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  Substance Info: (and synonyms)
Pea

Background Info:

Common Names: Pea, Garden Pea, Greenpea, Green Pea, Dry Pea. Snow Pea, Sugar Snap Pea

Pea probably originated in southwestern Asia, but it spread nearly throughout the world. Green Peas are the number-one processed vegetable in the UK and the USA. The plant is an annual, dwarf or climbing, growing as high as 2m. The Pea is a small, round, smooth or wrinkled seed, growing in pods.

There are many varieties of Pea, some grown to be eaten fresh, others to be used dried. (Dried Peas were the staple food of Europe during the Middle Ages.) Pod Peas are those that are eaten pod and all, namely the Snow Pea and Sugar Snap Pea. Dried Peas are high in carbohydrate and fibre and low in fat, an economical source of protein.

Green Peas are marketed fresh, canned, or frozen. They can be cooked alone as a vegetable or added to other dishes. They can also be sprouted and added to salads, soups, etc. The mature seed may be dried and used whole or split (in which form it is often served as dahl), or ground into a powder and then used to enrich the protein content of flour. Roasted Peas can be a coffee substitute. The leaves and young shoots are cooked as a potherb. Peas, either whole or ground and extruded, are increasingly popular snack items.

Peas are reported to be contraceptive, fungistatic and spermacidal, and are said to have several other medicinal properties. The dried and powdered seed, for example, has been used as a poultice for skin complaints, including acne.

 

Adverse Reactions:

IMMUNE REACTIONS


[ 1 / 17 ]

Legumes belonging to Fabaceae family of the order Fabales are a rich and important source of proteins and many essential elements. Due to its nutritious elements, these are preferably included in human diet in most part of the world. But, unfortunately, IgE binding proteins have been identified in majority of legumes, and allergenic response to these legumes may range from mild skin reactions to life-threatening anaphylactic reaction. Overall, allergenicity due to consumption of legumes in decreasing order may be peanut, soybean, lentil, chickpea, pea, mung bean, and red gram. So far, several allergens from different legumes have been identified and characterized. Most of identified allergens belong to storage proteins family, profilins, or the pathogenesis-related proteins. Legumes also have property of immunological cross-reactivity among themselves and from other sources that also increases the severity of allergenic response to a particular legume. This review summarizes the currently available knowledge on legume allergy and describes the allergenic problems associated with different legumes. It also tries to explore about the legume allergens identified so far by different scientific groups. The culmination of knowledge about identification and characterization of allergens from different legumes will be helpful in diagnosis and treatment of allergy, for development of novel therapeutic strategies, for strict avoidance of particular legume in diet by susceptible individual and also to produce hypoallergenic cultivars of leguminous crop through conventional breeding or genetic modification.

Reference:
Verma AK, Kumar S, Das M, Dwivedi PD. A comprehensive review of legume allergy. Clin Rev Allergy Immunol 2012 May 4;



[ 2 / 17 ]

The present manuscript provides data on food allergens such as peas and cauliflower, which have been reported as rare causes of anaphylaxis. (Dolle 2012 ref.28181 8)

Reference:
Dölle S, Hompes S, Grünhagen J, Worm M. Food-associated anaphylaxis. Data from the anaphylaxis registry. [German] Hautarzt 2012 Apr;63(4):294-298



[ 3 / 17 ]

The objective of this study was to describe the clinical features of a Spanish pediatric population allergic to legumes (lentils, chickpeas, peas, white beans, and peanuts), to evaluate the clinical allergy to several legumes, and to determine which legume extract is most appropriate to use in the diagnosis of legume allergy by skin tests. Fifty-four children with allergic reactions after exposure to legumes were studied. The onset of allergic reactions was at approximately the age of 2 years (median, 22 months). Skin prick test results were positive for at least 3 legumes in 38 children (70%). Positive results were more frequent to boiled extracts than to raw extracts in children with a positive oral challenge. Allergy to lentil was the most frequently diagnosed legume allergy (43 children [80%]), followed by allergy to chickpea (32 children [59%]), pea (27 children [50%]), peanut (18 children [33%]) and white bean (6 children [11%]). Oral challenges with more than 1 legume (median, 3 legumes) were positive in 37 children (69%). The most frequent induced symptoms on challenge were respiratory (rhinitis and/or asthma) and cutaneous.
Clinical Manifestations During Oral Challenges
Symptom Total Lentil Chickpea Pea White bean Peanut
(n=105) (n=37) (n=29) (n = 24) (n=6) (n=9)
Cutaneous 45 (43) 14 (38) 15 (52) 13 (54) 2(33) 3 (33)
GITl 20 (19) 4 (11) 3 (10) 3 (13) 2(33) 2 (22)
Resp 60 (57) 12 (32) 17 (59) 11 (46) 0 4 (44)
OAS 28 (27) 16 (43) 5 (17) 3 (13) 2 (33) 2 (22)
Severe react 11(10) 3 (8) 4(14) 2 (8) 0 2 (22)
(Martínez 2008 ref.22238 3)

