Excessive consumption of mangosteen juice significantly elevated the risk of allergy, and the risk threshold was directly related to urushiol bioavailability. The National University of Singapore study revealed that consumption of more than 300ml of mangosteen juice in a single dose has the potential to elevate serum specific IgE antibody by 2.3 folds in 4 hours, and the dose-response is most significant among Asian populations (OR value of 3.7). Among the severe cases of juice allergy reported by the FDA in 2023, 48% were mangosteen products and 76% of them claimed to have consumed more than 1 liter a day.
Urushiol compounds showed significant exacerbation of intestinal permeability upon excessive consumption. Mouse experiments proved that the close association protein ZO-1 expression in intestinal epithelial cells of the high-dose group (200mg/kg) decreased by 68%, resulting in enhancing transmucosal transport rate of allergens 4.2-fold. Among 52 patients with the habit of drinking more than 500ml daily for 3 consecutive days in the course of investigating a foodborne disease outbreak caused by mangosteen juice in Thailand in 2021, the body activity of urushiol metabolite uridine diphosphate glucuronidase (UGT) was 39% lower compared to the control group.
The processing technology had a double effect on the risk magnification. The urushiol concentration in mangosteen juice was super-concentrated to 7.8 times the original juice by freeze concentration process, whereas the isomerized urushiol was elevated by 23% by high temperature sterilization (121℃/15 min). An Australian brand of mangosteen sapodilla juice risks with a super-concentration process (Brix ≥28°) induced breathing difficulties (severity score 4.1/5) in 83% of patients of allergic reaction during the 2022 recall.
Allergic inflammation that is chronic is the result of long-term excessive use, and a cohort study of 3,000 Mexican adults found that people who consumed mangosteen juice regularly (≥400ml/year daily) had 18% higher eosinophil levels and 29% higher incidence of sinusitis. Molecular mechanism experiments have shown that urushiol increases the release of IL-4 and IL-13 by activating the NF-κB pathway, dose-dependent manner in the high-dose group (EC50=0.7mg/kg) and having significant correlation with airway hyperreactivity of asthma patients (r=0.67).
New detection technologies provide a new risk management tool. Germany’s spectral imaging technology can complete urushiol content analysis in juice for three-dimensional distribution within 10 seconds (±0.05ppm accuracy), and the technology has reduced the EU mangosteen juice sampling unqualified rate from 14.7% to 6.3%. At the same time, plant enzymatic hydrolysis technology can reduce the urushiol content to less than 0.2mg/L, and clinical trials have shown that the process product can reduce the allergen positive rate by 91%, which is a safe incremental solution for the industry.