Assessment of the tolerance to lupine-enriched pasta in peanut-allergic children

A. Fiocchi, P. Sarratud, L. Terracciano, E. Vacca, R. Bernardini, D. Fuggetta, C. Ballabio, M. Duranti, C. Magni, P. Restani

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Abstract

Background Reports of allergy to lupine derivatives (as de novo sensitization or cross-reactivity in subjects allergic to peanut) are increasing as their use in food products increases. Objectives The aim of this study was to assess: (1) lupine tolerance in a group of children allergic to peanut, using lupine enriched-pasta instead of raw flour as has been done in previous clinical studies; (2) whether technological treatments of lupine modify its cross-reactivity or co-sensitization with peanut; (3) the role of lupine seed proteins in sensitization, and (4) to identify the eliciting doses (EDs) by using double-blind, placebo-controlled food challenges (DBPCFC). Methods Twelve patients with a history of clinical allergic reactions to peanut were evaluated by skin prick tests (SPTs), the ImmunoCAP ® test, immunoblotting, and DBPCFC. The 12 selected subjects were included in a trial where lupine-enriched pasta and placebo pasta were administered in a DBPCFC protocol. Results Positive clinical reactions were observed in two children, the EDs being 0.2 and 6.4 g of pasta, corresponding to 50 mg and 1.6 g of lupine proteins, respectively. β-conglutin was the protein most involved in SPT positivity. Conclusion Lupine-enriched pasta can be tolerated by most subjects suffering from peanut allergy, but a sizeable minority (2/12 of them in this case) can develop potentially dangerous clinical reactions. Information about possible reactions to lupine derivatives by those allergic to peanuts must be included in the labelling of lupine-enriched products to protect consumers at risk.

Original languageEnglish
Pages (from-to)1045-1051
Number of pages7
JournalClinical and Experimental Allergy
Volume39
Issue number7
DOIs
Publication statusPublished - Jul 2009

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Keywords

  • Cross-reactivity
  • Food allergy
  • Lupine allergy
  • Peanut allergy
  • Technological treatments

ASJC Scopus subject areas

  • Immunology
  • Immunology and Allergy

Cite this

Fiocchi, A., Sarratud, P., Terracciano, L., Vacca, E., Bernardini, R., Fuggetta, D., Ballabio, C., Duranti, M., Magni, C., & Restani, P. (2009). Assessment of the tolerance to lupine-enriched pasta in peanut-allergic children. Clinical and Experimental Allergy, 39(7), 1045-1051. https://doi.org/10.1111/j.1365-2222.2009.03199.x