Can wine trigger anaphylaxis in individuals with asthma?

From the Guidelines

Wine can trigger anaphylaxis in individuals with asthma, particularly those sensitive to sulfites, which are commonly found in wine. This is based on the findings of the expert panel report 3 (epr-3): guidelines for the diagnosis and management of asthma-summary report 2007 1. According to this study, sulfites in foods, including wine, can precipitate asthma symptoms in people who are sensitive to these items. Furthermore, individuals with both food allergy and asthma are at increased risk for fatal anaphylactic reactions to the food to which they are sensitized, including wine.

Some key points to consider:

• Sulfite sensitivity is a common issue in asthmatics, with approximately 5-10% of asthmatics showing reactions
• Wine contains other potential allergens, including proteins from grapes, yeasts, and fining agents like egg whites or fish products
• Symptoms of wine-induced anaphylaxis can include difficulty breathing, wheezing, hives, swelling, rapid heartbeat, and a dangerous drop in blood pressure
• If you have asthma and suspect wine sensitivity, it is essential to carry an epinephrine auto-injector at all times and seek immediate medical attention if symptoms occur, even if they improve after using epinephrine.

It is crucial for individuals with asthma to be aware of the potential risks associated with wine consumption and to take necessary precautions to minimize these risks. Consulting an allergist for proper testing to identify specific triggers and develop an appropriate management plan is highly recommended 1.

From the Research

Wine and Anaphylaxis in Asthma

• Wine can trigger anaphylaxis in individuals with asthma, as it contains various components that can cause allergic and allergic-like responses, including rhinitis, itching, facial swelling, headache, cough, and asthma 2.
• Studies have shown that wine is the most commonly reported trigger for adverse responses, with sensitivities appearing to be due mainly to pharmacological intolerances to specific components, such as biogenic amines and sulphite additives 2, 3.
• The sulphite additives in wine have been associated with triggering asthmatic responses, and clinical studies have confirmed sensitivities to the sulphites in wine in limited numbers of individuals 2, 4, 5.
• Histamine in wine has also been associated with the triggering of a wide spectrum of adverse symptoms, including sneezing, rhinitis, itching, flushing, headache, and asthma 2, 3.
• Other components in wine, such as grape proteins, fish gelatin, and moulds, can also cause allergic reactions in some individuals 3.
• The prevalence of wine-induced asthmatic reactions is significant, with one study finding that 33% of respondents indicated that alcoholic drinks had been associated with the triggering of asthma on at least 2 occasions, with wines being the most frequent triggers 4.
• The mechanisms underlying wine-induced asthmatic reactions are complex and may involve several co-factors, including sensitivity to sulphites, histamine, and other biogenic amines, as well as immunologic and non-immunologic factors 2, 3, 4, 5, 6.

Key Findings

• Wine is a common trigger for asthmatic responses, particularly in individuals with pre-existing rhinitis and asthma 3, 4.
• Sulphite additives in wine are a major cause of asthmatic responses, and wine labels should provide information on the sulphite content 5.
• Histamine and other biogenic amines in wine can also cause adverse symptoms, including asthma 2, 3.
• Other components in wine, such as grape proteins and moulds, can cause allergic reactions in some individuals 3.
• The prevalence of wine-induced asthmatic reactions is significant, and individuals with asthma should be aware of the potential risks associated with wine consumption 4.