lipid transfer proteins) son una familia de proteínas presentes en diferentes alimentos. La sintomatología de la alergia a las LTP es muy variable, desde clínica leve hasta sistémica, en ocasiones, presentando síntomas únicamente en presencia de cofactores. Se presenta el caso de una paciente de 11 años que acude a urgencias con clínica de anafilaxia tras ingesta previa de fruta mientras realizaba ejercicio físico, destacando la importancia de la historia clínica y la sospecha diagnóstica en el enfoque de esta entidad (AU)

LTP (lipid transfer proteins) are a family of proteins present in different foods. The symptomatology of allergy to LTP is highly variable, ranging from mild to systemic. Sometimes, symptoms are only present in the presence of cofactors.We present the case of an 11-year-old female patient who presented to the emergency department with anaphylaxis following previous ingestion of fruit while doing physical exercise, highlighting the importance of the clinical history and diagnostic suspicion in the approach to this entity. (AU)

Infarto de miocardio alérgico por consumo de ciruela, presentación de caso clínico / Allergic myocardial infarction due to plum consumption, case report

We present the case of an elderly patient who presented with an allergic reaction secondary to fruit consumption and subsequently developed a non-ST-elevation coronary syndrome. (AU)

Se presenta el caso de un paciente adulto mayor que presenta un reacción alergica secundaria al consumo de fruta y posteriormente desarrolla un sindrome coronario sin elevacion del ST. (AU)

Why does ingestion of watermelon trigger headache attacks in patients with migraine? / Por que a ingestão de melancia desencadeia crises de dor de cabeça em pacientes com enxaqueca?

Several triggers can trigger a migraine attack, including food. By the way, food only triggers headache in migraine sufferers. The foods that most trigger headache attacks are these: cheese, chocolate, citrus fruits and some sweet fruits, such as watermelon.

Vários gatilhos podem desencadear uma crise de enxaqueca, incluindo alimentos. Aliás, a comida só provoca dor de cabeça em quem sofre de enxaqueca. Os alimentos que mais desencadeiam as crises de dor de cabeça são estes: queijo, chocolate, frutas cítricas e algumas frutas doces, como a melancia.

Cytotoxicity, acute and sub-chronic toxicities of the fruit extract of Tetrapleura tetraptera (Schumm. & Thonn.) Taub. (Fabaceae).

BACKGROUND: Tetrapleura tetraptera is a medicinal spice traditionally used to treat cancer, diabetes, and several other ailments. This study analyzed the cytotoxicity of the dichloromethane methanol extract of T. tetraptera fruits (TTF) and its constituents. The toxicity profile of the TTF extract was also evaluated in rats. METHODS: The Cytotoxicity of this extract was evaluated using the resazurin reduction assay (RRA). Acute and sub-chronic toxicity studies were performed according to the protocol described by the Organisation for Economic Cooperation, and Development (OECD). Hematological, serum, and urine biochemical parameters, as well as histological sections of the liver and kidney, were also evaluated based on standard methods. RESULTS: The TTF extract, compound 5, and the reference drug doxorubicin were active in all 9 tested cancer cell lines. The recorded IC50 ranged from 18.32 µM (against B16-F1 murine melanoma cells) to 36.18 µM (against SKMel-505 BRAF wildtype melanoma cells) for TTF, from 10.02 µM (towards MaMel-80a BRAF-V600E homozygous mutant melanoma cells) to 31.73 µM (against SKMel-28 BRAF-V600E homozygous mutant melanoma cells) for compound 5, and from 0.22 µM (against B16-F1 cells) to 9.39 µM (against SKMel-505 cells) for doxorubicin. The study of acute toxicity test showed that the lethal dose (LD50) of this extract was greater than 5000 mg/kg body weight. In the sub-chronic toxicity studies, variations were observed in some biochemical parameters, especially at higher doses. CONCLUSION: TTF and its most active compound (5) are found to be potential cytotoxic agents, meanwhile, TTF was safe when given a single oral dose of 5000 mg/kg. However, caution is necessary in case of prolonged oral administration due to potential alterations of renal function at high doses (> 1000 mg/kg).

Incidence of Vitis fruit-induced clinical signs and acute kidney injury in dogs and cats.

