Improvement of mustard allergy (Sinapis alba) diagnosis and management by linking clinical features and component-resolved approaches

To the Editor: Approximately 5% of young children and 4% of adults have some type of adverse immune responses to foods in westernized countries. Mustard is a widely consumed spice that can trigger life-threatening IgE-mediated allergic reactions. Mustard is frequently consumed as a hidden allergen in foods, resulting in unexpected allergic reactions. It has been reported that more than 50% of patients with mustard allergy are also sensitized to mugwort pollen and various foods of the Rosaceae family, nuts, and legumes. Four allergens from yellow mustard seeds have been characterized: (1) Sin a 1 (2S albumin, 14 kd), (2) Sin a 2 (11S globulin, 51 kd), (3) Sin a 3 (lipid transfer protein, 12 kd), and (4) Sin a 4 (profilin, 13-14 kd). Although component-resolved diagnosis of a number of food allergens and aeroallergens has been reported, there have not been similar analyses of mustard allergy. In the current study, we combine for first time a detailed clinical characterization of 34 patients with mustard allergy with component-resolved diagnosis by using the 4 purified mustard allergens described so far. This study was approved by the Fundaci!on Jim!enez D!ıaz Ethic Committee, and written informed consent was obtained from all subjects. Yellow mustard seed extract and purified mustard allergens were obtained as described. A skin prick test (SPT) was performed according to standard procedures. A wheal