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Les épices, herbes aromatiques et autres condiments
vendredi 4 juin 2010, par
L’alimentation humaine a recours à de très nombreux ingrédients destinés à modifier ou rehausser le goût des préparations culinaires. Ces épices, herbes ou condiments sont, en général, ajoutés en faible quantité à l’aliment mais se distinguent des additifs par leur origine naturelle et donc leur composition complexe.
Les faibles quantités ingérées expliquent peut-être la rareté des observations d’allergie alimentaire à ces produits. Il faut y ajouter que, pour beaucoup d’entre eux, une phase de cuisson a lieu, pouvant réduire l’allergénicité des protéines.
Les épices, herbes et condiments sont très diversement répartis dans les familles botaniques. Les parties utilisées de la plante sont très variables aussi. Il n’est donc pas étonnant que les positivités à plusieurs de ces produits se concentrent au sein d’une même famille (ex. Apiacées).
Le tableau suivant donne un aperçu des épices, herbes et condiments. Il donne les liens permettant d’accéder aux textes traitant plus spécifiquement de tel ou tel produit.
| Nom latin | Famille botanique | Partie utilisée | |
|---|---|---|---|
| Ail | Allium sativum | Alliacées | bulbe |
| Aneth | Anethum graveolens | Apiacées | feuilles, graines |
| Anis étoilé (badiane) | Illicium verum | Schisandracées | graines |
| Anis vert | Pimpinella anisum | Apiacées | graines |
| Basilic | Ocimum basilicum | Lamiacées | feuilles |
| Cannelle | Cinnamomum zeylanicum | Lauracées | écorce |
| Câpres | Capparis spinosa | Brassicacées | boutons floraux |
| Cardamome | Elettaria cardamomum | Zingibéracées | graines |
| Carvi | Carum carvi | Apiacées | graines |
| Casse | Cinnamomum aromaticum | Lauracées | écorce |
| Cerfeuil | Anthriscus cerefolium | Apiacées | feuilles |
| Ciboulette | Allium schoenoprasum | Alliacées | feuilles |
| Coriandre | Coriandrum sativum | Apiacées | feuilles, fruits |
| Cornichon | Cucumis sativus gherkin | Cucurbitacées | fruit |
| Cumin | Cuminum cyminum | Apiacées | graines |
| Curcuma | Curcuma longa | Zingibéracées | rhizome |
| Echalote | Allium ascalonicum | Alliacées | bulbe |
| Estragon | Artemisia dracunculus | Astéracées | feuilles |
| Fenouil | Foeniculum vulgare | Apiacées | bulbe foliaire, graines |
| Fenugrec | Trigonella foenum-graecum | Fabacées | graines |
| Gingembre | Zingiber officinale | Zingibéracées | rhizome |
| Girofle (clou de) | Syzygium aromaticum | Myrtacées | boutons floraux |
| Laurier | Laurus nobilis | Lauracées | feuilles |
| Livèche | Levisticum officinale | Apiacées | feuilles, graines |
| Macis | Myristica fragrans | Myristicacées | arille |
| Menthe | Mentha piperita | Lamiacées | feuilles |
| Moutarde | Brassica juncea / nigra / Sinapis alba | Brassicacées | graines |
| Muscade (noix de) | Myristica fragrans | Myristicacées | graine |
| Oignon | Allium cepa | Alliacées | bulbe |
| Origan (marjolaine) | Origanum vulgare / majorana | Lamiacées | feuilles, sommités |
| Paprika | Capsicum annuum cuneatum | Solanacées | fruit séché |
| Persil | Petroselinum crispum | Apiacées | feuilles |
| Piment | Capsicum annuum / chinense | Solanacées | fruit |
| Poivre | Piper nigrum | Pipéracées | baies |
| Poivre de Sichuan | Zanthoxylum simulans | Rutacées | coque du fruit |
| Quatre-épices | Pimenta dioica | Myrtacées | baies |
| Raifort | Armoracia rusticana | Brassicacées | racine |
| Romarin | Rosmarinus officinalis | Lamiacées | feuilles |
| Safran | Crocus sativus | Iridacées | stigmates |
| Sarriette | Satureja hortensis | Lamiacées | feuilles |
| Sauge | Salvia officinalis | Lamiacées | feuilles |
| Thym | Thymus vulgaris | Lamiacées | feuilles |
| Vanille | Vanilla planifolia | Orchidacées | gousses |
L’imputabilité de telle ou telle épice ou herbe aromatique dans une réaction clinique n’est pas facilitée par l’emploi fréquent de plus d’un de ces produits dans la même préparation culinaire.
