Czech J. Food Sci., 2016, 34(2):93-104 | DOI: 10.17221/357/2015-CJFS
Hidden exogenous proteins in wine: problems, methods of detection and related legislation - a reviewReview
- 1 Department of Biotechnology, University of Verona, Verona, Italy
- 2 Department of Agronomy, Food, Natural Resources, Animals and Environment, University of Padova, Legnaro (PD), Italy
Fining agents are commonly used in the winemaking process to clarify and stabilise wines. They have different origins (animal, vegetal or mineral) and are added to wines in order to remove specifically undesirable compounds that are discarded. Fining agents should not be present in the final product but their possible persistence, as well as other exogenous residual proteins such as the enzymes utilised in winemaking, cannot be excluded for sure. The principal concern about the presence of exogenous residual proteins is the health of allergic subjects. Nevertheless, the respect of religious creed or other practice of living of the consumer must be considered as well. In the present review we itemise the proteins used in winemaking and possible drawbacks of their permanence in the final products and the related risks, depict the status of the art of the studies performed about the detection of exogenous proteins, and describe the wine labelling laws adopted in different countries to avoid the drawbacks associated with these hidden substances.
Keywords: fining proteins; technological enzymes; residual protein detection; allergy; food ethics; wine labelling laws
Published: April 30, 2016 Show citation
References
- Aabin B., Poulsen L.K., Ebbehoj K., Norgaard A., Frokiaer H., Bindslev-Jensen C., Barkholt V. (1996): Identification of IgE-binding egg white proteins: comparison of results obtained by different methods. International Archives of Allergy and Immunology, 109: 50-57.
Go to original source...
Go to PubMed...
- Adachi A., Fukunaga A., Hayashi K., Kunisada M., Horikawa T. (2003): Anaphylaxis to polyvinylpyrrolidone after vaginal application of povidone-iodine. Contact Dermatitis, 48: 133-136.
Go to original source...
Go to PubMed...
- Baur X., Sander I., Jansen A., Czuppon A.B. (1994): Can amylases involved in bakery production be regarded as allergens? Schweizerische Medizinische Wochenschrift, 124: 846-851.
- Bindslev-Jensen C., Briggs D., Osterballe M. (2002): Can we determine a threshold level for allergenic foods by statistical analysis of published data in the literature? Allergy: European Journal of Allergy and Clinical Immunology, 57: 741-746.
Go to original source...
Go to PubMed...
- Borghesan F., Basso D., Chieco Bianchi F., Favero E., Plebani M. (2004): Allergy to wine. Allergy: European Journal of Allergy and Clinical Immunology, 59: 1135-1136.
Go to original source...
Go to PubMed...
- Boulton R.B., Singleton V.L., Bisson L.F., Kunkee R.E. (1996): The Fining and Clarification of Wines. In: Principles and Practices of Winemaking. New York, Springer: 279-319.
Go to original source...
- Cantani A. (2008): Pediatric Allergy, Asthma and Immunology. Berlin-Heidelberg, Springer-Verlag.
Go to original source...
- Carstens C., Deckwart M., Webber-Witt M., Schafer V., Eichhorn L., Brockow K., Fischer M., Christmann M., Paschke-Kratzin A. (2014): Evaluation of the efficiency of enological procedures on lysozyme depletion in wine by an indirect ELISA method. Journal of Agricultural and Food Chemistry, 62: 6247-6253.
Go to original source...
Go to PubMed...
- Castellari M., Spinabelli U., Riponi C., Amati A. (1998): Influence of some technological practices on the quantity of resveratrol in wine. European Food Research and Technology, 206: 151-155.
Go to original source...
- Cereda A., Kravchuk A.V., D'Amato A., Bachi A., Righetti P.G. (2010): Proteomics of wine additives: Mining for the invisible via combinatorial peptide ligand libraries. Journal of Proteomics, 73: 1732-1739.
Go to original source...
Go to PubMed...
- Chagas R., Monteiro S., Ferreira R.B. (2012): Assessment of potential effects of common fining agents used for white wine protein stabilization. American Journal of Enology and Viticulture, 63: 574-578.
Go to original source...
- Cosme F., Capao I., Filipe-Ribeiro L., Bennett R.N., MendesFaia A. (2012): Evaluating potential alternatives to potassium caseinate for white wine fining: Effects on physicochemical and sensory characteristics. LWT-Food Science and Technology, 46: 382-387.
