Abstract

Hypersensitivity reactions to alcoholic beverages (particularly red wine) are relatively frequent, affecting 10% of the general population. Hypersensitivity reactions due to alcoholic drinks, mainly in the form of airway reactions (rhinitis and asthma), occur significantly more frequently in persons with pre-existing rhinitis and asthma. Concerning pathogenesis it has to be differentiated between immunologic, mainly IgE-mediated, hypersensitivity reactions (wine allergies), and intolerance reactions, in which no causative allergen-specific immune mechanisms can be detected. Allergens responsible for wine allergy could be: grape (Vitis vinifera) proteins (particularly the major allergen lipid transfer protein Vit v1), proteins and ingredients used for the fining of wines as fish gelatine or bladder of huso (family of sturgeons), oval bumin, dairy (casein) products, gum arabic, enzymes (lysozyme, pectinase, glucanase, cellulase, glucosidase, urease, aromatic enzymes), molds (particularly Botrytis cinerea) responsible for the noble rot of wines, yeasts and proteins from insects that contaminated the mash. Possibly Type 1 allergic reactions (positive prick tests) have been described for inorganic ingredients like ethanol, acetaldehyde, acetic acid and sulfites, but no specific IgE could be detected in the serum. Ethanol, acetaldehyde and acetic acid, flavonoids (anthocyanins and chatechines), sulfites, histamine and other biogenic amines are the main causative agents of intolerance reactions (pseudoallergic reactions) to wine. After a short historic review on viticulture and the importance of wine in the classical antiquity we go into the chemical processes of alcoholic fermentation and on the genetically inherited “flush syndrome” due to an acetaldehyde dehydrogenase 2 polymorphism, subsequently we focus on the different etiologic factors of allergies and intolerance reactions to wine. The most frequent intolerance reactions are caused by sulfites, particularly after the ingestion of white wine and in asthma patients, and by histamine and other biogenic amines, mainly after ingestion of red wine and in persons with diamine oxidase (DAO) deficiency.

German version published in Allergologie, Vol. 34, No. 8/2011, pp. 427-436

Author Details

Authors

• B. Wüthrich

Departments

• Specialist for Allergology and Clinical Immunology, Specialist for Dermatology, Zollikerberg, Switzerland

Address

Prof. em. Dr. med. B. Wüthrich
Im Ahorn 18
CH–8125 Zollikerberg
Email: [email protected]

Citation