Le cas le plus typique est celui des currys, mélanges d’épices dont la composition varie selon les régions d’origine : des Zingibéracées (curcuma, cardamome, gingembre), des Apiacées (coriandre, cumin, fenouil), des Aliacées (ail, oignon), mais aussi piment, fenugrec, girofle, moutarde, cannelle ou casse, …
L’excellente revue de Schöll et Jensen-Jarolim 
donne la composition de mélanges classiques d’assaisonnements et sauces (ex. ketchup).
L’étiquetage des aliments manufacturés est souvent ambigu .
Les formes cliniques d’allergie aux épices et herbes aromatiques utilisées dans l’alimentation sont très majoritairement cutanées (dermites de contact) ou respiratoires (dans un cadre professionnel) si l’on met à part les réactions alimentaires aux Apiacées s’intégrant dans un syndrome armoise-bouleau-céleri et celles dues à la moutarde.
La sensibilisation par voie respiratoire peut exceptionnellement aboutir à une allergie alimentaire .
Les travaux concernant les observations d’allergie alimentaire aux épices intègrent parfois des produits qui sont plus des ajouts à l’aliment fini qu’un ingrédient à part entière : c’est le cas du sésame et du pavot. Dans le même esprit on pourrait y ajouter les pignons, d’autant que ces graines entrent dans la composition d’un assaisonnement, le pistou (ou sauce pesto).
La fréquence des réactions alimentaires aux épices et herbes aromatiques est mal précisée, mais probablement très faible en dehors des Alliacées (ail notamment), des Apiacées (fenouil et coriandre surtout) et de la moutarde :
- Niinimaki a étudié 1120 patients atopiques (âge moyen 22 ans) : il a été observé 17% de scratch-tests positifs pour le curry, 7% pour le paprika, entre 1 et 2% pour la cannelle et la cardamome, et moins de 1% pour gingembre, poivre, vanille, girofle et quatre-épices. Parmi les 225 TC ainsi positifs, seuls 5 patients rapportaient des réactions cliniques (Apiacées, moutarde) et aucun des 20 TPODA réalisés n’a été positif.
- Rancé a étudié 101 enfants avec allergie alimentaire non classique : des TC ont été positifs pour le paprika (8), la cannelle (3), le curry (2) et le clou de girofle (1) ; mais aucun pour poivre, muscade, gingembre ou vanille. Un diagnostic d’allergie a été retenu chez 13 enfants : il se limitait à la moutarde ou le fenouil.
- la cannelle est suspectée dans un cas pédiatrique d’anaphylaxie alimentaire . Cet enfant avait une allergie au latex, mais le lien entre cannelle (qui est une Lauracée, comme l’avocat) et le latex n’a pu être testé.
- Stäger a étudié un collectif de 70 patients présentant un syndrome armoise-bouleau-céleri . Des taux élevés de scratch-tests positifs ont été obtenus, sans surprise, pour diverses Apiacées (ex. 46/70 pour l’anis), tandis que les résultats positifs pour d’autres épices étaient plus rares : paprika 11, poivre 5, cannelle 3, muscade 3, gingembre 3.
- Un relevé des TC positifs concernant les épices a été effectué à partir des données du CICBAA en 2002 :
- chez les enfants : 2 TC positifs/11 pour le thym, 2/10 pour le laurier et 1/10 pour la menthe. Aucun test positif pour paprika, girofle, poivre, muscade ou safran (34 tests effectués). Aucun cas d’allergie clinique.
- chez les adultes : 4 TC positifs/41 pour le paprika, 4/35 pour le safran, 2/24 pour la menthe, 2/36 pour le laurier, 0/42 pour le curry. Aucun test positif pour girofle, poivre, muscade ou cardamome (112 tests effectués). Les seules histoires cliniques positives concernent des Apiacées (dans le cadre d’un syndrome armoise-bouleau-céleri) et des Aliacées.
- les données du CICBAA avec TPO positif sont les suivantes (février 2005, www.cicbaa.org, accédé 15/11/2009) : après 15 ans : moutarde 1,5% des allergies alimentaires, épices 3%, Apiacées 17,5% (mais y compris céleri et carotte)
- enfin le Réseau d’Allergo-Vigilance recensait en mai 2010 (900 déclarations) 3 cas pour la moutarde, 1 pour des " épices ", 1 pour un mélange d’Apiacées, 2 pour le persil et 1 pour le fenugrec. Ici encore on peut constater l’extrême rareté des allergies aux épices (ex. Zingibéracées) et herbes aromatiques (ex. Lamiacées).
