Allergy information for: Fig (Ficus carica (Common fig))

Clinical History

• Number of Studies:6-10
• Number of Patients:11-20
• Symptoms:

  Symptoms associated with fig allergy have been reported as follows: Palatine pruritus, sneezing, nasal obstruction, hydrorrhea, sore throat, sibilant dysnea, cough, and bilateral palpebral angioedema (Gandolfo et al. 2001) [829]. In addition, Caiaffa et al. (2003) [873] reported also symptoms involving abdominal pain, acute urticaria, and colic. A case of anaphylactic reaction has also been reported (Dechamp et al. 1995) [945]

Skin Prick Test

• Number of Studies:6-10
• Food/Type of allergen:

  Dried fig, skin and pulp of green fig, and commercial extract of fig (Gandolfo et al. 2001) [829].

  Fresh fig (Hemmer et al. 1998 [830], Focke et al. 2003 [599])

  Fresh and dried figs (Caiaffa et al. 2003) [873]

  Skin and pulp of figs and fig extracts (Antico et al. 2003) [874]. Extracts were prepared by separating the skin from the pulp and extracting them separately with PBS (1:4, w:v) for 15 min at 4°C. After centrifugation at 12 ooo g for 15 min at 4°C, the supernatants were collected and stored at -20°C.

• Protocol: (controls, definition of positive etc)

  Prick-to-prick method. Reactions were judged as ++ if the weal diameter exceeded 3 mm, and as +++ if equivalent to or greater than the positive control (histamine dihydrochloride 10 mg/mL). Weals between 2 and 3 mm with surrounding erythema were classified as weakly positive (+) (Focke et al. 2003).

  Prick to prick. Wheals greater than 3 mm were classified as positive (Caiaffa et al. 2003).

• Number of Patients:

  A 53-year-old, non-atopic woman. suffering of rhinoconjunctivitis and asthma 5 minutes after fig ingestion (Mock et al. 1998)

  Three patients reporting facial exanthema and edema or orolaryngeal itch and edema after the ingestion of figs (Hemmer et al. 1999)

  A 35-year-old woman who immediately after eating a dried fig, presented palatine pruritus, sneezing, nasal obstruction, hydrorrhea, sore throat, sibilant dysnea, cough, and bilateral palpebral angioedema (Gandolfo et al. 2001) [829].

  Five patients reporting adverse reactions after the ingestion of figs. A sixth patient, who never ever ate figs, was included because she reported respiratory symptoms from contact with ornamental FB (Ficus benjamina) trees (Focke et al. 2003).

  Three patients with clincal history of pollinosis and symptoms after ingestion of figs (Caiaffa et al. 2003)

  Two patients with symptoms after ingestion of fig fruis (Antico et al. 2003)

• Summary of Results:

  SPT was 1+ in 1 patient and 3+++ in two other patients. Testing with possibly associated fruits (mulberry, banana, avocado, kiwi fruit) and latex revealed weakly positive reactions to banana, avocado and kiwi fruit in some cases. No patient reacted with latex. (Hemmer et al. 1998)

  Skin prick test was positive for both fig and Ficus benjamina (FB) (Mock et al. 1998).

  Skin prick tests were positive with dried fig, skin and pulp of green fig, leaf and latex of F. benjamina (prick-prick), and commercial extract of fig (prick); they were negative with kiwi, banana, hops, chestnut, Hevea brasiliensis latex, common environmental pneumoallergens (prick), and Ficus lyrata (prick-prick) (Gandolfo et al. 2001) [829].

