Patient ate whole grain bread, experienced tingling and itching in mouth, angioedema and generalised urticaria (Malanin and Kalimo 1988) [407 ]
Angioedema, urticaria, pruritis, bronchospasm, dyspnea, laryngeal oedema, rhinitis, nausea, vomiting, diarrhoea, loss of consciousness (range of symptoms experienced, all 7 patients usually experienced several symptoms at once) (Atkins et al. 1988 [269])
Dysphagia, itching palms, wheezing, vomiting, loss of consciousness (O'Neil and Lehrer 1989 [446]).
Skin Prick Test
Number of Studies:
1-5
Food/Type of allergen:
Commercial extract and extract of foods causing a reaction with phosphate buffered saline (1:10 w/v). Extracts were filtered through 0.45µm pore filter and stored with 50% (v/v) glycerin (Atkins et al. 1988 [269]).
Protocol:
(controls, definition of positive etc)
Histamine (1mg/ml) and saline were positive and negative controls. Wheal diameters >3mm larger than negative control were taken as positive.
Number of Patients:
9
Summary of Results:
Bread extract produced 8x13mm wheal with pseudopods; crushed cottonseed produced 9x18mm wheal (Malanin and Kalimo 1988 [407 ])
7 patients with a history of reactions to products containing cottonseed protein tested were positive to cottonseed extracts and to extracts from foods containing cotton seed (Atkins et al. 1988 [269]).
One patient who suffered a reaction after eating a candy bar on an airliner was subsequently tested against cottonseed extract and phosphate buffered saline extract of candy bar - positive to cottonseed extract (O'Neil and Lehrer 1989 [446]).
IgE assay (by RAST, CAP etc)
Number of Studies:
1-5
Food/Type of allergen:
IgE protocol:
Number of Patients:
7
Summary of Results:
Atkins et al. 1988 [269] gives only total IgE levels (6-880 IU/ml) and no data on specific IgE or immunoblotting.
Immunoblotting
Immunoblotting separation:
Immunoblotting detection method:
Immunoblotting results:
Not performed
Oral provocation
Number of Studies:
1-5
Food used and oral provocation
vehicle
Defatted cotton seed flour was blended into chilled vanilla flavoured Vivonex (Norwich-Eaton Pharmaceutical).
Blind?
Yes
Number of Patients?
2
Dose response
Increasing doses of 100, 350, 500mg of cottonseed flour were given. One patient experienced symptoms after the third dose (500mg); the other after the first (Atkins et al. 1988 [269]).
Symptoms
Chest tightness, large falls in FEV1 (forced expiratory volume in 1 second), FVC (forced expiratory vital capacity), in both patients; pharyngeal pruritis, lip swelling, nausea in one patient only (Atkins et al. 1988 [269]).
IgE cross-reactivity and Polysensitisation
Other Clinical information
There is also a much earlier literature (1920s - 1950s) which confirm that cottonseed is a potent allergen, particularly as a consequence of occupational exposure. Spies et al. (1951) [793] purified an allergen called CS-1A using a scratch test as an assay. This was shown by Youle and Huang (1979) [249] to be identical with the 2S albumin.
Reviews (0)
References (5)
Atkins FM , Wilson M, Bock AS
Cottonseed hypersensitivity: new concerns over an old problem. J Allergy Clin Immunol 82: 242-250. 1988
PUBMED ID:
3403864
Malanin G and Kalimo K
Angioedema and urticaria caused by cottonseed protein in whole-grain bread. J Allergy Clin Immunol 82: 261-264. 1988
PUBMED ID:
3403866
Spies JR, Coulson EJ, Chambers DC, Bernton HS, Stevens H, Shimp JH.
The Chemistry of Allergens. XI. Properties and Composition of Natural Proteoses Isolated from Oilseeds and Nuts by the CS-1A Procedure J. Am. Chem. Soc. 73(8); 3995-4001. 1951
PUBMED ID:
unknown
[793]
Youle RJ, Huang AHC
Albumin storage protein and allergens in cottonseeds. J Agric Food Chem 27: 500-503. 1979
PUBMED ID:
582177
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