Update on the bird-egg syndrome and genuine poultry meat allergy

Abstract

SummaryAllergy to poultry meat is rare and affects both children and adults. The prevalence of poultry meat allergy is unknown, but presumably is similar to that of red meat allergy. There is no close relationship between allergy to poultry meat and allergy to red meat. Poultry meat allergy may present as primary (genuine) food allergy or as secondary food allergy resulting from cross-reactivity.Secondary poultry meat allergy may arise in the context of bird-egg-syndrome, which is due to sensitization to serum albumins present in many tissues including muscle tissue and egg yolk (Gal d 5). Primary sensitization to serum albumin may happen via the respiratory tract through exposure to pet birds (mainly in adults) or within the context of egg allergy in early childhood. Due to the heat lability of serum albumins, reactions are often limited to the skin upon contact with raw meat. Symptoms from meat ingestion are rare and mostly mild, whereas systemic reactions are common after ingestion of raw or soft-boiled egg yolk.Primary poultry meat allergy is mainly seen in adolescents and young adults, though hypersensitivity may have started already at (pre)school age. Egg allergy is usually absent. Typical symptoms of primary poultry meat allergy include OAS (±dyspnea), gastrointestinal complaints, urticaria and angioedema. Severe anaphylaxis with cardiovascular symptoms is rare. Chicken and turkey meat are highly cross-reactive and responsible for most reactions, while duck and goose meat causes milder or no symptoms. Soups, sausages, and ham represent relevant allergen sources, too. Patients with poultry meat allergy unexpectedly often suffer from concomitant allergy to fish and possibly shrimp. Serum specific IgE against fish and shrimp is found in respectively 60 and 40 % of sera, suggestive of cross-reactive allergens in these foods. The allergens thus far recognized in genuine poultry meat are LMW proteins of 5–25 kDa. One of them has been identified as α-parvalbumin cross-reactive with homologous mammal α-parvalbumins but not with fish α-parvalbumins. Recently, myosin light chains, including 23 kDa MLC-1 (Gal d 7) and 15 kDa MLC-3, have been recognized as new major allergens in chicken meat. The high similarity of chicken MLCs with those from various fish species (∼65 %) might explain the clinical association of poultry meat allergy with fish allergy.

Serum IgE cross‐reactivity between fish and chicken meats in dogs

“…A number of studies have demonstrated the existence of shared IgE‐binding proteins in unrelated foods . Most recently, an unexpected association between fish and chicken was noted, with 30% of chicken‐allergic patients also found to be allergic to fish . Suffering from the ‘fish‐chicken syndrome’, patients with concomitant fish and chicken allergy react to homologous proteins present in both meats .…”

“…10,11 Most recently, an unexpected association between fish and chicken was noted, with 30% of chicken-allergic patients also found to be allergic to fish. 12 Suffering from the 'fish-chicken syndrome', patients with concomitant fish and chicken allergy react to homologous proteins present in both meats. 13 Chicken parvalbumin (Gal d 8), aldolase A (Gal d 10) and (beta-)enolase (Gal d 9) have been recognized by specific IgE in 69%, 72% and 83% of 29 patients with concomitant fish and chicken allergy, respectively.…”

Hen’s egg allergy: an update

“…Сенсибилизация к данному белку лежит в основе механизма перекрестной реактивности с аллергенами пера и перхоти домашней птицы, так называемый синдром «птица -яйцо» (bird-egg syndrome). Такие больные в большей степени имеют гиперчувствительность к яичному желтку, нежели к белку, при ýтом в клинической картине преобладают респираторные и гастроинтестинальные проявления, а толерантность достигается реже и в более старшем возрасте [30].…”

“…В настоящее время установлена перекрестная реактивность между белками яиц кур, гусей, индейки, уток, перепелок, чаек [18]. Альфа-ливетин является причинно-значимым белком в развитии перекрестной аллергии к куриному мясу и куриному яйцу у лиц с сенсибилизацией к перу и перхоти домашней птицы (синдром «птица -яйцо») [30]. Также имеет место перекрестная реактивность между разными аллергенными компонентами, входящими в состав яйца, что обусловлено существованием общих аллергенных детерминант в молекулярной структуре [33].…”

“…Также возможно развитие сенсибилизации при попадании аллергенов куриного яйца ингаляционным путем с последующим развитием респираторных проявлений (например, во взрослом возрасте у работников кондитерской и хлебобулочной промышленности) [29]. Различные симптомы со стороны дыхательной системы при употреблении яиц также могут возникать у пациентов, сенсибилизированных к перу и перхоти домашней птицы по механизму перекрестной реактивности (синдром «птицаяйцо») [30].…”