Prevalence data are based on different diagnostic procedures. While the prevalence of sensitization (sensitivity) can be estimated by SPT, RAST, and immunoblot, a clinical relevant sensitization (allergy) is evaluated by convincing history (anamnesis) or food challenge tests (ideally by DBPCFC).
1.1 Subjects with Atopic or Other Diseases
| Country / Subjects | Incidences of Allergy / Sensitivity | References |
| Crotia, Zagreb
35 animal feed workers |
sunflower seed 54% (SPT) | Zuskin et al. 1992 |
| Italy, Genoa
132 pollen and food sensitive patients |
sunflower seed 0.7%
(incidents of hypersensitivity) |
Troise et al. 1992 |
| Israel, Tel-Aviv
112 patients with food allergy (onset after 10 years of age) |
sunflower seed 78% (SPT, n=108)
sunflower seed 35% (food challenge, n=71) |
Kivity et al. 1994 |
| Netherlands
131 cases of food-induced anaphylaxis (from 1993-1997) |
sunflower seed 0.8% (survey, reported to the TNO Nutrition and Food Research Institute) | European Commission 1998 |
| Spain, Gran Canaria
102 adults with symptoms after ingestion of specific foods |
sunflower seed 9% (SPT, RAST) | Castillo et al. 1996 |
| Spain, Madrid
355 food allergic children |
sunflower seed 4.2% (SPT, RAST) | Crespo et al. 1995a |
| Spain, Madrid
29 plant-derived food allergic patients |
sunflower seed 3.4% (SPT / RAST) | Diez-Gomez et al. 1999 |
| Spain, Plasencia (Caceres)
262 patients with pollinosis |
sunflower seed 4.5% (self-reported) | Garcia-Ortiz et al. 1995 |
| Spain, Salamanca
a) 84 mugwort sensitive patients without other pollen sensitizations b) 57 fruit allergic patients (age of 6-56 years, mean 21.5) |
a) sunflower seed 13%
honey 17% (RAST) b) sunflower seed 8.8% (clinical history) |
a) Garcia-Ortiz et al. 1996
b) Garcia Ortiz et al. 1998 |
| Sweden
61 cases of food-induced anaphylaxis (from 1994-1996) |
sunflower seed 1.6% (reported to the National Food Administration) | European Commission 1998 |
| Sweden, Stockhom
84 atopic patients with positive SPT to at least 1 common allergen |
sunflower seed 21% (SPT)
sunflower seed 3.6% (RAST) |
Axelsson et al. 1994 |
| Switzerland, Zurich
402 food allergic adults (study period 1978-87) |
sunflower seed 0.2%
(anamnesis, clinical relevance, diagnostic tests) |
Wüthrich 1993 |
1.2 Associated Allergies
| Country / Subjects | Allergy / Sensitivity | References |
| Spain, Madrid
52 children sensitized to sunflower seeds |
pollen 90% (SPT) | Crespo et al. 1995b |
2 Symptoms of Sunflower Seed Allergy
| Symptoms & Case Reports | References |
| Systemic reactions
anaphylaxis (1, 4, 5, 7, 8, 10, 11, 12, 15, 16) Symptoms of skin and mucous membranes
Gastrointestinal symptoms
Respiratory symptoms
Other symptoms
|
(1) Noyes et al. 1979
(2) Bernstein et al. 1982 (3) Bousquet et al. 1985 * (4) Halsey et al. 1986 (5) Stricker et al. 1986 (6) Fernández et al. 1993 * (7) Axelsson et al. 1994 (8) Iwaya et al. 1994 (9) Kanny et al. 1994 (10) Kivity et al. 1994 (11) Garcia Ortiz et al. 1995 (12) Fäh et al. 1995 (13) Duran et al. 1997 (14) Vandenplas et al. 1998 ** (15) Kelly et al. 2000 (16) Zitouni et al. 2000 * symptoms after ingestion of honey containing sunflower
pollen
|
| Onset of Symptoms
Symptoms occured within 15 min in DBPCFC and within 1 h in open challenge in 2 sunflower seed allergic patients (1) |
(1) Bernstein et al. 1982 |
| Percentage of reactions
Sunflower seed Oral pruritus in 67%, anaphylaxis in 33%, angioedema of lips/mouth in 33%, gastrointestinal symptoms in 25%, urticaria in 17%, and rhinoconjunctivitis in 8% of 12 patients with reported sunflower seed allergy (1) Sunflower pollen (honey) Itching in mouth in 52%, gastrointestinal symptoms in 17%, contact urticaria/angioedema in 9%, bronchial asthma in 30%, generalized urticaria in 9%, and anaphylaxis in 17% in 23 patients allergic to honey (2) |
(1) Garcia Ortiz et al. 1995
(2) Bauer et al. 1996 |
| Threshold for Elicitation of Symptoms
Doses of 14.6 g of sunflower seeds elicited allergic symptoms in 2 sunflower seed allergic patients (DBPCFC and open challenge, respectively) (1) A dose of 5 mL sunflower seed oil induced allergic symptoms in a sunflower seed allergic patient (DBPCFC) (2) |
