Pumpkin allergy, or autumn on the plate - Strefa Alergii
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Pumpkin allergy, or autumn on the plate

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No season pleases the eyes with such a substantial palette of colours as the beautiful golden autumn. With that comes the pumpkin season, too. The smell of pumpkin pie and other dishes based on the aromatic vegetable is already wafting through many houses. It is therefore worth considering whether we might also suffer from a pumpkin allergy.

Why is pumpkin a valuable product in the human diet?

The pumpkin belongs to the large plant family of Cucurbitaceae, known as cucurbits. This family includes different varieties of pumpkin, cucumbers, courgettes, watermelons, and melons. Pumpkins are known worldwide as a vegetable widely used in cooking. They can be used to create warming cream soups, bake pies, prepare stir-fries or other dishes. Thanks to their high β-carotene content, they are excellent for supplementing our menus with vitamin A. This is important especially for those on an elimination diet for chicken egg allergy, where the yolk is restricted. In addition, eating pumpkin provides the body with calcium, vitamin E and B vitamins. Pumpkin is also a source of fibre, which prevents constipation. It is also a relatively low-calorie vegetable, which will please those wishing to reduce their body weight. Some studies prove  that the consumption of pumpkin has some stimulating effects on the central nervous system. It may help with problems of dizziness. Pumpkin seeds also contain many valuable ingredients needed for the proper functioning of the body. They are abundant in potassium, magnesium, iron, vitamin E, and B vitamins. In addition, they supplement our diet with health-promoting monounsaturated and polyunsaturated fatty acids, which show anti-inflammatory effects [1,2].

Pumpkin allergy – pulp

Allergic symptoms after eating pumpkin can occur after eating both the flesh and the seeds, along with the oil pressed from them.

  • Allergic reactions after ingestion of pumpkin pulp are well known to medicine, while more severe symptoms are poorly documented. There are descriptions of only a few such cases. Cases can be found in the literature: a woman who developed more severe allergic symptoms following the consumption of pumpkin cream soup. A case report is also available of a 2.5-year-old boy who presented more severe clinical symptoms after eating the same dish.
  • The main allergen of pumpkin pulp has not yet been classified. However, studies in the first patient showed cross-reactivity occurring between pumpkin pulp and cucumber, courgette, watermelon and melon pulp. What can this mean in practice? A person showing allergy symptoms after eating pumpkin is likely to feel the same symptoms after eating the above-mentioned vegetables and fruits [3,4].

Pumpkin allergy – seeds

Pumpkin seed allergy is a different issue.

  • One group of patients at risk of allergy symptoms after the consumption of pumpkin seeds are those with allergies to tree and grass pollen. The proteins responsible for this reaction are profilins, quite widespread in the plant world. People with a known allergy to this protein may experience symptoms after eating pumpkin seeds and other vegetables and fruits. It is also worth noting that such a reaction mainly affects vegetables that have not been exposed to high temperatures [5]. Possible allergic reactions are usually limited to oral syndrome-related symptoms only. This is because profilins are sensitive to digestive enzymes. This syndrome is characterised by pruritus and swelling of the lips (especially the lower lip), pruritus and swelling of the mouth, throat, and larynx. Sometimes pruritus and a sensation of blocked ears may occur. Systemic symptoms are very rare but still possible [6]. The proteins responsible for the cross-reactivity between pollen and pumpkin seeds are sensitive to heat. This means that cooking or roasting pumpkin seeds should make them lose their ability to cause an allergic reaction [5].
  • Another group of patients who may experience allergy symptoms after consuming pumpkin seeds are those who are allergic to seed reserve proteins. These proteins are present in tree nuts, peanuts, soya, and many seeds. They show a certain level of cross-reactivity between them. They are characterised by high resistance to digestive enzymes and heat. In contrast, allergic reactions caused by the consumption of pumpkin seeds can be severe and systemic.

A reaction to pumpkin seeds does not exclude the possibility of eating pumpkin flesh. Cases of allergic symptoms after the ingestion of seeds with simultaneous absence of symptoms after eating pumpkin pulp are described in the literature [7,8].

 

Where might pumpkin seeds be hidden?

It is often the case that pumpkin seeds are one of the ingredients in bread. If you are shopping in a bakery, ask the shop assistant carefully about the content of the baked product. If you are shopping in a supermarket, make sure to check the composition of the product. In addition, pumpkin seeds can be found in ready-made porridge, bread pastes, pasta sauces, ready-made bread mixes, and ready-made salads. It is interesting to note that it is possible to acquire the allergy by inhalation in fishermen. Pumpkin seed flour is an ingredient in the fishing lures they use and, as a result of frequent contact, they may develop a food allergy to the seeds after some time [9]. Another source of exposure is pumpkin seed oils. Here, beware of ready-made dressings, massage oils and cosmetics. It is particularly important to check the composition of cosmetics, as there is currently a strong trend towards natural skincare, with the result that pumpkin seed oil can be found in many cosmetics. Allergic skin reactions may occur in predisposed individuals after contact with such cosmetics [10].

Are you allergic to pumpkin? Find out what to replace it with

Carrots and sweet potatoes, whose colour and texture when cooked or baked are very similar to pumpkin flesh, are ideal for this task. In addition, both vegetables are distinguished by their significant β-carotene concentration, so if egg yolk and pumpkin pulp are eliminated in the diet, they can successfully cover the vitamin A requirement [1].

Diagnosis and treatment of pumpkin allergy

The gold standard for the diagnosis of food allergy is the provocation test carried out under medical supervision. The aim is to confirm or exclude a link between the symptoms and the food consumed in order to implement appropriate recommendations. Each provocation trial is preceded by a period of approximately 4 weeks of food elimination, with the aim of alleviating existing symptoms.

If the allergy is confirmed, an elimination diet excluding flesh and/or pumpkin seeds is followed. Spot skin tests and measurement of specific IgE antibodies can be helpful. Against seed stock proteins and profilins it is possible to determine specific IgE, unfortunately in the context of pumpkin flesh such a test is not possible. After a strictly defined period of elimination of the harmful food from the diet, a re-provocation is also carried out under medical supervision in order to determine the degree of acquisition of tolerance to the eliminated food. This is necessary in order not to expose the patient to too long exclusion of a particular dietary component [11]. In seed protein allergy, it is more difficult to develop tolerance through an elimination diet, but it is not completely impossible [12].

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translation: Julia Majsiak

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