fragments, as well as intact proteins, have the poten-
tial to act as sensitizers. Similarly, such large frag-
ments may be able to cross-link mast cell IgE,
leading to histamine release. Whilst the bulk of food
proteins are broken down into immunologically in-
active fragments, very small proportions (milligram
amounts) of material, which are still immunologically
important, may escape digestion. Circumstantial evi-
dence that food proteins can resist digestion and cross
the gut barrier is offered by the presence of antibodies
to a wide range of food proteins in the circulation of
normal individuals. The presence of proteins, such
as ovalbumin in the blood of individuals after con-
sumption of egg, also supports the premise that intact
proteins, albeit in small quantities, can enter the body.
However, although the nature of the transported pro-
teins has not been clearly defined, a large proportion
of cow’s milk allergic patients have specific IgE, which
recognizes proteolyzed b-Lg, some of which reacts
better with the hydrolyzed protein than the intact
form. Thus, the resistance of allergens to the effects
of the digestive process plays an important role in
determining the allergenic potency of food proteins.
Allergens of Plant Origin
0008 Many plant food allergens are pathogen-related (PR)
proteins, which are produced by the plant as a defense
against pathogenic microorganisms, insects, and
invertebrate pests. They have been classified into a
number of families on the basis of sequence similar-
ities or enzymic properties and are receiving attention
from plant breeders, as a tool for GM crops, because
of their protective activities against agricultural pests.
However, they are cross-reactive allergens in fruits,
vegetables, and pollen. Allergens, other than PR
proteins, are inhibitors of proteases and a-amylases,
profilins (actin-binding proteins), seed-storage pro-
teins (albumins, globulins, and prolamins), proteases
and lectins (agglutinins). These are summarized in
Table 1.
Fruit and Vegetables
0009 Fruit allergy is increasing and is often associated with
birch- and grass pollinosis, as well as latex–fruit syn-
drome. Oral allergy syndrome is a manifestation of
food allergy, where certain foods cause itching or
hives when they touch the lips and mouth. Fruit and
vegetables are often responsible for this reaction,
owing to pollen cross-reactivity, and many fruit
allergens are PR proteins.
0010 Allergens homologous to the major birch pollen
allergen Bet v 1 (PR group 10), are found in apple
Mal d 1, cherry Pru av 1, apricot Pru ar 1, pear Pyr
c1, carrot Dau c 1, and celery Api g 1, but may trigger
responses to many other fruits and vegetables. By
contrast, in areas free of birch, the major allergens
in patients sensitized to Rosaceae fruits are lipid
transfer proteins (LTP, PR group 14), 9-kDa proteins
that often have antifungal and antibacterial activities.
LTP allergens characterized include apple Mal d 3 and
peach Pru p 3, but homologous proteins are found in
a range of plant-derived foods (vegetables, nuts, and
seeds), and as a consequence, LTPs have been de-
scribed as panallergens.
0011Class-I chitinases (PR group 3) are a group of car-
bohydrases active against the exoskeletons of insects
and the cell walls of fungi. They are widely distrib-
uted in plants and are also termed panallergens, with
characterized allergens including those from avocado
(Prs a 1) and banana (Mus p 1.2). Wound-induced
chitinases (Win) have been extracted from virus-
infected leaves (PR group 4) and have been reported
in turnip, tomato, and potato. Another group of
carbohydrases, the glucanases (PR group 2), are
active against fungal cell walls, have been isolated
from latex, and are recognized by IgE from food-
allergic patients with hypersensitivity to banana,
potato, and tomato. Lastly, thaumatin-like proteins
(PR group 5) are another group of allergens that have
antifungal and/or antibacterial activity, allergens
having been characterized in apple (Mal d 2)and
cherry (Pru a 2).
0012NonPR protein allergens include the profilins, ori-
ginally identified from birch pollen, Bet v2, which are
now recognized as cross-reactive plant allergens in a
wide range of fruits, vegetables, nuts, and seeds. Thiol
proteases (proteolytic enzymes) have also been iden-
tified as allergens in kiwi Act c 1, papaya, fig, pine-
apple, and soybean. Patatin, a storage protein from
potato, has also been shown to be an allergen in raw
potato and cross-react with the latex allergen, Hev v 7.
Tree Nut and Peanuts
0013Nut allergy is the most common form of food allergy
and the most common cause of death by anaphylaxis.
The major allergens are 2S albumins and the 7S and
11/12S globulins. In peanut, three of the major
allergens are major storage proteins: Ara h 1 is the
7S globulin, conarachin, a vicilin-like glycoprotein;
Ara h 2 is a 2S albumin; and Ara h 3, is a subunit of
the legumin-like 11S globulin, arachin. The IgE bind-
ing epitopes of Ara h 1 and 2 have been determined
and mutagenized to alter their activity. Brazil nut
contains a 2S storage protein allergen, Ber e 1;a
major allergen is a 2S albumin with a high methionine
content. Related 2S albumins are found in walnut,
Jug r 1, which also contains a 7S globulin allergen,
Jug r 2. In addition to storage protein allergens, chest-
nut contains an endochitinase allergen Cas s 1,and
ALLERGENS 145