Type:
Whole Allergen
Whole Allergen
Whole Allergen
Fennel seed
Ingestions as food
Apiaceae
Foeniculum vulgare
Foeniculum vulgare
Fennel, Florence fennel, Finocchio, Sweet fennel, Wild fennel, Common fennel, “Sweet Anise”
Fennel is a herb widely used in cooking, which can be eaten fresh or as a seed. Clinical reports of fennel allergy are rare and limited to case reports, with the majority being in oral allergy syndrome (OAS) patients who are typically pollen-sensitized, especially to birch and mugwort. Cross reactivity has also been observed to peach and celery allergens.
Fennel belongs to the Apiaceae family of aromatic plants, which also includes anise, coriander, cumin, dill, parsley, carrot and parsnip (1). The fennel plant is hardy and perennial, with yellow flowers and feathery leaves. Fennel is consumed as an edible herb in savory dishes, sauces, liqueurs and confectionary (2). As well as its wide use as a spice in cookery, it is also used as an aromatic in various medicinal products and occasionally as a flavor enhancer in toothpaste (1). In Northern Europe the seeds are more commonly eaten, whereas the fresh plant is often consumed in Mediterranean countries. Fennel contains abundant linoleic acid and other fatty acids in the shoots, stems, and inflorescences, giving it a valuable nutritional composition (3).
Taxonomic tree of Fennel (4) |
|
---|---|
Domain |
Eukaryota |
Kingdom |
Plantae |
Phylum |
Tracheophyta |
Subphylum |
Spermatophytina |
Class |
Magnoliopsida |
Family |
Apiaceae |
Genus |
Foeniculum |
Taxonomic tree of Fennel (4) |
---|
Allergy to spices is infrequent, accounting for about 6.4% of all food allergies in adults (5). Accordingly, mono-allergy to fennel is unusual, even among those sensitized to other Apiaceae (1, 6).
A large clinical study was carried out to determine the prevalence of Apiaceae based on carrot, celery, and fennel hypersensitivity in patients with birch pollen allergy. A total of 196 birch pollen-hypersensitive patients with OAS caused by different vegetable foods were examined, of which only one patient had Apiaceae allergy alone (6).
Another study addressed allergic sensitization to coriander, caraway, celery or fennel by skin prick testing in 589 patients, where 32% of children and 23% of adults were positive. However, only 3 patients (0.5%) were thought to have a clinical allergy to fennel (1).
Clinical reports of fennel allergy are rare, with the majority being birch and mugwort pollen-sensitized patients. This phenomenon is part of the general pollen-food allergies). There are adult case reports of such highlighting the cross-reactive nature of fennel. For example, a 20-year-old man with a history of mild grass pollen allergy experienced anaphylaxis (generalized urticaria, dysphonia, angioedema of the lips, palmar-plantar itch) after ingesting raw fennel, which resolved following the administration of systemic steroids and oral cetirizine. Another 41-year-old man with seasonal rhinitis experienced episodes of OAS and dyspnea after ingestion of raw and cooked fennel. Both were positive to fennel after skin prick testing. Similarly, A 34-year-old woman with a pollen allergy reported OAS with the ingestion of both fennel and cucumber (7).
Cases of allergy to fennel are rarely reported in children. One case study has been described in an 11-year old boy with seasonal allergic rhinitis following contact with toothpaste containing fennel. He presented with sneezing, nasal congestion, sinus pain, vomiting and abdominal pain, difficulty breathing, and palpitations. His serum specific IgE test result to fennel was positive as well as a skin prick test to fennel-flavored toothpaste (1).
One case of allergic contact dermatitis to raw fennel (along with parsnip and carrot) has been reported in a 51-year old man. Contact with fennel caused intermittent rashes which resolved naturally after 3 days (8).
Table adapted from Allergome.org (9).
Allergen |
Source |
---|---|
Foe v [Leaf] |
Apiaceae, Fennel, Foeniculum vulgare, Plants |
Foe v [Bulb] |
Apiaceae, Fennel, Foeniculum vulgare, Plants |
Foe v [Seed] |
Apiaceae, Fennel, Foeniculum vulgare, Plants |
Foe v 1 |
Apiaceae, Fennel, Foeniculum vulgare, Plants |
Foe v 2 |
Apiaceae, Fennel, Foeniculum vulgare, Plants |
Foe v 3 |
Apiaceae, Fennel, Foeniculum vulgare, Plants |
Foe v 5 |
Apiaceae, Fennel, Foeniculum vulgare, Plants |
Foe v 60kD |
Apiaceae, Fennel, Foeniculum vulgare, Plants |
Allergen |
Source |
---|
Several allergens in fennel have been identified, including Foe v 1 (Bet v 1-related protein), Foe v 2 ( profilin) and Foe v 3 (lipid transfer protein) (1, 10).
Cross reactivity has been demonstrated to birch (Bet v 1) and peach (Pru p 3) (1, 10). Homologous protein allergens may also exist with mugwort pollens, accounting for the mugwort-celery-spice syndrome (1, 11). A 60 kDa allergen, highly homologous to a celery allergen (Api g 5), has been recognized in fennel by patients’ IgE. Inhibition experiments showed a high degree of cross-reactivity between this fennel allergen and a homologous mugwort pollen allergen (11). The cross-reactivity seems to be clinically relevant as there is improvement of a patient’s OAS to fennel, cucumber, and melon after pollen-specific injection immunotherapy with a product containing grass, mugwort (50%) and ragweed (50%) allergens (1). Fennel allergens also show homology and cross-reactivity with other Apiaceae family members, such as celery (Api g 5) (11).
Author: RubyDuke Communications
Reviewer: Dr. Michael Thorpe
Last reviewed:January 2022