D1.204 - Pea-ling Back the Layers: A Systematic Review of Pea Allergies

The increasing adoption of alternative protein sources has raised concerns over the potential emergence of novel food allergies. Pea (Pisum sativum L.) and its derived ingredients are not classified as global priority allergens, and their allergenic potential remains poorly understood. To address this gap, this study aims to systematically review the literature to evaluate the evidence on immune-mediated adverse reactions to pea and identify clinically relevant pea allergens.

First, the systematic review protocol was registered in PROSPERO (CRD42024612967). Next, a systematic search was conducted across three databases – MEDLINE (OVID), ISI Web of Science, and Scopus – using validated filters and predetermined search terms to retrieve relevant studies. As of 18 February 2025, a total of 372 records were identified and exported to the Rayyan platform for screening for both IgE- and non-IgE-mediated pea allergies. After duplicate removal, 203 abstracts were screened based on predefined inclusion and exclusion criteria, resulting in 65 studies selected for full-text review. Ultimately, 39 studies met the eligibility criteria and were included in the systematic review. Extracted data included study details (author, year, DOI, country, duration, design), participant characteristics (sample size, gender, age, ethnicity), diagnostic methods used, reported symptoms, control sera usage, pea types analysed, and identified pea allergens. 

The included studies spanned multiple regions, including Asia, Europe, North America and Oceania. Most studies involved both male and female participants, with a mix of children and adults. Diagnostic approaches included food challenges, histories of anaphylaxis, clinical symptoms consistent with IgE- or non-IgE-mediated allergies, and biomarker testing for IgE-mediated reactions. Immunoblotting analyses revealed that IgE from pea-allergic individuals reacted with several pea protein families. 

This systematic review highlights the scientific evidence of immune-mediated reactions to pea and underscores the need for further research to characterize allergens and improve risk assessment for consumers adopting plant-based diets.