D2.198 - Cross-reactivity between Fusarium venenatum and cooked mushrooms and Aspergillus fumigatus: A case study of food-induced allergy
Case report
Introduction
Food allergies to fungal proteins, such as those found in Fusarium venenatum and mushrooms, can manifest through cross-reactivity. This study investigates a case of anaphylaxis triggered by Fusarium venenatum in plant-based meat products, examining its cross-reactivity with common environmental fungi and cooked mushrooms.
Materials and Methods
A 25-year-old female with asthma and a history of environmental fungal allergies presented with anaphylaxis, including chest pain, pruritus, and gastrointestinal symptoms, 10 minutes after consuming plant-based nuggets containing Fusarium venenatum. Skin tests confirmed sensitization to Fusarium venenatum and environmental molds. The patient tolerates mushrooms, suggesting specific reactivity to fungal proteins in Fusarium venenatum.
Protein extracts were prepared from Fusarium venenatum, environmental fungi (Aspergillus fumigatus, Alternaria alternata, and others), and mushrooms (raw and cooked). SDS-PAGE and IgE-Western blot analyses were performed to identify allergenic proteins, and inhibition assays were conducted to evaluate cross-reactivity.
Results
Western blot revealed IgE binding to a 15 kDa protein in Fusarium venenatum, similar to proteins in Aspergillus fumigatus. Cross-reactivity was confirmed between Fusarium venenatum and cooked mushrooms and Aspergillus fumigatus, with shared epitopes recognized at 15 kDa. However, no cross-reactivity was observed with Alternaria alternata. This suggests cosensitization rather than cross-reactivity with Alternaria alternata.
Conclusions
This case highlights Fusarium venenatum as a significant allergenic source in plant-based foods, with cross-reactivity observed in cooked mushrooms and Aspergillus fumigatus. The conformational changes in fungal proteins induced by cooking may favor cross-reactivity. These data suggest that in our patient the primary sensitivity is due to sensitization to Aspergillus fumigatus and the anaphylactic reaction is due to cross-reactivity to Fusarium venenatum. Comprehensive allergenic profiling is crucial for managing fungal allergies and preventing severe reactions in sensitized individuals.
