Garlic allergy

The garlic bulb is a spice and medicinal plant from the leek family (Alliaceae). The garlic bulb is a roundish to egg-shaped white bulb with a diameter of about 3.0 cm and a pungent, pungent smell. Ingredients are sulphur-containing gamma-glutamyl peptides, odourless, water-soluble alliin (S-allylcysteine sulfoxide). Furthermore, several enzymes such as: oxidases, catalases, dehydrogenases, lyases and various other enzymes. Vitamins. After the garlic bulb has been crushed and the tissue destroyed, the odourless alliin is broken down by enzymatic cleavage (with the help of alliinase) into the breakdown products allicin (unstable) and ajoene. These degradation products produce the typical garlic smell. Animal charcoal, dried milk or a few drops of angelica oil are used to eliminate the odour. However, this does not eliminate the unpleasant smell of the exhaled air (Ammon H et al 2014).

Type I reactions: Food allergies to garlic bulbs are rare. Immediate reactions are described as generalised urticaria, photoallergic urticaria, angioedema, bronchial asthma and/or anaphylactic reactions (Borrelli F et al. 2007; Almogren A et al. 2013). Vargo RJ et al. described burning of the oral mucosa after garlic consumption. There are indications of a thermolability of the allergen.

Other clinical cases: Occupationally induced allergies: Occupationally exposed cooks and greengrocers may develop allergic rhinitis and allergic bronchial asthma (Añibarro B et al. 1997).

Type IV reactions: Contact allergic reactions, especially in occupational exposure (cooks), have been described. The allergens are low molecular organic sulphur compounds (diallyl disulphide). Risk groups for contact allergies are cooks, housewives and greengrocers (Moyle M et al. 2004).

Interactions: Interactions with protease inhibitors (saquinavir) are described. Furthermore, interactions (inhibition of function) with anticoagulants (warfarin, fluindiones) have been reported.

(Non-allergic) intolerance reactions to garlic products: Intolerance reactions occur with severe flatulence or abdominal cramps. The fructans contained in the onion are responsible for this. Onions do not contain starch, but form and store fructans, high-molecular polysaccharides, as a reserve. These sulphur-containing polysaccharides are not broken down enzymatically in the small intestine in humans. They therefore reach the large intestine undigested and are metabolised there by the bacteria of the natural flora under strong gas development. After the consumption of onions, flatulence is therefore often caused by the odour of the sulphur-containing ingredients as well as the decomposition products of the fructans.

Prick and intradermal testing with commercial extracts, scratch with native material, RAST.

Epicutaneous testing: With 1% concentration of aqueous or ethanolic extract or expressed juice.

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