Study · Clinical and experimental allergy · 2018

Walnut allergen Jug r 4 in allergic adults

What it found

In 55 adults who had a walnut food challenge, 10 were sensitive to the walnut protein Jug r 4.

Nine of those 10 had a positive challenge, but most were also sensitive to other walnut proteins.

What they found

Studies in people

Jug r 4 sensitivity

Of the 55 adults, 10 were sensitive to Jug r 4 on the EUROLINE test and 5 on immunoblot. All 5 positive on immunoblot were also positive on EUROLINE.

Challenge outcomes

Nine of the 10 Jug r 4 sensitive adults had a positive walnut challenge. One had a negative challenge.

Test performance

The authors report that the test for Jug r 4 had a sensitivity of 27%, specificity of 95%, positive predictive value of 90% and negative predictive value of 47%.

Co-sensitization

All 10 Jug r 4 sensitive adults were also sensitive to other walnut components, mostly Jug r 1. None were sensitive to Jug r 4 alone.

Other 11S globulins

Among the 10 Jug r 4 sensitive adults, 6 were also sensitive to hazelnut Cor a 9, and some to cashew, soy and peanut 11S globulins. The authors say this may be due to cross-reactivity.

Other findings

ImmunoCAP extract

Lab analysis showed that the walnut extract used in the ImmunoCAP test does not contain Jug r 4 or Jug r 3, but does contain Jug r 1 and Jug r 2.

What the authors conclude

“Walnut 11S globulin Jug r 4 is a relevant minor allergen, recognized by 27% of walnut allergic adults.”
Blankestijn MA, den Hartog Jager CF, Blom WM, et al, 2018

Also in their conclusions

  • They conclude that walnut 11S globulin Jug r 4 is a relevant minor allergen, recognized by 27% of walnut allergic adults.
  • They state that it has a high positive predictive value of 90% for walnut allergy.
  • They note that specific IgE against Jug r 4 occurred mostly with concomitant sensitization to other walnut components, mainly Jug r 1.

How it was done

The known walnut allergens Jug r 1, 2 and 3 did not explain all cases of walnut allergy, so the authors looked for other walnut proteins that allergic adults react to.

They prepared walnut extracts in the lab and screened blood from 8 walnut allergic adults to find proteins that IgE antibodies bind to. Then they tested blood from 55 adults who had a walnut food challenge, 33 allergic and 22 tolerant, for sensitivity to Jug r 4 using two lab methods.

What it can’t tell you

  • This study cannot show whether being sensitive to Jug r 4 alone causes walnut allergy, because almost all sensitive people were also sensitive to other walnut proteins.
  • The results are from adults who had a walnut challenge, so they may not apply to children or to people not tested this way.

The paper

Title
A subset of walnut allergic adults is sensitized to walnut 11S globulin Jug r 4
Type
Study
Evidence
Studies in people
Summarised from
Full text
Cite
Blankestijn MA, den Hartog Jager CF, Blom WM, et al (2018). A subset of walnut allergic adults is sensitized to walnut 11S globulin Jug r 4. Clinical and experimental allergy. doi:10.1111/cea.13208Free full textPubMed 29904971DOI

Summary written 26 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error