Camomile

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Code: w206
Latin name: Matricaria chamomilla
Source material: Pollen
Family: Asteraceae (Compositae)
Common names: Chamomile, Wild Camomile, German Camomile, Scented Mayweed

Allergen Exposure

German Camomile is native to Europe and western Asia and naturalised in North America. It is cultivated in Germany, Hungary, Russia, and several other European countries.

German Camomile is a many-branched, erect annual, growing to a height of about 0.3 to 0.6m. The plant produces many terminal flower heads in a comb-like formation from June to July. The disk-like flowers are yellow and surrounded by ten to twenty petal-like white ray flowers. The scented flowers are hermaphrodite (have both male and female organs) and are pollinated by insects. The seeds ripen from July to August.

Camomile grows in the wild, but also may be grown in cultivated beds and escape into the surrounding area.

This plant is used as a condiment, and for Camomile tea, perfume, and medicine. The young sprigs serve as a seasoning. Essential oil distilled from the flower heads is added to shampoos to impart the odour of Camomile.

Camomile contains sesquiterpene lactones, an important cause of dermatitis.

Allergen Description

Allergens of 23-50 kDa have been detected, all heat-stable. (1)

A homologue of the major Birch pollen allergen Bet v 1 has been detected in two Camomile blots (from the plant, not the pollen). Deglycosylation experiments proved the presence of carbohydrate determinants in Camomile, which were, however, not responsible for IgE-binding. Profilins (Bet v 2) were not detected in the Camomile extracts. (1)

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 Asteraceae (Compositae). (2)

One study shows a high degree of in vivo cross-reactivity between Artemisia vulgaris and Matricaria chamomilla, and the authors suggest that sensitisation to A. vulgaris may thus result in allergic reactions to Camomile infusions. (3, 4)

In laboratory studies, binding to Camomile proteins was inhibited in variable degrees by extracts from Celery roots, Anise seeds and pollen from Mugwort, Birch and Timothy grass. (1)

In a group of flower sellers investigated for occupational allergy, extensive cross-sensitisation was seen to pollen of several members of the Asteraceae (Compositae) family (e.g., Matricaria, Chrysanthemum, Solidago) and to pollen of the Amaryllidaceae family (Alstroemeria and Narcissus). (5)

Cross-reactivity among Camomile tea extract and the pollens of Matricaria chamomilla, Ambrosia trifida (Giant Ragweed), and Artemisia vulgaris (Mugwort), was demonstrated by an ELISA-inhibition study. (6)

Clinical Experience

IgE mediated reactions

Camomile pollen can induce asthma, allergic rhinitis and allergic conjunctivitis. (3)

In a study of patients allergic to Camomile, 10 of 14 had a clinical history of immediate reactions to Camomile, in some cases life-threatening. Eleven subjects were also shown by specific IgE tests to be sensitised to Mugwort, and eight to Birch tree pollen. (1)

One study reports that Mugwort (Artemisia vulgaris) hay fever can be associated with the Asteraceae (Compositae) family of foods, including Camomile, but that it is not normally associated with other foods. The inference is that individuals allergic to Camomile pollen may be allergic to other parts of the plant or infusions made from the plant. (4, 7)

Nine patients with hay fever, with or without asthma, experienced systemic allergic reactions after ingestion of natural honeys and/or Camomile tea. This study suggests that pollen of Asteraceae (Compositae) may be responsible for allergic reactions to certain natural foods and that the reactions are mediated by an IgE-related mechanism. (8)

Allergy and anaphylaxis have been described to Camomile, (6, 9, 10) as well as anaphylaxis to a Camomile tea enema. (11, 12)

Camomile has been suggested to cause Oral Allergy Syndrome. (13)

Other reactions

A 43-year-old male tea-packing plant worker developed occupational asthma and rhinitis caused by inhalation exposure to chamomile dust. (14)

Camomile flowers, leaves and stems contain sesquiterpene lactone, which causes contact dermatitis. (15) Camomile is one of the commonest causes of contact dermatitis, and cross-reactivity between this plant and other members of the Compositae, e.g., Chrysanthemum, Feverfew and Tansy, are common. (16, 17, 18)

In this study, allergen-specific immunoglobulin E antibodies to black or Camomile tea were found in 5.6% of employees of a tea packing factory, but there was little evidence of specific allergic sensitisation to the tea varieties tested. The excess of work-related respiratory and nasal symptoms probably represented non-specific irritation. (19, 20)

Contact urticaria and allergic contact dermatitis have been reported to the plant and tea. (21, 22, 23, 24, 25, 26, 27)

Camomile tea eye washing has been shown to induce allergic conjunctivitis. (4) A 20-year-old woman with a proven allergy to camomile suffered from short-lasting rhinitis when using a camomile-scented toilet paper. (28)

