Risk of allergic reactions to wine, in milk, egg and fish-allergic patients

<p>Abstract</p> <p>Background</p> <p>European legislators and wine producers still debate on the requirement for labeling of wines fined with potentially allergenic food proteins (casein, egg white or fish-derived isinglass). We investigated whether wines fined with known concentrations of these proteins have the potential to provoke clinical allergic reactions in relevant patients.</p> <p>Methods</p> <p>In-house wines were produced for the study, fined with different concentrations of casein (n = 7), egg albumin (n = 1) and isinglass (n = 3). ELISA and PCR kits specific for the respective proteins were used to identify the fining agents. Skin prick tests and basophil activation tests were performed in patients with confirmed IgE-mediated relevant food allergies (n = 24). A wine consumption questionnaire and detailed history on possible reactions to wine was obtained in a multinational cohort of milk, egg or fish allergic patients (n = 53) and patients allergic to irrelevant foods as controls (n = 13).</p> <p>Results</p> <p>Fining agents were not detectable in wines with the available laboratory methods. Nevertheless, positive skin prick test reactions and basophil activation to the relevant wines were observed in the majority of patients with allergy to milk, egg or fish, correlating with the concentration of the fining agent. Among patients consuming wine, reported reactions were few and mild and similar with the ones reported from the control group.</p> <p>Conclusion</p> <p>Casein, isinglass or egg, remaining in traces in wine after fining, present a very low risk for the respective food allergic consumers. Physician and patient awareness campaigns may be more suitable than generalized labeling to address this issue, as the latter may have negative impact on both non-allergic and allergic consumers.</p

Etude du risque allergique à différentes protéines alimentaires Mise au point de modèle de souris allergiques à l'arachide, à l'albumine, à la caséine et à la colle de poisson

Allergic diseases are a common cause of illness in most industrialized countries. The prevalence of allergic disorders has been increasing in the past 10-15 years. Peanut, cow's milk, eggs and fish are strong allergens frequently found in many food products (flours, wines...). Therefore Codex Alimentarius called for the mandatory and comprehensive labelling of all products prepared with these proteins. Our purpose was to establish animal models producing specific immunoglobulin IgE and IgG1 to some food proteins (peanut, fish, albumin and casein) and developing anaphylactic reactions. First of all, we studied wine allergy in four strains of mice (C3H, CBA, DAB/2 and SJL). After the various steps of clarifying, we showed that the settling, filtration and ageing are important stages for the elimination of the proteins used for clarifying the wines. Then, we studied the cross reactivity of peanut-specific antibodies with lupine in four mouse strains. More specifically, C3H, CBA, SJL and BALB/c mice were sensitized with peanut. We showed that mice of different genetic backgrounds can be sensitized to peanut by ip injection to develop anti-peanut Abs that cross react with lupine. Cross-allergenicity may not directly correlate with the presence of cross-reactive Abs since no clinical symptoms of crossallergenicity were seen after ip challenge with lupine. Lastly, we studied the antibody responses to peanut induced in mice after several routes of sensitization in the presence of several adjuvants. We showed that peanut given in the diet with or without adjuvant did not sensitize C3H and CBA mice or cause any allergies. In conclusion, the ip immunization in the presence of alum as an adjuvant remained the fastest means and most effective way to obtain a model of allergic mice.L'allergie alimentaire est actuellement inquiétante par sa fréquence dans les pays industrialisés. En effet, son incidence est en constante et rapide augmentation. Parmi les allergènes majeurs: l'arachide, le poisson, l'oeuf et le lait de vache sont couramment trouvés dans de nombreux produits agro-alimentaires (farines, vins...) d'où l'obligation d'un étiquetage systématique. Notre objectif était d'établir des modèles de souris allergiques, à certaines protéines alimentaires (arachide, colle de poisson, albumine et caséine), caractérisés par la production in vivo d'IgE et d'IgG1 sériques spécifiques de ces protéines et par les manifestations cliniques suites aux tests de provocation avec ces mêmes protéines. Nous avons étudié, tout d'abord, l'allergénicité des vins sur quatre souches de souris (C3H, CBA, DAB/2 et SJL) après les différentes étapes du collage et nous avons montré que la décantation, la filtration et le vieillissement sont des étapes importantes pour l'élimination des produits utilisés pour la clarification des vins. Ensuite, nous avons étudié la réaction croisée arachide-lupin chez les souris C3H, CBA, SJL et BALB/c sensibilisées à l'arachide et nous avons montré que la réaction croisée arachidelupin in vitro n'implique pas une allergie croisée arachide-lupin. Enfin, nous avons, expérimenté et comparé plusieurs approches et voies de sensibilisation pour identifier les facteurs environnementaux nécessaires à la manifestation de la réponse allergique. Nous avons conclu que la sensibilisation avec l'arachide par voie orale naturelle sur un modèle de souris sensibilisable (C3H et CBA), en présence et en absence d'adjuvant, ne provoque pas d'allergie. En conclusion, la voie intrapéritonéale en présence d'adjuvant reste le moyen le plus rapide et le plus efficace pour obtenir un modèle de souris allergiques