Sesame allergy T78.1

A sesame allergy is relatively rare in Central European countries. In countries such as Australia, however, sesame allergy is already one of the most common food allergies. Due to the increasing consumption of sesame, especially in various Asian and Oriental dishes, an increase in allergic reactions to sesame can be expected in the USA and in Central European countries in the future.

Mainly IgE-mediated reactions to sesame, the prevalence is between 0.1 % and 0.9 %. Sesame is one of the 14 main triggers for allergic reactions. There are severe to fatal reactions to sesame seeds and sesame oil.

Allergenicity can be reduced by microwave treatment, salt and pH treatment, and clinical studies have confirmed a reduction in sesame allergenicity. A possible cross-reaction with peanuts and nuts should be noted.

The reduction of allergenicity in processed sesame should ultimately be confirmed by clinical studies.

Sesame products can be found among others in:

• Food: Bread, pastries, crackers, hamburger buns, waffles, pretzels, spice mixtures, Asian spice sauces and pastes, muesli and muesli bars, trail mixes and nibble mixes, various sweets, in crusts of meat and sausage products (pepper salami, meat cheese). Sesamum indicum is an ingredient of numerous oriental dishes.
• Cosmetics: Sesame oil can be used in cosmetics such as lipsticks or as a base for creams.
• Medicine: In injectable drugs like neuroleptics and vitamin D; as a base for ointments and creams.

The following allergens listed so far are known (Ses i 1- Ses i 7), whereby Ses i1(2S albumin, a 9 kDa protein) is of the greatest clinical relevance (Maruyama N et al. 2016). In sesame oil 3 allergens are relevant: sesamol, sesamine, sesamoline. The main allergens in sesame are heat stable (sesame rolls are tolerated).

Contact allergies to sesame can usually be traced back to the allergens sesamine and sesamoline (lignan derivatives).

Sesame oil: Allergic reactions to sesame oil are also known (however, depending on the extraction process, the allergens are usually destroyed during the production of sesame oil).

Furthermore, a non-IgE-mediated anaphylactoid reaction to sesame was also described.

Cross-reactions are possible (peanut, kiwi and poppy).

Described are anaphylactic reactions, allergic rhinitis, allergic bronchial asthma, oral allergy syndrome (Mc Intyre M et al. 2017); rare are contact allergic reactions to sesame oil-containing topicals.

Medical history, clinic, serology, prick test (epicutaneous test)

Detection possibility: serum IgE tests (see under IgE, specific) for the sesame proteins Ses i 1 to Ses i 7, these belong to the seed storage proteins and are resistant to heat and acid. Allergenicity can be reduced by microwave treatment, salt and pH treatment; clinical studies have confirmed the reduction of sesame allergenicity. A possible cross-reaction with peanuts and nuts should be noted.

Further detection options: sesame basophil activation tests, if necessary oral provocation under safety precautions (stationary). The reduction of allergenicity in processed sesame should ultimately be confirmed by clinical studies.

Avoid sesame; sesame oil should also be avoided.

Studies suggest that oral immunotherapy with sesame may be safe and effective, and these and other treatment options are emerging.

1. Beyer K et al. (2007) Identification of 2 new sesame seed allergens: Ses i 6 and Ses i 7. J Allergy Clin Immunol 119:1554-1556.
2. Maruyama N et al. (2016) Measurement of specific IgE antibodies to Ses i 1 improves the diagnosis of sesame allergy. Clin Exp Allergy 46:163-171.
3. Mc Intyre M et al. (2017) Sesame allergy, a diagnostic challenge. Allergo J Int 26: 58
4. Oriel RC et al. (2024) Comprehensive Diagnosis, Management, and Treatment of Sesame Allergy. J Allergy Clin Immunol Pract. 12(3):590-597. doi: 10.1016/j.jaip.2023.11.008. Epub 2023 Nov 11. PMID: 37952774.
5. https://www.daab.de/blog/2023/08/sesam-kleines-koernchen-als-aufstrebender-allergieausloeser
6. Pi X, Peng Z et al. (2024) Sesame allergy: mechanisms, prevalence, allergens, residue detection, effects of processing and cross-reactivity. Crit Rev Food Sci Nutr. 64(10):2847-2862. doi: 10.1080/10408398.2022.2128031. Epub 2022 Sep 27. PMID: 36165272.