Banana allergy in patients with immediate-type hypersensitivity to natural rubber latex: Characterization of cross-reacting antibodies and allergens. Asero et al. (2003) [ 582] studied 71 patients allergic to fruits and vegetables but not sensitized to lipid transfer protein or natural rubber latex

Cross-reacting IgE antibodies recognizing latex and fruit allergens (papaya, avocado, banana, chestnut, passion fruit, fig, melon, mango, kiwi, pineapple, peach, and tomato) were demonstrated by RAST-inhibition tests on 146 latex-allergic patients and a 30 control without clinical syntoms of latex allergy (Brehler et al. 1997) [ 292]. of the patients showed IgE binding to banana extract. IgE binding occurred mainly at 19 kDa (21%, 4/19), 33 kDa (88%, 15/19), 37 kDa (76%, 13/19), 39 kDa (21%, 4/19), and 40 kDa (26%, 5/19) (Delbourg et al. 1996) [ 42]

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Light - Have a job that involves long periods of sitting (office-based / driving) or are home-based and sitting for much of the day. Typical jobs: office worker, sales rep, bus/taxi/lorry driver. Crusha was originally sold in glass bottles, but was later changed to plastic. Crusha is sold in many different flavours, the first four flavours being chocolate, banana, strawberry and raspberry. Flavours like Lemon, Lime and pineapple were also available. out of 8 patients were SPT positive and three negative to banana extract (Fernandez de Corres et al 1993) [ 327] patients with asthma; 2 with rhinitis; 2 with eczema; 3 with urticaria; 2 with angioedema and 2 with OAS (Makinen-Kiljunen 1994) [ 405] High IgE cross-reactivity of banana profilin with birch pollen profilin, Bet v 2, and latex profilin, Hev b 8, was demonstrated by immunoblot inhibition as well as EAST inhibition experiments (Reindl et al. 2002) [ 601]

Dose response: Increasing amounts of 5, 10, 20 and 40 g. The smallest amount eliciting objetive symptoms were 2.6 g for one patient and 1.3 g for the other patient (Grob et al. 2002) [ 600] Hevein-like protein domains as a possible cause for allergen cross-reactivity between latex and banana. Two bands of 32 and 34 kDa were the major components recognised by sera (Sanchez Monge et al. 1999) [ 493] latex-allergic patients and 22 control subjects with no evidence of allergy to latex or to banana (Alenius et al. 1996) [ 5] patients with anaphylaxis; 3 with local sensitivity and 1 with severe abdominal cramping and nausea. (Beezhold et al. 1996) [ 281]A wheal the size of half of that caused by histamine dihydrochloride (10 mg/mL; ALK, Copenhagen, Denmark) or larger was regarded as a positive reaction. (Mikkola 1998) [ 418] IgE reactivity to profilin in pollen-sensitized subjects with adverse reactions to banana and pineapple. Isolation and characterization of major banana allergens: identification as fruit class I chitinases.

Due to cross-reactivity, patients considered to be at high risk of banana allergy, as for example subjects allergic to latex, avocado, chestnut, kiwi, melon, or to certain pollens, should be carefully asked about possible previous adverse reactions on banana ingestion. Unless consumption of banana with perfect tolerance is reported by the patient, a banana-free diet should be recommended, until proper diagnosis - on the basis of objective procedures to evaluate clinical reactivity - is made. Allergen purification: The recombinant banana profilin was purified by affinity chromatography using poly-(L)-proline as the solid phase and expressed in E. coli. Inhibition experiments indicated similar IgE reactivity of natural and recombinant allergen (Reindl et al. 2002) [ 601] latex-allergic patients and 22 control subjects with no evidence of allergy to latex or to banana. (Alenius et al 1996) [ 5]. Heavy - Active for much of the day, walking non-stop and carrying objects. Typical jobs: hospital/ward nurse, waitressing in a busy restaurant, cleaner, porter, labourer/construction worker, gardener, farm worker. Leisure Activity LevelThe banana RAST was positive in 12 out of 14 latex-allergic patients studied (Alenius et al. 1996) [ 5] SPT with fresh banana were positive in 11 of 31 (35%) patients with latex allergy tested (Mäkinen-Kiljunen 1994) [ 405] The pulp of banana was extract with NTE 1N solution: NaCl 1mol/L, Tris 0,1mol/lL ethylenediaminetetraacetic acid 0.01mol/L (Lavaud et al 1995) [ 102]. With respect to banana-pollen allergy, several patterns of associated allergies have been described. Examples for that are the following clusters: ragweed pollen allergy with banana and melon allergies; multiple pollen allergies with banana, melon, watermelon, citrus fruits and tomato allergies; and Platanus tree pollen allergy with banana, hazelnut, peanut and celery allergies. A group of allergens very common in the plant kingdom seem to be responsible for at least part of these cross-reactions, but other allergens may also be involved.

Determination and characterization of cross-reacting allergens in latex, avocado, banana, and kiwi fruit. Allergen properties & biological function: Ba 1 and Ba2 are endochitinases with a possible defence function against plant pathogens and belong to pathogenesis-related proteins family PR3. In January 2008, Crusha was rebranded with a new logo and with reformulated "Nothing Artificial" versions of their reduced range of flavours, consisting of Raspberry, Strawberry, Banana, Chocolate and White Chocolate. [7] In August 2007, after receiving thousands of complaints from dismayed customers, about the wildly different taste of the new 'Nothing Artificial' version of Strawberry Crusha, it was confirmed that they would revert to the old recipe. The white chocolate variety was later discontinued. Banana extracts (Delbourg et al. 1996) [ 42], (Alenius et al. 1996) [ 5], (Asero et al. 2003) [ 582] Two sera reacted strongly with protein at 32 and 34 kDa and a third patient sensitised to avocado and banana but not to pollen or latex reacted to a 70 kDa band. The fourth patient was sensitised to birch pollen but not to latex reacted with recombinant banana profilin (Grob et al. 2002) [ 600]SPT responses were positive to the crude banana extract in 14/15 patients, to the chitinase-enriched extract in 13/15, to Ba 1 in 8/15 and to Ba 2 in 9/15 (Sánchez-Monge et al 1999) [ 493] out of 4 patients allergic to natural rubber latex had a positive reaction to a 32-kDa banana protein (Mikkola rt al. 1998) [ 418] Unfortunately, there is scarce data on the occurrence of banana allergy in different age groups and geographical areas. It seems that, although it is not among the top-5 food allergies, it cannot be considered as a rare allergy, neither in children nor in adults. Certainly, it is much more frequent among specific groups of patients, as for example subjects allergic to latex, to pollens, or to plant-derived foods. In the same way, the development of banana allergy is not known, as long-term follow up of banana allergic patients have not been conducted. Nevertheless, clinical data suggests that patients allergic to banana should assume a lifelong avoidance diet, since – to our knowledge - patients outgrowing banana allergy have not been reported.