Anaphylaxis due to green beans (Phaseolus vulgaris): a new phenotype?

Main Article Content

Estela Menéndez-Rivero
Manuel Prados Castaño
Isabel María Domínguez Romero
María José Martínez Martínez
Fernando Pineda De La Losa

Keywords

anaphylaxis, green beans, Phaseolus vulgaris, 10-kDa protein

Abstract

Background: Anaphylaxis is a severe allergic reaction with increasing incidence in Europe. It is often caused by food, insect venom, and drugs. White, red, and green beans (Phaseolus vulgaris) are legumes of the Fabaceae family consumed worldwide. In Spain, beans are the third most consumed legume species after chickpeas and lentils. Allergy to different legumes is very frequent in children and represents the fifth cause of food allergy.


Objective: Demonstrate a new phenotype in patients with green bean anaphylaxis.


Material and Methods: We report a 20-year-old woman who experienced anaphylaxis after consuming cooked green beans and required emergency treatment. There were no associated cofactors such as medications, alcohol, or physical exercise. After the episode, she tolerated well nuts, garlic, chickpeas, peas, and soy. Prick-prick with raw and cooked green bean, ISAC, SDS-PAGE and IgE-Western blot were performed.


Results: The prick+prick test with raw and cooked green beans was positive. The sodium dodecyl sulfate–polyacrylamide gel electrophoresis–immunoglobulin E (SDS-PAGE/IgE)–western blot analysis with white and red beans as well as cooked and raw green beans showed identification of several proteins with a molecular weight of 25–75 kDa in the extract of raw beans. Only one protein with a molecular weight of approximately 10 kDa was recognized in cooked beans.


Conclusion: We present a case of anaphylaxis induced by green beans (Phaseolus vulgaris) because of a 10-kDa protein and tolerance to other legumes, which suggests a new phenotype.

Abstract 854 | PDF Downloads 931 HTML Downloads 0 XML Downloads 187

References

1 Panesar SS, Javad S, de Silva D, Nwaru BI, Hickstein L, Muraro A, et al. The epidemiology of anaphylaxis in Europe: A systematic review. Allergy. 2013;68(11):1353–61. Epub 14 Oct 2013. 10.1111/all.12272

2 Bilò MB, Martini M, Tontini C, Corsi A, Antonicelli L. Anaphylaxis. Eur Ann Allergy Clin Immunol. 2021Jan;53(1): 4–17. Epub 7 Jan 2021. 10.23822/EurAnnACI.1764-1489.158

3 Ibáñez MD, Martínez M, Sánchez JJ, Fernández-Caldas E. Reactividad cruzada de las legumbres. Allergol et Immunopathol. 2003;31(3):151–61. 10.1016/S0301-0546(03)79283-0

4 Martínez Alonso JC, Callejo Melgosa JA, Fuentes Gonzalo MJ, Martín García C. Angioedema induced by inhalation of vapours from cooked white bean in a child. Allergolet Immunopathol (Madr). 2005;33(4):228–30. 10.1042/BST0330228

5 Cabanillas B, Jappe U, Novak N. Allergy to peanut, soybean, and other legumes: Recent advances in allergen characterization, stability to processing and IgE cross-reactivity. Mol Nutr Food Res. 2018;62(1)1-9. 10.1002/mnfr.201700446

6 Rougé P, Culerrier R, Thibau F, Didier A, Barre A. A case of severe anaphylaxis to kidney bean: Phaseolin (vicilin) and PHA (lectin) identified as putative allergens. Allergy. 2011;66:301–2. 10.1111/j.1398-9995.2010.02466.x

7 Pereira MJ, Belver MT, Pascual CY, Martín Esteban M. The allergenic significance of legumes. Allergol Immunopathol (Madr). 2002;30(6):346–53. 10.1016/s0301-0546(02)79152-0

8 Laiseca García J, Alonso Díaz de Durana MD, Gonzalez Bravo L, Pineda de la Losa F, Macías Iglesias J, Rosado A. Allergy to white kidney beans with cross-reactivity to red kidney beans: Report of 2 cases in children. J Investig Allergol Clin Immunol. 2023;33(2):141–2. 10.18176/jiaci.0818

9 Pastorello EA, Pravettoni V, Farioli L, Primavesi L, Scibilia J, Piantanida M, et al. Green bean (Phaseolus vulgaris): A new source of IgE-binding lipid transfer protein. J Agric Food Chem. 2010 Apr 14;58(7):4513–6. 10.1021/jf100213g

10 Asero R, Mistrello G, Roncarolo D, Amato S, Falagiani P. Why do lipid transfer protein-hypersensitive patients tolerate bean (and other legumes)? Int Arch Allergy Immunol. 2005;137:236–40. Epub 13 Jun 2005. 10.1159/000086336

11 Asero R, Mistrello G, Roncarolo D, Amato S, Van Ree L. String bean-induced anaphylaxis. Allergy. 2001;56(3):259–60. 10.1034/j.1398-9995.2001.056003259.

12 Smits M, Verhoeckx K, Knulst A, Welsing P, De Jong A, Gaspari M, et al. Co-sensitization between legumes is frequently seen, but variable and not always clinically relevant. Front Allergy. 2023;Mar16:4:1115022. eCollection 2023. 10.3389/falgy.2023.1115022