Hypersensitivity to banana in latex-allergic patients. Identification of two major banana allergens of 33 and 37 kD patients with anaphylaxis; 3 with local sensitivity and 1 with severe abdominal cramping and nausea. (Beezhold et al. 1996) [ 281] Hevein-like protein domains as a possible cause for allergen cross-reactivity between latex and banana. CAP RAST (Delbourg et al. 1996) [ 42] (Grob et al. 2002) [ 600] (Asero et al. 2003) [ 582] (Sánchez-Monge et al 1999) [ 493]

IgE cross-reactivity was demonstrated by RAST-inhibition between latex, avocado, chestnut and banana (Blanco et al. 1994) [ 288] out of 4 patients were IgE-CAP positive (> or = class 2) and two were banana-profilin EAST positive (Grob et al. 2002) [ 600] Banana is the crescent-shaped edible fruit of any of several species of the musaceous genus Musa, which are tropical and subtropical herbaceous tree-like plants. Meanwhile, Plantain specifically refers to the fruit of Musa paradisiaca, a large tropical musaceous plant, eaten as a staple food in many tropical regions. World banana production is about 65 million tonnes per year, concentrated in Africa, Asia, the Caribbean and Latin America, due to climatic conditions. In Europe, estimated yearly consumption varies among countries, from 5 to 10 kg/capita in the Mediterranean area and the Netherlands, to more than 15 kg/capita in Sweden. Process, chemical, enzymatic: Ba 1 and Ba2 are thermolabile allergens (Sanchez-Monge et al. 1999) [ 493]patients with anaphylaxis, 6 cases with angioedema/urticaria, 2 cases with vomits, one case with bronchial asthma, and another case with rhinoconjuntivitis (Blanco et al. 1994) [ 287].

Interestingly, the content of these allergic proteins in fruits can be increased by certain chemical or physical factors. For example, some chemical products used for ripening bananas, clearly induce allergens, therefore rising fruit allergenicity. These proteins seem to be inactivated by heating, which could explain why some plant foods containing these allergens, but only consumed after cooking, are not associated with this syndrome. The pulp of banana was extract with NTE 1N solution: NaCl 1mol/L, Tris 0,1mol/lL ethylenediaminetetraacetic acid 0.01mol/L (Lavaud et al 1995) [ 102] patients with asthma; 2 with rhinitis; 2 with eczema; 3 with urticaria; 2 with angioedema and 2 with OAS (Makinen-Kiljunen 1994) [ 405] Isolation and characterization of major banana allergens: identification as fruit class I chitinases.

References (0)

Cinquetti et al. (1995) [ 304] reported a 3-year-old boy who developed an anaphylactic reaction following banana ingestion and who presented an associated immediate hypersensitivity to latex. Banana furits were peeled, freeze-dried, ground and defatted with cold acetone. The residue was extracted with PBS buffer, centrifuged and dialysed against water. The protein preparation was fractionated by affinity-chromatography on a regenerated chitin column equilibrated with 20 mM Tris-HCl. Elution was performed with 20 mM sodium acetate pH 5.5 followed by 20 mM acetic acid pH 3.2 to elute the retained proteins. The later eluate was fractionated by cation exchange chromatography on a Mono S HR 5/5 column equilibrated with 10 mM sodium acetate. Elution was performed with a salt linear gradient of 0-50% of 0.5 M NaCl (Sanchez-Monge et al. 1999) [ 493] Latex is the milky sap of Hevea brasiliensis tree, which is processed to manufacture multiple products, including gloves, condoms and balloons. Latex allergy has been recognized as a very important health problem, due to increase in frequency, and to its ability to induce severe reactions. It is noteworthy that as much as 50% of latex allergic patients may have cross-allergic reactions to certain plant-derived foods (mainly banana, chestnut, avocado and kiwi), a condition known as the latex-fruit syndrome. Allergens responsible for this syndrome seem to be a group of shared plant proteins, to which patients react. out of 4 patients allergic to natural rubber latex had a positive reaction to a 32-kDa banana protein (Mikkola rt al. 1998) [ 418]

Due to cross-reactivity, patients considered to be at high risk of banana allergy, as for example subjects allergic to latex, avocado, chestnut, kiwi, melon, or to certain pollens, should be carefully asked about possible previous adverse reactions on banana ingestion. Unless consumption of banana with perfect tolerance is reported by the patient, a banana-free diet should be recommended, until proper diagnosis - on the basis of objective procedures to evaluate clinical reactivity - is made. IgE from 9/10 group 2 (fruit and latex allergy) sera reacted to banana proteins. The most important allergen in the extract was at about 30 kDa. A minor band was found at 35 kDa in one serum. Two sera from group 1 (monoallergy to latex) reacted with the 30 kDa protein (Lavaud et al. 1995) [ 102] Moderate - On your feet for much of the day, either standing or occasional slow paced walking. Typical jobs: shop assistant, teacher, chef/cook, bar worker, engineer. Fresh banana (Rodriguez et al 1993) [ 492], (Blanco et al 1994) [ 288] [ 287], (Mäkinen-Kiljunen 1994) [ 405], (Alenius et al 1996) [ 5], (Delbourg et al 1996) [ 42], (Grob et al. 2002) [ 600]Moderately active - Do light to moderate intensity exercise 3-4 times a week. E.g. going to the gym / swimming / cycling / horse riding / dance classes / playing golf. Daily dog walking (brisk pace, twice a day). Crossreactivity between allergens in natural rubber latex and banana studied by immunoblot inhibition. High IgE cross-reactivity of banana profilin with birch pollen profilin, Bet v 2, and latex profilin, Hev b 8, was demonstrated by immunoblot inhibition as well as EAST inhibition experiments (Reindl et al. 2002) [ 601] Nature of main cross-reacting proteins: Ba 1 and Ba2 are panallergens involved in the latex-fruit syndrome. There are cross-reactions with other endochitinases of fruits such as avocado, mango, kiwi, or seeds such as chestnut (Cas s 5, 85%) (Sanchez-Monge et al. 1999 [ 493]; Moller et al. 1998 [ 115]) and latex (Alenius et al. 1996 [ 5]). Amino terminal sequencing revealed that both the 32- and 33-kDa proteins (16 residues analyzed) had 80% identity to the N-terminus of hevein (Mikkola et al. 1998) [ 418]