Le poivre
Le cas du poivre (Piper nigrum) a été étudié chez des patients Suisses et Autrichiens présentant un syndrome armoise/bouleau/épices. Une réactivité in vitro a été détectée chez 16 des 22 sujets, concernant principalement 2 bandes à 28 et 60 kD . La protéine migrant à 28 kD a été identifiée comme une protéine germine-like. Cependant, la relevance clinique de ces réactivités in vitro est faible, seulement 3 patients ayant un TC positif pour le poivre et des TPO n’ayant pas été pratiqués. Et les réactivités croisées observées entre pollens et poivre font suspecter des CCD (les germines sont glycosylées ).
Dans un travail plus ancien Wüthrich estimait à 10% la fréquence d’une allergie au poivre chez des patients présentant un syndrome armoise-bouleau-épices . Ce taux n’a pas été confirmé par TPO, ni n’a été retrouvé dans d’autres études.
Les Lamiacées
Les herbes aromatiques provenant de cette famille sont nombreuses : thym, origan, marjolaine, basilic, etc.. Les observations d’allergie alimentaire aux lamiacées sont rarissimes et les allergènes impliqués inconnus :
- un adulte en Espagne avec allergie au thym et à l’origan
- deux adultes en Grèce avec réactions pour le basilic (sauce pesto) et antécédents pour l’origan. Des réactions respiratoires étaient notées pour la lavande chez un des 2 patients
Les TC natifs étaient positifs pour de nombreuses Lamiacées dans ces observations, tandis que les tests in vitro étaient décevants.
Les Zingibéracées
Tous les cas publiés concernent des adultes :
- curcuma : une observation (USA)
- cardamome : 2 cas (Espagne, Japon)
- gingembre : 2 cas d’allergie respiratoire professionnelle, l’un avec TPO positif également , l’autre pour lequel l’imputabilité précise du gingembre n’est que suggérée (mélange d’épices) .
Le safran
L’allergie alimentaire au safran ne semble pas avoir été décrite. Par contre on connaît des cas d’allergie respiratoire au safran dans un cadre professionnel . Deux allergènes sont identifiés : une protéine Ole e 1-like nommé Cro s 1 et une profiline nommée Cro s 2 .
[1] - Schöll I, Jensen-Jarolim E. Allergenic Potency of Spices: Hot, Medium Hot, or Very Hot. Int Arch Allergy Immunol 2004;135:247-261
Spices are the most attractive ingredients to confer an authentic taste to food. As they are derived from plants, they harbour allergenic potency and can induce symptoms ranging from mild local to severe systemic reactions. Due to the content of pharmacologically active substances of spices, the diagnosis of allergy and the differentiation from intolerance reactions may be difficult. Association with inhalative allergies via IgE cross-reactivity, but also direct gastrointestinal sensitization plays a role. This article is a botanical and allergological overview of the most important spices and molecules responsible for eliciting IgE-mediated reactions or cross-reactions. As no curative treatments are known at present, strict avoidance is recommended and, therefore, accurate labelling of pre-packed food is necessary.
↩[2] - Pieretti MM, Chung D, Pacenza R, Slotkin T, Sicherer SH. Audit of manufactured products: use of allergen advisory labels and identification of labeling ambiguities. J Allergy Clin Immunol 2009;124:337-341
BACKGROUND: The Food Allergy Labeling and Consumer Protection Act became effective January 1, 2006, and mandates disclosure of the 8 major allergens in plain English and as a source of ingredients in the ingredient statement. It does not regulate advisory labels.
OBJECTIVE: We sought to determine the frequency and language used in voluntary advisory labels among commercially available products and to identify labeling ambiguities affecting consumers with allergy.
METHODS: Trained surveyors performed a supermarket survey of 20,241 unique manufactured food products (from an original assessment of 49,604 products) for use of advisory labels. A second detailed survey of 744 unique products evaluated additional labeling practices.
RESULTS: Overall, 17% of 20,241 products surveyed contain advisory labels. Chocolate candy, cookies, and baking mixes were the 3 categories of 24 with the greatest frequency (> or = 40%). Categorically, advisory warnings included "may contain" (38%), "shared equipment" (33%), and "within plant" (29%). The subsurvey disclosed 25 different types of advisory terminology. Nonspecific terms, such as "natural flavors" and "spices," were found on 65% of products and were not linked to a specific ingredient for 83% of them. Additional ambiguities included unclear sources of soy (lecithin vs protein), nondisclosure of sources of gelatin and lecithin, and simultaneous disclosure of "contains" and "may contain" for the same allergen, among others.
