Cross-allergenicity of peanut and lupine: The risk of lupine allergy in patients allergic to peanuts

• Published in: Journal of allergy and clinical immunology Vol. 104; no. 4; pp. 883 - 888
• Main Authors: Moneret-Vautrin, Denise-Anne, Guérin, Laurence, Kanny, Gisèle, Flabbee, Jenny, Frémont, Sophie, Morisset, Martine
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.10.1999; Elsevier
• Subjects: Adolescent; Allergens - immunology; Allergic diseases; Arachis - immunology; Arachis hypogaea; Biological and medical sciences; Child; Child, Preschool; Cross Reactions; cross-reactivity; double-blind; Fabaceae - immunology; Female; Flour; Food Hypersensitivity - immunology; Glycine max - immunology; Humans; immunoblot; Immunopathology; Infant; legumes; lupine allergenicity; Lupinus albus; Male; Medical sciences; Other localizations; Peanut allergy; placebo-controlled food challenge; Plant Proteins - immunology; Plants, Medicinal; Pollen - immunology; Skin Tests; lupine allergenicity; Peanut allergy; immunoblot; legumes; cross-reactivity; double-blind; placebo-controlled food challenge; DBPCFC; Human; Immunopathology; Allergy; Peanut; Lupin; Crossed allergy; Leguminosae; Etiology; Immunological investigation; Dicotyledones; Angiospermae; Lupinus albus; Spermatophyta; Food; Allergen
• ISSN: 0091-6749
• DOI: 10.1016/S0091-6749(99)70303-9

Background: Peanut allergy is common, but cross-allergy between legumes is rare. Proteins from Lupinus albus are increasingly eaten in the form of seeds or additives to wheat flour. The risk of cross-allergenicity is still insufficiently known. Objective: We sought to study the risk of cross-allergy to lupine in patients allergic to peanut and to study lupine allergenicity. Methods: Twenty-four patients allergic to peanuts were studied by means of skin prick tests with native lupine flour from Lupinus albus. Double-blind oral challenge tests were performed with lupine flour and peanut in 8 of these patients. Specific IgEs were assayed for peanut, lupine flour, and pollen in 6 sera. RAST inhibition tests for lupine pollen by peanut were performed on 4 of these sera. Peanut and lupine flour immunoblots were carried out for 6 sera, and crossed immunoblot inhibitions for peanut by lupine flour and lupine flour by peanut were carried out for 2 sera. Results: The skin prick test responses with lupine flour were positive in 11 (44%) subjects. The challenge test responses were positive in 7 of 8 subjects at the same doses as with peanut. The major lupine flour allergen (molecular mass, 43 kd) is present in peanuts. The RAST inhibition and immunoblot tests indicated cross-reactivity of peanut with the lupine flour and pollen. Conclusions: The risk of crossed peanut-lupine allergy is high, contrary to the risk with other legumes. The inclusion of 10% lupine flour in wheat flour without mandatory labeling makes lupine a hidden allergen, presenting a major risk of cross-reaction in subjects already allergic to peanut products. A high sensitizing potential can also be postulated for this legume. (J Allergy Clin Immunol 1999;104:883-8.)