Allergy information for: Persimmon (Diospyros kaki (Kaki persimmon))

Clinical History

• Number of Studies:1-5
• Number of Patients:1-5
• Symptoms:

  One patient reacted with pruritus, penis edema, urticaria, and asthma; the second reacted with nausea and vomitus; and the third reacted with rhinoconjunctivitis, asthma, and stomachache (Anliker et al. 2001) [893]

  itching, generalized urticaria, facial angioedema, asthma, gastrointestinal complaints, and diarrhea (Pradini and Marchesi, 1999) [892].

  A case of anaphylactic reaction (Martinez et al. 2001) [890]

Skin Prick Test

• Number of Studies:1-5
• Food/Type of allergen:Raw persimmon (Sharon) fruit (Anliker et al. 2001) [893], (Pradini and Marchesi, 1999) [892], (Martinez et al. 2001) [890]
• Protocol: (controls, definition of positive etc)

  Prick by prick (Anliker et al. 2001) [893], (Pradini and Marchesi, 1999) [892], (Martinez et al. 2001) [890]

  The test was considered positive when the average diameter of the wheal was > 3 mm (Martinez et al. 2001)

• Number of Patients:

  A 33-years old man (Martinez et al. 2001) [890]

  A 20-year-old man (Pradini and Marchesi, 1999) [892]

  3 patients (Anliker et al. 2001) [893]

• Summary of Results:The skin by prick tests with persimmon fruit were positive for all the studies (Anliker et al. 2001) [893], (Pradini and Marchesi, 1999) [892], (Martinez et al. 2001) [890]

IgE assay (by RAST, CAP etc)

• Number of Studies:0
• Food/Type of allergen:

  Commercial extracts (Pradini and Marchesi, 1999) [892], (Martinez et al. 2001) [890]

  Extract. Fresh persimmon fruits were cut into short pieces and ground in a mortar under liquid nitrogen to a fine powder. This powder was then added to prechilled 4-hyxdroxy-4-methyl-2-pentanone (–20°C, 1:2 w/v) in several portions, and the obtained suspension was homogenized with a spinning blade homogenizer. Chilled acetone (–20°C) was added to a final fruit/solvent ratio of 1:5. After the suspension was stored overnight at –20°C, it was filtrated over a suction filter and washed twice with chilled acetone (–20°C) and once with chilled acetone-diethyl ether (1:1, –20°C). The filter residue was lyophilized. One gram of the obtained acetone powder was extracted for 40 minutes at 4°C with 20 mL of PBS (10 mmol/L potassium phosphate and 150 mmol/L NaCl, pH 7.4). The suspension was centrifuged for 30 minutes at 20,000g, and the supernatant was filtered through a 1.2-µm membrane (Anliker et al. 2001) [893]

• IgE protocol:

  EIA (Martinez et al. 2001) [890]

  RAST (Pradini and Marchesi, 1999) [892]

  EAST (Anliker et al. 2001) [893]

• Number of Patients:

  A 33-years old man (Martinez et al. 2001) [890]

  A 20-year-old man (Pradini and Marchesi, 1999) [892]

  3 patients (Anliker et al. 2001) [893]

• Summary of Results:

  Specific IgE in patient serum, assayed by EIA was positive (Martinez et al. 2001) [890]

  Specific IgE in patient serum, assayed by RAST was negative. The authors explained this result by the short time between symptoms and blood examination (Pradini and Marchesi, 1999) [892]

  EAST test was positive (classes 2 and 3) (Anliker et al. 2001) [893]

Immunoblotting

• Immunoblotting separation:

  Fresh persimmon fruits were cut into short pieces and ground in a mortar under liquid nitrogen to a fine powder. This powder was added to 4-hyxdroxy-4-methyl-2-pentanone (–20°C, 1:2 wt/vol), and the suspension was homogenized. Chilled acetone (–20°C) was added to a final fruit/solvent ratio of 1:5. After the suspension was stored overnight at –20°C, it was filtrated over a suction filter and washed twice with chilled acetone (–20°C) and once with chilled acetone-diethyl ether (1:1, –20°C). The filter residue was lyophilized. One gram of the obtained acetone powder was extracted for 40 minutes at 4°C with 20 mL of PBS (10 mmol/L potassium phosphate and 150 mmol/L NaCl, pH 7.4). The suspension was centrifuged for 30 minutes at 20,000g, and the supernatant was filtered through a 1.2-µm membrane. Persimmon extract was separated by means of SDS-PAGE (T = 12.5%, C = 2.7%) under reducing conditions (Anliker et al. 2001) [893]