CONCLUSION: Numerous products have advisory labeling and ambiguities that present challenges to consumers with food allergy. Additional allergen labeling regulation could improve safety and quality of life for individuals with food allergy.
↩[3] - Ebo DG, Bridts CH, Mertens MH, Stevens WJ. Coriander anaphylaxis in a spice grinder with undetected occupational allergy. Acta Clin Belg 2006;61:152-156
BACKGROUND: Anaphylaxis after ingestion of spices as a result from occupational sensitization remains anecdotal. We describe a patient, working in a spice factory, with anaphylaxis from coriander in a meal. He also demonstrated urticaria, angio-edema, rhinoconjunctivitis and bronchospasm during handling coriander and fenugreek. OBJECTIVE: To determine the mechanism of the anaphylactic reaction and to evaluate cross-reactivity between both botanically unrelated spices.
METHODS: Investigations comprised quantification of total and specific IgE by Immuno-CAP FEIA, skin testing, basophil activation experiments by flow-assisted determination of CD63 expression in the patient and 3 healthy controls. Immuno-CAP inhibition experiments were applied to investigate cross-reactivity.
RESULTS: Specific IgE, skin tests and basophil activation tests were clearly positive in the patient, whereas they remained negative in controls. No cross-reactivity between fenugreek and coriander was demonstrable by inhibition experiments.
CONCLUSIONS: The clinical manifestations in temporal relationship to ingestion of coriander and handling of coriander and/or fenugreek, the positive specific IgE results, skin tests and basophil activation assays support the diagnosis of allergy to both spices. History suggests sensitization by occupational exposure.
↩[4] - Niinimäki A, Hannuksela M. Immediate skin test reactions to spices. Allergy 1981;36:487-493
Scratch tests with common spices were performed in 1,120 atopic and 380 non-atopic patients. Positive skin test reactions were seen almost exclusively in atopics. Curry and paprika produced reactions most frequently, and when the components of curry were tested separately, coriander, caraway, cayenne and mustard were responsible for the vast majority of the skin reactions. A high correlation between positive skin test reactions to spices, especially to curry and its components, and tree pollens, fruits and vegetables was demonstrated, suggesting that there may be a group of cross allergies. Clinical symptoms from ingested spices were noticed by five patients. When small amounts of spices were spread on the oral mucosa, local reactions, especially in the mouth and nasopharynx, were found in 14 out of 35 unselected patients with positive skin test reactions. Peroral challenges with spices in gelatin capsules were negative in 20 nonselected patients.
↩[5] - Rancé F, Juchet-Gibon A, Fejji S, Brémont F, Dutau G. Sensibilisation aux épices chez l'enfant. Rev Fr Allergol Immunol Clin 1994;34:475-479 ↩
[6] - Rodriguez-Trabado A, Bartolomé B, Prados M. Latex cross-reactivity with the Lauraceae family. Allergy 2008;63(suppl. 88):569
Background: A male children with allergy to latex and dysphonia after ingestion of cinnamon (a Lauraceae family member).
Objective: To demonstrate cross-reactivity between latex and other vegetables beginning to the Lauraceae family. Clinical case: An eight year-old patient, previously diagnosed of chestnut and latex hypersitivity after an anaphylaction reaction with the ingestion of chestnuts, suffered from an episode of dysphonia and dyspnea five minutes after eating home cooking custard with an important quantity of cinnamon. It immediately disappeared with the injection of adrenaline. They referred subsequent tolerance to custard. Cinnamon begins to the Lauraceae family, that includes threes such as Laurel and fruits than present cross-reactivity to latex. Methods and results: Prick-prick was performed with cinnamon in powder, with an immediate positive lecture (triplicate test). Four healthy controls were performed with negative result. Prick-prick with latex-related fruits was positive to kiwi (skin and pulp), and negative for pineapple, banana, tomato and laurel. Specific IgE was determined by Bial- Aristegui Laboraties by the Enzyme AllergoSorben Test (in kU/L) and was positive to latex (10.7), chestnut (1.2), and pulp of ripe avocado (1.5); and negative to cinnamon, skin and pulp of un-ripe avocado. The result was negative (o0.35) for laurel, although levels of specific IgE were higher than the pool of non-atopic controls. A SDS-PAGE was duplicated performed, with and without the reductor agent 2-mercaptoetanol. High fixation was found for latex extract (bands between 490-20 kDa without mercaptoetanol, and bands of 64, 54, 43 and 21-24 kD with mercaptoetanol). For avocado, bands of 33 and 25 kDa were detected without the reductor agent.
