Occupational rhinoconjunctivitis from white pepper.

A 44-year-old subject developed rhinoconjunctivitis symptoms when she was exposed to white pepper while working in the food industry. A positive skin prick test for white and black pepper extracts (1:10 w/v) were obtained. Specific IgE antibodies to white and black pepper were demonstrated by ELISA. The immunoblot analysis showed two IgE-reactive protein bands able to bind to IgE from white pepper extract of 11.8 kDa and 13.6 kDa and one band from black pepper extract of 11.8 kDa. IgE binding to blotted white and black pepper extract were inhibited by preincubation of patient serum with black pepper extract. A conjunctival provocation test was positive with a white pepper extract dilution of 1:100 w/v. We describe a patient with occupational rhinoconjunctivitis caused by hypersensitivity to white pepper.

Selective allergy to sheep's and goat's milk proteins.

BACKGROUND: Cow's milk proteins are amongst the most common causes of food allergy in infants, and caseins are probably the main allergens. The existence of a high degree of cross-reactivity between milk caseins from different animals has been reported. We describe a 2-year-old boy who experienced allergic reactions after eating and touching sheep's cheese, but who tolerated cow's milk and cow's milk dairy products. He had never ingested milk or milk derivatives from sheep or goat. METHODS: Skin prick tests were carried out using whey fractions of cow's milk, whole milk and casein from goat, sheep and cow. We also performed skin prick tests with enzymes used in cheese production. Prick-by-prick tests with cheese made from cow, sheep and goat and their corresponding whole milk were also performed. Total serum IgE and specific IgE to cow's milk proteins, whole cow's milk and sheep's milk were determined. Specific IgE against casein and whole milk from the three different species were determined by ELISA. Inhibition of IgE binding to bovine casein was tested for casein and whole milk from all three species. The proteins of three types of casein and whole milk from cow, sheep and goat were separated by SDS-PAGE and were incubated with the patient's serum. RESULTS: Skin tests were positive to sheep's milk and goat and sheep casein and were negative to all cow's milk proteins and whole cow's and goat's milk. Prick-by-prick tests were positive to goat's and sheep's cheese and were negative to cow's cheese. In ELISA-inhibition, sheep's milk and goat and sheep casein were able to inhibit > 50 % of specific IgE binding to sheep casein. The results of immunoblotting showed that the patient's circulating IgEs recognized only one band in the lanes corresponding to sheep and goat casein. CONCLUSIONS: We report a patient with allergy to sheep's and goat's milk proteins but not to cow's milk proteins. Sheep casein was probably the main allergen causing sensitization in this patient. The results suggest that sheep casein shows a high degree of cross-reactivity with goat casein but not with cow casein. Our patient presented allergic symptoms caused by sheep and goat milk and cheese proteins. However, he was able to tolerate cow's milk and cow's milk dairy products without any ill effects.

Specific IgE levels to Cicer arietinum (Chick pea) in tolerant and nontolerant children: evaluation of boiled and raw extracts.

The chick pea, Cicer arietinum, is a legume commonly consumed in Spain and other Mediterranean countries. The sera of 29 children (mean age: 8.4 years) with a current or past history of allergic reactions after ingestion of chick pea, and positive skin tests to this legume, were used to study the allergenic composition of raw and boiled chick pea extracts. The patient population was divided into 2 groups: group 1 consisted of 19 patients with clinical sensitivity confirmed by either positive oral challenges or a convincing recent history of anaphylaxis after eating chick peas, and group 2 consisted of 10 patients with clinical sensitivity in the past, but tolerant at the time of blood extraction. Six atopic children, not allergic to legumes, were included as controls. Specific IgE to the raw and boiled extracts was measured by ELISA. The allergenic composition of both extracts was analyzed by SDS-PAGE and immunoblots. There were no significant differences between specific IgE levels to the raw and boiled extracts (p = 0.23). The mean levels in group 1 were significantly higher than in group 2 and controls (p = 0.0001). Multiple IgE binding proteins/peptides were detected in both extracts in the molecular weight range of 10-106 kD. Only nontolerant patients recognized a similar number of bands in both extracts. Chick pea extracts contain a majority of heat-stable allergens, which could be responsible for the clinical sensitivity to chick pea. Patients with a current clinical allergy to chick pea have statistically higher specific IgE levels than tolerant patients and controls.

Specific IgE determinations to crude and boiled lentil (Lens culinaris) extracts in lentil-sensitive children and controls.

BACKGROUND: The aims of this study were to evaluate the allergenicity of boiled and crude lentil extracts and to compare specific IgE binding in tolerant and nontolerant lentil-allergic children. METHODS: Thirty-eight children were studied and divided into three groups. Group I comprised 24 children with a positive open oral challenge, or a convincing history of anaphylaxis after the ingestion of lentils; group II comprised nine children with a history of allergic reactions in the past, but currently tolerant of lentils; and group III comprised five children allergic to other legumes, but always tolerant of the ingestion of lentils. Specific IgE determinations and ELISA inhibitions were performed with the crude and boiled lentil extracts. The allergenic profile of both extracts was evaluated by SDS-PAGE and immunoblot. RESULTS: Mean specific IgE levels in group I were significantly higher than in groups II and III. The heating process caused a significant decrease in specific IgE binding. However, IgE-inhibition studies showed that the boiled lentil extract had a greater inhibitory capacity than the crude extract. Immunoblots revealed no important differences in IgE-binding patterns between the two extracts. Multiple allergens were detected in a wide range of molecular masses. CONCLUSIONS: Boiled lentil extracts maintain strong allergenicity. Patients who have developed tolerance of lentil ingestion have lower specific IgE levels than symptomatic patients.

