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f10 Sesame seed

f10 Sesame seed Scientific Information

Tipo:

Whole Allergen

Nome visualizzato:

Sesame seed

Route of Exposure:

Ingestion

Family:

Pedaliaceae

Species:

Sesamum indicum

Latin Name:

Sesamum indicum

Other Names:

Sesame, Benne seed

Summary

Sesamum indicum is one of the oldest oilseed plants belonging to the family Pedaliaceae and widely grown species in Sesamum genus. Asia and Africa hold 96% of world sesame seed production. It is commonly used in Middle Eastern cuisine and in Mediterranean diet and is increasingly being used in various foods in US like breads, sauces like tahini or confectionaries like halva. The prevalence of sesame allergy in USA, Mexico, Canada and Europe is reported 0.1% and 0.8% in Australia. It is considered ninth most common childhood food allergy in US while third most common food allergen and second most common food to cause anaphylaxis in children in Israel. Australia, Canada, Europe and New Zealand have recognized sesame as priority food allergen which required food labeling, but it is not currently mandatory in USA. Oral ingestion of sesame seeds either whole or in food preparations can lead to symptoms ranging from oral food allergy presented by recurrent episodes of wheezing and dyspnea to asthma, atopic dermatitis to anaphylaxis. Sesame skin prick test was found to be more accurate predictor than sesame serum specific IgE levels. The World Health Organization(WHO)/International Union of Immunological Societies(IUIS) Allergen Nomenclature Subcommittee has registered seven sesame allergen components: four storage proteins including two 2S albumins (Ses i 1 and Ses i 2) and two 11S globulins (Ses i 6 and Ses i 7), sesame extract also contains two oleosins (Ses i 4 and Ses i 5) and one vicilin-like 7S globulin (Ses i 3). Sesame allergy was reported as commonly co-existent in patients with peanut and tree nut (pine nut, macadamia nut, brazil nut and hazelnut) allergies.

Allergen

Nature

Sesamum indicum (S. indicum) is one of the oldest oilseed plants. It is a self-pollinated annual plant grown for its seed which contains 50-60% oil (1, 2). 

Taxonomy

S. indicum is a widely grown species in Sesamum genus. 23 species have been listed under the Sesamum and S. indicum is assumed to be domesticated from S. malabaricum which was native to South Asia and spread to the west through Mesopotamia. S. radiatum is also cultivated in certain African countries as a leafy vegetable (1). 

Taxonomic tree of Sesame (3)  
Domain Eukaryota
Kingdom Plantae
Phylum Spermatophyta
Subphylum Angiospermae
Class Dicotyledonae 
Order Scrophulariales
Family Pedaliaceae
Genus Sesamum
Species Sesamum indicum

Tissue

The proteins present in the water-soluble fraction and oil body fraction of sesame seed extract are identified as allergens (4). Whole sesame seeds and seed oil are said to be better tolerated compared to sesame paste such as tahini or hummus since they contain fewer allergens or are uncrushed and pass through the gut undigested (5). 

Epidemiology

Worldwide distribution

The prevalence of sesame allergy in the USA, Mexico, Canada and Europe is reported 0.1% (6, 7) and 0.8% in Australia (8). Recently, it is considered as the ninth most common childhood food allergy in the US (5) with 0.23% prevalence in a population survey (8). Sesame was responsible for allergy in 9.8% of food allergic patients in the UK as per Pronuts study (9).

It is the third most common food allergen and the second most common food to cause anaphylaxis in children in Israel (10) with a prevalence of 0.93% (11).

Allergy to sesame occurs in individuals ranging from infants to adults including de novo sensitization in adults (12). The age-specific prevalence reported convincing sesame allergy in 0.21% children and 0.24% adults in the US while probable sesame allergy in Canada was found in 0.23% children and 0.05% adults (8).

Risk factors

Sesame allergy has been reported to co-exist in 50-54% of patients with both peanut and tree nut allergy (13). Thus, peanut and tree nut allergies could pose a risk for sesame allergy. 

Environmental Characteristics

Living environment

Sesame adapts well to environmental variations like water and light intensity and grows throughout the year (14). Tropical and temperate climate conditions with stored soil moisture and minimal irrigation or rainfall may produce high-quality yields for sesame seeds under high temperatures (15).

Worldwide distribution

The sesame plant has been found to have its origin in Africa and India (2, 15). Asia and Africa hold 96% of world sesame seed production where it is an important part of the human diet. The country with the highest sesame seed consumption is Tanzania followed by China, Sudan, Myanmar, India, Ethiopia, and Nigeria (16). The black and white sesame varieties are most consumed in Western countries (17). It is commonly used in Middle Eastern cuisine and included in the Mediterranean diet but now increased usage in the US in various foods like bread, sauces like tahini, or confectionaries like halva. Sesame oil is widely used in the pharmaceutical and cosmetic industry in addition to the food industry (12). 

Route of Exposure

Main

Oral ingestion of sesame seeds either whole or in food preparations can lead to symptoms ranging from oral food allergy to atopic dermatitis to anaphylaxis (12, 18, 19).

Secondary

Certain cases have reported allergic symptoms like contact dermatitis due to mucosal contact or severe respiratory symptoms due to inhalation (20).

Detection

Main methods

Koppelman, Söylemez (17) developed a sensitive ELISA for detection and quantification of sesame seed residue in food with a lower limit of 0.5 ppm and no cross-reactivity with 92 other food or food ingredients. This may be helpful for detection in highly allergic individuals.

Clinical Relevance

Sesame allergy can manifest symptoms ranging from oral food allergy syndrome presented by recurrent episodes of wheezing and dyspnea to atopic dermatitis and anaphylaxis (12).

