Amongst Anacardiaceae members, allergic cross-reactivity between pistachio and cashew nut is well recognised and avoidance of both nuts is advised in case of a confirmed cashew nut allergy. Photos are from Shutterstock.Ĭross-sensitisation between cashew and other tree nuts, such as hazelnut and walnut has been reported at IgE level as well as at T-cell level where mostly Ana o 1 and Ana o 2 acted as cross-reacting allergens. Phylogenetic classification of Anacardiaceae family members in accordance to other tree nuts: almond ( Prunus dulcis), Brazil nut ( Bertholletia excelsa), cashew ( Anacardium accidentale), chestnut (genus Castanea), hazelnut (genus Corylus), macademia (genus Macademia), mango (genus Magnifera), pecan ( Carya illinoinensis), pine nut ( Pinus koraiensis), pink peppercorn ( Schinus terebinthifolia/molle), pistachio ( Pistacia vera), sumac (genus Rhus), and walnut ( Juglans regia). Bet v 1 homologues) and pan allergens (profilin and hevein-related proteins) present in tree nuts and other botanically related foods. The underlying reason is thought to be the major sequential and structural homology between the highly abundant seed storage proteins (glycinins, vicilins, and 2S albumins) and to a lesser extent the defence-related proteins (nsLTP, chitinases, and PR-10 proteins, e.g. Several studies have shown that a tree nut-allergic patient has considerable chance of being sensitised (86%) or allergic to multiple tree nuts (35–37% based on clinical history and 14–47% based on food challenges ). This raises the question whether cashew nut allergy manifests from a primary sensitisation or is caused by cross-sensitisation to botanically related or unrelated foods.Ĭashew belongs to the family of Anacardiaceae, categorised under the taxonomic class of Magnoliopsida to which most common tree nuts belong, as depicted in Figure 1. Often, young children suffer from a cashew nut allergy without a clear history of cashew nut consumption. Karger AG, BaselĬashew nut allergy has been recognised as a severe tree nut allergy amongst (Dutch) children and young adults, and its prevalence seems to be increasing. The clinical relevance of this widespread cross-sensitisation is unknown. In this study, putative novel allergens were identified in cashew, pistachio, and pink peppercorn, which may pose factors that underlie the observed cross-sensitivity to these species. Conclusions: Results demonstrate the in vitro presence of IgE cross-sensitisation in children towards multiple Anacardiaceae species. In addition, a putative luminal binding protein was identified, which, among others, may be involved in cross-reactivity between several Anacardiaceae species. In pink peppercorn, putative albumin- and legumin-type seed storage proteins were found to cross-react with serum of cashew nut-sensitised subjects in vitro. Subjects co-sensitised to Anacardiaceae species displayed a different allergen recognition pattern than subjects sensitised to common tree nuts. Of these, 50% were mono-sensitised to cashew nuts, 19% were co-sensitised to Anacardiaceae species, and 31% were co-sensitised to tree nuts. Results: From the 56 subjects analysed, 36 were positive on dot blot for cashew nut (63%). Allergen cross-reactivity patterns between Anacardiaceae species were subsequently examined by SDS-PAGE and immunoblot inhibition, and IgE-reactive allergens were identified by LC-MS/MS. Method: Sera from children with a suspected cashew nut allergy ( n = 56) were assessed for IgE sensitisation to common tree nuts, mango, pink peppercorn, and sumac using dot blot technique. We aimed to determine IgE cross-sensitisation and cross-reactivity profiles in cashew nut-sensitised subjects, towards botanically related proteins of other Anacardiaceae family members and related tree nut species. Objectives: Cashew nut allergic individuals may cross-react to foods that are phylogenetically related to cashew. IgE cross-reactivity between cashew and pistachio nut is well described however, the ability of cashew nut-specific IgE to cross-react to common tree nut species and other Anacardiaceae, like mango, pink peppercorn, or sumac is largely unknown. Background: Allergic sensitisation towards cashew nut often happens without a clear history of eating cashew nut.
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