Go to original source...
- Cosme F., Ricardo-da-Silva J.M., Laureano O. (2007): Protein fining agents: Characterization and red wine fining assays. Italian Journal of Food Science, 19: 39-56.
- D'Amato A., Kravchuk A.V., Bachi A., Righetti P.G. (2010): Noah's nectar: The proteome content of a glass of red wine. Journal of Proteomics, 73: 2370-2377.
Go to original source...
Go to PubMed...
- Deckwart M., Carstens C., Webber-Witt M., Schafer V., Eichhorn L., Kang S., Fischer M., Brockow K., Christmann M., Paschke-Kratzin A. (2014): Development of a sensitive ELISA for the detection of casein-containing fining agents in red and white wines. Journal of Agricultural and Food Chemistry, 62: 6803-6812.
Go to original source...
Go to PubMed...
- Ducasse M.A., Canal-Llauberes R.M., de Lumley M., Williams P., Souquet J.M., Fulcrand H., Doco T., Cheynier V. (2010): Effect of macerating enzyme treatment on the polyphenol and polysaccharide composition of red wines. Food Chemistry, 118: 369-376.
Go to original source...
- EFSA (2011a): Scientific Opinion related to a notification from the International Organisation of Vine and Wine (OIV) on casein/caseinate/milk products to be used in the manufacture of wine as clarification processing aids pursuant to Article 6, paragraph 11 of Directive 2000/13/EC - for permanent exemption from labelling. EFSA Journal, 9: 2384.
Go to original source...
- EFSA (2011b): Scientific Opinion related to a notification from the International Organisation of Vine and Wine (OIV) on ovalbumin/egg white to be used in the manufacture of wine as clarification processing aids pursuant to Article 6, paragraph 11 of Directive 2000/13/EC - for permanent exemption from labelling. EFSA Journal, 9: 2385.
Go to original source...
- European Commission (2003): Commission Directive 2003/89/EC of 10th of November 2003 amending Directive 2000/13/EC as regards indication of the ingredients present in foodstuffs. Official Journal of the European Union, L 308: 15-18.
- European Commission (2005): Commission Directive 2005/26/EC of 21 March 2005 establishing a list of food ingredients or substances provisionally excluded from Annex IIIa of Directive 2000/13/EC of the European Parliament and of the Council. Official Journal of the European Union, L 75: 33-44.
- European Commission (2005): Council Regulation (EC) No 2165/2005 of 20 December 2005 amending Regulation (EC) No 1493/1999 on the common organization of the market in wine. Official Journal of the European Union, L 345: 1-4.
- European Commission (2007): Commission Directive 2007/68/EC of 27 November 2007 amending Annex IIIa to Directive 2000/13/EC of the European Parliament and of the Council as regards certain food ingredients. Official Journal of the European Union, L 310: 11-14.
- European Commission (2010): Commission Regulation (EU) 1266/2010 of 22 December 2010 amending Directive 2007/68/EC as regards labelling requirements for wines. Official Journal of the European Union, L 347: 27-28.
- European Commission (2012): Commission Implementing Regulation (EU) No 579/2012 of 29th June 2012 amending Regulation (EC) No 607/2009 laying down certain detailed rules for the implementation of Council Regulation (EC) No 479/2008 as regards protected designations of origin and geographical indications, traditional terms, labelling and presentation of certain wine sector products. Official Journal of the European Union, L 171: 4-7.
- European Commission (2001): Commission Regulation (EU) 2066/2001of the European Parliament and of the Council of 22 October 2001 amending Regulation (EC) No 1622/2000 as regards the use of lysozyme in wine products. Official Journal of the European Union, L 278: 9-10.
- Exl B.M., Fritsché R. (2001): Cow's milk protein allergy and possible means for its prevention. Nutrition, 17: 642-651.
Go to original source...
Go to PubMed...
- FDA (2013): Code of Federal Regulations, 21 CFR 101.100. Chapter I - Food and Drug Administration. Department of Health and Human Services., Part 101 - Food Labeling.
- FSANZ (2004): Final assessment report. Application A482. Plant proteins as wine processing aids. Food Standards Australia New Zealand.
- Gambuti A., Rinaldi A., Moio L. (2012): Use of patatin, a protein extracted from potato, as alternative to animal proteins in fining of red wine. European Food Research and Technology, 235: 753-765.
