# Fenugreek: New Therapeutic Resource or Emerging Allergen?
###### Abstract  
Background: Fenugreek, or _Trigorella foun genomic_, is an ancient medicinal plant native to the eastern Mediterranean that later spread to Asia; it is used as a medicinal herb, spice, or food. It is a component of spice mixes, such as curry, and it is also used as a supplement in wheat and corn flour for bread making. Fenugreek appears to have many health benefits and potential medicinal properties; for this reason, it is increasingly being used in nutraceuticaltical formulations. This study aimed to describe patients who visited our operative unit for a suspected adverse reaction after ingestion of fenugreek and to highlight possible cross-reactivity between fenugreek and other legumes or other foods. Methods: A total of 13 patients (5 males and 8 females; mean age: 30.6; range: 20-42 years) visited our outpatient clinic with a clinical history suggestive of an allergic reaction to spices or legumes. They underwent a skin pick test for fenugreek, fresh foods, and food extracts. Results: A total of 6 out of 13 patients positive for fenugreek had experienced allergic symptoms after ingesting foods containing spices, and 10 patients presented polysensitization with other legumes, of which 8 also presented sensitization to pistachios. Conclusions: Given the increasing use of novel spices in Mediterranean cuisine and the possible spread of fenugreek-based nutraceuticalticals, it is relevant to draw attention to possible allergic reactions. Further studies are also needed to be able to establish its cross-reactivity pattern. fontsize; pistachio; fabaceae; cross-reactivity; food allergy; nutraceuticalticals; diagnosis; trigonella; peanut; pathogenesis +
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There are many plant species that possess great biological activity [5; 6; 7; 8; 9]. Some pigments contained in plants play an important role in health [10]. Many foods on the market are defined as nutraceuticals because they are of plant origin [11]. Typical Mediterranean foodstuff, such as olive oil and wine, also contain very important biologically active molecules [12; 13]. Fenugreek seeds contain soluble galactomannan, proteins, lipids, alkaloids (trigonelline), saponins (diosgenin and yamogenin-based saponins), 4-hydroxyisoleucine, volatile oils, C-glycosflavones of apigenin, luteolin, and insoluble fiber [14]. In particular, it is mainly used to improve digestion, activate metabolism, facilitate childbirth, and increase milk flow. Trigonelline appears to be the most active metabolite of fenugreek; it is useful in treating diabetes, reducing cholesterolemia, and treating cancers (liver, breast, cervical, and pancreatic cancers) as a phytohormone [15; 16]. Furthermore, fenugreek is used by chopping/crushing its seeds, or as an herbal preparation, dry or soft extract (preparations of intermediate consistency, between liquid and dry extracts, obtained by partial evaporation of the solvent used for preparation), powder, or in combination with other substances. Its main applications are appetite enhancement, topical treatment of localized skin and intestinal inflammation, and as an adjuvant in diabetes or hypercholesterolemia treatments [12; 13; 14; 15; 16]. It is considered nontoxic up to a maximum dose of 5 g/kg body weight. Side effects such as flatulence, diarrhea, abdominal distension, dyspepsia, hypokalemia, increased micturition frequency, and dizziness have been reported. Regarding adverse immunological reactions, the reports in the literature are mainly allergic reactions after contact with or ingestion of fenugreek, characterized by urticaria, angioedema, wheezing, cough, rhinorrhea, and itching. Type IV or delayed skin reactions after contact with fenugreek preparations are rare but possible. Finally, many authors have reported cross-reactivity between fenugreek and foods belonging to the Leguminosae (or Fabaceae) family [17; 18; 19; 20]. As the use of fenugreek is increasing worldwide, both in diets and in nutraceuticals, an increase in adverse reactions can be expected in the coming years.