Conclusions: Specific IgE to cinnamon could not been detected, probably because the protein extraction from its stalk is difficult enough to perform an adequate allergenic extract, but the anaphylaxis was attributed to cinnamon because to a positive prick-prick test.The immunological study suggests a cross-reactivity between avocado and laurel with latex as a primary sensitizer, and cross-reactivity with cinnamon is highly suspected, too.
↩[7] - Stäger J, Wüthrich B, Johansson SGO. Spice allergy in celery-sensitive patients. Allergy 1991;46:475-478
Scratch tests (SCT) with powdered commercial spices were performed in 70 patients with positive skin tests to birch and/or mugwort pollens and celery. Positive SCT to aniseed, fennel, coriander and cumin - all from the same botanical family (Apiaceae) as celery - were observed in more than 24 patients. Spices from unrelated families (red pepper, white pepper, ginger, nutmeg, cinnamon) elicited positive immediate skin test reactions only in three of 11 patients. Specific serum IgE to spices (determined in 41 patients with positive RAST to celery) up to class 3 were seen especially in patients with celerymugwort or celery-birch-mugwort association, and concerned various botanical families. Celery-birch association pattern was linked to positive reactions (RAST classes 1-2) to spices from the Apiaceae family only.
↩[8] - Moneret-Vautrin DA, Morisset M, Lemerdy P, Croizier A, Kanny G. Food allergy and IgE sensitization caused by spices: CICBAA data (based on 589 cases of food allergy). Allerg Immunol (Paris) 2002;34:135-140
BACKGROUND: Spices originate in various botanical families: Apiaceae, Lamiaceae, Lauraceae, Leguminosae, Liliaceae, Myristicaceae, Myrtaceae, Piperaceae, Solanaceae, Zingiberaceae.... METHODOLOGY: Prick-tests to native spices have been carried out in patients suspected of food allergies to spices. The CICBAA data bank includes 589 cases of food allergies, a part of which has benefited from investigations for spices.
Data about the rate of sensitization and food allergy are available.
RESULTS: Frequent sensitization to Apiaceae is observed: coriander, caraway, fennel, celery: 32% of prick-tests in children, 23% of prick-tests in adults. Sensitization to Liliaceae: garlic, onion, chive, is observed in 4.6% of prick-tests in children, 7.7% of prick-tests in adults. Rare cases of sensitization to paprika and saffron are recorded.
Prick-tests to nutmeg, ginger and clove are currently negative. 10 food allergies related to the mugwort-celery-spices syndrome are reported: coriander: 1, caraway: 2, fennel: 3, garlic: 3, onion: 1. Food allergy to spices is unfrequent: 2% of the totality of food allergies. However, only adults are allergic to spices and allergy to spices accounts for 6.4% of food allergies in adults. Tiny amount of proteins are usually ingested.
Patients at risk of spice allergy are young adults sensitized to mugwort and birch allergens, sharing cross-sensitization with various food vegetal allergens. The clinical suspicion raises from frequent post-prandial systemic reactions. Other allergens of vegetal origin have to be cleared.
Diagnosis can be established by DBPCFC using powdered spices in capsules.
[References: 22]
↩[9] - Leitner A, Jensen-Jarolim E, Grimm R, Wüthrich B, Ebner H, Scheiner O, et al. Allergens in pepper and paprika. Immunologic investigation of the celery-birch-mugwort-spice syndrome. Allergy 1998;53:36-41
Mugwort and birch pollen allergy are frequently associated with IgE-mediated hypersensitivity to celery and spices. We analyzed 22 sera from patients with the mugwort-birch-celery-spice syndrome for IgE binding to the spices pepper and paprika by immunoblotting. Immunoblot results revealed two major allergens of 28 and 60 kDa in pepper and a 23-kDa allergen together with allergens of higher molecular weight in paprika. In immunoblot-inhibition studies, crude mugwort, birch pollen, and celery extracts significantly reduced the IgE binding to pepper and paprika allergens. However, no inhibition was achieved with rBet v 1 and rBet v 2, suggesting that no homologs of these birch proteins act as allergens in pepper or paprika extracts. N-terminal sequence analysis of the 14- and 28-kDa pepper and 23-kDa paprika allergens revealed no homology to known allergens. The 28-kDa pepper allergen showed homology to a wheat germin protein, and the 23-kDa paprika allergen was identified as a homolog of a osmotin-like or pathogenesis-related protein in tomato. Therefore, we conclude that the IgE cross-reactivity in the mugwort-birch-celery-spice syndrome to the spices pepper and paprika is not caused by homologs of Bet v 1 and profilin. N-terminal amino acid sequence analysis of the main allergens in pepper and paprika indicate a relation to frequently occurring plant proteins.