(1) Bernstein et al. 1982
(2) Zitouni et al. 2000 |
3 Diagnostic Features of Sunflower Seed
Allergy
| Parameters / Subjects | Outcome | References |
| Route of Sensitization
4 patients with sunflower seed allergy |
All 4 patients had kept cage birds fed on sunflower seeds and reacted at the first time of sunflower seed ingestion; therefore, the route of sensitization was probably by inhalation of airborne sunflower seed allergens | Axelsson et al. 1994 |
| Augmentation Factors
Simultaneous ingestion of acetylsalicylic acid: 39 year old patient with sunflower seed sensitivity (SPT, RAST) |
Intense allergic reaction and shock after simultaneous ingestion of sunflower seeds and acetylsalicylic acid; ingestion of sunflower seeds and acetylsalicylic acids alone induced only milder symptoms or no symptoms, respectively | Moller & Paul 1996 |
| SPT
12 patients with reported sunflower seed allergy |
Positivity in SPT with
a) commercial extract 8% b) fresh sunflower seeds 42% |
Garcia Ortiz et al. 1995 |
4 Composition of Sunflower
Seeds
5 Allergens of Sunflower Seed and Pollen
| Seed Proteins / Glycoproteins | Allergen Nomenclature | References |
| 2S Methionine-rich Protein [12 kDa] | Kelly & Hefle 2000 | |
| Allergen: 13.5 kDa | Iwaya et al. 1994 | |
| Allergen: 67 kDa | Zitouni et al. 2000 | |
| Allergens: 10.5, 13.5, 15.9, 16.7, 17.2, 22.7, 33.2, 43.6, and 48.9 kDa | Kelly et al. 2000 |
| Pollen Proteins / Glycoproteins | Allergen Nomenclature | References |
| 34-kDa Allergen | Hel a 1 | Jiménez et al. 1994 |
| Sunflower Profilin [15.7 kDa] | Hel a 2 | Asturias et al. 1998 |
| Allergen: 14 kDa | Ostroumov et al. 1979 | |
| Allergens: 14, 24, 25, 47, and 56 kDa | Fernández et al. 1993 | |
| Allergens: 24, 32, and 55 kDa | de la Hoz et al. 1994 | |
| Allergens: 14-102 kDa | Jiménez et al. 1994 | |
| Allergens: 17, 42, and 85 kDa | Astwood et al. 1995 | |
| Allergens: 30, 33, 54, 60, and 72 kDa | Bauer et al. 1996 |
5.1 Sensitization to Sunflower Allergens
| Country / Subjects | Sensitivity to | References | ||||||||||||||||
| Austria, Vienna / Bad Vöslau
a) 23 patients allergic to honey b) 10 patients allergic to bee venom |
Sunflower Pollen (honey extract):
|
Bauer et al. 1996 | ||||||||||||||||
| Spain, Bilbao
14 patients with Compositae pollen allergy |
Sunflower Pollen:
|
Jiménez et al. 1994 | ||||||||||||||||
| Spain, Bilbao
121 patients sensitive to sunflower pollen |
Sunflower pollen profilin 31%
(specific IgE) |
Asturias et al. 1998 | ||||||||||||||||
| Spain, Guadalajara / Madrid
20 patients with Compositae pollen allergy |
Sunflower Pollen:
|
Fernández et al. 1993 | ||||||||||||||||
| Spain, Madrid
21 patients with sunflower pollen allergy |
Sunflower Pollen:
|
de la Hoz et al. 1994 | ||||||||||||||||
| USA, Lincoln, NE
5 sunflower seed allergic patients |
Sunflower Seed:
16-17 kDa allergen in 40% (SDS-PAGE / immunoblot) |
Kelly et al. 2000 |
5.2 2S-Methionine-rich
Protein (SSA)
5.3 Properties of Sunflower Pollen Profilin
(Hel a 2)
| Extract / Purified Allergens | Methods | References |
| Protein extract from seeds | After the oil was squeezed out (hydraulic press) pressed sunflower seeds were extracted overnight with physiologic saline solution followed by centrifugation, ultracentrifugation, and sterile filtration | Axelsson et al. 1994 |
| Protein extract from seeds | Seeds were ground and respectively extracted in either 0.01-M PBS (pH 7.4) or double-destilled water overnight with shaking at RT; followed by centrifugation, storage at -20°C | Kelly et al. 2000 |
| Protein extract from seed oil | Extraction of oil with 0.05-M PBS (pH 6.5) with rocking for 24 h at 60°C; followed by centrifugation, dialysis of the aqueous phase and lyophilization | Zitouni et al. 2000 |
| Protein extract from seeds, pollens and honey | Crushed seeds, pollens, and honey extracted with Coca's solution by stirring for 24 h at 4°C, followed by sterile filtration and lyophylization | Bousquet et al. 1985 |