Go to original source...
- Gerbaux V., Villa A., Monamy C., Bertrand A. (1997): Use of lysozyme to inhibit malolactic fermentation and to stabilize wine after malolactic fermentation. American Journal of Enology and Viticulture, 48: 49-54.
Go to original source...
- Government of Canada Food and Drug Act (2011): Regulations Amending the Food and Drug Regulations (1220 - Enhanced Labelling for Food Allergen and Gluten Sources and Added Sulphites). Canada Gazette, 145 (4).
- Guérin L., Sutter D.H., Demois A., Chereau M., Trandafir G. (2009): Determination of activity profiles of the main commercial enzyme preparations used in winemaking. American Journal of Enology and Viticulture, 60: 322-331.
Go to original source...
- Hischenhuber C., Crevel R., Jarry B., Maeki M., MoneretVautrin D.A., Romano A., Troncone R., Ward R. (2006): Review article: Safe amounts of gluten for patients with wheat allergy or coeliac disease. Alimentary Pharmacology and Therapeutics, 23: 559-575.
Go to original source...
Go to PubMed...
- Hochwallner H., Schulmeister U., Swoboda I., Spitzauer S., Valenta R. (2014): Cow's milk allergy: From allergens to new forms of diagnosis, therapy and prevention. Methods, 66: 22-33.
Go to original source...
Go to PubMed...
- Howdle P.D., Ciclitira P.J., Simpson F.G., Losowsky M.S. (1984): Are all gliadins toxic in coeliac disease? An in vitro study of α-, β-, γ-, and ω-gliadins. Scandinavian Journal of Gastroenterology, 19: 41-47.
Go to original source...
- Kalogeromitros D.C., Makris M.P., Gregoriou S.G., Katoulis A.C., Straurianeas N.G. (2006): Sensitization to other foods in subjects with reported allergy to grapes. Allergy and Asthma Proceedings, 27: 68-71.
Go to original source...
Go to PubMed...
- Kaul S., Luttkopf D., Kastner B., Vogel L., Holtz G., Vieths S., Hoffmann A. (2007): Mediator release assays based on human or murine immunoglobulin E in allergen standardization. Clinical and Experimental Allergy, 37: 141-150.
Go to original source...
Go to PubMed...
- Kirsch S., Fourdrilis S., Dobson R., Scippo M.L., MaghuinRogister G., De Pauw E. (2009): Quantitative methods for food allergens: a review. Analytical and Bioanalytical Chemistry, 395: 57-67.
Go to original source...
Go to PubMed...
- Kirschner S., Belloni B., Kugler C., Ring J., Brockow K. (2009): Allergenicity of wine containing processing aids: A double-blind, placebo-controlled food challenge. Journal of Investigational Allergology and Clinical Immunology, 19: 210.
- Laborde B., Moine-Ledoux V., Richard T., Saucier C., Dubourdieu D., Monti J.P. (2006): PVPP-polyphenol complexes: A molecular approach. Journal of Agricultural and Food Chemistry, 54: 4383-4389.
Go to original source...
Go to PubMed...
- Lacorn M., Gossewein C., Immer U. (2011): Determination of residual egg white proteins in red wines during and after fining. American Journal of Enology and Viticulture, 62: 382-385.
Go to original source...
- Lacorn M., Ristow R., Weiss T., Immer U. (2014): Collaborative tests of ELISA methods for the determination of egg white protein and caseins used as fining agents in red and white wines. Food Analytical Methods, 7: 417-429.
Go to original source...
- Lam H.-Y., van Hoffen E., Michelsen A., Guikers K., van der Tas C.H.W., Bruijnzeel-Koomen C.A.F.M., Knulst A.C. (2008): Cow's milk allergy in adults is rare but severe: both casein and whey proteins are involved. Clinical & Experimental Allergy, 38: 995-1002.
Go to original source...
Go to PubMed...
- Liburdi K., Straniero R., Benucci I., Garzillo A.M.V., Esti M. (2012): Lysozyme immobilized on micro-sized magnetic particles: kinetic parameters at wine pH. Applied Biochemistry and Biotechnology, 166: 1736-1746.
Go to original source...
Go to PubMed...