  Skin testing with fig fruit was positive in 5/6 patient (Focke et al. 2003)

  Skin testing with fig fruit was positive in all patients (Caiaffa et al. 2003)

  Prick to prick tests carried out with the skin fraction gave a stronger positive response than with the pulp fractions. These results were confirmed by pricking the extracts of both fig skin and pulp (Antico et al. 2003)

IgE assay (by RAST, CAP etc)

• Number of Studies:0
• Food/Type of allergen:Commercial fig extracts
• IgE protocol:

  RAST, CAP

• Number of Patients:

  A 77-year-old woman (Dechamp et al. 1995)

  A 53-year-old, non-atopic woman. suffering of rhinoconjunctivitis and asthma 5 minutes after fig ingestion (Mock et al. 1998)

  3 patients reporting facial exanthema and edema or orolaryngeal itch and edema after the ingestion of figs (Hemmer et al. 1999)

  A 35-year-old woman (Gandolfo et al. 2001) [829].

  3 patients with clincal history of pollinosis and symptoms after ingestion of figs (Caiaffa et al. 2003)

  2 patients with symptoms after ingestion of fig fruis (Antico et al. 2003)

• Summary of Results:

  Specific IgE was positive for both fig fruit and Ficus benjamina (FB) latex. PAST was completly inhibited by preincubation of serum with FB. However, the specific IgE binding to FB was only partially (50-55%) inhibited by preincubation of serum with fig extract. Immunoblot-inhibition also showed cross-reactivity between FB and fig but not to birch, mugwort and phleum pollens or Bet v 2 (Mock et al. 1998)

  RAST to fig fruit was positive in all patients (1.68/4.98/1.39 kU/l) as was RAST to Ficus sp. (CAP K81) (5.31/60.8/1.22 kU/l). All patients were also sensitized to pollen allergens (Hemmer et al. 1999).

  Specific IgE to fig was 4.2 kU/l and to H. brasiliensis latex, <0.35 kU/l (Gandolfo et al. 2001) [829].

  RAST to fig was negative in all the patients (Caiaffa et al. 2003)

  No IgE to fig was detected for any of the patients (Antico et al. 2003). IgE immunoblotting showed recognition of a major band of 20 kDa by one patient and three bands of 10, 22 and 24kDa by the other patient.

  Specif IgE to fig extract was found in the patients's serum (Dechamp et al. 1995)

Immunoblotting

• Immunoblotting separation:

  Proteins were separated on a 14 % polyacrylamide gel (Antico et al. 2003)

  Proteins were separated by SDS-PAGE according to Laemmli et al. 1970. (Gandolfo et al. 2001) [829].

  Proteins were separated by SDS-PAGE under either non-reducing or reducing conditions (Hemmer et al. 1999)

  SDS-PAGE was carried out using 12% homogeneous gels (10.5 × 8.0 × 0.1 cm) with 5% stacking gels. The resuspended lyophilized proteins (15 µg protein/lane) were mixed 3 : 1 with sample buffer (tris buffer containing 0.1% SDS) and, prior to SDS-PAGE, were (1) either denatured and reduced by boiling in the presence of mercaptoethanol (95 °C, 5 min), or (2) reduced with 0.22 mol dithiothreitol (DTT) (37 °C, 30 min) and subsequent incubation with 0.5 mol iodoacetamide for 10 min to alkylate reduced disulphide bonds, or 3) separated by electrophoresis without any denaturation and reduction steps (Focke et al. 2003).

• Immunoblotting detection method:

  Proteins were transferred onto PVF membranes and the membrane incubated with patient sera (1:3). IgE antibody detection was performed with anti-human IgE peroxidase-conjugated antibody and blots were revealed by chemiluminescence (Antico et al. 2003).

  Electrophoretically separated proteins were blotted to nitrocellulose. After transfer, sheets were cut into strips of 3 mm and blocked with bovine serum albumin (BSA)-containing buffer (50 mmol/L sodium phosphate, 0.5% (v/v) Tween 20, 0.5% (w/v) BSA, and 0.05% (w/v) sodium azide, giving a final pH of 7.5) for 30 min. Each strip was incubated overnight with 1 mL of serum (diluted either 1 : 10 or 1 : 4) at 4 °C under continuous shaking, washed twice in buffer for 30 min and incubated overnight at room temperature with ¹²⁵I-labelled rabbit anti-human IgE (Focke et al. 2003).