↩[10] - Jensen-Jarolim E, Schmid B, Bernier F, Berna A, Kinaciyan T, Focke M, et al. Allergologic exploration of germins and germin-like proteins, a new class of plant allergens. Allergy 2002;57:805-810
BACKGROUND: Germins and the related germin-like proteins (GLPs) are glycoproteins expressed in many plants in response to biotic and abiotic stress. To test the potential impact of germins and GLPs, recombinant germin from Triticum aestivum (tGermin) and GLPs from Arabidopsis thaliana (tGLP), both produced in transformed tobacco plants, were used .
METHODS: Sera from 82 patients with type I allergy to birch, grass or mugwort pollen and/or wheat were tested in immunoblot for IgE binding to tGermin and tGLP, and the IgE reactivity after chemical and enzymatic deglycosylation was analysed. The biological activity of tGermin and tGLP was determined in a histamine release assay and in skin prick testing (SPT) .
RESULTS: In an immunoblotting assay, 24 out of 82 tested sera (29.26%) from allergic patients showed IgE-binding to tGermin, and 18 of these sera (21.95%) displayed also IgE-binding to tGLP. The deglycosylation experiments indicated that glycan moieties contribute significantly to the IgE-binding of tGermin and tGLP. Both tGermins and tGLP induced specifically histamine release in an in vitro assay as well as in SPT .
CONCLUSION: Our in vitro and in vivo findings demonstrate that germin and GLPs are capable to bind IgE most likely via carbohydrate determinants, and represent allergenic molecules.
↩[11] - Wüthrich B, Hofer T. [Food allergy: the celery-mugwort-spice syndrome. Association with mango allergy ?]. Dtsch Med Wochenschr 1984;109:981-986
Celery allergies are commonly observed in mugwort pollen-allergic patients. This situation is frequently associated with an allergy to spices of the umbelliferous family. Thus a "celery-mugwort-spice syndrome" has been established. In 31 patients (27 females, 4 males) allergy to celery was diagnosed between 1978 and 1982. They were followed up in 1983 and complementary tests (skin and RAST) with various raw vegetables, spices and mugwort pollen were done. For specific diagnosis of allergy to celery skin testing (scratch or prick) with fresh celery bulb was reliable. In contrast, RAST was not sufficiently sensitive, 87% of patients allergic to celery had pollinosis in the form of mugwort pollen sensitisation established by skin testing and RAST. Allergy to carrots was clinically and by testing currently associated in 52%. In contrast, a clinically relevant hypersensitivity to caraway (26%), parsley (16%), fennel (13%), green pepper (10%) and aniseed (3%) was found less frequently although these allergens showed a much larger positivity in skin testing. This signifies group sensitisation within the umbelliferous plants. The association of celery-mugwort allergy with allergy to mango fruit described here for the first time cannot be explained as group sensitisation within a botanic relation, as mango, and pistachio-nut, belong to the family of anacardiaceae.
↩[12] - Benito M, Jorro G, Morales C, Pelaez A, Fernandez A. Labiatae allergy: systemic reactions due to ingestion of oregano and thyme. Ann Allergy Asthma Immunol 1996;76:416-418
BACKGROUND: There are no cases described in the medical literature of systemic allergic reactions due to oregano (Origanum vulgare) or thyme (Thymus vulgaris). These herbs belong to the Lamiaceae (Labiatae) family which comprises other plants such as hyssop (Hyssopus officinalis), basil (Ocimum basilicum), marjoram (Origanum majorana), mint (Mentha piperita), sage (Salvia officinalis) and lavender (Lavandula officinalis) .
OBJECTIVE: We describe three systemic allergic reactions caused by oregano and thyme in the same patient .
METHODS: Skin tests with inhalant allergens and plants of the Labiatae family were done. We used the prick by prick technique with dried commercial plants and prick tests with extracts prepared with the Frugoni method in our patient and in ten control patients. Total serum IgE was determined by Phadezym IgE PRIST (Pharmacia). Specific IgE was measured by two methods: CAP system (Pharmacia) and Phadezym RAST (Pharmacia Diagnostics, Uppsala, Sweden) with activated discs of the allergenic extracts that were prepared in our laboratory .