- Lifrani A., Santos J.D., Dubarry M., Rautureau M., Blachier F., Tome D. (2009): Development of animal models and sandwich-ELISA tests to detect the allergenicity and antigenicity of fining agent residues in wines. Journal of Agricultural and Food Chemistry, 57: 525-534.
Go to original source...
Go to PubMed...
- Losito I., Introna B., Monaci L., Minella S., Palmisano F. (2013): Development of a method for the quantification of caseinate traces in italian commercial white wines based on liquid chromatography-electrospray ionization-ion trap-mass spectrometry. Journal of Agricultural and Food Chemistry, 61: 12436-12444.
Go to original source...
Go to PubMed...
- Marchal R., Marchal-Delahaut L., Lallement A., Jeandet P. (2002a): Wheat gluten used as a clarifying agent of red wines. Journal of Agricultural and Food Chemistry, 50: 177-184.
Go to original source...
Go to PubMed...
- Marchal R., Marchal-Delahaut L., Michels F., Parmentier M., Lallement A., Jeandet P. (2002b): Use of wheat gluten as clarifying agent of musts and white wines. American Journal of Enology and Viticulture, 53: 308-314.
Go to original source...
- Mattarozzi M., Milioli M., Bignardi C., Elviri L., Corradini C., Careri M. (2014): Investigation of different sample pre-treatment routes for liquid chromatography-tandem mass spectrometry detection of caseins and ovalbumin in fortified red wine. Food Control, 38: 82-87.
Go to original source...
- Maury C., Sarni-Manchado P., Lefebvre S., Cheynier V., Moutounet M. (2003): Influence of fining with plant proteins on proanthocyanidin composition of red wines. American Journal of Enology and Viticulture, 54: 105-111.
Go to original source...
- Monaci L., Losito I., De Angelis E., Pilolli R., Visconti A. (2013): Multi-allergen quantification of fining-related egg and milk proteins in white wines by high-resolution mass spectrometry. Rapid Communications in Mass Spectrometry, 27: 2009-2018.
Go to original source...
Go to PubMed...
- Monaci L., Losito I., Palmisano F., Visconti A. (2010): Identification of allergenic milk proteins markers in fined white wines by capillary liquid chromatography-electrospray ionization-tandem mass spectrometry. Journal of Chromatography A, 1217: 4300-4305.
Go to original source...
Go to PubMed...
- Moneret-Vautrin D.A., Kanny G. (2004): Update on threshold doses of food allergens: Implications for patients and the food industry. Current Opinion in Allergy and Clinical Immunology, 4: 215-219.
Go to original source...
Go to PubMed...
- Moreno-Arribas M.V., Pueyo E., Polo M.C. (2002): Analytical methods for the characterization of proteins and peptides in wines. Analytica Chimica Acta, 458: 63-75.
Go to original source...
- Morisset M., Moneret-Vautrin D.A., Kanny G., Guénard L., Beaudouin E., Flabbée J., Hatahet R. (2003): Thresholds of clinical reactivity to milk, egg, peanut and sesame in immunoglobulin E-dependent allergies: Evaluation by double-blind or single-blind placebo-controlled oral challenges. Clinical & Experimental Allergy, 33: 1046-1051.
Go to original source...
Go to PubMed...
- OIV-Comex (2012): Criteria for the quantification of potentially allergenic residues of fining agent proteins in wine. Resolution OENO 427/2010 modified by OIV-Comex 502/2012. Resolution OENO, 8.
- Picariello G., Mamone G., Addeo F., Ferranti P. (2011): The frontiers of mass spectrometry-based techniques in food allergenomics. Journal of Chromatography A, 1218: 7386-7398.
Go to original source...
Go to PubMed...
- Post R. (2002): Agency Response Letter GRAS Notice No. GRN 000086. Center for Food Safety and Applied Nutrition, US Department of Agriculture.
- Powrie W.D., Nakai S. (1985): Characteristics of edible fluids of animal origin: eggs. In: Fennema O.R.: Food Chemistry. 2nd Ed. New York, Marcel Dekker: 289-285.
- Proctor V.A., Cunningham F.E. (1988): The chemistry of lysozyme and its use as a food preservative and a pharmaceutical. Critical Reviews in Food Science & Nutrition, 26: 359-395.
Go to original source...
Go to PubMed...
- Ramasamy I., Law M., Collins S., Brooke F. (2003): Organ distribution of prion proteins in variant Creutzfeldt-Jakob disease. Lancet Infectious Diseases, 3: 214-222.
