High IgE cross-reactivity of banana profilin with birch pollen profilin, Bet v 2, and latex profilin, Hev b 8, was demonstrated by immunoblot inhibition as well as EAST inhibition experiments (Reindl et al. 2002) [ 601] Reindl et al. (2002) [ 601] observed that IgE binding to the recombinant profilins was observed in 7/16 sera from subjects with suspected banana allergy (44%)

out of 4 patients were IgE-CAP positive (> or = class 2) and two were banana-profilin EAST positive (Grob et al. 2002) [ 600] Due to cross-reactivity, patients considered to be at high risk of banana allergy, as for example subjects allergic to latex, avocado, chestnut, kiwi, melon, or to certain pollens, should be carefully asked about possible previous adverse reactions on banana ingestion. Unless consumption of banana with perfect tolerance is reported by the patient, a banana-free diet should be recommended, until proper diagnosis - on the basis of objective procedures to evaluate clinical reactivity - is made. Interestingly, the content of these allergic proteins in fruits can be increased by certain chemical or physical factors. For example, some chemical products used for ripening bananas, clearly induce allergens, therefore rising fruit allergenicity. These proteins seem to be inactivated by heating, which could explain why some plant foods containing these allergens, but only consumed after cooking, are not associated with this syndrome.Heavy - Active for much of the day, walking non-stop and carrying objects. Typical jobs: hospital/ward nurse, waitressing in a busy restaurant, cleaner, porter, labourer/construction worker, gardener, farm worker. Leisure Activity Level The pulp of banana was extract with NTE 1N solution: NaCl 1mol/L, Tris 0,1mol/lL ethylenediaminetetraacetic acid 0.01mol/L (Lavaud et al 1995) [ 102]

The positive results of the tests were designated as follows: + < 1/2; positive surface reference (histamine control: 10 mg/ml), ++ > 1/2; positive reference, +++ > positive reference, and ++++ > twice reference (Lavaud et al 1995) [ 102]. Asero et al. (2003) [ 582] studied 71 patients allergic to fruits and vegetables but not sensitized to lipid transfer protein or natural rubber latex On 5 March 2014, Crusha rebranded fully, scrapping "Errol's Crew" and giving Errol a younger appearance, with kittens doing stunts to make Crusha. [12] The flavour selection rebranded to just raspberry, strawberry and chocolate, with a new No Added Sugar version of the chocolate flavour. Inactive - Do very little exercise, going for the occasional walk (moderate pace, low intensity). Spend majority of leisure time doing activities such as watching TV, playing computer games, on the internet, reading, cooking, driving, general household chores. Hevein-like protein domains as a possible cause for allergen cross-reactivity between latex and banana.With respect to banana-pollen allergy, several patterns of associated allergies have been described. Examples for that are the following clusters: ragweed pollen allergy with banana and melon allergies; multiple pollen allergies with banana, melon, watermelon, citrus fruits and tomato allergies; and Platanus tree pollen allergy with banana, hazelnut, peanut and celery allergies. A group of allergens very common in the plant kingdom seem to be responsible for at least part of these cross-reactions, but other allergens may also be involved. Banana extracts (Delbourg et al. 1996) [ 42], (Alenius et al. 1996) [ 5], (Asero et al. 2003) [ 582] IgE cross-reactivity was demonstrated by RAST-inhibition between latex, avocado, chestnut and banana (Blanco et al. 1994) [ 288] Banana PBS extract; endochitinase-enriched protein preparation and the endochitinase allergens ( Ba1 and Ba2) (Sánchez-Monge et al 1999) [ 493]

Patients suspected of being allergic to banana, should completely avoid the ingestion of both fresh bananas and of any banana-containing food, until evaluated. Once diagnose of true banana IgE-mediated allergy is confirmed, patient should follow a lifelong banana-free diet. They should also take care of possible unadvertised exposures, since – unfortunately - this food has not been included in the list of potential allergenic ingredients to be labelled, of the new EU labelling directive (2003/89/EC).

FREE diet profile

In 2020, The Lime flavour was reintroduced as a limited edition product, with it being available in No Added Sugar for the first time. Amino terminal sequencing revealed that both the 32- and 33-kDa proteins (16 residues analyzed) had 80% identity to the N-terminus of hevein (Mikkola et al. 1998) [ 418] Unfortunately, there is scarce data on the occurrence of banana allergy in different age groups and geographical areas. It seems that, although it is not among the top-5 food allergies, it cannot be considered as a rare allergy, neither in children nor in adults. Certainly, it is much more frequent among specific groups of patients, as for example subjects allergic to latex, to pollens, or to plant-derived foods. In the same way, the development of banana allergy is not known, as long-term follow up of banana allergic patients have not been conducted. Nevertheless, clinical data suggests that patients allergic to banana should assume a lifelong avoidance diet, since – to our knowledge - patients outgrowing banana allergy have not been reported. patients with asthma; 2 with rhinitis; 2 with eczema; 3 with urticaria; 2 with angioedema and 2 with OAS (Makinen-Kiljunen 1994) [ 405]