Milk & Meat

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Lars Yman, Pharmacia & Upjohn Diagnostics AB, Uppsala, Sweden
 
Meat and dairy products have several things in common. Nutritionally they have been regarded as the main protein sources for man in western civilization in the proportion of meat, about 35% and dairy products, 25%. In the food processing industry, dairy products and meat products are often combined. Milk lactose is often included in processed meats for flavor and milk protein as sodium caseinate is added as an emulsifier. Such processed meats include frankfurters, Vienna sausages, mortadella, luncheon meats, chicken sausages and pâtés. Caseinate is added to ham brines for injecting to improve slicing ability. Beef, mutton, chicken fat and pork fat are easier to emulsify with the help of sodium caseinate.
 
A chicken soup served in a hospital to a child with cow’s milk allergy caused near fatal anaphylaxis. The soup contained sodium caseinate. The hospital staff did not recognize this as a milk protein. Furthermore, the staff was unaware of the difference between lactose intolerance and milk protein allergy and considered reactions to milk to be relatively harmless. The child was saved because the mother recognized the early phase of the reaction and proper treatment could be given (3).
 
Undeclared additives are commonly found in food products on the market. The reason varies from illegal substitution for higher priced ingredients to unintended contamination during food processing.
 
Over a 3-year period, 18 situations with discrepancies between contents and label were confirmed by the Swedish National Food Adminis-tration (1). In 13 cases, the investi-gation was initiated because of reactions observed by individuals with known disease (Table 3). In 3 cases, the dose of allergen leading to the reaction could be estimated. Both 6mg hazelnut and milk corresponding to 10mg casein caused reactions requiring medication. A meal of sausage containing the amount of cow’s milk equivalent to about 60mg casein resulted in fatal anaphylaxis.
 
Furthermore, antibiotic residues may be present in meat and milk and cause allergic reactions (2), although the incidence is considered to be low (4, 5).
 
Allergic reactions to salami (6, 7) may in fact be caused by mites living on the dried meat.
 
An asthmatic reaction to the vapor from boiling hot dog was shown to be caused by inhalation of chicken meat allergens present in the hot dog (8).
 
It is a well documented fact that serum proteins, like serum albumin, are potent allergens and present in meat as well as in milk. It should therefore not be surprising that severe anaphylactic reactions and serum sickness reactions occur in artificial insemination or in vitro fertilization when bovine serum albumin (BSA) is added to sperm or embryo culture. IgE and IgG antibodies against BSA can be found in the observed cases and the link to polyvalent sensitization to animal danders, meat and milk is obvious (9, 10, 11, 12). The role of serum albumins in cross-reactions between species is further discussed below.
 
Gelatin, finally, is a protein product of animal origin with widespread use in foods and drugs (13). Gelatin-specific IgE antibodies (ImmunoCAP allergen c74) were found in all of group of children with immediate type reactions to live attenuated virus vaccines (14).
 
Allergens in ImmunoCAP and Pharmacia CAP System
 

Milk & constituents

  • a-lactalbumin f76
  • b-lactoglobulin f77
  • Boiled cow’s milk f231
  • Bovine lactoferrin f334
  • Casein f78
  • Cheese, Cheddar-type f81
  • Cheese, mold-type f82
  • Cow’s milk f2
  • Cow's whey f236
  • Goat’s milk f300
  • Mare’s milk f286
  • Sheep’s milk f325
  • Sheep's whey f326

Meat products

  • Beef f27
    Bos spp.
     
  • Elk, moose f285
    Alces spp.
     
  • Horse f321
    Equus spp.
     
  • Mutton f88
    Ovis spp.
     
  • Pork f26
    Sus spp.
     
  • Rabbit f213
    Oryctolagus spp.

References:

    1. Malmheden-Yman, I; Eriksson, A; Karlsson, T; Yman, L. Adverse reactions to food. Analysis of food proteins for verification of contamination or mislabeling. J Allergy Clin Immunol; 1993; 91(1 pt 2): 345.
    2. Malmheden-Yman, I; Eriksson, A; Everitt, G; Yman, L; Karlsson, T. Analysis of Food proteins for verifications of contamination or mislabeling. Food & Agricultural Immunology;1994;6:167-172.
    3. Sigurs, N; Hattevig, G; Kjellman, B. Maternal avoidance of eggs, cow's milk, and fish during lactation. Pediatr; 1992; 89(4): 735-739.
    4. Dewdney, J M; Maes, L; Raynud, J P; Blanc, F; Sheid J P; Jackson, T; Verschueren, C. Risk assessment of antibiotic residues of b-lactams and macrolides in food products with regard to their immuno-allergic potential. Fd Chem Toxic; 1991; 29:477-483.
    5. Dayan, AD. Allergy to antimicrobial residues in food: assessment of the risk to man. Vet Microbiol; 1993; 35: 213-226.
    6. Liccardi, G; D’Amato, M; D’AmATO, G. Oral allergy syndrom after ingestion of salami in a subject with monosensitization to mite allergens. J Allergy Clin Immunol; 1996; 98: 850-652.
    7. Armentia, A; Fernández, A; Pérez-Santos, C; de la Fuente, R; Sanchis, F; Méndez, J; Stolle, R. Occupational allergy to mites in salty ham, chorizo and cheese. Allergol et Immunopatol; 1994; 22:152-154.
    8. Polasani, R; Melgar, L; Reisman, R; Ballow, M. Hot dog vapor-induced status asthmaticus. Ann Allergt Asthma Immunol; 1997;78:35-36.
    9. Moneret-Vautrin, A; Wal, JM; Guillet-Rossof, F; Gerard, H; Boulard,H. Bovine serum albumin immunization: a new risk of allergy during protocols for in vitro fertilization. Allergy;1991; 46: 228-234.
    10. Sonenthal, KR; McKnight, T; Shaughnessy, MA; Grammer, LC; Jeyendran, RS. Anaphylaxis during intrauterine insemination secondary to bovine serum albumin. Fertil Steril; 1991; 56: 1188-1191.
    11. Wüthrich, B; Stern, A; Johansson, SGO. Severe anaphylactic reaction to bovine serum albumin at the first attempt of artificial insemination. Allergy; 1995; 50: 179-183.
    12. Morales, C; Braso, JV; Pellicer, A; Ruiz, A; Pelaez, A. Serum sickness due to bovine serum albumin sensitization during in vitro fertilization. J Investig Allergol Clin Immunol; 1994; 4: 246-249.
    13. Wahl, R; Kleinhans, D. IgE mediated allergic reactions to fruit gums and investigation of cross-reactivity between gelatine and modified gelatine containing products. Clin Exp Allergy; 1989; 19: 77-80.
    14. Kumagai, T; Yamanaka, T; Wataya, Y; Umetsu, A; Kawamura, N; Ikeda, K; Furukawa, H; Kimura,K; Chiba, S; Saito, S; Sugawara, N; Kurimoto, F; Sakaguchi, M; Inouye, S. Gelatine-specific humoral and cellular immune responses in children with immediate-type reactions to live measles, mumps, rubella, and varicella vaccines. J Allergy Clin Immunol; 1997; 100: 130-134.
1999