Go to original source...
Go to PubMed...
- Restani P., Uberti F., Tarantino C., Ballabio C., Gombac F., Bastiani E., Bolognini L., Pavanello F., Danzi R. (2014): Collaborative interlaboratory studies for the validation of ELISA methods for the detection of allergenic fining agents used in wine according to the criteria of OIV Resolution 427-2010 modified by OIV-Comex 502-2012. Food Analytical Methods, 7: 706-712.
Go to original source...
- Restani P., Uberti F., Tarantino C., Ballabio C., Gombac F., Bastiani E., Bolognini L., Pavanello F., Danzi R. (2012): Validation by a collaborative interlaboratory study of an ELISA method for the detection of caseinate used as a fining agent in wine. Food Analytical Methods, 5: 480-486.
Go to original source...
- Rolland J.M., Apostolou E., De Leon M.P., Stockley C.S., O'Hehir R.E. (2008): Specific and sensitive enzyme-linked immunosorbent assays for analysis of residual allergenic food proteins in commercial bottled wine fined with egg white, milk, and nongrape-derived tannins. Journal of Agricultural and Food Chemistry, 56: 349-354.
Go to original source...
Go to PubMed...
- Rolland J.M., Apostolou E., Deckert K., De Leon M.P., Douglass J.A., Glaspole I.N., Bailey M., Stockley C.S., O'Hehir R.E. (2006): Potential food allergens in wine: Doubleblind, placebo-controlled trial and basophil activation analysis. Nutrition, 22: 882-888.
Go to original source...
Go to PubMed...
- Ronnau A.C., Wulferink M., Gleichmann E., Unver E., Ruzicka T., Krutmann J., Grewe M. (2000): Anaphylaxis to polyvinylpyrrolidone in an analgesic preparation. British Journal of Dermatology, 143: 1055-1058.
Go to original source...
Go to PubMed...
- Schmidt M.H.H., Raulf-Heimsoth M., Posch A. (2002): Evaluation of patatin as a major cross-reactive allergen in latex-induced potato allergy. Annals of Allergy, Asthma and Immunology, 89: 613-618.
Go to original source...
Go to PubMed...
- Seppala U., Alenius H., Turjanmaa K., Reunala T., Palosuo T., Kalkkinen N. (1999): Identification of patatin as a novel allergen for children with positive skin prick test responses to raw potato. Journal of Allergy and Clinical Immunology, 103: 165-171.
Go to original source...
Go to PubMed...
- Shewry P.R. (2009): Wheat. Journal of Experimental Botany, 60: 1537-1553.
Go to original source...
Go to PubMed...
- Shi J., Luo Y., Xiao Y., Li Z., Xu Q., Yao M. (2014): Effects of fermentation by Lactobacillus casei on the antigenicity and allergenicity of four bovine milk proteins. International Dairy Journal, 35: 75-80.
Go to original source...
- Sicherer S.H., Sampson H.A. (2010): Food allergy. Journal of Allergy and Clinical Immunology, 125 (Suppl. 2): S116-S125.
Go to original source...
Go to PubMed...
- Simonato B., Mainente F., Selvatico E., Violoni M., Pasini G. (2013): Assessment of the fining efficiency of zeins extracted from commercial corn gluten and sensory analysis of the treated wine. LWT-Food Science and Technology, 54: 549-556.
Go to original source...
- Simonato B., Mainente F., Suglia I., Curioni A., Pasini G. (2009): Evaluation of fining efficiency of corn zeins in red wine: A preliminary study. Italian Journal of Food Science, 21: 97-105.
- Simonato B., Mainente F., Tolin S., Pasini G. (2011): Immunochemical and mass spectrometry detection of residual proteins in gluten fined red wine. Journal of Agricultural and Food Chemistry, 59: 3101-3110.
Go to original source...
Go to PubMed...
- Skripak J.M., Matsui E.C., Mudd K., Wood R.A. (2007): The natural history of IgE-mediated cow's milk allergy. Journal of Allergy and Clinical Immunology, 120: 1172-1177.
Go to original source...
Go to PubMed...
- Taylor S.L., Nordlee J.A., Niemann L.M., Lambrecht D.M. (2009): Allergen immunoassays-considerations for use of naturally incurred standards. Analytical and Bioanalytical Chemistry, 395: 83-92.