Reference:
Martínez San Ireneo M, Ibáñez MD, Sánchez JJ, Carnés J, Fernández-Caldas E. Clinical features of legume allergy in children from a Mediterranean area. Ann Allergy Asthma Immunol 2008 Aug;101(2):179-84



[ 4 / 17 ]

Legume allergy, mainly to lentils and chickpeas, is the fifth most common cause of food allergy in Spanish children. Serological cross-reactivity among legumes is frequent, but its clinical relevance is controversial. The aim of this study was to investigate the cross-reactivity among lentils, chickpeas, peas, white beans and peanuts and its clinical relevance in pediatric patients. Fifty-four children with clinical allergy to legumes were included. Inhibition experiments demonstrated more than 80% inhibition with lentil, chickpea and pea extracts. Immunoblots performed with raw legume extracts (lentil, chickpea and pea) and individual sera revealed that more than 50% of the sera identified an allergen with approximately 50 kDa in all three legume extracts. In all three boiled extracts an intense band at approximately 50 kDa was visualized using a serum pool. The oral legume challenges demonstrated that 37 children (69%) were allergic to 2 or more legumes (median 3 legumes). The most frequent associations were allergy to lentils and chickpeas (57%), allergy to lentils and peas (54%) and allergy to lentils, chickpeas and peas (43%). Food challenges confirmed that clinical allergy to all three legumes is frequent in this cohort of Spanish children. (Martínez 2008 ref.21964 7)

Reference:
Martínez San Ireneo M, Ibáñez MD, Fernández-Caldas E, Carnés J. In vitro and in vivo cross-reactivity studies of legume allergy in a Mediterranean population. Int Arch Allergy Immunol 2008 Jul 2;147(3):222-230



[ 5 / 17 ]

15 green pea allergic individuals were assessed to determine the influence of maturation on the alteration of allergenicity. (Sell 2005 ref.11319 7)

Reference:
Sell M, Steinhart H, Paschke A. Influence of maturation on the alteration of allergenicity of green pea (Pisum sativum L.). J Agric Food Chem 2005;53(5):1717-22



[ 6 / 17 ]

A protein from bean was found immunogenic when expressed in pea. Specifically, immunological assessments carried out on this transgenic protein showed that post-translational processing subsequent to gene transfer into an alien species introduced new antigenicities that turned a previously harmless protein into a strong immunogen. Furthermore, the transgenic protein promoted immune reactions against multiple other proteins in the diet. "The transgenic expression of a plant protein (alpha-amylase inhibitor-1 from the common bean (Phaseolus vulgaris L. cv. Tendergreen)) in a non-native host (transgenic pea (Pisum sativum L.)) led to the synthesis of a structurally modified form of this inhibitor. Employing models of inflammation, we demonstrated in mice that consumption of the modified alphaAI and not the native form predisposed to antigen-specific CD4+ Th2-type inflammation. Furthermore, consumption of the modified alphaAI concurrently with other heterogeneous proteins promoted immunological cross priming, which then elicited specific immunoreactivity of these proteins. Thus, transgenic expression of non-native proteins in plants may lead to the synthesis of structural variants possessing altered immunogenicity." (Prescott 2005 ref.13123 7)

Reference:
Prescott VE, Campbell PM, Moore A, Mattes J, Rothenberg ME, Foster PS, Higgins TJ, Hogan SP. Transgenic expression of bean alpha-amylase inhibitor in peas results in altered structure and immunogenicity. J Agric Food Chem 2005 Nov 16;53(23):9023-30.



