![]() ![]() Clinical importance of cross-reactivity in food allergy. This article, even though written in 2001, still remains a valid source of information, and according to my search of the literature, very little has been added to the literature regarding this subject since that time.Ī slightly more recent review on cross-reactivity to food (van Ree, R. Clinical implications of cross-reactive food allergens. A case of sesame seed-induced anaphylaxis. Asero R, Mistrello G, Roncarolo D, Antoniotti PL, Falagiani P. Common allergenic structures in hazelnut, rye grain, sesame seeds, kiwi, and poppy seeds. Vocks E, Borga A, Szliska C, Seifert HU, Burow G, Borelli S. "Reactions to seeds, such as sesame, mustard, and poppy, are reported (27, 35, 36) andĬross-reactivity with foods (hazel, kiwi, and other seeds) and pollens is potentially important, but the full clinical implications are far from established. ![]() Sicherer's superb and comprehensive article on the clinical significance of cross-reactivity between foods, which is: What is the current data regarding cross-reactivity of seeds (sesame, mustard, sunflower, and poppy)? If a toddler has a history and testing positive for an allergy to one seed, should testing for other seed allergies be considered? How accurate is ImmunoCap blood testing for seeds?Ī: I am going to preface my answer to your question with a quote from Dr. In summary, I am not able to help you in your advising patients except the concern about poppy and sesame and possibly mustard and sunflower. I searched the Allergome data base and the information I found was related to inhalant allergens, as you indicated. Poppy and sesame and mustard and sunflower may cross react (see below). However, the clinical evidence of the importance of this cross-reactivity is not well substantiated. The 2S, 7S, 11S storage proteins are common to many seeds and could provide cross reactivity. Because of the limited sensitivity of in vivo and in vitro testing, the most prudent way of establishing the tolerability of a compound of the same group in patients who especially require one is a graded challenge when other allergologic tests are negative.I think your summary of the literature suggesting that we do not have a great deal of detail on the cross reactivity of ingested seeds is a fair assessment. In assessing T cell-mediated cross-reactivity among contrast media, corticosteroids, anticonvulsants and heparins, delayed-reading intradermal tests and patch tests, together with lymphocyte transformation tests, can be performed. In choosing alternative compounds, skin testing has been used in evaluating IgE-mediated cross-reactivity between penicillins and cephalosporins, as well as among muscle relaxants. The main clinical problem deriving from cross-reactivity among drugs is the compelling need to choose a potentially cross-reactive compound and, therefore, to assess cross-reactivity by diagnostic tests. In the case of compounds provoking non-allergic hypersensitivity reactions, cross-reactivity is explained by a common pharmacological characteristic, such as the inhibitory effect of non-steroidal anti-inflammatory drugs on cyclooxygenase-1 and the capability of muscle relaxants or contrast media to release histamine through a non-immunologic mechanism. The former kind is usually explained by the presence of common antigenic determinants in the cross-reacting drugs. Cross-reactivity among drugs is either mediated by immunologic mechanisms or not. ![]()
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