OBJECTIVES: To determine the incidence of clinical signs and Vitis fruit-induced acute kidney injury in dogs and cats with a Vitis fruit ingestion reported to the Dutch Poisons Information Center, and a description of the therapies instituted by the veterinarians. MATERIALS AND METHODS: All cases of Vitis fruit ingestions in dogs and cats reported to the center between January 1, 2018 and December 31, 2018 were included in this study. Veterinarians and pet owners were contacted by phone or email to obtain follow-up information. Information was collected using a standardised data collection sheet. RESULTS: Ninety-five dogs and 13 cats with proven Vitis fruit ingestion were included. Fourteen dogs and two cats developed clinical signs: emesis (11/16, 68.8%), lethargy (5/16, 31.3%), diarrhoea (3/16, 18.8%), anorexia (3/16, 18.8%), tremor (2/16, 12.5%) and restlessness (1/16, 6.3%). The overall incidence for developing clinical signs was 14.7% in dogs and 15.4% in cats. One (1/95, 1%) dog developed acute kidney injury after ingestion of Vitis fruit. No cats developed acute kidney injury. Induction of emesis and/or administration of activated charcoal was instituted in 72 of 82 (88%) and eight of 11 (73%) of asymptomatic dogs and cats and six of 14 (43%) and two of two (100%) of symptomatic dogs and cats, respectively. Overall, emesis was induced in 72 of 95 (76%) dogs (100% success rate) and removed Vitis fruits in the majority of cases (98% when induced <4 hours after ingestion and 83% when induced 4 to 12 hours after ingestion). Emesis was induced in seven of 13 (54%) cats (86% success rate) and removed Vitis fruits in 83% of the cases. CLINICAL SIGNIFICANCE: In this study, a significant proportion (around 15%) of dogs and cats developed clinical signs after ingestion of Vitis fruits, which were predominantly related to the gastrointestinal tract. Symptomatic acute kidney injury was rare. Our findings suggest the use of decontamination measures, i.e. induction of emesis, may be warranted up to 12 hours after ingestion.

A Berry and Acute Kidney Injury.

Plant toxins have well been implicated in the etiopathogenesis of acute kidney injury (AKI). Certain plant toxins are endemic to a particular country and region. Knowledge of the regional plant toxins will be useful to give travel advisory measures for the public and patients with chronic kidney disease. We report a case of poisoning with tutu berry, endemic to New Zealand causing AKI.

Caracterização de cereja-do-rio grande (Eugenia involucrata DC. ) e grumixama (Eugenia brasiliensis LAM. ), frutos nativos da Mata Atlântica, quanto a compostos voláteis e precursores / Volatile compounds and precursors characterization of the Grumixama (Eugenia brasiliensis LAM. ) and Cereja-do-Rio-Grande (Eugenia involucrata DC. ), atlantic forest native fruits

Mesmo reduzida e fragmentada, o vasto bioma da Mata Atlântica abriga milhares de plantas. Como destaque, tem-se as espécies frutíferas, aos quais podem ser atribuídas um importante valor para a segurança alimentar, nutricional e sociocultural. Entre elas, têm-se a cereja-do-rio grande (Eugenia involucrata DC.) e a grumixama (Eugenia brasiliensis Lam.), caracterizadas pela polpa de sabor doce-acidulado, sendo muito apreciadas e utilizadas tanto in natura, quanto no preparo de doces, xaropes, licores e geleias. Uma das características determinantes para o sucesso e aceitação destes frutos pelo consumidor, são os atributos de qualidade sensorial. As propriedades aromáticas dos frutos dependem da potência individual dos voláteis e a concentração de cada um, bem como a combinação com outros compostos. Todavia, apesar do grande potencial de mercado, devido às características nutricionais, fitoterápicas, potencial funcional e ao sabor exótico, os plantios existentes destas são oriundos de multiplicação por sementes, resultando em plantas desuniformes quanto as características de produção e qualidade. Neste sentido, o presente trabalho teve como objetivo identificar metabólitos voláteis que confiram características sensoriais desejáveis aos frutos. Auxiliando na identificação de plantas que produzem frutos com voláteis de interesse para o sabor, o que permitirá a clonagem e propagação de plantas com homogeneidade na produção. Os compostos voláteis foram analisados em triplicata, de acordo com o método de microextração em fase sólida (SPME, do inglês Solid Phase Microextraction). Os resultados mostraram que os grupos de frutos das diversas regiões se diferenciaram quanto a composição dos metabolitos voláteis, bem como na abundância destes compostos. Observou-se também uma variação de composição entre as árvores da mesma região demonstrando tal irregularidade ocasionada pela propagação por sementes. A maioria de compostos voláteis produzidos foram identificados como terpenos, sendo estes já conhecidos pela importância no flavor em frutos. Desta forma, conhecer o aroma fornecerá um conjunto de dados que são subsídios para outros pesquisadores trabalharem em suas diversas áreas buscando características necessárias para o sucesso da comercialização, ocasionando no incentivo ao cultivo e valorização da riqueza nacional, no âmbito das espécies frutíferas, com vistas à proteção ambiental e em defesa da biodiversidade brasileira

