Sesame Seed Allergens

  • Ses i 1 - 2S albumin
  • Ses i 2 - 2S albumin
  • Ses i 3 - 7S vicilin-like globulin
  • Ses i 4 - oleosin
  • Ses i 5 - oleosin
  • Ses i 6 - 11S globulin
  • Ses i 7 - 11S globulin

Note:
  • Oleosins are structural proteins found in plant cell oil bodies (oil bodies are lipid-containing structure found in plant cells)
  • Common food allergen in countries where it is regularly consumed (Japan, Israel, Europe) and it is becoming more common in the US


Sesame Seed Allergen Cross-reactivity





Diagnosis

Method
Comment
SPT
  • Commercial extracts - may be sufficient for detection of water soluble sesame proteins
  • Fresh prick to prick with:
    • Sesame seed crushed in saline
    • Commercial sesame oil (e.g. Crudigno brand)

sesame_spt_performance.png
Immediate skin contact test
  • May allow better detection of oleosin-sensitized patients
  • Apply a square of filter paper (10x10 mm) dipped in sesame oil (Crudigno) on the volar side of the forearm and remove it after 20 minutes
In-vitro specific IgE
  • Thermo Scientific (Phadia):
    • Sesame seed (complete allergen) - ImmunoCAP
    • nSes i 1 (component) is included in ISAC microarray

sesame_IgE_performance.png
Oral food challenge
  • Sampson: challenge to sesame if sIgE is ≤20 kUA/L; avoidance if >20
    • We will perform a challenge in patients with sIgE >20 if the patient/family would like to have sesame in the diet
    • If the skin test is negative, sesame may be introduced into the diet

Note: Sesame oil differs from the others because it is typically available as an unrefined, crude oil, which contains a significantly higher amount (3-13 mg/g) of proteins



Sesame Seed Allergy Monitoring





Sesame OFC Protocols

  • Dalal, Sampson: patients may tolerate the sesame seed but react to sesame-based spreads and sauces. Thus, it is important to educate these patients that the ability to eat sesame- topped bread does not imply a tolerance to other sesame-based products.

Kanny

  • Challenge material: sesame seeds
  • Interval: 30 min
  • Total dose: 16.55 g
    • 0.05 g
    • 0.5 g
    • 1 g
    • 5 g
    • 10 g


HealthNuts

  • Designed for 1 year old infants
  • Challenge material: Unhulled tahini (Mayver’s, Altona North, Victoria, Australia). After the initial dose, the allergen is mixed with an age-appropriate previously tolerated food (eg, apple sauce or yogurt) on the basis of preferred parental choice of food.
  • Interval: 20 min
  • Total dose: 9.7 mL tahini (11.3 g)
    • Drop inside lip (not to touch outside lip)
    • 0.31 mL
    • 0.62 mL
    • 1.25 mL
    • 2.5 mL
    • 5 mL


Permaul

  • Challenge material: sesame seeds
  • Interval: 15 min
  • Children3 yo
    • 100 mg
    • 500 mg
    • 1 g
    • 2 g
    • 4 g
    • 4 g
  • Children <3 yo
    • 500 mg
    • 1 g
    • 2 g
    • 4 g



References