Allergy to Beer and Wine Caused by Saccharomyces cerevisiae in a Patient Sensitized to Fungi.

Abstract

J Investig Allergol Clin Immunol 2022; Vol. 32(4): 304-323 © 2022 Esmon Publicidad The presence of potential barley allergens and proteins from S cerevisiae have been described in beer through proteomic studies (nonspecific lipid transfer protein [nsLTP], gliadins, glutelins, trypsin a-amylase inhibitors, serpins) [3,4], and some have been shown to trigger allergic reactions, as follows: nsLTP (9 kDa), protein Z (45 kDa) [5], and protein Z–type serpin (20-25 kDa) [6]. Similarly, sensitization to yeast [7] has been described as the cause of allergy to beer, cider, and wine. The patient was a 33-year-old woman with a personal history of allergic rhinoconjunctivitis and exercise-induced asthma who had been experiencing episodes of anaphylaxis (ocular pruritus, eyelid angioedema, globus sensation, dysphonia, diarrhea, urticaria, and dizziness) with no associated exercise over a period of 3 years. These reactions resolved with self-administered epinephrine. She related the episodes to ingestion of beer with chips or olives. Occasionally, she had experienced milder symptoms after drinking red and white wine. She tolerates other alcoholic beverages, cereals (including bread), grapes, nuts, and all kinds of food. Protein extracts from various brands of beer (Heineken, San Miguel, Chimay, Franziskaner) were prepared by homogenization in phosphate-buffered saline (50% vol/vol) (50 mM phosphate buffer, 100 mM NaCl, pH 7.5), dialyzation against distilled water, and lyophilization. As some beers are produced with wheat, 1 of the beers studied was a wheat beer (Franziskaner). Skin prick tests (SPTs) with common aeroallergens (pollens, dust mites, molds, pet dander) were positive to Allergy to Beer and Wine Caused by Saccharomyces cerevisiae in a Patient Sensitized to Fungi