Cucumber

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Code: f244
Latin name: Cucumis sativus
Source material: Fresh fruit
Family: Cucurbitaceae
Common names: Cucumber, Cuke, Gherkin, Cowcumber

Allergen Exposure

Geographical distribution
First recorded in the Himalayan foothills of India, Cucumber has been cultivated for over 4,000 years. This long, cylindrical, green-skinned fruit of the gourd family has edible seeds surrounded by a mild, crisp flesh. Leading countries in the cultivation of Cucumbers include Britain, China, India, Iraq, Java, Kurdistan, Turkey, and Venezuela.

Cucumber is among the most widely grown vegetables, common in home gardens, on truck farms and as a greenhouse crop. It consists of around 96% water. The plant is trailing, usually on the ground in the open, but on trellises in greenhouses. The Cucumber is called a Gherkin when small and used in preserves and pickles, often with dill-flavoured vinegar. Cucumbers are available year-round, with the peak crop from late spring to late summer.

Environment
Cucumbers grow only under cultivation. They are used for fresh consumption, or for preservation, marinated with vinegar, salt, or spices. The thin skin, unless waxed, does not require peeling.

Cucumbers contain 5 calories per ounce and only very small amounts of nutrients. But some cultivars have significantly higher levels of vitamins A and C. Many people find the fruit to be indigestible: this is due to the high cellulose content. Oil from the seed is used in salad dressings and French cooking.

The leaf juice is emetic and used to treat dyspepsia in children. The fruit may be used as a natural remedy.

The fruit is applied to the skin as a cleansing cosmetic to soften and whiten it. The juice is used in many beauty products.

Cucumber skins have been shown to repel cockroaches in laboratory experiments. The roots of Cucumber plants secrete a substance that inhibits the growth of most weeds.

Allergens
The following allergen has been characterised:
  • Cuc s 2, a profilin (1-2).

The activity of a chitinase has been detected in xylem sap from Cucumber stems. Cucumber roots produce a chitinase and secrete it into xylem sap for delivery to aboveground organs (3). Whether this chitinase is found in the Cucumber fruit, and whether it has panallergen activity, are questions that have not been investigated yet. Cucumber leaves may contain a chitinase protein following a plant infection (4).

A beta-1,3-glucanase protein, a PR panallergen, was shown to be activated by plant stress in Cucumbers. Whether this panallergen has any clinical significance, or whether it occurs in the Cucumber fruit, has not been determined yet (5).

Potential cross-reactivity

An extensive cross-reactivity among the different individual species of the genus could be expected, as well as to a certain degree among members of the family Cucurbitaceae, such as Watermelon, Melon, and Cucumber (6).

An association between Ragweed pollinosis and hypersensitivity to Cucurbitaceae vegetables and Banana has been reported (7). Six of 26 patients who had Watermelon IgE antibodies reported developing oropharyngeal symptoms (itching and/or swelling of the lips, tongue, or throat) after ingesting at least 1 of the study foods of the gourd family (Watermelon, Cantaloupe, Honeydew melon, Zucchini, and Cucumber), or Banana (8).

There is cross-allergenicity among Celery, Cucumber, Carrot, and Watermelon. Immuno-blots of individual sera showed a 15 kDa protein band common to all 4 foods (9).

Cross-reactivity was demonstrated among Pumpkin, Pumpkin seed, Muskmelon, Watermelon, Cucumber and Zucchini (10). Cuc m 3 from Melon shares a sequence identity of 60% or more with PR-1 proteins from Grape and Cucumber (11).

Hevamine, an enzyme with lysozyme/chitinase activity from Hevea brasiliensis Latex, has a sequence identity of about 60% with a chitinase from Cucumber, and 95% with the N-terminal sequence of the lysozyme/chitinase of Parthenocissus quinquefolia. The differences in cellular location, charge properties and sequence between hevamine and Cucumber chitinase are similar to those between class I and class II chitinases from Tobacco and other plant species (12).

Clinical Experience

IgE-mediated reactions
Cucumber can induce symptoms of food allergy in sensitised individuals (5-6,13-14). A French cross-sectional, descriptive, questionnaire-based survey was conducted in Toulouse schools to determine the prevalence of food allergies among schoolchildren. Out of the questionnaires, 2,716 were returned. Of the 192 questionnaires reporting a food allergy, 1 reported allergy to Cucumber (15).
Oral allergy syndrome and pruritis of the lips, tongue and throat have been reported (6,10). Contact with Cucumber may result in atopic dermatitis or contact urticaria (16-17).

Anaphylaxis due to Cucumber is rare but has been reported (7).
An Indian study evaluated the effect of a specific elimination diet on symptoms of 24 children aged 3 to 15 years with documented deterioration in control of their perennial asthma. IgE antibody analysis for a range of food items found that 21 children (88%) had IgE antibodies directed at Cucumber (18).

Cultivation of Cucumber in greenhouses may lead to occupational allergy caused by the vegetable or tetranychus mites living on the plants among other mites (19-21).

Other reactions
Contact dermatitis to Cucumber has been reported (22-23). Cucumber plants produce elevated levels of phytoalexins in their leaves in response to treatment of powdery mildew with a fungicide. Phytoalexins are important causes of contact dermatitis (24).

Red spider mite found on carnation, Cucumber and vegetable marrow growing in greenhouses may result in occupational asthma and rhinitis (25).

High levels of nitrate are found in Cucumbers and may be a risk, especially to young children (26).

