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Association Between the Seed Storage Proteins 2S Albumin and 11S Globulin and Severe Allergic Reaction After Flaxseed Intake

Bueno-Díaz C1, Biserni C2, Martín-Pedraza L3, de las Heras M4, Blanco C5, Vázquez-Cortés S6, Fernández-Rivas M6, Batanero E1, Cuesta-Herranz J4, Villalba M1

Department of Biochemistry and Molecular Biology, Chemistry Faculty, Complutense University of Madrid, Madrid, Spain
2Department of Food, Environmental and Nutritional Sciences, DEFENS, University of Milan, Milan, Italy
3Allergy Department, Hospital Universitario Infanta Leonor, Madrid, Spain
4Hospital Universitario Fundación Jiménez Díaz, Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD, UAM), RETIC ARADyAL, Instituto de Salud Carlos III, Madrid, Spain
5Allergy Department, Hospital Universitario La Princesa, Instituto de Investigación Sanitaria Princesa (IP), Madrid, Spain
6Allergy Department, Hospital Clínico San Carlos, IdISSC, ARADyAL, Madrid, Spain

J Investig Allergol Clin Immunol 2022; Vol 32(5) : 375-382
doi: 10.18176/jiaci.0713

Background: Given the increased popularity of flaxseed in meals, several cases of allergy to these seeds have been reported. Little is known about the allergens implicated in hypersensitivity reactions to flaxseed. The present study aimed to identify the allergens involved in IgE-mediated reactions in 5 patients with a clinical history of severe systemic symptoms after flaxseed consumption.
Methods: Proteins that were potential allergens with IgE-binding capacity were purified from flaxseed extract using chromatography and identified via MALDI-TOF mass spectrometry. Immunoassays were performed using the 5 allergic patients’ sera tested individually and as a pool.
Results: Immunoblotting of the flaxseed extract revealed a low-molecular-mass protein (around 13 kDa) in 4 of the 5 patients, while a protein of approximately 55 kDa was detected in 2 patients. The proteins were identified by mass spectrometry as flaxseed 2S albumin, which is included in the WHO/IUIS allergen nomenclature as Lin u 1, and 11S globulin. Inhibition assays revealed in vitro IgE-mediated cross-reactivity between Lin u 1 and peanut and cashew nut proteins, while IgE-mediated recognition of 11S globulin by patients’ sera was partially inhibited by several plant-derived sources.
Conclusions: Seed storage proteins from flaxseed were involved in the development of severe symptoms in the 5 patients studied and exhibited cross-reactivity with other allergenic sources. Besides the severity of flaxseed allergy in patients sensitized to 2S albumin, this is the first time that 11S globulin has been identified as a potential allergen. Taking these data into account should ensure a more accurate diagnosis.

Key words: Food allergy, Flaxseed, 2S albumin, 11S globulin, Cross-reactivity, Anaphylaxis

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