title: Anaphylactic reaction to probiotics. Cow's milk and hen's egg allergens in probiotic compounds.
abstract: BACKGROUND
  Probiotics are used in the treatment of allergic diseases. We investigated the safety of probiotics for subjects with food allergy.
  
  
  METHODS
  Labels of probiotics commercially available in Spain were examined to assess their content of cow's milk or hen's egg. Skin prick tests with these compounds (20 mg/ml) were performed in five children allergic to cow's milk, five children allergic to hen's white egg, and five control subjects non-allergic to food. Three serum pools: I (positive-specific IgE to cow's milk and hen's egg white proteins), II (positive-specific IgE to cow's milk and negative to hen's egg white proteins), and III (negative-specific IgE to cow's milk and positive to hen's egg white proteins) were used to detect cow's milk and hen's egg white allergens in probiotics. ImmunoCAP(®) (Phadia), in-house ELISA, SDS-PAGE immunoblotting, and inhibition studies of these assays were performed. Proteins were quantified by enzyme-immunoassay.
  
  
  RESULTS
  Eleven probiotics were studied. No label advertised about egg content, eight labels warned about lactose, lactic acid or cow's milk, one label claimed to be milk-free, and two gave no information. Cow's milk proteins were detected, by at least one lab technique, in 10/11 probiotics, three over 2.5 mg/kg (21, 52, 112 mg/kg). Hen's egg white proteins were detected in 3/11 probiotics, only one had more than 2.5 mg/kg (47 mg/kg).
  
  
  CONCLUSIONS
  Probiotic compounds may contain hidden allergens of food and may not be safe for subjects with allergy to cow's milk or hen's egg.
authors.affiliation: Department of Allergy, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain. mfmartin@luflo.e.telefonica.net
authors.forename: María Flora
authors.initials: MF
authors.lastname: Martín-Muñoz
authors.forename: Monserrat
authors.initials: M
authors.lastname: Fortuni
authors.forename: Magdalena
authors.initials: M
authors.lastname: Caminoa
authors.forename: Teresa
authors.initials: T
authors.lastname: Belver
authors.forename: Santiago
authors.initials: S
authors.lastname: Quirce
authors.forename: Teresa
authors.initials: T
authors.lastname: Caballero
mesh_terms: D000485:Allergens / Q000009:adverse effects / Q000032:analysis* / Q000276:immunology; D000707:Anaphylaxis / Q000209:etiology*; D000818:Animals; D002417:Cattle; D002648:Child; D021181:Egg Hypersensitivity / Q000150:complications / Q000175:diagnosis* / Q000276:immunology; D004527:Egg Proteins / Q000009:adverse effects / Q000032:analysis* / Q000276:immunology; D005260:Female; D006801:Humans; D008892:Milk / Q000009:adverse effects* / Q000276:immunology; D016269:Milk Hypersensitivity / Q000150:complications / Q000175:diagnosis* / Q000276:immunology; D008894:Milk Proteins / Q000009:adverse effects / Q000032:analysis* / Q000276:immunology; D019936:Probiotics / Q000009:adverse effects* / Q000737:chemistry / Q000627:therapeutic use
chemical_list: D000485:Allergens; D004527:Egg Proteins; D008894:Milk Proteins