RESULTS: Skin tests with inhalants were positive to grasses. Skin tests with plants of the Labiatae family were positive in all cases when the skin prick technique was used; tests were negative with basil and lavender, and positive with all the others when we used the prick by prick technique. We did not detect any positive skin tests nor specific IgE to plants of the Labiatae family in control patients. Total serum IgE was 406 U/mL. Specific IgE was detected to all herbs tested; higher levels were obtained with the CAP system .
CONCLUSIONS: Plants belonging to the Labiatae family seem to show cross-sensitivity on the basis of clinical history and in vitro and in vivo test results.
↩[13] - Vartholomaios S, Pitsios C, Mikos N, Kompoti E, Kouridakis S. Allergy to Basil, a Lamiaceae Herb. J Investig Allergol Clin Immunol 2007;17:348-349
A report of the first 2 cases of allergy to basil. A 65-year-old woman reported an episode of dyspnea, urticaria, and angioedema involving the face and lips occurring within 30 minutes of eating homemade pesto genovese sauce containing raw basil, pine nuts, garlic, olive oil, and parmesan cheese. She had experienced oral pruritus each time she tasted oregano in a salad containing tomato, cucumber, feta cheese, and olive oil. She also gave a history consistent with the sudden onset of sneezing, nose congestion, coughing, and wheezing every time she smelled lavender. A 25-year-old male complained of oral pruritus, rhinorrhea, nose congestion, eye pruritus, angioedema on his lower lip, and emesis occurring 15 minutes after eating pesto sauce made with the same recipe as above. He reported a 7-year history of seasonal rhinitis, conjunctivitis, and asthma and a history of systemic allergic reactions to pistachio and cashew nuts. He also complained of oropharyngeal pruritus every time he tasted walnuts. Patient 1 had positive tests to Artemisia vulgaris and to all Labiatae tested. Patient 2 had positive tests to Gramineae species, basil, oregano, lavender, pistachio, cashew nut, hazelnut, almond, walnut and celery. The tests for sIgE to basil, marjoram, and thyme were negative in both patients.
↩[14] - Robinson DM. Anaphylaxis to Turmeric. AAAAI 59th Annual Meeting, Denver, 7-12 March, 2003, Poster n°120
Turmeric has been used for centuries as a spice and color additive for foods. It is found in a wide variety of common food items. There are few reports of adverse health effects from turmeric. This is a case report of an individual with turmeric-induced anaphylaxis on three occasions. A 44-year-old woman was seen for evaluation of an episode of food-related urticaria and angioedema that occurred while traveling in Hawaii. She had eaten a variety of foods but the only uncommonly encountered food that she could identify was wasabe. She experienced a protracted reaction with recurrent urticaria and angioedema over three days despite initial treatment with epinephrine, diphenhydramine and methylprednisolone. She was advised by the emergency physician to seek specialist evaluation to determine the cause of her reaction. She had a similar, less severe episode 1 year earlier associated with roast beef with horseradish sauce. A search for ingredients of wasabe and horseradish sauce yielded a number of variable ingredients, but both always contain horseradish and most contain turmeric. RAST testing for horseradish was negative. RAST testing for turmeric was moderately positive (both IBT Reference Lab, Lenexa, Kansas). Now carefully monitoring ingredients of all food items she had another reaction at a local restaurant associated with some herbed potatoes. Careful review of spicing agents used revealed undeclared „spices.‰ On contact with the manufacturer these were found to be annatto seed, paprika, saffron and turmeric. This would appear to represent an unusual case of food allergy to turmeric.
↩[15] - Sanchez Machin I, Garcia Robaina JC, de la Torre Morin F. Anaphylaxis due to the ingestion of cardamom (Elettaria cardamomum) present in biscuits and German bread. EAACI 22th Congress, Paris, 7-11 June, 2003, Poster n°697
Background: Allergic symptoms caused by spices are infrequent, and account only for 2% of food allergies. Adverse reactions have been reported to several spices, although only a few cases have been reported where cardamom was the offending agent causing allergic contact dermatitis. Cardamom belongs to Zingiberaceae botanical family along with ginger and Indian saffron (Curcuma domestica). Cardamom is a popular traditional flavouring agent for coffee, sweets and baked goods, particularly in Arabic countries. Besides having some pharmacological properties, such as antiinflammatory, analgesic and antispasmodic activity, extracts of cardamom are capable of enhancing the cutaneous penetration of drugs, such as indomethacin, prednisolone.
Material and Methods: We present a 41year old man with no family or personal history of allergic reactions, who in the past year experienced 6 episodes of scalp, genital area, palms and soles pruritus, urticaria, facial angioedema, throat swelling and general malaise 15 to 30 minutes following the ingestion of wholemeal biscuits and home-made German-style bread. Emergency treatment was required in all these episodes. Skin prick tests were conducted with mites, pollens, moulds, animal danders, cereals and additives. The patient tolerates the ingestion all type of cereals. A further battery of tests was conducted with seeds, nuts and spices, including cardamom.
