Λεξικό .. Beer

Beer has rarely been reported as a cause of type I allergic reactions. Beer mainly contains malt, hops, brewer's yeast and water. For the production of special beers, other cereals (e.g., wheat, rice, or corn) and enzymes may be added. Malt is obtained from germinated and heated or roasted barley. Hops (Humulus lupulus) provides the characteristic bitterness and aroma of beer and prevents bacterial contamination. For the fermentation process, the yeast species Saccharomyces cerevisiae and S. carlsbergensis are used. In the literature on beer allergy, urticaria was the commonest clinical manifestation; anaphylaxis has rarely been reported. van Ketel (1980) described two patients with immediate type allergy to beer; one of them developed an itchy swollen face after entering a bar and anaphylactic shock on drinking some beer, and the other patient had recurrent urticaria after drinking beer. The scratch test to malt was positive in both patients [1]. Jover et al. (1986) studied 12 patients with immediate hypersensitivity to beer. The 12 patients had positive scratch tests to beer, malt, brewer's yeast, and rice, and nine of them were positive to hops. Since oral challenge tests with raw rice and yeast powder yielded negative results in these patients, malt was considered the main causative antigen of beer allergy [2]. Keller & Schwanitz (1994) reported a patient with angioedema after drinking beer or eating fresh white bread or cake, the disorder being attributed to wheat and barley allergy [3]. Gutgesell & Fuchs (1995) described a patient with hives on her hands upon contact with beer at work; however, drinking beer elicited no symptoms in her [4]. Santucci et al. (1996) studied three patients in whom urticaria developed after drinking beer, suggesting that malt was the component causing urticaria. Recently, Vidal & González Quintela (1995) reported a patient who developed asthma after both occupational exposure to barley flour and ingestion of beer [6].

Figueredo, E, et al (1999) reported  a patient who experienced severe anaphylactic reactions after drinking beer and eating a corn made snack. The results of in vivo and in vitro tests strongly suggested that these reactions were due to an IgE mediated mechanism against barley/malt and corn allergens. Although specific IgE against other cereals were also found in the patient's serum, the only clinically relevant allergens seem to be those from malt and corn flour. In fact, oral challenge with wheat flour was negative and the ingestion of bread and baking products elicited no symptoms in this patient. Moreover, the negative results of challenge tests with sulfites and ethanol (whisky) rules out sensitivity to these compounds [7].

The IgE-binding proteins in beer were examined by immunoblotting analysis with sera of patients sensitive to beer. Several proteins were immunoblotted with the sera, and among these, 18-kDa proteins were identified as new IgE-binding proteins in beer. Perhaps they originated from barley as a raw material.

References

1. van Ketel WG. Immediate type allergy to malt in beer. Contact Dermatitis 1980;6: 297-298

2. Jover V, García Hernández J, Pagán F, García Sellés FY, Negro J. Hipersensibilidad inmediata a cerveza: estudio de doce casos. Rev Esp Alergol Inmunol Clin 1986;1: 74-78

3. Keller K, Schwanitz HJ. Type I hypersensitivity to beer. Contact Dermatitis 1994;30: 44-45.

4. Gutgesell C, Fuchs T. Contact urticaria from beer. Contact Dermatitis 1995;33: 436-437.

5. Santucci B, Cristaudo A, Cannistraci C,

Curioni A, Furegon L, Giannattasio M. Urticaria from beer in 3 patients. Contact Dermatitis 1996;34: 368

6. Vidal C, González quintela A. Food induced and occupational asthma due to barley flour. Ann Allergy Asthma Immunol 1995;75: 121-12

7. Figueredo, E, et al: Beer induced anaphylaxis: identification of allergens. Allergy 1999:54(6):630-634.

8. Hiemori M, Eguchi Y, Kimoto M, Yamasita H, Takahashi K, Takahashi K, Tsuji H. Characterization of new 18-kDa IgE-binding proteins in beer. Biosci Biotechnol Biochem. 2008 Apr;72(4):1095-8. Epub 2008 Apr 7