Anaphylaxis and food allergy

Allergic manifestations in patients with sesame allergy found skin symptoms to be most common followed by gastrointestinal, respiratory and cardiovascular symptoms along with anaphylaxis in few patients (18, 19). However, among several nuts evaluated, sesame was found to produce allergic symptoms with the highest severity and more involvement of the lower respiratory tract or cardiovascular/neurological system (9). 2.8% of cases in Canada and 43% in Israel reported sesame induced anaphylaxis among the total cases of food-induced anaphylaxis (21). Anaphylactic symptoms were prominent in sesame allergic patients as seen from studies reporting 41% in Japan (19) and 61.7% in North America and Canada (22). Further, 5 cases of food protein-induced enterocolitis syndrome (non-IgE mediated hypersensitivity) induced by sesame in children in Israel were reported, presented as acute repetitive vomiting, lethargy, and pallor (21).

Allergic rhinitis

A study conducted in the UK on 33 adult patients (16-81 years) who underwent sesame oral food challenge (OFC) reported allergic rhinitis in 48% of patients (23).

Asthma

Asthma was reported in 28.3% of sesame allergic children in Japan (19) while in 36% of UK adults who underwent OFC (23). It was also reported in 25.4% of patients with positive sesame OFC in Israel (18). Bronchospasm was reported in 2 cases of bakers and a young girl due to sesame seeds through inhalation route (20).

Atopic dermatitis

Li, Gunawardana (23) reported atopic dermatitis in 30% of patients in the UK study while Maruyama, Nakagawa (19) reported in 66.3% sesame allergic Japanese children. Atopic dermatitis was found to be positively associated with positive sesame OFC with 56.7% of patients affected having positive sesame OFC (18). Lignin like allergens, sesamol and sesamin in sesame oil has been identified to cause allergic contact dermatitis (20).

Other diseases

Contact urticaria was reported in one case to sesame by oral mucosal contact manifested as oral edema, erythema, and blood-tinged vesicles. Delayed hypersensitivity as contact dermatitis was also reported in a patient who received progesterone injection in sesame oil manifested as respiratory symptoms several days after receiving the injection (20).

Diagnostics Sensitization

Skin prick tests

 Sesame skin prick test (SPT) was found to be a more accurate predictor than sesame serum specific IgE (24) while Ses i 1 IgE levels were found better than SPT in another study (5, 25).

Prevention and Therapy

Other topics

Australia, Canada, Europe and New Zealand have recognized sesame as a priority food allergen that required food labeling, but it is not currently mandatory in the USA (8). Sesame food allergy has been shown to resolve in 20-30% of patients (5).

Molecular Aspects

Allergenic molecules

The World Health Organization(WHO)/International Union of Immunological Societies(IUIS) Allergen Nomenclature Subcommittee has registered seven sesame allergen components: four storage proteins including two 2S albumins (Ses i 1 and Ses i 2) and two 11S globulins (Ses i 6 and Ses i 7), sesame extract also contains two oleosins (Ses i 4 and Ses i 5) and one vicilin-like 7S globulin (Ses i 3).

Allergen

Biochemical Name

Molecular weight

Allergenicity

Ses i 1

2S albumin

9 kDa

All sesame allergic patients were found sensitized to 2S albumins  and with positive IgE binding (19, 26). Ses i 1 and Ses i 2 sensitization was found in 91.7% and 66.7% sesame allergic symptomatic Japanese patients with Ses i 1 to be more allergenic (19).

Related to peanut allergen Ara h 2,6 and 7 (27).

Ses i 2

2S albumin

7 kDa

Ses i 3

7S vicilin-like globulin

45 kDa

75% sesame allergic patients revealed obvious IgE binding (19)

Related to peanut allergen Ara h 1(27).

Ses i 4

Oleosin

17 kDa

Consistent sensitization was demonstrated in 29 of 32 sesame allergic patients showing systemic reactions (28).

Related to peanut allergens Ara h 12, 13, 14 and 15 (27).

Ses i 5

Oleosin

15 kDa

Ses i 6

11S globulin

52 kDa

The basic subunits of these proteins were found to be major allergens in a cohort of 18 Italians (3-73 years) (29). 67% sesame allergic patients showed IgE binding (19).

Related to peanut allergens Ara h 3 (27).

Ses i 7

11S globulin

57 kDa

Biomarkers of severity

Ehlers, Rossnagel (31) identified sesame oleosins as minor allergens but suggested their ineffectiveness in diagnosing sesame allergy based on serum IgE and IgG detection. However, oleosin is identified as dominant allergen in 5 of the 6 patients who reported anaphylaxis to sesame (10). 

Cross-reactivity

Sesame allergy was reported as commonly co-existent in patients with peanut and tree nut (pine nut, macadamia nut, brazil nut and hazelnut) allergies (9, 13, 32). Cross reactivity and co-sensitizations have been reported among allergens in sesame and other foods like peanuts, hazelnut, walnut, black walnut, cashew, macadamia, pistachio, kiwi, rye and poppy seeds (5, 12, 20).

IgE cross-reactivity between 7S and 11S globulins from sesame and peanuts is common. The homology between peanut 7S globulin (Ara h 1) and 11 S globulin (Ara h 3) and sesame proteins is high with Ses i 3 showing 36% homology to Ara h 1while IgE binding epitopes of peanut 2S albumin (Ara h 2) has limited sequence identity with sesame 2S albumin (Ses i 1) (19). This may give false positive sesame IgE based diagnosis (13). Further, Albunni, Wessels (33) reported cross-sensitization between chia seeds and sesame seeds by demonstrating the strong inhibition of anti-sesame antibodies by chia globulin fraction. 

Compiled By

Author: Turacoz Healthcare Solutions

Reviewer: Dr. Magnus Borres

 

Last reviewed: November 2020

References
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