f1 Egg white

Allergens within Food of Animal Origin

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  • Latin name: Gallus spp.
  • Source material: Freeze-dried hen’s egg-white
Egg-specific IgE antibodies are usually the first antibodies to appear in children developing atopic disease.

Allergen Exposure

Cooked or raw eggs.
Bread and pastry.
Numerous dishes like pancakes, sauces etc.
 
Unexpected exposure
Candy.
Beverages.
Meat products like sausages, patês, etc.

Potential Cross-Reactivity

Eggs from related animals.
Presence of shared allergens in egg-white, egg-yolk, serum and meat from hen and chicken has been demonstrated.

Clinical Experience

IgE-mediated reactions
igE antibodies were found in more than 65% of children with eczema and respiratory tract symptoms. Egg-white is often responsible for early development of urticaria and eczema during infancy. Egg-white specific IgE antibodies predict development of atopic respiratory allergy.

Remaining egg intolerance in older children and adults may be linked to exposure to cage birds and chicken meat.
 
Review
Foods that may contain egg include salad dressings, breads, breaded foods, muffins, pancakes, waffles, meringues, marshmallows, prepared soups and beverages, frostings, ice cream and sherbets, pie fillings, sausages, prepared meats (egg as a binding agent), mayonnaise, coatings and breading for fried foods, tartar and hollandaise and other sauces. It is sometimes used for producing foam in root beer and in some coffee and wines for clarification (1).
 
Clinical experience
Allergy to egg is generally agreed to be one of the most common causes of food allergy in infants and young children. Rowntree et al. (2), when studying egg-allergic children, found IgE antibodies in more than 65% of children with eczema and respiratory tract symptoms.
 
In a follow-up study of infants where the authors had concluded that egg-white sensitivity was a better indicator of atopy than total serum IgE, the infants presenting with egg-white allergy were more likely to have developed inhalant allergy by 7 years of age (3).
 
Egg-white is often responsible for early development of urticaria and eczema during infancy. Pruritus and exacerbation of atopic dermatitis were the symptoms most often recorded in a study of 84 egg-allergic children (4). Certain vaccines grown on chick embryos may cause severe allergic reactions in patients when injected (5). However, other investigators have not found such reactions in children with documented egg-allergy (6). Further development of vaccines seems to have decreased or even eliminated the risk (7).
 
IgE-mediated sensitivity to egg proteins in egg-processing workers has been reported (8).
 
Egg white-specific IgE level (f1, Pharmacia CAP System™ RAST® FEIA) was found to be an efficient tolerance marker in follow-up of egg allergy (9). The relative likelihood of positive rechallenge was 9% in patients with levels > 1.2 kUA/l. Even low levels could consequently be adequate grounds for delaying the follow-up of elimination diets with egg challenge.
 
The major allergens of egg white are ovotransferrin (also called conal-bumin), ovomucoid, ovalbumin, and lysozyme (10).
 
Cross-reactivity
The major allergens have been characterized (11) and lysozyme was capable of binding strongly to IgE in all human sera from egg-allergic individuals. Ovomucoid is resistant to heat, acid and proteolytic enzymes (12). IgE antibodies to another egg-white component, ovomucin, have been detected (13). Usually, cooked egg is slightly less allergenic than raw (14). Langeland (15) found cross-reactivity between hen’s egg-white and turkey, duck, goose and seagull egg-whites.
 
Allergens were also found in hen’s egg yolk, hen and chicken sera and flesh (15).

References:

    1. Hill, YJ. Encyclopedia of food science and technology. NY, NY: John Wiley & Sons; 1992; p. 545.
    2. Rowntree,S; Cogswell, JJ; Platts-Mills, TAE; Mitchell, EB. Development of IgE and IgG antibodies to food and inhalant allergens in children at risk of alelrgic disease. Arch Dis Childh; 1985; 60: 727-735.
    3. Hattevig, G; Kjellman, B; Björkstén, B. Clinical symptoms and IgE responses to common food proteins and inhalants in the first 7 years of life. Clin Allergy (Clin Exp Allergy); 1987; 17: 571-578.
    4. Langeland, T. Allergy to hen's egg white in atopic dermatitis. Acta Derm Venereol (Stockh); 1985; 114(Suppl): 109-112.
    5. Lavi, S; Zimmerman, B; Koren, G; Gold, R. Administration of measles, mumps, and rubella virus vaccine (live) to egg-allergic children. JAMA; 1990; 263: 269-271.
    6. Bruno, G; Grandolfo, M; Cantani, A; Vazzoler, C; Businco, L. Measles immunization in children with IgE-mediated egg allergy. J Allergy Clin Immunol; 1991; 87(Suppl 1 pt 2): 274.
    7. Bruno, G; Grandolfo, M; Lucenti, P; Novello, F; Ridolfi, B; Businco, L. Measles vaccine in egg allergic children: poor immunogenicity of the Edmoston-Zagreb strain. Pediatr Allergy Immunol; 1997; 8: 17-20.
    8. Bernstein, DI; Smith, AB; Moller, DR; Gallagher, JS; Aw, T-C; London, M; Kopp, S; Carson, G. Clinical and immunological studies among egg-producing workers with occupational asthma. J Allergy Clin Immunol; 1987; 80: 791-797.
    9. Crespo, JF; Pascual, C; Ferrer, A; Burks, W; Diaz Pena, JM; Esteban, MM. Egg white-specific IgE level as a tolerance marker in the follow up of egg allergy. Allergy Proc.; 1994; 15: 73-76.
    10. Aabin, B; Poulsen, LK; Ebbehoej, K; Noergaard, A; Froekiaer, H; Bindslev-Jensen, C; Barkholt, V. Identification of IgE binding egg white proteins: comparison of results obtained by different methods. Int Arch Allergy Immunol; 1996; 109: 50-57.
    11. Holen, E; Elsayed, S. Characterization of four major allergens of hen egg-white by IEF/SDS-PAGE combined with electrophoretic transfer and IgE immunoautoradiography. Int Arch Allergy Appl Immunol; 1990; 91: 136-141.
    12. Cooke, SK; Sampson, HA. Allergenic properties of ovomucoid in man. J Immunol 1997; 159: 2026-32.
    13. Walsh, BJ; Barnett, D; Burley, RW; Elliott, C; Hill, DJ; Howden, MEH. New allergens from hen's egg white and egg yolk. Int Arch Allergy Appl Immunol; 1988; 87: 81-86.
    14. Yunginger, JW. Classical food allergens. Allergy Proc; 1990; II: 7-9.
    15. Langeland, T. A clinical and immunological study of allergy to hen's egg white. Allergy; 1983; (38): 399-412.

1999



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