Fungus-related foods, such as edible mushrooms, mycoprotein, and fungi-fermented foods, can cause fungus food allergy syndrome (FFAS) by allergic cross-reactivity with airborne fungi. FFAS may involve one or more target organs, with various allergy symptoms ranging from oral allergy syndrome to severe anaphylaxis.
A recent article reviews the current knowledge on the field of allergic cross-reactivity between fungal allergens and related foods, shining the spotlight on an area the authors maintain is still largely neglected in basic research as well as in clinical practice.
Mycoprotein, the protein-rich food obtained from filamentous fungal biomass, is gaining increasing popularity as an alternative to meat. Quorn is the trade name for a line of foods made with mycoprotein, developed and marketed in the UK since 1985. Since then, complaints from consumers have reported adverse reactions including urticaria; swelling of the throat, tongue, mouth, or lips; breathing difficulties; anaphylaxis; and nausea, emesis, diarrhea, and abdominal cramps.
With approximately 70 per cent of reported adverse reactions to Quorn occurring after an individual’s first exposure to a Quorn product, it appears sensitisation has occurred previously via cross-allergenicity with another antigen. As fungi live in nature and are one of the main airborne allergens, this is the likely route of sensitisation. Despite this, the authors say adverse reactions of any kind to mycoprotein are rare, and for the vast majority of individuals, mycoprotein represents a safe foodstuff.
In addition to mycoprotein, fungus-related foods that have been documented as causing allergic reactions include macro fungi with fruiting bodies, fermented foods, and foods contaminated with fungi.
The authors urge more research in this field to identify the causative allergens and to understand the immunological events that take place.