[ 7 / 17 ]

Infantile food protein-induced enterocolitis syndrome (FPIES) is a severe, cell-mediated gastrointestinal food hypersensitivity typically provoked by cow's milk or soy. This study reports on other foods causing this syndrome: 14 infants with FPIES caused by grains (rice, oat, and barley), vegetables (sweet potato, squash, string beans, peas), or poultry (chicken and turkey) were identified. Symptoms of typical FPIES are delayed (median: 2 hours) and include the onset of vomiting, diarrhea, and lethargy/dehydration. Eleven infants (78%) reacted to >1 food protein, including 7 (50%) that reacted to >1 grain. Nine (64%) of all patients with solid food-FPIES also had cow's milk and/or soy-FPIES. Initial presentation was severe in 79% of the patients, prompting sepsis evaluations (57%) and hospitalization (64%) for dehydration or shock. None of the patients developed FPIES to maternally ingested foods while breastfeeding unless the causal food was fed directly to the infant. (Nowak-Wegrzyn 2003 ref.7791 5)

Reference:
Nowak-Wegrzyn A, Sampson HA, Wood RA, Sicherer SH. Food protein-induced enterocolitis syndrome caused by solid food proteins. Pediatrics 2003;111(4 Pt 1):829-35



[ 8 / 17 ]

In a Spanish study, in 20 of 22 subjects who experienced allergy symptoms following exposure to lentils, the most frequent symptoms were oropharyngeal symptoms (40%) and acute urticaria (30%); 3 patients also reported symptoms when they were exposed to steam from cooked lentils. Onset of sensitisation occurred less than 4 years of age and 9 patients had allergic reactions to other legumes: chick peas (6 patients), peas (2 patients), and green beans (1 patient). The heating process caused a significant decrease in specific-IgE-binding.
CLINICAL FEATURES
Age-onset Symptoms Lentil-slgE Other food allergies
(kUA/L)
2.5* U 6.64 Chick peas
3 U 4.75 Chick peas
4 OAS 18.2
5 NS 44.9 Fish
12 U,C,W 13.1
3* OAS/R 17.5 Green beans
3 U,V,LE 5.61 Chick peas, peaches, fish
3 V,AP,D 8.7 Fish, milk
2 AD 54.6
2 U/A 7.16 Peas
3 U/A 16.7 Peas, fish
3* OAS/R 4.72 Chick peas
3 OAS 4.86
12 U/A,C,W 20.3 Peaches
6 NS 8.9 Chestnut
1.5 U,C,W >100
1.5 OAS 25.9 Fish
1.5 OAS 13.4 Chick peas
1.7 U/A 5.43
2.1 OAS 43.6
1.8 OAS 5.87 Chick peas
1.2 U/A 44.4
U, generalized urticaria; OAS, oral allergy syndrome; NS, no symptoms; C. cough; W, wheezing; R, rhinitis; V, vomiting; LE, laryngeal edema; AP, abdominal pain; D, diarrhea; AD, atopic dermatitis; A, facial angioedema.
*Also, symptoms after exposure to steam from cooked lentils.
(Pascual 1999 ref.7341 3)

Reference:
Pascual CY, Fernandez-Crespo J, Sanchez-Pastor S, Padial MA, Diaz-Pena JM, Martin-Munoz F, Martin-Esteban M. Allergy to lentils in Mediterranean pediatric patients. J Allergy Clin Immunol 1999;103(1 Pt 1):154-8



[ 9 / 17 ]

In a 38-year-old woman with allergy to lupine seed, in oral challenge, 10 minutes after pea ingestion, she developed ocular itching, rhinorrhea, sneezing, watery eyes, and palm-plantar itching. (Matheu 1999 ref.4081 3)

Reference:
Matheu V, de Barrio M, Sierra Z, Gracia-Bara MT, Tornero P, Baeza ML. Lupine-induced anaphylaxis. Ann Allergy Asthma Immunol 1999;83(5):406-8



[ 10 / 17 ]

This study reports on a 33 year old woman who developed tongue swelling and burning and mouth itching occurring minutes after eating baked beans. Similar symptoms occurred a day after ingesting pea soup, and on another occasion within 15 minutes after eating a bean burrito, and again 20 minutes after eating chilli containing kidney and pinto beans. In this instance she also developed chest tightness, wheezing, generalised erythema, urticaria, abdominal pain, feeling of impending doom and light headedness. Skin specific IgE was positive to red kidney and white beans but negative to pea, string and lima beans. Serum specific IgE was positive to red kidney, white, pinto , chick, garden and black-eyed peas. (Zacharisen 1998 ref.7310 2)

Reference:
Zacharisen MC, Kurup V. Anaphylaxis to beans. J Allergy Clin Immunol 1998;101(4 Pt 1):556-7



[ 11 / 17 ]

A 54-year-old female, who developed episodes of asthma, sometimes requiring hospital care, when exposed to vapours from cooking certain legumes (peas, chick peas, beans, lentils). The same symptoms appeared after ingestion of these legumes, as well as mouth itch and lip angioedema immediately after eating peanuts. The SPT for the 5 legumes: peas, peanuts, beans, lentils and chickpeas, including the heated extracts, were clearly positive. CAP values were: pea (> 100 KU/L), peanut (55.3 KU/L), bean (9 KU/L), lentil (> 100 KU/L) and chickpea(> 100 KU/L). Inhibition tests showed cross-reactivity among legumes. (Garcia 1995 ref.735 8)

