Substance Info: (and synonyms)|
Melon Background Info:
Common Names: Melon, Common Melon, Winter Melon, Armenian Cucumber, Cantaloupe, Honey Dew, Muskmelon
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In this study aimed at finding new mustard allergens, 15 mustard-allergic patients with symptoms to peach were included. The mean age ranged from 18 to 54. The majority suffered from systemic symptoms when eating mustard (13/15) as well as OAS. All patients had OAS on eating fresh peach and 5/15 patients also suffered from systemic symptoms. Most of them also presented symptoms with other plant-derived foods, such as nuts (11/15), legumes (5/15), peanut (10/15), melon (12/15) or kiwi (9/15). The recombinant proteins, Sin a 3 and/or Sin a 4, were recognized by the IgE of sera from 11 out of 15 patients used in the study. The remaining patients recognized protein bands corresponding to major allergens such as Sin a 1 and Sin a 2 or not yet explored allergens. Sin a 3 shows 65% identity with amino acid sequence of Bra o 3 (nsLTP from cabbage, B. oleraceae var. capitata), and moderate, from 51% to 55% with Pru p 3, Mal d 3, Pru av 3, Fra a 3 or Cor a 8. Sin a 3 (nsLTP) and Sin a 4 (profilin) were identified as new mustard allergens and showed IgE cross-reactivity with fruits such as peach or melon, respectively. (Sirvent 2009 ref.24489 6)
Sirvent S, Palomares O, Vereda A, Villalba M, Cuesta-Herranz J, Rodríguez R. nsLTP and profilin are allergens in mustard seeds: cloning, sequencing and recombinant production of Sin a 3 and Sin a 4. Clin Exp Allergy 2009 Dec;39(12):1929-1936
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A report of 2 cases of anaphylactic reactions to peach with a negative peach ImmunoCAP. A 35-year-old man, who felt an itch in his oral cavity immediately after ingesting a whole fresh peach, rapidly developed generalized urticaria, dyspnea, vomiting, and loss of consciousness. Peach ImmunoCAP conducted for screening allergens was negative for peach and the cause of anaphylaxis remained unclear resulting in his referral. He was pollen allergic and reported previously experiencing an itch on his oral cavity after ingesting melon, watermelon, apple, and strawberry. Total serum IgE was 436 IU/ml. CAP-RAST was negative for peach, strawberry and kiwi. Skin prick tests with raw peach pulp, canned peach pulp, strawberry and kiwi were positive. The second patient, was a 30-year-old woman who felt an itch on her oral cavity accompanied by blepharedema, rhinorrhea, generalized urticaria, nausea, abdominal pain and diarrhea after eating peach. She was pollen allergic. She had previously developed urticaria after ingesting an apple. Total serum IgE was 85 IU/ml. ImmunoCAP was negative for peach and apple. SPTs with canned yellow peach, strawberry and apple were positive. In both patients ImmunoCAP to rPru p 1, rPru p 3, and rPru p 4 were negative. However, in IgE-immunoblotting of peach, serum IgE antibodies of two patients were bound to approximately 10 kDa proteins. These results suggest that in patients suspected of having peach anaphylaxis and with a negative peach ImmunoCAP, additional testing, such as SPT with peach, should be performed for diagnosis. (Maeda 2009 ref.23336 7)
Maeda N, Inomata N, Morita A, Kirino M, Moriyama T, Ikezawa Z. Anaphylaxis due to peach with negative ImmunoCAP result to peach allergens, including rPru p 1, rPru p 3, AND rPru p 4: A report of two cases. [Japanese] Arerugi 2009 Feb;58(2):140-7.
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Immunological contact urticarial and/or protein contact dermatitis. Classically, the protein sources are divided into 4 main groups: group 1: fruits, vegetables, spices, plants, and woods; group 2: animal proteins; group 3: grains and group 4: enzymes. Taking into account the nature of the causal proteins, a wide variety of jobs can be affected. (Amaro 2008 ref.20923 7)
Amaro C, Goossens A. Immunological occupational contact urticaria and contact dermatitis from proteins: a review. Contact Dermatitis 2008 Feb;58(2):67-75.
