Slide 1: Ingestion of which food may cause lupus flares?
Slide 2: Alfalfa Sprouts!
Slide 3: In the 80s, an RCT randomized monkeys to receive an alfalfa-containing or standard diet. The monkeys fed alfalfa sprouts had: significantly higher levels of ANA, anti-dsDNA; complement deposition in the skin and glomeruli; hemolytic anemia. Shortly after, two human lupus flares thought to be related to alfalfa ingestion were reported in the New England Journal of Medicine. It was postulated that the compound L-canavanine was the culprit.
Slide 4: L-canavanine is structurally related to (and may substitue for) arginine. This is hypothesized to affect histones and tRNA functions. Antibodies to histones are known to be associated with drug-induced lupus.
Slide 5: Unfortunately, no high-quality studies have examined the relationship between L-canavanine or alfalfa sprouts and lupus flares in humans. However, the Lupus Foundation of America currently recommends that lupus patients avoid ingesting alfalfa.
- Roberts JL, Hayashi JA. Exacerbation of SLE associated with alfalfa ingestion. N Engl J Med. 1983 Jun 2;308(22):1361. PMID 6843625.
- Malinow MR, Bardana EJ, Pirofsky B, Craig S, Mclaughlin P. Systemic lupus erythematosus-like syndrome in monkeys fed alfalfa sprouts: role of a nonprotein amino acid. Science. 1982;216(4544):415-7. PMID 7071589/a>.
- Diet and Nutrition with Lupus. Lupus Foundation of America. https://www.lupus.org/resources/diet-and-nutrition-with-lupus. Updated May 28, 2013. Accessed October 31, 2019.
Tags: alfalfa sprouts, lupus, rheumatology