Baker's asthma related to soybean lecithin exposure

Lavaud, F.; Perdu, D.; Prévost, Alain; Vallerand, H.; Cossart, C.; F, Passemard

doi:10.1111/j.1398-9995.1994.tb00819.x

Cited by 37 publications

(17 citation statements)

References 12 publications

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“…Most of these reports involve bakers with occupational asthma that was attributed to one or more ingredients (e.g. alpha-amylase, lecithin, soybean flour) used in making bread [8, 9]. A link to lecithin as a causative agent was established for 2 of these bakers by positive bronchial challenge tests using diluted soy lecithin [9].…”

Section: Introductionmentioning

confidence: 99%

“…alpha-amylase, lecithin, soybean flour) used in making bread [8, 9]. A link to lecithin as a causative agent was established for 2 of these bakers by positive bronchial challenge tests using diluted soy lecithin [9]. Other cases of allergic reaction to lecithin include a 3-year-old boy who was found to have allergic reactions including chronic diarrhea to candies and frozen foods.…”

Section: Introductionmentioning

confidence: 99%

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Identification of IgE-Binding Proteins in Soy Lecithin

Gu¹,

Beardslee

Zeece³

et al. 2001

Int Arch Allergy Immunol

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Background: Soy lecithin is widely used as an emulsifier in processed foods, pharmaceuticals and cosmetics. Soy lecithin is composed principally of phospholipids; however, it has also been shown to contain IgE-binding proteins, albeit at a low level. A few clinical cases involving allergic reactions to soy lecithin have been reported. The purpose of this investigation is to better characterize the IgE-binding proteins typically found in lecithin. Methods: Soy lecithin proteins were isolated following solvent extraction of lipid components and then separated on sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE). The separated lecithin proteins were immunoblotted with sera from soy-sensitive individuals to determine the pattern of IgE-binding proteins. The identity of IgE-reactive bands was determined from their N-terminal sequence. Results: The level of protein in six lecithin samples obtained from commercial suppliers ranged from 100 to 1,400 ppm. Lecithin samples showed similar protein patterns when examined by SDS-PAGE. Immunoblotting with sera from soy-sensitive individuals showed IgE binding to bands corresponding to 7, 12, 20, 39 and 57 kD. N-terminal analysis of these IgE-binding bands resulted in sequences for 3 components. The 12-kD band was identified as a methionine-rich protein (MRP) and a member of the 2S albumin class of soy proteins. The 20-kD band was found to be soybean Kunitz trypsin inhibitor. The 39-kD band was matched to a soy protein with unknown function. Conclusions: Soy lecithin contains a number of IgE-binding proteins; thus, it might represent a source of hidden allergens. These allergens are a more significant concern for soy-allergic individuals consuming lecithin products as a health supplement. In addition, the MRP and the 39-kD protein identified in this study represent newly identified IgE-binding proteins.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Identification of IgE-Binding Proteins in Soy Lecithin

Gu¹,

Beardslee

Zeece³

et al. 2001

Int Arch Allergy Immunol

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“…Allergic reactions to soy lecithin have been previously reported in the literature: occupational asthma in bakers [7], chronic diarrhea in a child [8], and anaphylactic reaction in a 40-year-old woman treated with an inhalatory drug [9]. …”

Section: Discussionmentioning

confidence: 99%

Adverse reaction to benzathine benzylpenicillin due to soy allergy: a case report

et al. 2015

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IntroductionSoybean allergy is one of the most common food allergies especially among children. The Food Allergen Labeling and Consumer Protection Act (FALCPA) in the US requires the labeling of soy lecithin because it is derived from soybeans and may contain a number of IgE-binding proteins, possibly representing a source of hidden allergens. Here we describe a pediatric case of soy allergy misunderstood as drug allergy.Case presentationAn 11-year-old Caucasian girl was referred to our Allergy Unit because of the delayed appearance of an itching papular rash at the site of an injection of benzathine benzylpenicillin delivered by prefilled syringe. A skin test with benzathine benzylpenicillin and detection of serum-specific IgE to penicilloyl V, penicilloyl G, ampicillin and amoxicillin were negative. From her past medical history we know that, at the age of three years, she presented with edema of the lips and difficulty in breathing after eating a soy ice-cream. For that reason, she underwent a skin prick test with soybean that was negative and a serum-specific IgE to soybean test that was weakly positive (0.21KU/L). She underwent an oral provocation test with soy milk that yielded a positive result.ConclusionsWe describe a case of a patient with a delayed reaction to soy as a hidden allergen in a benzathine benzylpenicillin prefilled syringe. This case shows that lecithin contaminated by soy proteins and used as an excipient in drugs can cause reactions in patients with soy allergy. For that reason, the source of lecithin should always be specified among the constituents of drugs to avoid a source of hidden allergens and difficulties in the allergy work-up.

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“…The presence of specific IgE antibodies recognizing lipoxygenase and/or soybean trypsin inhibitor have been demonstrated in symptomatic bakers,75,81,82 and soybean lecithin has also been reported as a causative agent of OA 83. More recently, cases of rhinitis and asthma caused by lupin flour have been reported but their impact in the bakery sector is not yet established 84…”

Section: Other Allergens Associated With Grain Induced Asthmamentioning

confidence: 99%

Diagnosis and Management of Grain-Induced Asthma

Quirce

Díaz‐Perales

2013

Allergy Asthma Immunol Res

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Grain-induced asthma is a frequent occupational allergic disease mainly caused by inhalation of cereal flour or powder. The main professions affected are bakers, confectioners, pastry factory workers, millers, farmers, and cereal handlers. This disorder is usually due to an IgE-mediated allergic response to inhalation of cereal flour proteins. The major causative allergens of grain-related asthma are proteins derived from wheat, rye and barley flour, although baking additives, such as fungal α-amylase are also important. This review deals with the current diagnosis and treatment of grain-induced asthma, emphasizing the role of cereal allergens as molecular tools to enhance diagnosis and management of this disorder. Asthma-like symptoms caused by endotoxin exposure among grain workers are beyond the scope of this review. Progress is being made in the characterization of grain and bakery allergens, particularly cereal-derived allergens, as well as in the standardization of allergy tests. Salt-soluble proteins (albumins plus globulins), particularly members of the α-amylase/trypsin inhibitor family, thioredoxins, peroxidase, lipid transfer protein and other soluble enzymes show the strongest IgE reactivities in wheat flour. In addition, prolamins (not extractable by salt solutions) have also been claimed as potential allergens. However, the large variability of IgE-binding patterns of cereal proteins among patients with grain-induced asthma, together with the great differences in the concentrations of potential allergens observed in commercial cereal extracts used for diagnosis, highlight the necessity to standardize and improve the diagnostic tools. Removal from exposure to the offending agents is the cornerstone of the management of grain-induced asthma. The availability of purified allergens should be very helpful for a more refined diagnosis, and new immunomodulatory treatments, including allergen immunotherapy and biological drugs, should aid in the management of patients with this disorder.

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Baker's asthma related to soybean lecithin exposure

Cited by 37 publications

References 12 publications

Identification of IgE-Binding Proteins in Soy Lecithin

Identification of IgE-Binding Proteins in Soy Lecithin

Adverse reaction to benzathine benzylpenicillin due to soy allergy: a case report

Diagnosis and Management of Grain-Induced Asthma

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