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A 20 year-old male presented with rhinoconjunctivitis, facial swelling and generalized itching a few minutes after ingestion of a fresh lychee. One year before, he had a similar episode which appeared after eating a fresh mango. He had persistent rhinoconjunctivitis, with worsening in Spring, since 11 years old and symptoms of oral allergy syndrome associated with peach and melon since 15 years old. Skin prick tests with commercial extracts and fresh fruits were positive to lychee, mango, peach, melon, apple, kiwi and watermelon, Artemisia vulgaris, Olea europea, Platanus acerifolia, Betula verrucosa, Plantago lanceolata, grasses mixture and dust mites. Specific IgE for allergens positive in SPT were: lychee(6.08), apple(4.43), peach(3.62), mango(1.23), melon(0.85), Artemisia(26.7),Olea(10.7), Platanus(10.7), Plantago(4.53), Betula(5.43), Phleum(3.46), D.pteronyssinus(0.48). Inhibition studies showed a marked inhibition between Artemisia/Olea/Betula/Plantago and lychee/mango/peach/melon. Bet v2 t216, profilin, was positive while Bet v1 was negative. The profilin in Lychee fruit was identified as the most probably protein responsible for the patient's syndrome and the cross reaction between pollen and fruits.
Costa AC, Pereira-Santos MC, Santos AS, Ferreira MB, Pedro E, Lundberg M, Kober A, Pereira-Barbosa MA. Profilin as the Most Probable Protein Responsible for Cross-Reactivity between Lychee, Other Fruits and Plants. ACAAI Annual Scientific Meeting. 2007:Nov, Dallas. Poster 145.
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A 32-year-old male reported dyspnea accompanied by wheals, and symptoms of low blood pressure while walking after eating Chinese noodles and donuts. He also reported uncomfortable sensations in his mouth and throat after ingesting melon. No symptoms were induced by exercise or by the ingestion of any single food item before exercise. However, numerous wheals appeared when exercise followed the combined ingestion of foods. Likewise, the sequence of eating pancakes and then exercising resulted in numerous wheals and anaphylaxis. The skin prick tests resulted in fruit-induced erythema and wheals. The results of these tests with wheat, butter and sugar were negative, and no symptoms were induced by the exercise test after ingestion of watermelon, melon or apple. The anaphylactoid symptoms were accompanied by a significant increase of plasma noradrenaline. In this case, not only wheat, but sugar and butter may induce the onset of FDEIA. (Kato 2007 ref.22564 8)
Kato Y, Nagai A, Saito M, Ito T, Koga M, Tsuboi R. Food-dependent exercise-induced anaphylaxis with a high level of plasma noradrenaline. J Dermatol 2007 Feb;34(2):110-3.
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In an overview of the role of hidden allergens in allergic reactions in a geographical area of Spain, although fruit was the most frequent cause of food allergy in our study (33%), reactions by hidden fruits were very uncommon (2.8%). Two of these reactions were due to kiwi, one was caused by melon, another by peach and the last by apple, hidden in ice-creams or by indirect contact through kisses or utensils. All the patients affected had previous anaphylactic sensitivity to these fruits. Nuts were the second cause (25%) of allergic reactions, acting as hidden allergens in 11 cases (8.4%). The most frequent sources of hidden nuts were chocolates, cookies, pastries and cakes. Peanut was the nut most frequently involved (8 cases).
