Page last updated: Tuesday, December 16, 2008
Adverse reactions to wine
The author states that wine contains chemical and biological contaminants. Symptoms such as facial flushing, asthma and oral allergic swelling and burning (oral syndrome) have been attributed to these contaminants and food additives. Their clinical implications should be known. Recent studies have reported a high prevalence of hypersensitivity symptoms after intake of alcoholic drinks in the general population. Red wine was the most common beverage implicated. Wine contains many contaminants. Some of them come from Hymenoptera insects that fall into the wine when grapes are collected and pressed. It has previously been reported that patients may be sensitised to Hymenoptera venom without previous stings and may develop allergic symptoms related to wine consumption. The aim of this study was to assess the potential importance of their sensitisation to Hymenoptera antigens as the cause of their symptoms and also to comment on other recent studies on wine hypersensitivity.

Results showed that there were patients with allergic symptoms related to wine consumption who were sensitised to Hymenoptera venoms by products in wine. Challenges were negative with sulfites, other additives and aging wines, but positive with young wines. Sera from all the patients detected Hymenoptera venom antigens. The authors state that this is the first report on cases of sensitisation to venom antigens by the oral route.

Professor R Curtis Ellison comments: This is a paper that is important to allergists as it suggests that the oral administration of substances produced by hymenoptera insects (that includes bees, wasps, and ants) that fall into wine when the grapes are being collected and pressed can lead to allergy when the product (e.g., red wine) is consumed. The study is based on 5 patients seen in Spain who developed allergic-type symptoms after drinking either grape juice or newly-pressed red or white wine. The present study revealed no evidence of allergy to sulfites or other usual substances in wine, but to allergens produced by two types of wasps.

Allergy to wine is not rare, usually manifest by nasal stuffiness or wheezing, but (unlike what the public believes), it is almost never related to sulfites in wine. Neither is it related to substances such as milk proteins or eggs sometimes used in filtering (fining) the wine, but may relate to histamine substances in wine. Since wine comes from a plant, reaction to many types of plant products could result in an allergic reaction from wine. Further, alcohol itself (whatever the beverage) can lead to vasodilation of the cerebral vessels and result in headaches and other symptoms.

This report adds to this list substances getting into wine from common wasps in Spain (two species of hymenoptera) that apparently caused allergic symptoms even though the patients developing the symptoms had not been previously stung. The authors point out that this is the first report of such allergy developing from sensitisation to venom antigens by the oral route.

Another interesting result of this paper is that the allergic reactions occurred only when the subjects were given “young wines;” they did not show a response to the same types of wines that had been aged (they do not say how long the “aging” wines had been stored). The authors believe that fermentation can lead to denaturation of the antigen, so the potential allergy is eliminated with aging of the wine.

Article: Armentia A. Adverse reactions to wine: Think outside the bottle. Current Opinion Allergy Clin Immunology 2008;8:266-269.

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