High prevalence of lupin allergy among patients with peanut allergy: Identification of γ-conglutin as major allergen

Ann Allergy Asthma Immunol. 2023 Feb;130(2):225-232. doi: 10.1016/j.anai.2022.09.036. Epub 2022 Oct 1.

Abstract

Background: Lupin is a protein-rich legume with a growing presence in the food market worldwide. With increased consumption, lupin allergy (LA) reports are also rising. Uncertainties exist on the cross-reactivity between peanut and lupin, the allergenic potential of different lupin species, and sensitization patterns among different populations.

Objective: To evaluate the molecular basis of LA and to determine lupin allergens from 3 different species that may be involved in peanut allergy (PA) cross-reactivity.

Methods: A total of 43 subjects with PA, those with LA, or controls without food allergy were evaluated with skin prick tests (SPTs) and specific IgEs (sIgEs). Lupin-sensitized subjects were offered a lupin oral food challenge (OFC). Immunoblots and enzyme-linked immunosorbent assays were performed on sera from lupin-sensitized subjects.

Results: In this study, 44% of the PA subjects were confirmed to have LA by OFC. Anaphylaxis was the most frequent manifestation after lupin consumption, with a minimal eliciting dosage of 1 g lupin flour. There was no difference in lupin sIgE or SPT wheal size between lupin-sensitized and confirmed LA subjects or in the severity of symptoms among confirmed LA subjects. Sera from lupin-sensitized subjects uniformly reacted to all 3 different lupin species. Immunoblotting and enzyme-linked immunosorbent assays revealed immunoglobulin E binding to α- and γ-conglutin in all analyzed sera, whereas α- and β-conglutin recognition was variable.

Conclusion: Our findings reveal a high prevalence of LA among PA subjects, emphasizing lupin must be labeled as an allergen in foods. Owing to high variability in lupin-sIgE and lupin-SPT results, LA diagnosis may require OFC. In our population, γ-conglutin is the major allergen of lupin.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Allergens
  • Arachis
  • Food Hypersensitivity*
  • Humans
  • Immunoglobulin E
  • Lupinus* / adverse effects
  • Peanut Hypersensitivity* / diagnosis
  • Peanut Hypersensitivity* / epidemiology
  • Prevalence
  • Skin Tests / methods

Substances

  • Allergens
  • Immunoglobulin E