Añíbarro B, Seoane FJ, Múgica MV. Involvement of hidden allergens in food allergic reactions. J Investig Allergol Clin Immunol 2007;17(3):168-172
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Multiple allergy syndrome in a 24 years old female, who suffered several episodes of gastrointestinal complaints after eating fish since 9 months and nasal symptoms after inhaled fish allergens since 2 years. At 2 years she developed atopic dermatitis (extensive after fish and chocolate ingestion), at 6 years rhinoconjunctivitis and at 7 years itching of the hands after peeling orange, oral allergy syndrome associated with peach ingestion and contact dermatitis with peach peel. Total IgE 2819 U/ml, positive SPT and serum specific IgE to mites, cockroach, dog dander, alternaria, grasses, birch pollen, mugworth, pellitory, plantago, peach, apple, tomato, onion and several fish species (commercial extracts, raw and cooked fresh fish): cod, pollack, salmon, sole, tuna, horse-mackerel, sardine and trout. Immunoblotting to cod, salmon, tuna and sardine showed that these species of fish share antigenic and allergenic determinants, namely Gad cI and Gad mI (except tuna). Tests for Anisakis simplex were negative. Positive patch test to balsam of Peru (included in chocolate and orange peel). Specific immunotherapy to dust mites worsened her dermatitis. Unintentional inhalation fish allergens and voluntary fish ingestion induce symptoms. Hypersensitivity reactions type I and IV to a different allergens can appeared in the same person and the food allergy can persist to adult age worsening the quality of life. (Costa 2006 ref.23502 7)
Costa A, Santos M, Santos A, Pedro E, Pereira-Barbosa M. Multiple allergy syndrome - Case report. EAACI Congress, Vienna-Austria. 2006 Jun; Oral Abstract 1553.
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A report on 16 cases of childhood OAS in a Japanese study. The rate of sensitization against four major pollens (Japanese cedar, orchard grass, short ragweed, alder) among 1067 pediatric patients with allergic diseases was investigated. OAS in childhood differs from that in adulthood in some ways. One is that childhood OAS does not always accompany with pollinosis. The most frequent allergen in this study was kiwi fruit followed by tomato, orange and melon. The sensitization rate against alder was equivalent as that against orchard grass and short ragweed, but less than that against Japanese cedar. The study concludes that Childhood OAS may have different mechanisms from adulthood OAS which almost always accompanies with pollinosis or latex allergy. (Sugii 2006 ref.16084 3)
Sugii K, Tachimoto H, Syukuya A, Suzuki M, Ebisawa M. Association between childhood oral allergy syndrome and sensitization against four major pollens (Japanese cedar, orchard grass, short ragweed, alder). [Japanese] Arerugi 2006 Nov;55(11):1400-1408
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Melon allergy is commonly associated with oral allergy syndrome (OAS) and with hypersensitivity to pollens and other plant foods. In this study, a pool or individual sera from 23 patients, and an additional group of 10 patients, all of them with melon allergy, were assessed using melon profilin (nCuc m 2) and its recombinant counterpart (rCuc m 2). Specific IgE to nCuc m 2 and rCuc m 2 was found in 100% and 78% of the 23 individual sera analysed, respectively. nCuc m 2 evoked positive SPT responses in all (10/10) patients tested, and rCuc m 2 induced HR in two out of three sera assayed. (Lopez-Torrejon 2005 ref.14238 8)
Lopez-Torrejon G, Crespo JF, Sanchez-Monge R, Sanchez-Jimenez M, Alvarez J, Rodriguez J, Salcedo G. Allergenic reactivity of the melon profilin Cuc m 2 and its identification as major allergen. Clin Exp Allergy 2005 Aug;35(8):1065-72.
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Seventeen patients with melon allergy were evaluated for allergy to melon profilin. Ages ranged from 21 to 52 years. Symptoms included cough, dyspnoea, eczema, rhinitis, rhinoconjunctivitis, git symptoms, skin itching, urticaria and oral allergy syndrome. rCuc m 2 specific IgE was raised in 11. SPT with melon extract was positive in all. Allergy to other fruits included to grape, kiwi, tomato, peach, zucchini, cantaloupe, walnut, spice, fig, watermelon (the commonest being grape, tomato, kiwi, zucchini) (Sankian 2005 ref.12611 5)
Sankian M, Varasteh A, Pazouki N, Mahmoudi M. Sequence homology: A poor predictive value for profilins cross-reactivity. Clin Mol Allergy 2005 Sep 10;3(1):13
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In 2002, 107 cases were reported to the French Allergy Vigilance Network of which 59.8 % were cases of anaphylactic shock (one being fatal), 18.7% systemic reaction, 15.9% laryngeal angio-edema, 5.6% serious acute asthma (one fatal). Adults represented 69% of cases (74 cases). The most frequent causal allergens were peanut (14), nuts (16), shellfish (9) latex group fruit (9 patients), and most often in-patients allergic to latex: avocado (4), kiwi (2), fig (2), and banana (1). Next came lupine flour (7), wheat flour (7), celery (5) and snails (5), sesame (4), milk (3), buckwheat (3), fish (3), peach (2), chicken (2). Single observations included sulfites, quinine (an additive in a tonic drink), mustard, lentils, kidneys, pork, melon, grapes, pears, chicory, artichokes, oranges and Anisakis simplex. Four patients had an immediate post-prandial shock and were reported as idiopathic shock. The allergen was present in a masked form in 13% of cases: peanut (6 - with one fatal), lupine (4), sesame (3), and hazelnut (1).
