Description
Pineapple Allergy Test
Code: f210
Latin name: Ananas comosus
Source material: Whole fresh fruit
Family: Bromeliaceae
Common names: Pineapple, Ananas, Piña
Pineapple is a food which may result in allergy symptoms in sensitised individuals.
Pineapple Allergy Test: Allergen Exposure
Originating in South America, cultivation of pineapples has since spread to many tropical locations, with the principal producer being Hawaii. The fruit is large and ovoid with a thick rind, the exterior of which resembles a pinecone, which explains its name.
The pineapple is a multiple fruit, with many spirally-arranged flowers along the axis, each producing a fleshy fruit that presses against the fruits of adjacent flowers and congeals with them to form a single fleshy fruit. The fruit is yellow, very juicy, sweet to acidic, and with a distinctly rich taste.
Fresh Pineapple is expensive and less commonly eaten in comparison to other fresh tropical fruits, principally due to difficulties in storage, transport, and control of ripening, and also in part because it is awkward to prepare, being tough to cut into and extract the edible portion of the fruit.
Pineapple is more commonly encountered tinned and is available as a juice or in juice combinations. Tinned pineapple is often used in desserts, salads, meat dishes and ‘fruit cocktail’.
Pineapple enzymes are useful in marinades and meat tenderisers, and have various industrial uses. Pineapple is a topical anti-inflammatory and proteolytic remedy.
Pineapple Allergy Test: Allergen Description
Two allergens present in pineapple have been characterised, a profilin and a protease. Additionally a chitinase protein has been shown to be present in pineapple stems, fruit and leaves, which is produced following ethylene induction, however its allergenic potential has not been evaluated.
The presence of a lipid transfer protein has been reported, but the allergen has not been characterised.
Pineapple Allergy Test: Potential Cross-Reactivity
Cross-reactivity between pineapple and latex was demonstrated in a study with latex-allergic patients, where 19% exhibited IgE antibodies to pineapple. Cross-reactivity has also been found with perennial rye grass pollen, and with papain.
As a result of the profilin present in pineapple, cross-reactivity with banana, bell pepper, celery and pineapple may occur, as seen in latex-fruit syndrome.
Cross-reactivity has been reported to occur between apricot, avocado, banana, cherry, chestnut, grape, kiwi, papaya, passion fruit, peach and pineapple.
Pineapple Allergy Test: Clinical Experience
Ingestion of pineapple has been reported to cause asthma, rhinitis and gastrointestinal symptoms. Angioedema and shock have also been observed. One study reports that pineapple is one of the most common self-reported triggers of atopic dermatitis.
Of 32 patients who became symptomatic shortly after they had eaten pineapple, most complained of intense itching and urticarial rashes, followed by abdominal pain, vomiting and diarrhoea; 68% became symptomatic within half an hour of eating pineapple; 20 presented with shock.
A cross-sectional, descriptive, questionnaire-based survey was conducted in Toulouse (France) schools to determine the prevalence of food allergies among schoolchildren. It was reported that, out of 2 716 questionnaires returned, 192 reported a food allergy. Of these, 7 reported adverse reactions to pineapple.
Other reactions
The protease Bromelain from pineapple is used frequently in industry as an enzyme, and may result in occupational allergy.
Bromelain is a natural mixture of proteolytic enzymes derived from the pineapple stem and has been shown to have anti-inflammatory activity when administered orally. Although most proteins given orally without an adjuvant (which would usually be food) are tolerated, researchers previously reported that long-term oral exposure to Bromelain stimulated the development of serum anti-Bromelain antibody titers.