Intense itching and urticarial rashes, followed by abdominal pain, vomiting and diarrhoea. 20 of 32 patients presented with shock after eating pineapples (Kabir et al. 1993)

Asthmatic reactions and gastrointestinal symptoms after ingestion of pineapple (Baur and Fruhmann, 1979)

1 (Nettis et al. 2001)

6 workers sensitized to papain and 60 asthmatics workers not exposed to airborne proteases but probably to these as constituents of foods (Baur and Fruhmann, 1979)

SPT for bromelain was positive (Nettis et al. 2001)

5/6 workers sensitized to papain, and 2/60 showed positive skin tests to bromelain (Baur and Fruhmann, 1979)

Bromelain (a purified protease of pineapple) (Baur and Fruhmann, 1979) .

Purified recombinant pineaple profilin and pineapple extract prepared as follows: Fresh fruits were cut into short pieces and ground in a mortar under liquid nitrogen to a fine powder. This powder was then added to prechilled 4-hyxdroxy-4-methyl-2-pentanone (–20°C, 1:2 wt/vol) in several portions, and the obtained suspension was homogenized with a spinning blade homogenizer. Chilled acetone (–20°C) was added to a final fruit/solvent ratio of 1:5. After the suspension was stored overnight at –20°C, it was filtrated over a suction filter and washed twice with chilled acetone (–20°C) and once with chilled acetone-diethyl ether (1:1, –20°C). The filter residue was lyophilized. One gram of the obtained acetone powder was extracted for 40 minutes at 4°C with 20 mL of PBS (10 mmol/L potassium phosphate and 150 mmol/L NaCl pH7.4). The suspension was centrifuged for 30 minutes at 20,000g, and the supernatant was filtered through a 1.2-µm membrane (Reindl et al. 2002)

EAST, CAP (Reindl et al. 2002).

6 workers sensitized to papain and 60 asthmatics workers not exposed to airborne proteases but probably to these as constituents of foods (Baur and Fruhmann, 1979)

19 (Reindl et al. 2002).

5/6 workers sensitized to papain, and 8/60 had positive RAST results to bromelain (Baur and Fruhmann, 1979)

10/19 sera reacted with pineapple in the CAP assay and six had a positive result in the pineapple profilin EAST (Reindl et al. 2002).

IgE binding to the recombinant profilins was observed in 8/19 sera from subjects with suspected pineapple allergy (42%). In the pineapple extract immunoblot 13 sera reacted with proteins ranging from 20 to 50 kda. At least 2 sera reacted only to pineapple profilin (Reindl et al. 2002).

A 58-year-old worker (Baur and Fruhmann, 1979)

32 patients (Kabir et al. 1993)

Not described

Asthmatic reactions and gastrointestinal symptoms after ingestion of 190 g pineapple (Baur and Fruhmann, 1979)

Most of the patients complained of intense itching and urticarial rashes, followed by abdominal pain, vomiting and diarrhoea. 18 patients had an urticarial rash and a flushed face. Although none of the patients were severely dehydrated, 20 patients presented with shock. Their peripheral pulse and blood pressure were low or absent suggesting an anaphylactic reaction (Kabir et al. 1993)