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Published on: April 21, 2019
Clustered sensitivity to fungi: anaphylactic reactions caused by ingestive allergy to yeasts
Kristiina Airola1, Leena Petman, Soili Mäkinen-Kiljunen
1Skin and Allergy Hospital, Helsinki University Central Hospital, Finland. kristiina.airola@hus.fi
Background:
Respiratory allergy to environmental molds is relatively common, and fungal allergen-specific reactivity seems to cluster in certain persons. However, generalized reactions caused by ingested fungi have seldom been described.
Objective:
To describe a mold-sensitized patient who developed multiple anaphylactic reactions after ingesting a yeast preparation widely used by the food industry as flavoring in, for example, powdered and ready-made sauces.
Methods:
Skin prick tests and serum IgE tests were performed with inhalant and food allergens, including molds and yeasts, 2 pasta sauces consumed by the patient, individual sauce ingredients, and a food-quality yeast extract. Radioallergosorbent test inhibition was used for specificity studies.
Results:
Skin prick and serum IgE test results were positive to several molds (Cladosporium herbarum, Alternaria alternata, Aspergillus fumigatus, and Penicillium notatum), baker's yeast (Saccharomyces cerevisiae), Malassezia furfur, and champignon and to the 2 pasta sauces, the yeast ingredient, and a food-quality yeast extract. Radioallergosorbent test inhibition studies confirmed that the sauces contain cross-reacting yeast and mold allergens.
Conclusions:
This patient has a clustered sensitization to fungi characterized by allergy to environmental fungal allergens and to yeast extracts used in the food industry. Yeasts should be considered as possible ingestive allergens in mold-allergic patients.
Insights
Individuals with mold allergies may react to ingested yeast extracts found in foods. This study highlights a patient with mold sensitization who experienced anaphylaxis after consuming yeast-containing sauces, indicating yeast as a potential food allergen.
Area of Science:
- Immunology and Allergy
- Food Science
- Mycology
Background:
- Respiratory allergies to environmental molds are common, with some individuals exhibiting cross-reactivity to fungal allergens.
- Generalized allergic reactions from ingested fungi are less frequently documented.
- Yeast extracts are widely used as food flavorings, particularly in sauces and processed foods.
Observation:
- A patient with known mold sensitization experienced multiple anaphylactic reactions.
- Reactions occurred after ingesting pasta sauces containing yeast extract.
- The patient also reacted to specific mold species, baker's yeast (Saccharomyces cerevisiae), and food-grade yeast extract.
Findings:
- Skin prick and serum IgE tests confirmed sensitization to multiple molds (e.g., Cladosporium herbarum, Alternaria alternata) and yeasts (Saccharomyces cerevisiae, Malassezia furfur).
- Positive reactions were observed to the consumed pasta sauces and the yeast ingredient.
- Radioallergosorbent test inhibition studies demonstrated cross-reactivity between yeast, mold allergens, and the food products.
Implications:
- This case suggests that yeast extracts used in the food industry can act as significant ingestible allergens in mold-sensitized individuals.
- Clinicians should consider yeast-based food ingredients as potential triggers for allergic reactions in patients with known fungal allergies.
- Further research is warranted to understand the prevalence and mechanisms of cross-reactivity between environmental molds and food yeasts.
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