title: Identification of carmine allergens among three carmine allergy patients.
abstract: BACKGROUND
  There have been several reports of carmine allergy; however, identification of the responsible carmine allergens has not been widely documented.
  
  
  METHODS
  Three female patients presented with a history of anaphylaxis and/or urticaria/angioedema after ingestion of carmine-containing foods. All three patients had 4+ skin prick tests to carmine. Among them, two patients were confirmed to have carmine allergy by blinded, placebo-controlled food challenges to carmine. SDS-PAGE of cochineal insects and carmine, immunoblotting for IgE antibody with sera from all three patients, and immunoblotting inhibition with carmine were performed.
  
  
  RESULTS
  SDS PAGE of minced cochineal insects revealed several protein bands of 23-88 kDa. Several of these bands were variably recognized by our three patients' sera, and this reactivity was inhibited by carmine. Although no protein bands could be visualized on SDS-PAGE of carmine in Coomassie brilliant blue staining, three protein bands were recognized by two of the three patients' serum.
  
  
  CONCLUSIONS
  These results suggest that commercial carmine retains protein-aceous material from the source insects. These insect-derived proteins (possibly complexed with carminic acid) are responsible for IgE-mediated carmine allergy. Patient reactivity to these proteins may vary.
authors.affiliation: Department of Internal Medicine, University of Michigan Hospital, Ann Arbor 48109-0380, USA.
authors.forename: K
authors.initials: K
authors.lastname: Chung
authors.forename: J R
authors.initials: JR
authors.lastname: Baker
authors.forename: J L
authors.initials: JL
authors.lastname: Baldwin
authors.forename: A
authors.initials: A
authors.lastname: Chou
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000485:Allergens / Q000276:immunology; D002329:Carmine / Q000008:administration & dosage / Q000009:adverse effects*; D004396:Coloring Agents / Q000008:administration & dosage / Q000009:adverse effects*; D004591:Electrophoresis, Polyacrylamide Gel; D005260:Female; D005505:Food Coloring Agents / Q000008:administration & dosage / Q000009:adverse effects*; D005512:Food Hypersensitivity / Q000209:etiology / Q000276:immunology*; D006801:Humans; D015151:Immunoblotting; D007073:Immunoglobulin E / Q000276:immunology; D019476:Insect Proteins / Q000276:immunology*; D012882:Skin Tests
chemical_list: D000485:Allergens; D004396:Coloring Agents; D005505:Food Coloring Agents; D019476:Insect Proteins; D007073:Immunoglobulin E; D002329:Carmine