title: Preacutionary labelling of cross-reactive foods: The case of rapeseed.
abstract: Food allergic individuals are exposed to unnecessary dietary restrictions due to precautionary food allergy labelling (PFAL). Two forms of PFAL exist: type I identifies the possible presence of allergenic contaminaion in foods ('may content…'), type II indicates as potentially dangerous ingredients or contaminants that do no belong to official list of food allergens. PFAL type II is based on the fear of cross-reactivity with foods belonging to that list. PFAL type II is less known, but may be tempting for the legal offices of food companies, for clinicians in a 'defensive medicine' key, and even for legislators. We identify here a case of PFAL type II, allergy to rapeseed (belonging to the family ofBrassicaceae). Increasingly used for their nutritional and nutraceutic value in asthma prevention, rapeseed has been indicated by regulatory authorities in Canada and Europe as potential cross-reactor with mustard. In this review, we provide the elements for a risk assessment of cross-reactivity of rapeseed/mustard allergy in the general population both clinically and from the point of view of the molecular allergy. Three findings emerge: 1. Allergic reactions to rapeseed are exceptional 2. The allergens identified in rapeseed and mustard are similar, but not identical 3. Reactions to rapeseed have never been described in mustard-allergic patients. On the ground of existing evidence, a precautionary labeling for rapeseed as potentially dangerous for patients allergic to mustard is not justified. In the interest of patients with multiple food allergy, PFAL type II must be avoided.
authors.affiliation: Ospedale Pediatrico Bambino Gesù, Dipartimento Pediatrico Universitario Ospedaliero (DPUO), UOC Allergologia, Rome, Vatican City Italy.
authors.forename: Alessandro
authors.identifier: 0000-0002-2549-0523
authors.initials: A
authors.lastname: Fiocchi
authors.affiliation: Ospedale Pediatrico Bambino Gesù, Dipartimento Pediatrico Universitario Ospedaliero (DPUO), UOC Allergologia, Rome, Vatican City Italy.
authors.forename: Lamia
authors.initials: L
authors.lastname: Dahdah
authors.affiliation: Ospedale Pediatrico Bambino Gesù, Dipartimento Pediatrico Universitario Ospedaliero (DPUO), UOC Allergologia, Rome, Vatican City Italy.
authors.forename: Carla
authors.initials: C
authors.lastname: Riccardi
authors.affiliation: Ospedale Pediatrico Bambino Gesù, Dipartimento Pediatrico Universitario Ospedaliero (DPUO), UOC Allergologia, Rome, Vatican City Italy.
authors.forename: Oscar
authors.initials: O
authors.lastname: Mazzina
authors.affiliation: Ospedale Pediatrico Bambino Gesù, Dipartimento Pediatrico Universitario Ospedaliero (DPUO), UOC Allergologia, Rome, Vatican City Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Fierro