The Atlantic Forest harbors thousands of plants despite of its reduced and fragmented character. It is important to highlight the fruit species which hold attributed and important value for food and socio-cultural security. Among them, there are the big cherry (Eugenia involucrata DC.) And the grumixama (Eugenia brasiliensis Lam.), fruit with sweet-acidulated flavor, which is much appreciated and used in the preparation of sweets, syrups, liqueurs, and jellies. One of the determining characteristics for the success and acceptance of these fruits by the consumer are the attributes of sensorial quality. The aromatic properties of the fruits depend on the individual potency of the volatiles and the concentration in each one of them, as well as the combination with other compounds. Despite of the great market potential due to the nutritional, phytotherapic and exotic flavor characteristics, the existing plantations of these fruits are originated from seed multiplication, resulting on uneven plants in terms of production and quality characteristics. In this sense, the presented work below was aimed to identify volatile metabolites that confer desirable sensorial characteristics to the fruits. The volatile compounds were analyzed in triplicate according to the Solid Phase Microextraction (SPME) method. The results showed that the fruit groups from different regions differed in terms of the composition of volatile metabolites, as well as in the abundance of these compounds. There was also a variation of composition among the trees of the same region which demonstrated such heterogeneity caused by seed propagation. Most volatile compounds produced were identified as terpenes which are known for playing an important role in the flavor of fruits. In this way, by knowing the aroma, a set of data will be provided and used as an allowance for other researchers who are working in the various areas related to the pursue of the necessary characteristics for the commercial success, resulting on the motivation to cultivate and value the forest

Clonagem, expressão recombinante e validação por microarray de proteínas alimentares potencialmente alergênicas / Cloning, recombinant expression and validation by microarray of potentially allergenic food proteins

A maioria das respostas alérgicas a alimentos é mediada por IgE, que pode ser detectada para fins de diagnóstico da alergia alimentar. No entanto, para isso é necessário que alérgenos purificados estejam disponíveis para a elaboração dos diferentes formatos de ensaio, inclusive por microarray, que se constitui em uma ferramenta bastante útil para análise simultânea, e também para a identificação de reatividade cruzada. A esse respeito, é imprescindível ampliar a plataforma de alérgenos que possam ser empregados para a confecção de microarrays. Atualmente, alguns alimentos que constituem objeto de interesse na clínica em função do número de casos de alergia, e sobre os quais as informações a respeito dos alérgenos são escassas, são: abacaxi, mamão, mandioca e manga. Assim, o objetivo desse trabalho foi clonar, expressar e purificar proteínas potencialmente alergênicas de alimentos de importância regional. Após confirmadas por ensaios imunológicos, essas proteínas foram utilizadas na construção e validação de um microarray através de ensaios com os soros de pacientes alérgicos aos alimentos selecionados. Para atingir esse objetivo, foram selecionadas proteínas potencialmente alergênicas coincidentes, apontadas tanto pela similaridade com espécies taxonomicamente mais próximas, quanto pela técnica 2D Western Blotting acoplada à espectrometria de massas. Dezenove proteínas, sendo 4 de abacaxi, 5 de mamão, 6 de mandioca e 4 de manga, foram expressas em Pichia pastoris, purificadas e impressas em um microarray. Após incubar essas proteínas com os soros dos pacientes alérgicos aos alimentos estudados, 18 proteínas mostraram-se potencialmente alergênicas. Além disso, foi observada reatividade cruzada entre proteínas dos alimentos estudados e também em relação ao látex e outros frutos

The majority of allergic reactions to foods is IgE-mediated, which can be detected for the diagnosis of food allergy. However, purified allergens are necessary to produce different kinds of allergy tests, including microarray, which is a useful tool for simultaneous analysis, as well as for the identification of cross-reactivity. In this respect, it is essential to expand the platform of allergens to include them on microarrays. Nowadays, some foods that are object of interest in the clinical area in Brazil and it is necessary a further evaluation about their potential allergens, since there is a limited information about them, are: pineapple, papaya, cassava and mango. Therefore, the aim of this study was cloning, expressing and purifying potentially allergenic proteins of important Brazilian foods. After confirmed by immunological tests, these proteins were used in microarray production and validation by assays with sera from allergic patients to the selected foods. Achieving this goal, matching potentially allergenic proteins were selected, which were identified by comparison among taxonomically closer species (in silico) and 2D Western Blotting coupled with Mass Spectrometry. Nineteen proteins: 4 from pineapple, 5 from papaya, 6 from cassava and 4 from mango were expressed in Pichia pastoris, purified and printed on a microarray. After incubating those proteins with sera from allergic patients to the selected foods, 18 proteins were detected as potentially allergenic. In addition, cross-reactivity was observed among the proteins from the studied foods, and also regarding to the latex and other fruits