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Sample records for ige-mediated food allergy

  1. IgE mediated food allergy in Korean children: focused on plant food allergy.

    PubMed

    Lee, Soo-Young

    2013-01-01

    Food allergy (FA) is a worldwide problem, with increasing prevalence in many countries, and it poses a clearly increasing health problem in Korea. In Korea, as a part of International Study of Asthma and Allergy in Childhood (ISAAC), a series of nation-wide population studies for prevalence of allergic disease in children were carried out, with the Korean version of ISAAC in 1995, 2000, and 2010. From the survey, the twelve-month prevalence of FA showed no significant differences from 1995 to 2000 in both age groups (6-12 years-old, 6.5% in 1995 and 5.7% in 2000; 12-15 year-olds, 7.4% in 1995 and 8.6% in 2000). The mean lifetime prevalence of FA which had ever been diagnosed by medical doctor was 4.7% in 6-12 year-olds and 5.1% in 12-15 year-olds respectively in 2000. In Korean children, the major causes of FA are almost same as in other countries, although the order prevalence may vary, a prime example of which being that peanut and tree nut allergies are not prevalent, as in western countries. Both pediatric emergency department (ED) visits and deaths relating to food induced anaphylaxis have also increased in western countries. From a study which based on data from the Korean Health Insurance Review and Assessment Service (KHIRA) from 2001 to 2007, the incidence of anaphylaxis under the age of 19 was 0.7-1 per 100,000 person-year, and foods (24.9%) were the most commonly identified cause of childhood anaphylaxis. In another epidemiologic study, involving 78889 patients aged 0-18 years who visited the EDs of 9 hospitals during June 2008 to Mar 2009, the incidence of food related anaphylaxis was 4.56 per 10,000 pediatric ED visits. From these studies, common causes of food related anaphylaxis were seafood, buckwheat, cow's milk, fruits, peanut and tree nuts. Although systematic epidemiologic studies have not reported on the matter, recently, plant foods related allergy has increased in Korean children. Among 804 children with moderate to severe atopic dermatitis

  2. Diversity of Food Allergy.

    PubMed

    Moriyama, Tatsuya

    2015-01-01

    Food allergy is defined as an immune system-mediated adverse reaction to food components. Food allergic reactions are mostly IgE mediated and also known as immediate type hypersensitivity (type I reaction). There are several characteristic clinical types of food allergy, such as Anaphylaxis, Food-dependent exercise-induced anaphylaxis (FDEIA), and Oral allergy syndrome (OAS). In addition, food allergy is also classified into two types (class 1 and class 2) based on the pathophysiological mechanism. In the class 2 food allergy, pollen allergy causes plant food allergy; therefore this type of allergy is sometimes called Pollen-food allergy syndrome (PFAS). The risk of food allergy (allergenicity) may vary with the treatment of the food allergens. The formation or status of the causative food affects its allergenicity. Class 1 food allergens are generally heat-, enzyme-, and low pH-resistant glycoproteins ranging in size from 10 to 70 kD. Class 1 food allergens induce allergic sensitization via the gastrointestinal tract and are responsible for systemic reactions. Class 2 food allergens are generally heat-labile, susceptible to digestion, and highly homologous with pollen allergens. Taken together, it may be important to consider the diversity of food allergy in order to fight against food allergy.

  3. [Food allergy or food intolerance?].

    PubMed

    Maître, S; Maniu, C-M; Buss, G; Maillard, M H; Spertini, F; Ribi, C

    2014-04-16

    Adverse food reactions can be classified into two main categories depending on wether an immune mechanism is involved or not. The first category includes immune mediated reactions like IgE mediated food allergy, eosinophilic oesophagitis, food protein-induced enterocolitis syndrome and celiac disease. The second category implies non-immune mediated adverse food reactions, also called food intolerances. Intoxications, pharmacologic reactions, metabolic reactions, physiologic, psychologic or reactions with an unknown mechanism belong to this category. We present a classification of adverse food reactions based on the pathophysiologic mechanism that can be useful for both diagnostic approach and management.

  4. Food Allergies

    MedlinePlus

    ... de los dientes Video: Getting an X-ray Food Allergies KidsHealth > For Kids > Food Allergies Print A ... cow's milk eggs soy wheat What Is a Food Allergy? Food allergies happen when the immune system ...

  5. Food allergy in children.

    PubMed

    Baral, V R; Hourihane, J O'B

    2005-11-01

    Food allergy is being increasingly recognised with the highest prevalence being in preschool children. Pathogenesis varies so diagnosis rests on careful history and clinical examination, appropriate use of skin prick and serum-specific IgE testing, food challenge, and supervised elimination diets. A double blind placebo controlled food challenge is the gold standard diagnostic test. Avoidance of the allergenic food is the key towards successful management. IgE mediated food allergy may present as a potentially fatal anaphylactic reaction, and management consists of the appropriate use of adrenaline (epinephrine) and supportive measures. Sensitisation remains a key target for intervention. Disease modifying agents are currently under trial for managing difficult allergies. Management requires a multidisciplinary approach and follow up.