Compiled by Dr Harris Steinman, harris@zingsolutions.com

References

  1. van Ree R, Voitenko V, van Leeuwen WA, Aalberse RC. Profilin is a cross-reactive allergen in pollen and vegetable foods.
    Int Arch Allergy Immunol 1992;98(2):97-104
  2. Rodriguez-Perez R, Crespo JF, Rodriguez J, Salcedo G. Profilin is a relevant melon allergen susceptible to pepsin digestion in patients with oral allergy syndrome.
    J Allergy Clin Immunol 2003;111(3):634-9
  3. Masuda S, Kamada H, Satoh S. Chitinase in cucumber xylem sap. Biosci Biotechnol Biochem 2001;65(8):1883-5
  4. Lawton KA, Beck J, Potter S, Ward E, Ryals J.
    Regulation of cucumber class III chitinase gene expression.
    Mol Plant Microbe Interact 1994;7(1):48-57
  5. Repka V, Tamas L, Fischerova I, Fric F. Identification and partial characterization of beta-1,3-glucanase from virus-infected cucumber cotyledons.
    Acta Virol 1997;41(1):35-9
  6. Yman L. Botanical relations and immunological cross-reactions in pollen allergy. 2nd ed. Pharmacia Diagnostics AB. Uppsala. Sweden. 1982: ISBN 91-970475-09
  7. Caballero T, Martin-Esteban M. Association between pollen hypersensitivity and edible vegetable allergy: a review. J Investig Allergol Clin Immunol 1998;8(1):6-16
  8. Enberg RN, Leickly FE, McCullough J, Bailey J, Ownby DR. Watermelon and ragweed share allergens.
    J Allergy Clin Immunol 1987;79(6):867-75
  9. Jordan-Wagner DL, Whisman BA, Goetz DW. Cross-allergenicity among celery, cucumber, carrot, and watermelon.
    Ann Allergy 1993;71(1):70-9
  10. Figueredo E, Cuesta-Herranz J, Minguez A, Vidarte L, et al. Allergy to pumpkin and cross-reactivity to other Cucurbitaceae fruits.
    J Allergy Clin Immunol 2000;106(2):402-3
  11. Asensio T, Crespo JF, Sanchez-Monge R, Lopez-Torrejon G, Somoza ML, Rodriguez J, Salcedo G.
    Novel plant pathogenesis-related protein family involved in food allergy.
    J Allergy Clin Immunol 2004;114(4):896-9
  12. Jekel PA, Hartmann BH, Beintema JJ. The primary structure of hevamine, an enzyme with lysozyme/chitinase activity from Hevea brasiliensis latex.
    Eur J Biochem 1991;200(1):123-30
  13. Asero R. Fennel, cucumber, and melon allergy successfully treated with pollen-specific injection immunotherapy. Ann Allergy Asthma Immunol 2000;84(4):460-2
  14. Zuidmeer L, Goldhahn K, Rona RJ, Gislason D, Madsen C, Summers C, Södergren E, Dahlström J, Lindner T, Sigurdardottir ST, McBride D, Keil T. The prevalence of plant food allergies: a systematic review.
    J Allergy Clin Immunol 2008;121(5):1210-8
  15. Rance F, Grandmottet X, Grandjean H. Prevalence and main characteristics of school-children diagnosed with food allergies in France. Clin Exp Allergy 2005;35(2):167-72
  16. Weltfriend S, Kwangsukstith C, Maibach HI.
    Contact urticaria from cucumber pickle and strawberry.
    Contact Dermatitis 1995;32(3):173-4
  17. Ottolenghi A, De Chiara A, Arrigoni S, Terracciano L, De Amici M. Diagnosis of food allergy caused by fruit and vegetables in children with atopic dermatitis. [Italian] Pediatr Med Chir 1995;17(6):525-30
  18. Agarkhedkar SR, Bapat HB, Bapat BN. Avoidance of food allergens in childhood asthma. Indian Pediatr. 2005; 42(4):362-6
  19. Ueda A, Ueda T, Matsushita T, Ueno T,
    Nomura S. Prevalence rates and risk factors for allergic symptoms among inhabitants in rural districts. Sangyo Igaku 1987;29(1):3-16
  20. Illing HP. Is working in greenhouses healthy? Evidence concerning the toxic risks that might affect greenhouse workers.
    Occup Med 1997;47(5):281-93
  21. Orta JC, Navarro AM, Bartolome B, Delgado J, Martinez J, Sanchez MC, et al. Comparative allergenic study of Tetranychus urticae from different sources. Journal of Investigational Allergology & Clinical Immunology 1998;8(3):149-54
  22. Zachariae CO. Cucumber contact dermatitis. Contact Dermatitis 2000;43(4):240-1
  23. Amaro C, Goossens A. Immunological occupational contact urticaria and contact dermatitis from proteins: a review.
    Contact Dermatitis 2008 Feb;58(2):67-75
  24. Daayf F, Schmitt A, Belanger RR. Evidence of Phytoalexins in Cucumber Leaves Infected with Powdery Mildew following Treatment with Leaf Extracts of Reynoutria sachalinensis.
    Plant Physiol 1997;113(3):719-27
  25. Orta JC, Navarro AM, et al. Comparative allergenic study of Tetranychus urticae from different sources. J Investig Allergol Clin Immunol 1998;8(3):149-54
  26. Rostkowski J, Borawska M, Omieljaniuk N, Otlog K. Content of nitrates and nitrites in early vegetables and potatoes sold in the marketplace of Bialystok in the year 1992. [Polish] Rocz Panstw Zakl Hig 1994;45(1-2):81-7

As in all diagnostic testing, the diagnosis is made by the physican based on both test results and the patient history.