In 4 cases of which one lethal a severe anaphylactic reaction occurred after consumption of macaroon in which the almonds have been replaced by peanuts paste without an adequate labeling. Two cases of anaphylactic shocks in hospitalized children were due to chocolate drink containing lupine flour. Both children were allergic to peanuts and AS occurred by cross allergy. A case of food allergy to hazelnuts is due to a mislabeling on chocolate packaging at Halloween. Two cases of severe anaphylaxis by proxy are reported: the incriminated allergenic peanuts. The patient presented the allergic reaction by contact with another person eating peanuts. (Moneret-Vautrin 2004 ref.10176 0)
Moneret-Vautrin DA, Kanny G, Morisset M, Rance F, Fardeau MF, Beaudouin E. Severe food anaphylaxis: 107 cases registered in 2002 by the Allergy Vigilance Network. Allerg Immunol (Paris) 2004;36(2):46-51
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17 patients with allergy to melon confirmed by means of double-blind, placebo-controlled food challenge were used to detect IgE binding proteins of extracts from melon pulp and juice. (Asensio 2004 ref.9982 3)
Asensio T, Crespo JF, Sanchez-Monge R, Lopez-Torrejon G, Somoza ML, Rodriguez J, Salcedo G. Novel plant pathogenesis-related protein family involved in food allergy. J Allergy Clin Immunol 2004;114(4):896-9.
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The most common clinical feature associated with melon allergy is oral allergy syndrome (OAS). (Rodriguez-Perez 2003 ref.7557 2)
Rodriguez-Perez R, Crespo JF, Rodriguez J, Salcedo G. Profilin is a relevant melon allergen susceptible to pepsin digestion in patients with oral allergy syndrome. J Allergy Clin Immunol 2003;111(3):634-9
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In a Spanish study of Melon allergy, 161 patients were included in the study: 66 with Melon allergy and 95 in the pollen-allergic control group. Patients were aged between 5-61 years. Although all patients of the Melon allergy group had oral symptoms, 13 (19.7%) of the patients had extra-oral symptoms and none experienced generalised urticaria or anaphylaxis. Five patients (7.6%) reported gastrointestinal symptoms, 3 patients (4.5%) reported conjunctivitis, 3 patients (4.5%) reported contact urticaria, 1 patient (1.5%) reported rhinitis, and 1 patient (1.5%) reported contact urticaria and conjunctivitis. Oral symptoms preceded extra-oral symptoms. A total of 22 patients (33%) had rhinoconjunctivitis and 44 (67%) had rhinoconjunctivitis and asthma. Skin prick-prick test with fresh Melon pulp was positive in all patients in the Melon allergy group. Skin testing with 3 commercially available Melon extracts resulted in positive skin tests in 12%, 17% and 90% dependant on the commercial extract. Up to 13.7% of pollen-allergic patients had a positive skin prick-prick test result to fresh Melon pulp; however, only 7.4% of the patients in the pollen allergy group had Melon allergy based on positive results on the skin test and oral challenge test. The fruit most frequently self-reported by the Melon-allergic patients to elicit symptoms was Peach (62% of patients), Fig (48%) and Kiwi allergy (42%). Forty-seven percent of patients reported symptoms caused by some nuts, with Walnut (35%) and Hazelnut (18%) most frequently implicated. Excluding other Cucurbitaceae fruits, Peach, Fig, and Kiwi most frequently elicited positive skin test results and symptoms. Up to 23% of Melon-allergic patients had a concomitant latex sensitisation. Melon allergy was especially linked to pollen allergy, since all the melon-allergic patients were also allergic to pollen. (Figueredo 2003 ref.8550 5)
Figueredo E, Cuesta-Herranz J, De-Miguel J, Lázaro M, Sastre J, Quirce S, Lluch-Bernal M, De las Heras M. Clinical characteristics of melon (Cucumis melo) allergy. Ann Allergy Asthma Immunol 2003;91(3):303-8
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Melon is the second most frequent allergy-eliciting fruit in Spain. (Cuesta-Herranz 2000 ref.5295 4)
Cuesta-Herranz J, Lázaro M, Figueredo E, Igea JM, Umpiérrez A, De-Las-Heras M. Allergy to plant-derived fresh foods in a birch- and ragweed-free area. Clin Exp Allergy 2000;30(10):1411-6