• Immunoblotting results:

  A major band of 20 kda plus a minor band with a lower molecular weight were recognised in the skin extract by patient no. 1, while 3 bands (10,22 and 24 kda) weere detected by patient no. 2. No IgE-binding bands were found in PBS-soluble fraction of of the fig pulp. However, 2 bands were recognised by patient no. 1 in the PBS-insoluble fraction of the pulp (Antico et al. 2002).

  The extract contained two allergens of 19 and 35 kda recognised by the patient (Gandolfo et al. 2001) [829].

  Under non-reducing conditions no IgE bands were detected. Under reducing conditions strong IgE binding to high molecular weight allergens (30-70 kda) were seen in only one patient (Hemmer et al. 1999)

  Only two patients were positive in the fig fruit blots. Patient 3 reacted moderately with a protein smear between 40 and 100 kDa and a 20 kDa band. Patient 6 reacted with allergens between 30 and 100 kDa, with two poorly delineated bands near 45 and 55 kDa. RAST to FB (Ficus benjamina) was inhibited >95% by FB extracts and 16-65% (mean 49%) by extracts from fresh fig. RAST to fig fruit was inhibited >95% by FB and fresh fig, 63-97% (mean 86%) by dried fig, and 0-84% (mean 35.5%) by kiwi fruit (Focke et al. 2003).

Oral provocation

• Number of Studies:1-5
• Food used and oral provocation vehicle:About 20 g of a green fig were chewed for 1 min and spat out (Antico et al. 2003)
• Blind:Open
• Number of Patients:

  Two patients with symptoms after ingestion of fig fruis (Antico et al. 2003)

• Dose response:Not reported
• Symptoms:The oral challenge tests were positive in both patients with the oral mucosal symptoms, conjunctivitis, rhinitis and asthma (Antico et al. 2003)

IgE cross-reactivity and Polysensitisation

Other Clinical information

Reviews (0)

References (8)

• Mock B, Rudeschko O, Henzgen M, Schlenvoigt G, Jager L
  Fig allergy - cross-reactivities to Ficus benjamina and attempt for the characterization of allergens
  ALLERGOLOGIE: 21 (12): 588-592. 1998
  PUBMEDID:
• Hemmer W, Focke M, Götz M, Jarisch R
  Allergy to Fig (Ficus carica).
  J Allergy Clin Immun 103 (1): 355 Part 2 Suppl.. 1999
  PUBMEDID:
• Gandolfo M, Baeza M, De Barrio M
  Anaphylaxis after eating figs
  Allergy 56(5): 462-463. 2001
  PUBMEDID: 11350321
• Brehler R, Abrams E, Sedlmayr S
  Cross-reactivity between Ficus benjamina (weeping fig) and natural rubber latex.
  Allergy. 53(4):402-6. 1998
  PUBMEDID: 9574883
• Caiaffa MF, Cataldo VM, Tursi A, Macchia L
  Fig and mulberry cross-allergy
  Ann Allergy Asthma Immunol. 91(5):493-5. 2003
  PUBMEDID: 14692435
• Antico A, Zoccatelli G, Marcotulli C, Curioni A.
  Oral allergy syndrome to fig
  Int Arch Allergy Immunol. 131(2):138-42. 2003
  PUBMEDID: 12811022
• Dechamp C, Bessot JC, Pauli G, Deviller P
  First report of anaphylactic reaction after fig (Ficus carica) ingestion
  Allergy. 50:514-516. 1995
  PUBMEDID: 7573846
• Focke M, Hemmer W, Wohrl S, Gotz M, Jarisch R.
  Cross-reactivity between Ficus benjamina latex and fig fruit in patients with clinical fig allergy.
  Clin Exp Allergy 33(7):971-977.. 2003
  PUBMEDID: 12859455