Banana

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Lars Yman, Pharmacia & Upjohn Diagnostics AB, Uppsala, Sweden
 

f92 Banana

Banana is the fruit of a tropical moncotyledone of the family Musaceae, order Zingiberales. Other families belonging to the same order are, e.g. Zingiberaceae (ginger and cardamom) and Marantaceae (Jamaica arrow root). The edible part of the banana fruit is rich in protein, about 5 % of the dry weight, and contains a range of enzymes and pharmacologically active substances, e.g. serotonin (1).
Banana was recognized as a food allergen already about 80 years ago (2) and IgE mediated reactions have been described by several authors since the 1970s. Several cases of anaphylactic reactions to banana have been reported (3,4) Severe reactions were recently reported to have occurred in 6-month-old children (5), in one of the cases the first time the fruit was eaten by the child.
 
Allergic reactions to banana have been observed to be common in adults and children with latex hypersensitivity. The sensitivity has been ascribed to the presence of cross-reacting IgE binding allergen epitopes in the banana fruit and in the natural rubber latex of Hevea brasiliensis. Several studies have shown that IgE binding to separated banana proteins can be inhibited by latex extracts. However, it is obvious that banana allergy can also be fully independent of latex hypersensitivity. It is clear from the comparative studies that both allergen sources are heterogeneous mixtures of several allergenic proteins and that patients, as with all other allergens, produce IgE antibodies to their own individual selection of allergenic components. The correlation between measured IgE antibody concentrations to banana and latex (6) does not identify cross-reacting allergens as the dominating allergens (See also k82 Latex).
 
Banana has also been suspected of sharing allergens with other fruits, like avocado and kiwi, that show antigenic relations to natural rubber latex (7), and with melon and ragweed pollen (8).
 
Allergen specific IgE antibodies can be quantitated in serum and testing should be considered in the investigation of suspected latex allergy, in food allergy in children, and in urticaria of unknown cause.

References:

    1. Vettorazzi G. 5-hydroxytryptamine content of banana and banana products. Food Cosmet Toxicol 1974; 12: 107-113.
    2. Fries J, Glazer H. Studies on the antigenicity of banana, raw and dehydrated. J Allergy 1950; 21: 169-175.
    3. Linaweaver WE, Sachs GL, Heiner DC. Anaphylactic shock following banana ingestion. Am J Dis Child 1976; 130: 207-209.
    4. Frosch P, Kalveram KJ, Fork G. Anaphylaktische Reaktionen auf Bananen. Allergologie 1987; 10: 152-154.
    5. Tokuyama K, Takei K, Arakawa J, Kato M, Shimizu T, Hoshino M, Mochizuki H, Morikawa A. Banana allergy in infants. Allergy 1997; 52: 350-351.
    6. Alenius H, Mäkinen-Kiljunen S, Ahlroth M, Turjanmaa K, Reunala T, Palosuo T. Crossreactivity between allergens in natural rubber latex and banana studied by immunoblot inhibition. Clin Exp Allergy 1996; 26: 341-8.
    7. Beezhold DH, Sussman GL, Liss GM, Chang NS. Latex allergy can induce clinical reactions to specific foods. Clin Exp Allergy 1996; 26: 416-22.
    8. Enberg RN, Leickley FE, McCullough J, Bailey J, Ownby DR. Watermelon and ragweed share allergens. J Allergy Clin Immunol 1987; 79: 867-875.
1998