Go to original source...
Go to PubMed...
- Threlfall R.T., Morris J.R., Mauromoustakos A. (1999): Effects of fining agents on trans-resveratrol concentration in wine. Australian Journal of Grape and Wine Research, 5: 22-26.
Go to original source...
- Tolin S., Pasini G., Curioni A., Arrigoni G., Masi A., Mainente F., Simonato B. (2012a): Mass spectrometry detection of egg proteins in red wines treated with egg white. Food Control, 23: 87-94.
Go to original source...
- Tolin S., Pasini G., Simonato B., Mainente F., Arrigoni G. (2012b): Analysis of commercial wines by LC-MS/MS reveals the presence of residual milk and egg white allergens. Food Control, 28: 321-326.
Go to original source...
- Uberti F., Danzi R., Stockley C., Penas E., Ballabio C., Di Lorenzo C., Tarantino C., Restani P. (2014): Immunochemical investigation of allergenic residues in experimental and commercially-available wines fined with egg white proteins. Food Chemistry, 159: 343-352.
Go to original source...
Go to PubMed...
- Van Do T., Elsayed S., Florvaag E., Hordvik I., Endresen C. (2005): Allergy to fish parvalbumins: Studies on the crossreactivity of allergens from 9 commonly consumed fish. Journal of Allergy and Clinical Immunology, 116: 1314-1320.
Go to original source...
Go to PubMed...
- Vassilopoulou E., Karathanos A., Siragakis G., Giavi S., Sinaniotis A., Douladiris N., Fernandez-Rivas M., Clausen M., Papadopoulos N.G. (2011): Risk of allergic reactions to wine, in milk, egg and fish-allergic patients. Clinical and Translational Allergy, 1: 10 pages. doi: 10.1186/2045-7022-1-10
Go to original source...
Go to PubMed...
- Verma A.K., Kumar S., Das M., Dwivedi P.D. (2013): A comprehensive review of legume allergy. Clinical Reviews in Allergy and Immunology, 45: 30-46.
Go to original source...
Go to PubMed...
- Vincenzi S., Dinnella C., Recchia A., Monteleone E., Gazzola D., Pasini G., Curioni A. (2013): Grape seed proteins: A new fining agent for astringency reduction in red wine. Australian Journal of Grape and Wine Research, 19: 153-160.
Go to original source...
- Vincenzi S., Mosconi S., Zoccatelli G., Dalla Pellegrina C., Veneri G., Chignola R., Peruffo A., Curioni A., Rizzi C. (2005): Development of a new procedure for protein recovery and quantification in wine. American Journal of Enology and Viticulture, 56: 182-187.
Go to original source...
- Walsh B.J., Barnett D., Burley R.W., Elliott C., Hill D.J., Howden M.E.H. (1988): New allergens from hen's egg white and egg yolk. International Archives of Allergy and Immunology, 87: 81-86.
Go to original source...
Go to PubMed...
- Weber P., Kratzin H., Brockow K., Ring J., Steinhart H., Paschke A. (2009): Lysozyme in wine: A risk evaluation for consumers allergic to hen's egg. Molecular Nutrition and Food Research, 53: 1469-1477.
Go to original source...
Go to PubMed...
- Weber P., Steinhart H., Paschke A. (2007a): Allergenic potential of fining agent residues in German wines related to their dosage and an ordinary bentonite treatment. Agro Food Industry Hi-Tech, 18: 22-24.
- Weber P., Steinhart H., Paschke A. (2007b): Investigation of the allergenic potential of wines fined with various proteinogenic fining agents by ELISA. Journal of Agricultural and Food Chemistry, 55: 3127-3133.
Go to original source...
Go to PubMed...
- Yokotsuka K., Singleton V.L. (1995): Interactive precipitation between phenolic fractions and peptides in wine-like model solutions - turbidity, particle-size and residual content as influenced by pH, temperature and peptide concentration. American Journal of Enology and Viticulture, 46: 329-338.
Go to original source...
- Yoshida K., Sakurai Y., Kawahara S., Takeda T., Ishikawa T., Murakami T., Yoshioka A. (2008): Anaphylaxis to polyvinylpyrrolidone in povidone-iodine for impetigo contagiosum in a boy with atopic dermatitis. International Archives of Allergy and Immunology, 146: 169-173.
Go to original source...
Go to PubMed...
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