| Protein extract from pollens | Extraction by incubation of pollens in 0.05-M ammonium carbonate buffer for 7 h at 4°C followed by centrifugation, filtration, and lyophylization; storage at -20°C | Fernández et al. 1993 |
| Protein extract from pollens | Extraction of pollens with 0.05-M ammonium carbonate buffer for 60 min at RT followed by centrifugation, dialysis, centrifugation, membrane filtration, and lyophylization | de la Hoz et al. 1994 |
| Protein extract from pollens | Defatted pollen extracted with 0.1-M phosphate buffer (pH 8) by stirring for 24 h at 4°C; followed by centrifugation, membrane filtration, dialysis, sterile filtration, and lyophylization | Jiménez et al. 1994 |
| Protein extract from honey | Honey suspended and extracted in water overnight at 4°C, followed by centrifugation, dialysis, and lyophylization, storage at -20°C | Bauer et al. 1996 |
| 2S Methionine-rich Protein (Seeds) | Extraction of albumins from washed, dried, and defatted raw sunflower seed meal; isolation of 2S methionine-rich protein by HPLC; followed by dialysis of fractions and lyophilization | Kelly & Hefle 2000 |
| 34-kDa Allergen (Hel a 1) (Pollen) | Purification from pollen extract by size exclusion chromatography followed by anion exchange chromatography | Jiménez et al. 1994 |
| Sunflower Profilin (Pollen) | Isolation from pollen extract by affinity chromatography on poly-(L-prolin)- Sepharose column, followed by purification by anion exchange chromatography (MonoQ column) and size exclusion chromatography (Superdex column) | Asturias et al. 1998 |
| Cross-Reacting Allergens | Subjects / Methods | References |
| Sunflower Pollen (Pollen)
Compositae pollen |
Maximal inhibition of 90% of IgE-binding to sunflower
pollen extract by mugwort and marguerite pollen extract; less inhibition
by golden rod, short ragweed, and dandelion pollen extracts (RAST inhibition);
Inhibition of IgE-binding to sunflower pollen extract in immunoblot inhibition by mugwort, marguerite, and short ragweed pollen extract |
Fernández et al. 1993 |
| Sunflower Pollen (Pollen)
Compositae pollen |
Inhibition of IgE-binding to sunflower pollen extract by Ambrosia, Artemesia, and Crysanthemum pollen extracts (RAST inhibition, pooled serum) | Jiménez et al. 1994 |
| Sunflower Pollen (Pollen)
Compositae pollen, other plant pollen, and sunflower profilin |
High cross-reactivity between recombinant Hel a 2 and profilins from mugwort, short ragweed, Bermuda grass, olive tree, Mercuialis annua pollen profilins (immunoblot inhibition, EAST inhibition, pooled serum) | Asturias et al. 1998 |
| Sunflower Pollen (Pollen,
Camomile)
Mugwort pollen, dried Martricaria chamomila, honey containing 24% of sunflower pollen of total pollen |
Inhibition of IgE-binding to extract of honey containing sunflower pollen by mugwort pollen and camomile extract (RAST inhibition, pooled serum from honey and camomile tea allergic patients) | Florido-Lopez et al. 1995 |
| Sunflower Pollen (Honey
Bee)
Honey bee head extract, sunflower pollen (honey extract) |
Inhibition of IgE-binding to extract form sunflower pollen honey by honey bee head extract (immunoblot inhibition, pooled sera from honey and/or honey bee venom allergic patients) | Bauer et al. 1996 |
| Sunflower Seed / Pollen
(Pollen)
Mugwort pollen, sunflower pollen and seed |
IgE-binding to mugwort pollen extract was inhibited by sunflower pollen about 50% and by sunflower seed extract about 28% (RAST inhibition, 1 patient allergic to mugwort pollen and sunflower seed) | Kanny et al. 1994 |
| Sunflower Seed (Pollen)
birch pollen, 35 kDa birch allergen, Bet v 1, and sunflower seed |
IgE binding to sunflower seed extract inhibited by birch pollen extract (97% inhibition), 35 kDa birch allergen (40%) and Bet v 1 (28%) (EAST inhibition, pooled serum from 7 birch pollen allergic patients) | Wellhausen et al. 1996 |
| Sunflower Seed (Fruits)
Lychee fruit, sunflower seed |