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Oral Allergy Syndrome. In a Japanese study, 23 patients with Japanese cedar pollinosis and OAS for fresh fruits and vegetables were included in this study (age range = 5 to 62). The fruits that caused OAS in these patients included melon, apple, peach, and kiwi fruit. Most patients with OAS exhibited hypersensitivity to more than two foods. Eleven of the 16 subjects with specific IgE antibodies for birch pollen, did not suffer symptoms during the birch and alder pollen season. In subjects with specific IgE antibodies for fruits, 13 out of 20 patients showed specific IgE antibodies for apple, and 8 out of 9 patients with OAS for apples were also positive for specific IgE antibodies for apples. On the other hand, 17 patients had no specific IgE antibodies for melon, and only two patients and one patient showed specific IgE antibodies for kiwi fruit and peach, respectively. (Ishida 2000 4493 1)
Ishida T, Murai K, Yasuda T, Satou T, Sejima T, Kitamura K. Oral allergy syndrome in patients with Japanese cedar pollinosis. [Japanese] Nippon Jibiinkoka Gakkai Kaiho 2000;103(3):199-205
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Fifty-three consecutive adult patients complaining of adverse reactions to melon were included in the study. Actual clinical reactivity was confirmed in 19 (36%) using using DBPCFC. The most frequent symptom was oral allergy syndrome (n = 14), but two patients experienced life-threatening reactions, including respiratory symptoms and hypotension. The positive predictive value for a skin prick test was 42%, and that for specific IgE measurement was 44%. Isolated melon allergy is rare, with most patients either having allergic rhinitis, asthma, or both and associated food allergies. (Rodriguez 2000 ref.4001 3)
Rodriguez J, Crespo JF, Burks W, Rivas-Plata C, Fernandez-Anaya S, Vives R, Daroca P. Randomized, double-blind, crossover challenge study in 53 subjects reporting adverse reactions to melon (Cucumis melo). J Allergy Clin Immunol 2000;106(5 Pt 1):968-972
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OAS associated with immediate laryngeal edema after the ingestion of melon. The study reports the succesful treatment of fennel, cucumber, and melon allergy with pollen-specific injection immunotherapy. (Asero 2000 ref.3719 1)
Asero R. Fennel, cucumber, and melon allergy successfully treated with pollen-specific injection immunotherapy. Ann Allergy Asthma Immunol 2000;84(4):460-2
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This study investigated the cross-reactivity to non-Rosaceae LTPs. IgE antibodies to Rosaceae LTPs reacted to a broad range of vegetable foods were evaluated in 498 subjects (age > 12 years) with Rosaccae allergy as judged by skin prick test with fresh fruits and (in most cases) clinical history. The majority had OAS (>97%), and only a minority (approximately 10%) showed urticaria/angioedema, gastrointestinal symptoms, food-induced rhinitis, asthma, or anaphylaxis. Sera from 37 patients were available for follow-up studies. Peach was identified most frequently as an offending Rosaceae food (in 30/37 patients), followed by apple (16/37), apricot (11/37), cherry (9/37), plum (8/37), almond (7/37) and pear (6/37). Four patients did not have any clinical symptoms related to Rosaccae fruits, despite a positive SPT with commercial plum extract and peach peel extract. All 37 patients were interviewed for allergies to other foods. Walnut and hazelnut were most frequently reported as offending foods (19/37 and 15/37, respectively), closely followed by peanut (9/37). For the other 33 different foods, the number of patients reporting symptoms ranged from 1 to 5. These foods were found among all major groups of vegetable foods, including cereals (corn, wheat), legumes (soybean, string bean, white bean, chick pea, lentils, lupine), Solanaceae (potato, tomato, eggplant) Brassicaceae (cabbage, mustard), Umbelliferae (celery, fennel), Rutaceae (lemon, orange), and several other plant families. This article contains a table of the 37 patients and the effecting foods and symptoms of each patient.