Selective allergy to sheep's and goat's milk proteins

Background: Cow's milk proteins are amongst the most common causes of food allergy in infants, and caseins are probably the main allergens. The existence of a high degree of cross-reactivity between milk caseins from different animals has been reported. We describe a 2-year-old boy who experienced allergic reactions after eating and touching sheep's cheese, but who tolerated cow's milk and cow's milk dairy products. He had never ingested milk or milk derivatives from sheep or goat. Methods: Skin prick tests were carried out using whey fractions of cow's milk, whole milk and casein from goat, sheep and cow. We also performed skin prick tests with enzymes used in cheese production. Prick-by-prick tests with cheese made from cow, sheep and goat and their corresponding whole milk were also performed. Total serum IgE and specific IgE to cow's milk proteins, whole cow's milk and sheep's milk were determined. Specific IgE against casein and whole milk from the three different species were determined by ELISA. Inhibition of IgE binding to bovine casein was tested for casein and whole milk from all three species. The proteins of three types of casein and whole milk from cow, sheep and goat were separated by SDS-PAGE and were incubated with the patient's serum. Results: Skin tests were positive to sheep's milk and goat and sheep casein and were negative to all cow's milk proteins and whole cow's and goat's milk. Prick-by-prick tests were positive to goat's and sheep's cheese and were negative to cow's cheese. In ELISA-inhibition, sheep's milk and goat and sheep casein were able to inhibit > 50 % of specific IgE binding to sheep casein. The results of immunoblotting showed that the patient's circulating IgEs recognized only one band in the lanes corresponding to sheep and goat casein. Conclusions: We report a patient with allergy to sheep's and goat's milk proteins but not to cow's milk proteins. Sheep casein was probably the main allergen causing sensitization in this patient. The results suggest that sheep casein shows a high degree of cross-reactivity with goat casein but not with cow casein. Our patient presented allergic symptoms caused by sheep and goat milk and cheese proteins. However, he was able to tolerate cow's milk and cow's milk dairy products without any ill effects (AU)

Introducción: La alergia a proteínas de la leche de vaca es una de las causas más frecuentes de alergia alimentaria en la infancia y las caseínas son probablemente los principales alergenos implicados. Ya ha sido descrita con anterioridad la existencia de alto grado de reactividad cruzada entre las caseínas de distintos animales. Describimos un niño de 2 años que presentó reacciones alérgicas tras la ingesta y el contacto con queso de oveja, pero que toleraba el consumo de leche de vaca y derivados. Nunca había tomado previamente leche o derivados de oveja o cabra. Métodos: Se realizaron tests cutáneos mediante prick con leche y caseína de vaca, oveja y cabra así como con las fracciones de la leche de vaca. También se realizaron tests cutáneos con enzimas empleadas en la elaboración de queso. Se llevaron a cabo prickprick con leche entera y queso de vaca, oveja y cabra.Se determinó IgE total y específica frente a leche de vaca y sus fracciones y leche de oveja. También se determinó mediante ELISA la IgE específica frente a caseina y leche entera de las tres especies. Asimismo se calculó mediante ELISA-inhibición el porcentaje de inhibición de la caseína bovina frente a caseína y leche entera de las tres especies. Se separaron las proteínas de la leche y caseína de vaca, oveja y cabra mediante SDS-PAGE y posteriormente fueron incubadas con el suero del paciente. Resultados: Los tests cutáneos resultaron positivos frente a leche de oveja y caseína de oveja y cabra, y negativos frente a las proteínas séricas de vaca, así como frente a leche entera de vaca y cabra. Los prick-prick fueron positivos frente a queso de oveja y cabra, siendo negativos frente a queso de vaca. En el ELISA-inhibición, la leche de oveja y la caseína de oveja y cabra fueron capaces de inhibir más del 50 por ciento de los sitios de unión de la IgE a la caseína de oveja. Los resultados del immunoblot mostraron que los anticuerpos IgE del paciente reconocían solo una banda en las calles correspondientes a las caseínas de oveja y cabra. Conclusiones: Presentamos un paciente con alergia a proteínas de la leche de oveja y cabra pero no a las proteínas de la leche de vaca. La caseína de la oveja es probablemente el principal alergeno causante de la sensibilización de este sujeto. Los resultados sugieren que la caseína de oveja muestra un elevado grado de reactividad cruzada con la caseína de cabra, pero no con la de vaca. Nuestro paciente presentaba síntomas alérgicos causados por la exposición frente a las proteínas de la leche y queso de oveja y cabra, pero es capaz de tolerar el consumo de leche y derivados de vaca sin ningún efecto adverso (AU)