*Corresponding author: Estela Menéndez Rivero, Allergy Department, Virgen del Rocio University Hospital, Seville, Spain. Email address: [email protected]
Received 22 March 2025; Accepted 23 March 2025; Available online 1 May 2025
Copyright: Menéndez-Rivero E, et al.
License: This open access article is licensed under Creative Commons Attribution 4.0 International (CC BY 4.0). http://creativecommons.org/licenses/by/4.0/
Dear Editor,
Thank you for giving me this opportunity to respond to the letter from Öner Özdemir and Hacer Efnan Melek Arsoy regarding our article “Anaphylaxis due to green beans (Phaseolus vulgaris): A new phenotype?” published in Allergologia et Immunopathologia. We appreciate the interest in our work and the comments provided. We have carefully reviewed the points raised and would like to address them as follows:
Regarding the foods implicated in anaphylaxis, geographical differences, dietary habits, and the age groups studied result in diverse findings in published studies, as indicated by Hacer Efnan Melek Arsoy and Öner Özdemir. According to data from the Alergológica 20151 study, the most frequently implicated foods in anaphylaxis in Spain were fish, eggs, nuts, fruits, and legumes. When mentioning the foods that cause anaphylaxis in our article, our intention was not to establish a ranking but simply to provide a list.
It is true and also well known by our team that the way a food is prepared can alter the allergic response to it.2–4 In this case, since beans are consumed cooked rather than raw in Spain, as may also be the case with other foods, we did not consider it necessary to include this aspect in the discussion. The SDS-PAGE/IgE (Sodium Dodecyl Sulfate-Polyacrylamide Gel Electrophoresis/Immunoglobulin E)-western blot analysis provides ample and understandable results.
As previously described, the cross-reactivity of olive pollen as a cause of anaphylaxis is associated with fruits, not legumes.5 The patient had not reported oral allergy syndrome (OAS) with foods prior to the episode. Although some symptoms overlap with OAS, she developed pruritic papules on the thorax and upper extremities when the prick + prick test was performed with raw and cooked green beans, leading us to diagnose anaphylaxis rather than OAS.
Minor point: We did not want to alter the original figure, and the reason why it is in Spanish.
In summary, we value the scientific discussion and appreciate the opportunity to clarify these aspects. We hope our response provides clarity and contributes to a constructive dialogue on this topic.
1 Alergológica 2015. Factores epidemiológicos, clínicos y socioeconómicos de las enfermedades alérgicas en España en 2015. (Ed.) Capitulo 8. Sociedad Española de Alergología e Inmunología Clínica, 2017.
2 Prados-Castaño M, Reguero-Capilla M, Bartolomé B, Pastor-Vargas C, Ochando M, Quiralte J. Allergens responsible for anaphylaxis after olive fruit ingestion. J Investig Allergol Clin Immunol. 2023 Oct;33(5):403–4. 10.18176/jiaci.0880
3 De Aramburu Mera T, Labella Álvarez M, Baynova K, Bartolomé Zavala B, Prados Castaño M. Urticaria induced by ingestion of anemonia sulcata. J Investig Allergol Clin Immunol. 2018 Jun;28(3):208–9. 10.18176/jiaci.0244
4 Álvarez ML, Mera TA, Baynova K, Zavala BB, Castaño MP. Anaphylaxis due to roasted sunflower seeds with tolerance to raw sunflower seeds. Ann Allergy Asthma Immunol. 2018 Mar;120(3):330–1. 10.1016/j.anai.2017.12.008
5 Quiralte J, Palacios L, Rodríguez R, Cárdaba B, Arias de Saavedra JM, Villalba M, et al. Modelling diseases: The allergens of olea europaea pollen. J Investig Allergol Clin Immunol. 2007;17(1):76–82