77% inhibition of IgE-binding to lychee extract by sunflower seed extract (RAST inhibition, 1 lychee fruit allergic patient) | Fäh et al. 1995 |
| Unique Allergens | Subjects / Methods | References |
| Sunflower Seed / Pollen
Sunflower seed, sunflower pollen, honey containing sunflower pollen |
IgE-binding to sunflower pollen significantly inhibited by honey containing sunflower pollen; no IgE-binding to sunflower seeds (RAST, RAST inhibition, 1 patient allergic to sunflower pollen) | Bousquet et al. 1985 |
8 Stability of Sunflower Seed Allergens
| Treatment | Effects | References |
| Sunflower Seeds (Heat)
roasting |
IgE-binding to protein extract of salted roasted sunflower seeds (3 patients with sunflower seed allergy) | Kelly et al. 2000 |
| Sunflower Seed Oil (Refining
Steps)
steps of the refining process: a) crude pressed oil (expeller, chemical extraction), b) acidification and neutralization (85°C, 15 min), c) pregumming by centrifugation (10°C, 4 h), d) washing (85°C, 5 min), e) bleaching 85°C, 20 min), f) gumming by filtration (10°C, 5 h), and g) deodorization (220°C, 4 min, vacuum) |
Protein content decreased after each refining
step:
a) to c) from 13.6 to 11.3 µg/mL, d) to g) from 2.75 to 0.22 µg/mL; SDS-PAGE showed 5 bands (67 to 145 kDa), amount of most abundant protein (67 kDa) decreased after each step, trace amounts in the refined oil Immunoblot: 67-kDa protein showed allergenic activity, faint bands at 114, 131, 132, and 145 kDa in crude oil (1 patient serum) |
Zitouni et al. 2000 |
| Reported Adverse Reactions | References |
| Food / Food additives
After ingestion of sunflower seeds (1) |
(1) see 2 Symptoms of Sunflower Seed Allergy |
| Sunflower Seeds in Foods
Allergic reactions in a patient after ingestion of a fruit yoghurt containing sunflower seeds (SPT, RAST inhibition) (1) |
(1) Fäh et al. 1995 |
| Sunflower Seed Oil
Allergic reactions to sunflower seed oil in a patient allergic to mugwort pollen and sunflower seed oil (SPT, single blinded oral challenge test with 5 mL oil) (1) Allergic reactions after ingestion of a meal containing sunflower oil and margarine in a sunflower seed allergic patient (2) |
(1) Kanny et al. 1994
(2) Zitouni et al. 2000 |
| Honey (Sunflower Pollens)
Allergic reactions in a sunflower pollen allergic patient after ingestion of honey containing 30% sunflower pollen among total pollens (1) 50% of 20 patients with allergy to Compositae pollen experienced allergic symptoms after ingestion of sunflower honey (2) Allergic reactions after ingestion of honey containing 24% sunflower pollen among total pollen in 7 patients (clinical history, SPT, RAST) (3) |
(1) Bousquet et al. 1985
(2) Fernández et al. 1993 (3) Florido-Lopez et al. 1995 |
| Sunflower Seed (Sunflower
Pollens)
Allergic reactions to sunflower pollen concealed in a commercial preparation of peeled sunflower seeds in a 22-year old woman (RAST, open food challenge) (1) |
(1) Rottem & Waisel 1998 |
| Allergens in Sunflower Seed Products | Content / Products | References |
| Sunflower Seed Oil
1 patient with sunflower seed allergy |
IgE-binding to 67-kDa in crude and refined oil; faint
bands at 114, 131, 132, and 145 kDa in crude oil (SDS-PAGE immunoblot)
Positive SPT to refined sunflower oil |
Zitouni et al. 2000 |
| Potential Sources | References |
| Transgenic Lupins
Aim: improving the nutritive value of an important grain legume crop Modification: expression of the 2S methionine-rich sunflower seed albumin (SSA) stably transformed into narrow-leafed lupin (Lupinus angustifolius L.) Allergenicity: transferred protein is a known sunflower seed allergen which accounted for 5% of extractable seed proteins in transgenic lupins; allergenicity of transgenic lupin not tested (1) |
(1) Molvig et al. 1997 |
| Reported Safe Products | References |
| Sunflower Seed Oil *
2 patients with clinical relevant sunflower seed allergy: negative SPT (only 1 patient tested) and safe ingestion of up to 16 mL of refined and cold-pressed sunflower seed oil (open challenge, protein concentration of both oils: 2-8 µg/mL) (1) |
(1) Halsey et al. 1986 |