Reference:
Garcia Ortiz JC, Lopez Asunsolo A, Cosmes P, Duran AM. Bronchial asthma induced by hypersensitivity to legumes. Allergol Immunopathol (Madr) 1995;23(1):38-40



[ 12 / 17 ]

Pea allergy in an individual. (Huertas 1995 ref.7385 3)

Reference:
Huertas AJ, Iriarte P, Polo P, Ayuso R. Urticaria during prick by prick skin test with legumes. [Abstract] Allergy 1995;50S:230



[ 13 / 17 ]

A 54-year-old female patient, diagnosed of nasal polyposis and intrinsic corticodependent bronchial asthma, who since a year has developed episodes of asthma when exposed to vapours from cooking some kinds of legumes (peas, chick-peas, beans, lentils) and an oral allergy syndrome with peanuts.The skin tests were clearly positive for legumes. Specific IgE by CAP was strongly positive for legumes. (Martin 1991 ref.32 112)

Reference:
Martin MA, Compaired JA, de la Hoz B, et.al. Bronchial asthma induced by legumes (abstract). CH Schweiz med Wschr 1991;121:2297.S40



[ 14 / 17 ]

In a study of 57 children under 1 year of age, 43 children aged 12 to 35 months, and 42 children aged 3 to 15 years with atopic dermatitis were skin tested with foods suspected to have caused their dermatitis and other possible allergic symptoms, hen egg was the most common food allergen in children under 1 year of age. After that age, apple, carrot, pea, and soybean elicited positive reactions as often as egg.
Seventeen infants were still on breast milk only at the time of the initial examination. Skin prick testing with egg was positive in 12 of them, and milk SPT in two, while only two children were SPT negative. The mother's exclusion diet was helpful in both the infants with apparent milk allergy and in two further children with a positive egg SPT result. In addition to these four cases, allergen avoidance diets were beneficial, i.e., most symptoms disappeared within 2 weeks in 16 children, all of whom were under 5 years of age. Milk, cereals, cooked potato, banana, and soy were the allergens responsible for hypersensitivity in these particular 16 cases. This author first reported that cooked potato could cause atopic eczema in infants under one year of age, whereas older children appeared to be asymptomatic. Of 24 patients aged 0-11 months skin prick tested for potato, 3 were positive, of which 2 were consistent with patient history. Of 11 children aged 12-35 months skin prick tested with fresh Potato, 1 was positive and consitent with the patient’s history, and 4 of 29 children aged 3-15 years tested positive, of which 3 were consistant with patient history. (Hannuksela 1987 ref.1711 8)

Reference:
Hannuksela M. Diagnosis of dermatologic food allergy. Ann Allergy 1987;59(5 Pt 2):153-6



[ 15 / 17 ]

In this study, 102 patients with the initial diagnosis of idiopathic anaphylaxis were evaluated with a battery of 79 food-antigen skin prick tests selected to include foods reported or suspected of provoking anaphylaxis. Thirty-two patients (31%) had positive tests to one or more food antigens. In five of these patients, subsequently eating a food that elicited a positive test provoked an anaphylactic reaction. Two patients eliminated the foods completely, stopped having reactions, and refused challenge. In these seven patients, 10 different antigens provoked anaphylaxis: aniseed, cashew nut, celery, flaxseed, hops, mustard, mushroom, shrimp, sunflower, and walnut. We conclude that a battery of selected food-antigen skin prick tests provided a useful method for identifying an offending antigen in these patients and that some (7% in our series) cases of "idiopathic" anaphylaxis by history are not truly idiopathic.
The 10 antigens with positive clinical correlation
Antigens A B C
Aniseed 1 5 20
Cashew nut 1 2 50
Celery 2 4 50
Flaxseed 1 1 100
Hops 1 2 50
Mushroom 1 3 33
Mustard 2 3 66
Shrimp 1 3 33
Sunflower seed 1 3 33
Walnut 1 1 100
A = Total No. of positive skin tests with positive correlation
B = Total No. of positive skin tests
C = Percent of positive skin tests with positive correlation

