Oral allergy syndrome to jackfruit (Artocarpus integrifolia)
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Attergy 1997:52:428-431 Copyrigiit © Miini3 mm with
By means of RAST inhibition studies with rBet v the presence of a negative response to the glycerol
1 and rBet v 2, we could demonstrate specific control was considered to be positive and scored
sensitization to jackfruit. as +, a wheal >5-10 mm as -(--H, and a wheal >10-
15 mm as + + +.
Case report
A 30-year-old man from the Philippines, living for Total and specific IgE
many years in Switzerland, had suffered since 1989
from seasonal rhinoconjunctivitis and asthma from Total and allergen-specific IgE was measured by
spring until late summer. He noted the appearance the Pharmacia CAP System FEIA, according to the
of OAS after contact with raw apple, peach, and raw manufacturer's instructions.
celery. Recently, he had also experienced itching and Jackfruit ImmunoCAP was provided by the
burning in the mouth and throat after eating jackfruit. Pharmacia Research Forum.
428OAS to jackfrnit
Fig. 1. Positive prick-to-prick test to jackfruit {Artocarpus integrifolia).
RAST inhibition Table 1. Specific IgE to inhalants and foods (Pharmacia CAP)
RAST-inhibition experiments with the patient's CAP class kU/l
serum were performed with recombinant (r)Bet v
Inhalants
1 and rBet v 2 and with jackfruit according to Yman Birch 52
et al. (20). rBet V 1 and rBet v 2 were provided by Hazel 43
Biomay Produktions- und Handelsgesellschaft Alder 35
mbH, Salzburg, Austria. Beech 23
Oak 17
Ash 1.5
Results Olive 2.4
Grass mix 41.5
The routine SPT were + + -I- positive for birch and 1.6
Mugwort
+ + positive for alder, ash, hazel, grass mix, and
Foods
mugwort pollen, but negative for house-dust mites, 8.2
Hazelnut
storage mites, animal danders, cow's milk, and Apple 3
hen's egg white. Kiwi 1.1
The prick-to-prick testing ehcited strong wheal- Melon 0.9
and-flare reactions (+-I-, wheal > 7 mm) to apple, Carrot 51
peach, celery and jackfruit (-t- + +, wheal >10mm) Celery 4.5
(Fig. 1 shows the prick-to-prick reaction with jack- Parsley 1.7
fruit in respect to the histamine control and the Jackfruit 8.2
jackfruit itself).
429Wiithrich et al.
1.2 T
1 --
0.8
I
(A
- Jackfruit
0.6 4- - Bet V 1
- Bet V 2
Icc
0.4 -
0.2 -
0.0001 0.001 0.01 0.1
inhibitor cone.
Fig. 2. tnhibition experiments with rBet v 1 and rBet v 2 in jackfruit-positive serum. Neither rBet v 1 nor Bel v 2 (profilin) could
inhibit specific IgE response to jackfruit, whereas jackfruit extract dose-dependently inhibited positive jackfruit response.
The total IgE level was 640 kU/1. The RAST avocado (25), and lychee (12) has been described
CAP (Table 1) showed multiple sensitization to in recent years. Jackfruit (Artocarpus integrifolia)
different pollens and various fruits and vegetables belongs to the Moraceae family (mulberry) and to
as well as to jackfruit (CAP class 3, 6.1 kU/1). the genus Artocarpus (breadfruit tree). Other
In the RAST-inhibition experiments, neither members of this family are Morus nigra (common
rBet V 1 nor rBet v 2 could inhibit the specific IgE mulberry), Castilla elastica (caoutchouc tree), and
response to jackfruit (Fig. 2). Brosinum galactodendron (milk tree).
To our knowledge, this is the first report des-
cribing an allergic reaction to jackfruit. Surpris-
Discussion ingly, the sensitization to jackfruit in this case is not
Patients with allergy to pollens frequently suffer likely to be explained by cross-reactions between
from various clinical symptoms after eating differ- Bet V 1 and Bet v 2 analogs. Whether the reaction
ent foods. Well-known examples are the association to jackfruit is species-specific or whether other
between birch-pollen allergy and allergic reactions cross-reacting allergenic components of protein or
in the mouth and throat (OAS) after ingestion of carbohydrate nature exist (26), should be investi-
raw fruits and vegetables. This phenomenon is mainly gated further.
due to the existence of cross-reactive allergens in
birch pollen and related foods (1-8). Bet v 1- and
Bet V 2-related allergens have been identified as References
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