(Asero 2000 ref.3711 7)
Asero R, Mistrello G, Roncarolo D, de Vries SC, Gautier MF, Ciurana CL, Verbeek E, Mohammadi T, Knul-Brettlova V, Akkerdaas JH, Bulder I, Aalberse RC, van Ree R. Lipid transfer protein: a pan-allergen in plant-derived foods that is highly resistant to pepsin digestion. Int Arch Allergy Immunol 2000;122(1):20-32
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This study reports on a 24-year-old woman with ethanol-induced anaphylaxis who developed anaphylaxis following ingestion of overripe, but not fresh rock melon (Cucumis melo). The accumulation of endogenous ethanol in overripe fruit may occur. (Mallon 1997 ref.605 12)
Mallon DF, Katelaris CH. Ethanol-induced anaphylaxis following ingestion of overripe rock melon, Cucumis melo. Ann Allergy Asthma Immunol 1997;78(3):285-6
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Melon is the most important cause of food-allergy in Spanish adults. (Joral 1995 ref.1302 2)
Joral A, Villas F, Garmendia J, Villareal O. Adverse reactions to food in adults. J Investig Allergol Clin Immunol 1995;5(1):47-9
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In a study investigating the prevalence of avocado allergy, in 100 consecutive atopic patients with allergic rhinitis undergoing skin testing were also prick skin tested to avocado and/or for specific serum IgE antibodies to avocado. Of the 100 atopic patients not selected for avocado sensitivity, 21 had positive prick skin tests to avocado. Eight of the 21 avocado skin test positive patients reported that symptoms repeatedly followed the ingestion of avocado; two reported systemic reactions, but six noted oral symptoms only. Serum IgE antibodies to avocado were elevated in seven of the eight patients reporting symptoms after eating avocado. Seven of the eight patients also reported oral symptoms following cantaloupe ingestion. Four reported similar symptoms upon eating banana.
Telez-Diaz G, Ellis MH, Morales Russo F, Heiner DC. Prevalence of avocado allergy among atopic patients. Allergy Proc 1995;16(5):241-3
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Anaphylaxis. (Schwartz 1987 ref.7721 3)
Schwartz LB, Metcalfe DD, Miller JS, Earl H, Sullivan T. Tryptase levels as an indicator of mast-cell activation in systemic anaphylaxis and mastocytosis. N Engl J Med 1987;316(26):1622-6
[ 1 ]
An active substance, probably adenosine, was isolated from an aqueous melon extract and shown to inhibit human platelet aggregation induced by various substances, e.g., epinephrine, ADP, collagen, thrombin, sodium arachidonate, prostaglandin endoperoxide analogue, etc. (Altman 1985 ref.6893 4) The clinical relevance of this has not been determined yet.
Altman R, Rouvier J, Weisenberger H. Identification of platelet inhibitor present in the melon (Cucurbitacea cucumis melo). Thromb Haemost 1985;53(3):312-3
[ 1 ]
Occupational protein contact dermatitis due to melon. (Garcia 2004 ref.9288 3)
García S, Lombardero M, Serra-Baldrich E, Amat P, Lluch-Pérez M, Malet A. Occupational protein contact dermatitis due to melon. Allergy 2004;59(5):558-9