• Immunoblotting detection method:The separated proteins were transferred onto nitrocellulose membranes by means of semidry blotting. The membrane was blocked with 0.05 mol/L TRIS-HCl, 0.15 mol/L NaCl, and 0.3% (v/v) Tween-20 (pH 7.4). Cut nitrocellulose strips were incubated overnight in diluted patient serum (1:6.7). Bound IgE was detected with mouse monoclonal anti-human IgE alkaline phosphatase conjugate (1:750) and subsequent staining with 4-nitroblue tetrazolium chloride and 5-bromo-4-chloro-3-indolylphosphate (Anliker et al. 2001) [893]
• Immunoblotting results:With both sera, multiple IgE-reactive bands were obtained ranging from 30 to 70 kDa (Anliker et al. 2001) [893]

Oral provocation

• Number of Studies:1-5
• Food used and oral provocation vehicle:

  Doble blind placebo control food challenge (DBPCFC) was conducted with fresh persimmon, using passion fruit as placebo and to disguise the taste of persimmon. The persimmon drink contained 100 g of persimmon, 50 g of yogurt, 5 g of honey, 40 g of passion fruit, 20 g of water, 15 g of lemon juice, 5 g of sugar, and 25 g of cream (total, 260 g); the placebo drink contained 50 g of yogurt, 10 g of honey, 90 g of passion fruit, 20 g of apple, 10 g of sugar, 10 g of raspberry syrup, 30 g of cream, and 2 g of Nesvital (total, 222 g). For DBPCFCs, a spit-and-swallow protocol was followed. The patients were advised to keep the drink in the oral cavity for 1 minute and spit it into a basin thereafter. Reactions were monitored for 15 minutes or longer until they subsided. After inspecting the mouth for erythema or swelling, the next dose was given. If the patients did not complain about symptoms during this spit phase, they had to swallow the drinks (10 g persimmon) doubling the dose every 15 minutes until the drink was finished (Anliker et al. 2001) [893]

• Blind:Yes
• Number of Patients:

  3 patients (Anliker et al. 2001) [893]

• Dose response:

  The starting dose for the spit protocol was one teaspoon of persimmon (2.15 g). The dose was doubled with each challenge up to 8 teaspoons. In the swallow protocol the starting dose was 10 g persimon doubling the dose every 15 minutes until the drink was finished. (Anliker et al. 2001) [893]

• Symptoms:One patient reacted with nausea after 8.6 g and 17.2 g in the spit protocol, a burning of the oral cavity, and rhinorrhea after 8.6 g of persimmon after switching drinks back and forth. Another patient reacted with slight itching of the throat after 1.8 g and 8.2 g in the spit protocol and nausea, itching of the throat, sneezing, and rhinorrhea after 55 minutes and a total of 100 g in the swallow protocol. The third patient reacted with an oral allergy syndrome (itching and burning of the oral cavity and slight erythema on the margin of the lips) after 1.8 g of persimmon in the spit protocol and 8.2 g twice after switching drinks back and forth (Anliker et al. 2001) [893]

IgE cross-reactivity and Polysensitisation

Other Clinical information

Reviews (0)

References (3)

• Martinez JC, Armentia A, Bartolome B, Callejo A, Fuentes MJ, Fernandez A
  Anaphylaxis after ingestion of sharon fruit
  Allergol Immunopathol (Madr). 29(2):69-71. 2001
  PUBMEDID: 11420030
• Prandini M, Marchesi S.
  Anaphylaxis to persimmon
  Allergy. 54(8):897. 1999
  PUBMEDID: 10485400
• Anliker MD, Reindl J, Vieths S, Wuthrich B.
  Allergy caused by ingestion of persimmon (Diospyros kaki): detection of specific IgE and cross-reactivity to profilin and carbohydrate determinants
  J Allergy Clin Immunol. 107(4):718-23. 2001
  PUBMEDID: 11295664