Total number of positive skin prick tests.
2 - Almond
5 - Aniseed
1 - Artichoke
1 - Baker's yeast
1 - Beet
1 - Brazil nut
2 - Brewer's yeast
1 - Caraway seed
2 - Cashew nut
5 - Castor bean
4 - Celery
8 - Chamomile
2 - Chestnut
1 - Chicory
1 - Clam
2 - Coconut
1 - Cottonseed
2 - Crab
1 - Fennel
4 - Filbert (hazelnut)
I - Flaxseed
1 - Garbanzo bean
2 - Ginger
1 - Halibut
1 - Honey
2 - Hops
3 - Horseradish
1 - Lentil
1 - Lima beans
2 - Lobster
2 - Mango
1 - Milk
5 - Millet
3 - Mushroom
3 - Mustard
1 - Nutmeg
2 - Pea
1 - Pistachio
3 - Poppy seed
2 - Sesame seed
3 - Shrimp
3 - Sunflower
1 - Thyme
1 - Tumeric
1 - Walnut
None for Allspice, Apple, Banana, Bay leaf, Black pepper, Buckwheat, Cantaloupe, Chicken, Chili pepper, Chocolate, Cinnamon, Clove, Cod, Corn, Cumin seed, Dill seed, Egg, Garlic, Juniper berry, Orange, Oyster, Peach, Peanut, Potato, Psyllium seed, Raspberry, Sage, Salmon, Soybean, Strawberry, Sweet potato, Tangerine, Tapioca, Vanilla.
7 patients with positive clinical correlation to a SPT
1 : Aniseed
2 : Shrimp
3 : Mustard, flaxseed
4 : Celery, hops
5 : Celery, mustard, sunflower
6 : Walnut, cashew nut
7 : Mushroom
(Stricker 1986 ref.9 3606)

Reference:
Stricker WE, Anorve Lopez E, Reed CE. Food skin testing in patients with "idiopathic anaphylaxis". J Allergy Clin Immunol 1986;77:516-519



[ 16 / 17 ]

The death of an 18-month-old child during re-challenge with peas was also reported by von Starck in 1926. (Von 1926 ref.11945 8)

Reference:
Von Starck K. Primäre spezifische Allergie und idiosynkratischer Schock. Monatsschr Kinderheilkd 1926;32:119-127.



[ 17 / 17 ]

A 1.5 year-old child with atopic dermatitis experienced facial angioedema and cutaneous itching on three separate occasions after eating peas. The child developed facial angioedema, cyanosis, and cardiopulmonary arrest after being fed an in-hospital diagnostic "test meal" containing peas. (Von Starck ref.22814 2) (In: Yunginger 1988 ref.278 37)

Reference:
Von Starck Primary specific allergy and idiosyncratic shock. MonatsschrKinderheilkd 1926;32:119-127.




Non-Immune reactions


[ 1 ]

Six patients (four males, two females aged 3-12 months) were diagnosed with food protein-induced enterocolitis syndrome (FPIES) triggered by foods other than cow's milk and soy: chicken in four, turkey in two, peas in one, and lentils in one (five patients reacted to more than one food type). All reactions developed within 2 h of ingestion of the allergenic food. (Levy 2003 ref.8320 1)

Reference:
Levy Y, Danon YL. Food protein-induced enterocolitis syndrome--not only due to cow's milk and soy. Pediatr Allergy Immunol 2003;14(4):325-9.



[ 2 ]

Rice- and pea-induced food protein-induced enterocolitis syndrome, a symptom complex of severe vomiting and diarrhea occurring several hours after the ingestion of particular food proteins in infants.

Sixteen patients had typical FPIES; 11 reacted to milk, 11 to soy, and 7 to both. Mean age at diagnosis was 7 weeks for milk reactivity and 8 weeks for soy reactivity. Two patients also had rice- and pea-induced FPIES. Among 14 patients who were followed up for a median period of 25 months, loss of sensitivity to milk occurred in 6 of 10 patients and loss of sensitivity to soy occurred in 2 of 8. Six additional cases of FPIES were considered atypical: 1 patient had late-onset disease caused by poultry, and in 5 patients IgE antibody to milk or soy developed. During supervised food challenges with milk and soy, the peripheral blood neutrophil count rose over 3500 cells/mm3 in 9 of 10 positive challenges and did not rise above this value in the 7 negative challenges. Emergency treatment was required in 62% of challenges. (Sicherer 1998 ref.2389 6)

Reference:
Sicherer SH, Eigenmann PA, Sampson HA. Clinical features of food protein-induced enterocolitis syndrome. J Pediatr 1998;133(2):214-9




Occupational reactions


[ 1 ]

Occupational asthma caused by pea flour. (Bhagat 1995 ref.7312 2)

Reference:
Bhagat R, Swystun VA, Cockcroft DW. Occupational asthma caused by pea flour. [Letter] Chest 1995;107(6):1772




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