Results: All skin tests were negative except the prick by prick with raw cardamom, which showed a positive immediate response with a wheal size of 9 x 6 mm. Specific IgE to cereals were negative. The patient remains symptom free since avoiding the ingestion of foods containing cardamom.
Conclusions: We present a case of anaphylaxis due to sensitisation to, and ingestion of cardamom. Due to the severity of the clinical manifestations, the patient was not challenged with this spices. To the best of our knowledge, this is the first reported case of cardamom sensitivity inducing severe generalised symptoms. Cardamom should be included in the list of "hidden" food allergens.
↩[17] - Cueva B, Izquierdo G, Crespo JF, Rodriguez J. Unexpected spice allergy in the meat industry. J Allergy Clin Immunol 2001;108:144 ↩
[18] - van Toorenenbergen AW, Huijskes-Heins MIE, Leijnse B, Dieges PH. Immunoblot analysis of IgE-binding antigens in spices. Int Arch Allergy Appl Immunol 1988;86:117-120
The IgE response to coriander and other spices was studied by immunoblotting, after separation of the spice extracts by isoelectric focusing and sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). A major IgE-binding component from coriander had an isoelectric point of pH5. After incubation of SDS-PAGE-separated spice extracts with serum from a patient with an occupational allergy to spices, a closely related pattern of IgE binding to coriander, dill and anise extract was observed. These results suggest that the botanically related spices, coriander, anise and dill, contain common IgE-binding structures.
↩[19] - Feo F, Martinez J, Martinez A, Galindo PA, Cruz A, Garcia R, et al. Occupational allergy in saffron workers. Allergy 1997;52:633-641
Sensitization to the flower of saffron, a plant commonly grown in Spain for commercial purposes, and its clinical significance as an occupational allergen were studied. The prick test and RAST, with saffron pollen, stamen, and pistil extracts, were used to evaluate the cutaneous and specific antibody responses in the studied population. Provocation tests in patients with clinical findings were used to verify the implication of saffron components in these symptoms. Fifty saffron workers were evaluated. Three of them were sensitized to saffron pollen and stamen proteins, giving prick and RAST positive values. One patient presented asthma, showing a positive bronchial provocation test, and two patients rhinoconjunctivitis, showing positive conjunctival provocation tests. Of a general allergic population of 237, 10 patients also presented cutaneous test and IgE positive to saffron. Saffron allergens (from pollen and stamens) were characterized by SDS-PAGE immunoblotting. A relevant allergen of 15.5 kDa with profilinic nature was detected and further purified by high-resolution gel filtration chromatography. No allergenic components were demonstrated in pistils. Cross-reactivity of saffron extracts was evaluated by RAST inhibition with respect to other pollen species commonly causing sensitization in the same area of study. A significant degree of cross-reactivity was demonstrated between saffron and Lolium, Salsola, or Olea. The identification of the protein components involved in the cross-reactions was investigated by blot inhibition
↩[20] - Varasteh AR, Moghadam M, Vahedi F, Kermani T, Sankian M. Cloning and Expression of the Allergen Cro s 2 Profilin from Saffron (Crocus sativus). Allergol Int 2009;58:429-435
Imprimer la bibliographieBackground: Profilin is a panallergen that is recognized by IgE in allergic patients. Allergy to saffron (Crocus sativus) pollen has been described in people exposed to its pollen. Saffron contains a profilin that may cause allergic reactions in atopic subjects. The aim of this study was to describe the cloning, expression and purification of saffron profilin from pollen.
Methods: Cloning of saffron profilin was performed by polymerase chain reaction using specific primers from saffron pollen RNA. Expression was carried out in Escherichia coli BL21 (DE3) using a vector pET-102- TOPO. A recombinant fusion protein was expressed and the recombinant profilin was purified by metal precipitation. Immunological characterization was performed by immunoblotting experiments.
Results: The 34kDa- recombinant saffron profilin, Cro s 2, as a fusion protein was purified. Immunoblotting tested with the sera of allergic patients showed a specific reaction with the recombinant Cro s 2 band.
Conclusions: The sequence of Cro s 2 showed a high degree of identity and similarity to other plant profilins and the recombinant saffron profilin, Cro s 2, may be used for target-specific diagnosis and structural analyses and investigation of cross reactivity of Cro s 2 with other plant profilins.
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