Anaphylaxis to rice by inhalation

Fiocchi, Alessandro; Bouygue, Gabriel R.; Restani, Patrizia; Gaiaschi, Antonella; Terracciano, Luigi; Martelli, Alberto M.

doi:10.1067/mai.2003.12

Cited by 30 publications

(27 citation statements)

References 8 publications

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“…FPIES is a non-IgE-mediated hypersensitive disorder that can affect children younger than 12 months old very severely and cause vomiting, diarrhoea, shock and metabolic acidosis [2]. IgE-mediated allergies can affect children and adults, causing respiratory symptoms upon inhalation of raw rice dust or rice vapour when rice is boiled, as well as gastrointestinal and other systemic symptoms upon ingestion [3,4,5,6,7,8]. However, there are few reports in the literature of such reactions.…”

Section: Introductionmentioning

confidence: 99%

Rice Allergy Demonstrated by Double-Blind Placebo-Controlled Food Challenge in Peach-Allergic Patients Is Related to Lipid Transfer Protein Reactivity

Pastorello

Scibilia

Farioli

et al. 2013

Int Arch Allergy Immunol

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Background: The risk factors for sensitisation to rice and the involved allergens are still partially unknown. In this study we evaluated the clinically relevant aspects of rice allergy in DBPCF-positive patients, the major rice allergens, the severity of peach- and rice-induced symptoms in respect to Pru p 3 sensitisation and the role of anti-rPru p 3 IgE levels as a risk factor for rice allergy. Methods: In 148 peach-allergic subjects, patients with allergic reactions to rice and rice-positive serum IgE were selected. Symptoms were verified by double-blind placebo-controlled food challenges (DBPCFCs), performed at a maximum dosage of 25 g. Rice allergens, identified by IgE immunoblotting, were characterised by N-terminal amino acid sequencing. The relationship between anti-rPru p 3, 1 and 4 IgE levels and rice symptoms were statistically analysed. Results: Eight out of 10 recruited rice-allergic patients had positive DBPCFCs, while 2 patients were not challenged due to their previously documented severe reactions. All patients with rice-induced symptoms were Pru p 3 positive and presented with higher anti-rPru p 3 levels than the rice-sensitised but tolerant patients. A 9-kDa lipid transfer protein, which was highly homologous to Pru p 3, was identified as the major rice allergen and elicited a positive response in all of the patients. Five patients reacted to a putative 15- to 17-kDa rice allergenic protein, and 3 patients reacted to an [alpha]-amylase/subtilisin inhibitor that was approximately 20 kDa. Conclusion: Rarely, allergic reactions to rice can arise in patients with peach allergies who are sensitised to Pru p 3, particularly in patients with high anti-rPru p 3 IgE levels.

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Section: Introductionmentioning

confidence: 99%

Rice Allergy Demonstrated by Double-Blind Placebo-Controlled Food Challenge in Peach-Allergic Patients Is Related to Lipid Transfer Protein Reactivity

Pastorello

Scibilia

Farioli

et al. 2013

Int Arch Allergy Immunol

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“…So far, rice has been described merely as inhalant [2,3,4,5] or contact allergen [6,7,8], rather than as food allergen [2,9,10,11,12,20]. In Europe and North America, food allergy due to rice causing IgE-mediated anaphylaxis has been reported very rarely [2,10,12,20].…”

Section: Discussionmentioning

confidence: 99%

“…In Europe and North America, food allergy due to rice causing IgE-mediated anaphylaxis has been reported very rarely [2,10,12,20]. Symptoms after rice ingestion have involved the skin (urticaria) [2,5,6,7,20], the respiratory tract (rhinoconjunctivitis or bronchial asthma) [4,10,12] and the gastrointestinal system [2]. In some cases, rice might also account for specific food-dependent exercise-induced anaphylaxis [24].…”

Section: Discussionmentioning

confidence: 99%

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Rice-Induced Anaphylaxis: IgE-Mediated Allergy against a 56-kDa Glycoprotein

Trcka

Schäd

Scheurer

et al. 2011

Int Arch Allergy Immunol

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Background: Although rice (Oryza sativa) is one of the most common cereals produced and consumed around the world, there have been only a few reports on immediate hypersensitivity reactions after ingestion of rice. Few clinical studies on rice allergy in Asia have been reported concerning rhinitis, asthma and atopic dermatitis. In this case study, we identify allergens presumably responsible for anaphylaxis after ingestion of rice in a German patient. Methods: Prick-to-prick tests, determination of specific IgE and the basophil activation test (BAT) were performed to confirm IgE-mediated allergy. IgE reactivity was further analyzed by immunoblotting of protein extracts from cooked commercial rice products. Rice allergens were purified, subjected to N-terminal sequencing and characterized by IgE binding and IgE inhibition assays using additional sera from 8 subjects with sensitization to rice and/or a history of hypersensitivity symptoms after rice ingestion. Results: Prick-to-prick tests were positive to raw and cooked rice (basmati rice and long-grain rice) and preparations of different rice extracts. Specific IgE against rice (f9) was 1.87 kU_A/l. The BAT showed specific IgE-mediated activation of basophils after stimulation with rice extracts. Four IgE-reactive rice proteins with an apparent molecular weight of 49, 52, 56 and 98 kDa were identified. Interestingly, only binding to the 56-kDa glycoprotein was at least partially independent from cross-reactive carbohydrate determinants (CCD), whereas IgE binding to the other rice proteins was completely inhibited by pre-incubation with the CCD MUXF derived from bromelain. Conclusions: Yet unidentified high-molecular-weight allergens from rice seeds, predominantly a 56-kDa glycoprotein, seem to be responsible for anaphylaxis after consumption of rice in a German patient.

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“…Food airborne anaphylactic reactions are unusual and most are related to cooked foods owing to aerosolized or vaporized particles. 10 In the present case, the implicated food was the native fig, probably owing to sprayed particles induced by its manipulation.…”

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confidence: 93%