Compiled by Dr Harris Steinman, harris@allergyadvisor.com

References

  1. Reider N, Sepp N, Fritsch P, Weinlich G, Jensen-Jarolim E. Anaphylaxis to camomile: clinical features and allergen cross-reactivity. Clin Exp Allergy 2000;30(10):1436-43.
  2. Yman L. Botanical relations and immunological cross-reactions in pollen allergy. 2nd ed. Pharmacia Diagnostics AB. Uppsala. Sweden. 1982: ISBN 91-970475-09.
  3. de la Torre Morin F, Sanchez Machin I, Garcia Robaina JC, Fernandez-Caldas E, Sanchez Trivino M. Clinical cross-reactivity between Artemisia vulgaris and Matricaria chamomilla (chamomile). J Investig Allergol Clin Immunol 2001;11(2):118-22.
  4. Subiza J, Subiza JL, Alonso M, Hinojosa M, Garcia R, Jerez M, Subiza E. Allergic conjunctivitis to chamomile tea. Ann Allergy 1990;65(2):127-32.
  5. de Jong NW, Vermeulen AM, Gerth van Wijk R, de Groot H. Occupational allergy caused by flowers. Allergy 1998;53(2):204-9.
  6. Subiza J, Subiza JL, Hinojosa M, Garcia R, Jerez M, Valdivieso R, Subiza E. Anaphylactic reaction after the ingestion of chamomile tea: a study of cross-reactivity with other composite pollens. J Allergy Clin Immunol 1989;84(3):353-8.
  7. Garcia Ortiz JC, Cosmes PM, Lopez-Asunsolo A. Allergy to foods in patients monosensitized to Artemisia pollen. Allergy 1996;51(12):927-31.
  8. Florido-Lopez JF, Gonzalez-Delgado P, Saenz de San Pedro B, Perez-Miranda C, Arias de Saavedra JM, Marin-Pozo JF. Allergy to natural honeys and camomile tea. Int Arch Allergy Immunol 1995;108(2):170-4.
  9. Casterline CL. Allergy to chamomile tea. JAMA 1980;244(4):330-1.
  10. Benner MH, Lee HJ. Anaphylactic reaction to chamomile tea. J Allergy Clin Immunol 1973;52(5):307-8.
  11. Thien FC. Chamomile tea enema anaphylaxis. [Letter] Med J Aust 2001;175(1):54.
  12. Jensen-Jarolim E, Reider N, Fritsch R, Breiteneder H. Fatal outcome of anaphylaxis to camomile-containing enema during labor: a case study. J Allergy Clin Immunol 1998;102(6 Pt 1):1041-2.
  13. Gluck U. Pollinosis and oral allergy syndrome. [German] HNO 1990;38(5):188-90.
  14. Vandenplas O, Pirson F, D'Alpaos V, Vander Borght T, Thimpont J,  Pilette C. Occupational asthma caused by chamomile. Allergy 2008;63(7):1090-2.
  15. Dutkiewicz J, Skorska C, Milanowski J, Mackiewicz B, Krysinska-Traczyk E, Dutkiewicz E, Matuszyk A, Sitkowska J, Golec M. Response of herb processing workers to work-related airborne allergens. Ann Agric Environ Med 2001;8(2):275-83.
  16. Paulsen E, Andersen KE, Hausen BM. Sensitization and cross-reaction patterns in Danish Compositae-allergic patients. Contact Dermatitis 2001;45(4):197-204.
  17. Hausen BM. A 6-year experience with compositae mix. Am J Contact Dermat 1996;7(2):94-9.
  18. Hausen BM. The sensitizing capacity of Compositae plants. III. Test results and cross-reactions in Compositae-sensitive patients. Dermatologica 1979;159(1):1-11
  19. Abramson MJ, Sim MR, Fritschi L, Vincent T, Benke G, Rolland JM. Respiratory disorders and allergies in tea packers. Occup Med (Lond) 2001;51(4):259-65.
  20. Zuskin E, Skuric Z. Respiratory function in tea workers. Br J Ind Med 1984;41(1):88-93.
  21. van Ketel WG. Allergy to Matricaria chamomilla. Contact Dermatitis 1987;16(1):50-1.
  22. Foti C, Nettis E, Panebianco R, Cassano N, Diaferio A, Pia DP. Contact urticaria from Matricaria chamomilla. Contact Dermatitis 2000;42(6):360-1.
  23. Giordano-Labadie F, Schwarze HP, Bazex J. Allergic contact dermatitis from camomile used in phytotherapy. Contact Dermatitis 2000;42(4):247.
  24. Rodriguez-Serna M, Sanchez-Motilla JM, Ramon R, Aliaga A. Allergic and systemic contact dermatitis from Matricaria chamomilla tea. Contact Dermatitis 1998;39(4):192-3.
  25. Pereira F, Santos R, Pereira A. Contact dermatitis from chamomile tea. Contact Dermatitis 1997;36(6):307.
  26. Bossuyt L, Dooms-Goossens A. Contact sensitivity to nettles and camomile in 'alternative' remedies. Contact Dermatitis 1994;31(2):131-2.
  27. McGeorge BC, Steele MC. Allergic contact dermatitis of the nipple from Roman chamomile ointment. Contact Dermatitis 1991;24(2):139-40.
  28. Scala G. Acute, short-lasting rhinitis due to camomile-scented toilet paper in patients allergic to compositae. Int Arch Allergy Immunol 2006;139(4):330-1.

 

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