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Cashew nut extract is a biological preparation derived from the seeds of the *Anacardium occidentale* plant. It contains a complex mixture of proteins, including the major allergens Ana o 1 (a 7S vicilin-like globulin), Ana o 2 (an 11S legumin-like globulin), and Ana o 3 (a 2S albumin). In clinical and research settings, it is primarily utilized as a diagnostic agent to identify cashew nut sensitization and allergy. It is used in skin prick testing (SPT), in vitro immunoglobulin E (IgE) binding assays (such as ELISA or IMMULITE inhibition methods), and double-blind, placebo-controlled food challenges (DBPCFC). The extract acts by presenting native allergenic epitopes to patient-derived IgE antibodies; the binding and subsequent cross-linking of these antibodies on mast cells or basophils trigger the allergic cascade, which is measured for diagnostic purposes. It is also used in studies of cross-reactivity between cashew and other tree nuts, such as pistachio and hazelnut, due to the presence of shared or structurally similar protein epitopes.
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