Naoko Takeo1, Masashi Nakamura2, Satoshi Nakayama3, Osamu Okamoto4, Naoki Sugimoto5, Shinichi Sugiura6, Nayu Sato2, Susumu Harada7, Masao Yamaguchi8, Naoya Mitsui9, Yumiko Kubota10, Kayoko Suzuki11, Makoto Terada12, Akiyo Nagai13, Junko Sowa-Osako14, Yutaka Hatano15, Hiroshi Akiyama16, Akiko Yagami11, Sakuhei Fujiwara15, Kayoko Matsunaga17. 1. Department of Dermatology, Faculty of Medicine, Oita University, Oita, Japan. Electronic address: takeo@oita-u.ac.jp. 2. Department of Integrative Medical Science for Allergic Disease, Fujita Health University School of Medicine, Toyoake, Japan; General Research and Development Institute, Hoyu Co., Ltd., Nagakute, Japan. 3. Clinical Diagnositic Division, Thermo Fisher Diagnostics, Tokyo, Japan. 4. Department of Dermatology, Faculty of Medicine, Oita University, Oita, Japan; Department of Dermatology, Almeida Memorial Hospital, Oita, Japan. 5. Division of Food Additives, National Institute of Health Sciences Ministry of Health, Labour and Welfare, Tokyo, Japan. 6. Clinical Pharmacy, Doshisha Women's College of Liberal Arts, Kyoto, Japan. 7. Dermatology, Harada Skin Clinic, Nishinomiya, Japan. 8. Division of Respiratory Medicine and Allergology, Department of Medicine, Teikyo University School of Medicine, Tokyo, Japan. 9. Clinic of Pediatrics, Mitsui Hospital, Yamagata, Japan. 10. Dermatology, Fukuoka Sanno Hospital, Fukuoka, Japan. 11. Department of Allergology, Fujita Health University School of Medicine, Nagoya, Japan. 12. Division of Rheumatology, Department of Allergology, Itami City Hospital, Itami, Japan. 13. Department of Dermatology, Fujita Health University School of Medicine, Nagoya, Japan. 14. Department of Dermatology, Osaka City University Graduate School of Medicine, Osaka, Japan. 15. Department of Dermatology, Faculty of Medicine, Oita University, Oita, Japan. 16. Division of Foods, National Institute of Health Sciences, Tokyo, Japan. 17. Department of Integrative Medical Science for Allergic Disease, Fujita Health University School of Medicine, Toyoake, Japan.
Abstract
BACKGROUND: Cochineal dye is used worldwide as a red coloring in foods, drinks, cosmetics, quasi-drugs, and drugs. The main component of the red color is carminic acid (CA). Carmine is an aluminum- or calcium-chelated product of CA. CA and carmine usually contain contaminating proteins, including a 38-kDa protein thought to be the primary allergen. Severe allergic reactions manifest as anaphylaxis. The aim of this study was to review all Japanese reported cases and propose useful diagnostic chart. METHODS: All reported Japanese cases of cochineal dye-induced immediate allergy were reviewed, and newly registered cases were examined by skin prick test (SPT) with cochineal extract (CE) and measurement of CE and carmine-specific serum IgE test. Two-dimensional (2D) western blotting using patient serum was conducted to identify the antigen. RESULTS: Twenty-two Japanese cases have been reported. SPT and the level of specific IgE test indicated that six cases should be newly registered as cochineal dye allergy. All cases were adult females, and all cases except three involved anaphylaxis; 13 cases involved past history of local symptoms associated with cosmetics use. Japanese strawberry juice and fish-meat sausage, and European processed foods (especially macarons made in France) and drinks were recent major sources of allergen. 2D western blotting showed that patient IgE reacted to the 38-kDa protein and other proteins. Serum from healthy controls also weakly reacted with these proteins. CONCLUSIONS: SPT with CE and determination of the level of CE and carmine-specific IgE test are useful methods for the diagnosis of cochineal dye allergy.
BACKGROUND: Cochineal dye is used worldwide as a red coloring in foods, drinks, cosmetics, quasi-drugs, and drugs. The main component of the red color is carminic acid (CA). Carmine is an aluminum- or calcium-chelated product of CA. CA and carmine usually contain contaminating proteins, including a 38-kDa protein thought to be the primary allergen. Severe allergic reactions manifest as anaphylaxis. The aim of this study was to review all Japanese reported cases and propose useful diagnostic chart. METHODS: All reported Japanese cases of cochineal dye-induced immediate allergy were reviewed, and newly registered cases were examined by skin prick test (SPT) with cochineal extract (CE) and measurement of CE and carmine-specific serum IgE test. Two-dimensional (2D) western blotting using patient serum was conducted to identify the antigen. RESULTS: Twenty-two Japanese cases have been reported. SPT and the level of specific IgE test indicated that six cases should be newly registered as cochineal dye allergy. All cases were adult females, and all cases except three involved anaphylaxis; 13 cases involved past history of local symptoms associated with cosmetics use. Japanese strawberryjuice and fish-meat sausage, and European processed foods (especially macarons made in France) and drinks were recent major sources of allergen. 2D western blotting showed that patientIgE reacted to the 38-kDa protein and other proteins. Serum from healthy controls also weakly reacted with these proteins. CONCLUSIONS: SPT with CE and determination of the level of CE and carmine-specific IgE test are useful methods for the diagnosis of cochineal dye allergy.
Authors: Marco Iammarino; Annalisa Mentana; Diego Centonze; Carmen Palermo; Michele Mangiacotti; Antonio Eugenio Chiaravalle Journal: MethodsX Date: 2019-04-22