Role of Hidden Food Allergy/Intolerance in Chronic Disease
Ann Allergy Asthma Immunol 2001 Aug;87(2):140-5
Chickpea: a major food allergen in the Indian subcontinent and its clinical
and immunochemical correlation.
Patil SP, Niphadkar PV, Bapat MM. The Institute of Science, Mumbai, India.
BACKGROUND: The food allergy pattern
of a country is influenced by the foods most commonly consumed. In India,
the majority of the population consumes a vegetarian diet made up of pulse
(legumes), cereals, and vegetables. In contrast to many western countries,
chickpea preparations are consumed in large quantities in India. This
study reports for the first time chickpea hypersensitivity reactions diagnosed
with in vivo and in vitro tests.
METHODS: One thousand four hundred patients visiting allergy clinics
were randomly selected for the study. Those patients reporting an allergic
reaction on every occasion after eating chickpea were considered history-positive.
Modified prick tests were performed with chickpea and other members of
the legume family on all these patients. The claims of the history-positive
patients were verified with double-blind, placebo-controlled food challenges
(DBPCFCs). Proteins in chickpea extracts were separated by sodium dodecyl
sulfate-polyacrylamide gel electrophoresis and transferred on nitrocellulose
paper. Serum specimens from history-positive patients were analyzed by
immunoblot and ELISA. To verify the IgE specificity, an immunoblot inhibition
assay was also performed.
RESULTS: Of the 1,400 patients screened, 142 patients were history-positive
to some food and 59 of these implicated chickpeas. Forty-one patients
were skin test-positive and 31 were DBPCFC-positive for chickpea. The
predominant symptoms after chickpea ingestion were respiratory. The ELISA
results did not correlate well with the DBPCFC results; however, the skin
test results correlated with DBPCFC in 75% of patients. Immunoblot analysis
showed that 70, 64, 35, and 26 kD proteins were major allergens.
CONCLUSIONS: Chickpea is an important source of allergen that
can cause IgE-mediated hypersensitivity reactions ranging from rhinitis