  6. Food Allergies

    MedlinePlus

    ... food allergy reactions: milk eggs peanuts soy wheat tree nuts (such as walnuts and cashews) fish shellfish ( ... peanut allergy and about 10% of kids with tree nut allergy outgrow their allergy. Fish and shellfish ...

  7. Food Allergies

    MedlinePlus

    ... of food, most food allergies are caused by tree nuts, peanuts, milk, eggs, soy, wheat, fish and ... all do. People rarely outgrow allergies to peanuts, tree nuts, fish and shellfish QuestionsQuestions to Ask Your ...

  8. Food Allergy.

    PubMed

    Sathe, Shridhar K; Liu, Changqi; Zaffran, Valerie D

    2016-01-01

    Food allergy is receiving increased attention in recent years. Because there is currently no known cure for food allergy, avoiding the offending food is the best defense for sensitive individuals. Type I food allergy is mediated by food proteins, and thus, theoretically, any food protein is a potential allergen. Variability of an individual's immune system further complicates attempts to understand allergen-antibody interaction. In this article, we briefly review food allergy occurrence, prevalence, mechanisms, and detection. Efforts aimed at reducing/eliminating allergens through food processing are discussed. Future research needs are addressed.

  9. Food Allergy

    MedlinePlus

    ... in allergy and immunology to epidemiological and observational studies to identify risk factors and to clinical trials that are testing new strategies to prevent and treat food allergy. Read on ...

  10. Food Allergy

    MedlinePlus

    ... the Library View All » Allergy-Free Recipes » Allergy-Free Play Dough Recipes » Anaphylaxis Action Plan » Anaphylaxis Wallet Card » ... D and Food Allergy » When Should Children and Adolescents Assume Responsibility for Self-Treatment of ... Free Zone » Peanut Free Zone » Information ...

  11. Food Allergies.

    PubMed

    Grief, Samuel N

    2016-09-01

    Food allergies are common and seem to be increasing in prevalence. Preventive measures have become far more evident in the public arena (schools, camps, sports venues, and so forth). Evaluation and management of food allergies has evolved such that primary care practitioners may choose to provide initial diagnostic and treatment care or refer to allergists for similar care. Food allergies, once considered incurable, are now being diminished in intensity by new strategies.

  12. Ultrasensitive carbohydrate-peptide SPR imaging microarray for diagnosing IgE mediated peanut allergy.

    PubMed

    Joshi, Amit A; Peczuh, Mark W; Kumar, Challa V; Rusling, James F

    2014-11-21

    Severity of peanut allergies is linked to allergen-specific immunoglobulin E (IgE) antibodies in blood, but diagnostics from assays using glycoprotein allergen mixtures may be inaccurate. Measuring IgEs specific to individual peptide and carbohydrate epitopes of allergenic proteins is promising. We report here the first immunoarray for IgEs utilizing both peptide and carbohydrate epitopes. A surface plasmon resonance imaging (SPRi) microarray was equipped with peptide and β-xylosyl glycoside (BXG) epitopes from major peanut allergen glycoprotein Arachis hypogaea h2 (Ara-h2). A monoclonal anti-IgE antibody was included as positive control. IgEs were precaptured onto magnetic beads loaded with polyclonal anti-IgE antibodies to enhance sensitivity and minimize non-specific binding. As little as 0.1 attomole (0.5 pg mL(-1)) IgE was detected from dilute serum in 45 min. IgEs binding to Ara-h2 peptide and BXG were quantified in 10 μL of patient serum and correlated with standard ImmunoCAP values.

  13. Food allergy

    PubMed Central

    Watson, J. B. G.; Timmins, J.

    1979-01-01

    Two children with food allergy could not be successfully managed on dietary restriction alone. There was a good response to treatment with oral sodium cromoglycate but none to placebo treatment. The use of sodium cromoglycate in the management of food allergy should be studied further. PMID:105671

  14. Food allergy

    MedlinePlus

    ... people of all ages) Soy (mostly in children) Tree nuts (people of all ages) Wheat (people of ... Allergies to peanuts, tree nuts, and shellfish tend to last a lifetime. Avoiding the problem foods may be easy if the food is ...

  15. Probiotics and food allergy.

    PubMed

    Castellazzi, Anna Maria; Valsecchi, Chiara; Caimmi, Silvia; Licari, Amelia; Marseglia, Alessia; Leoni, Maria Chiara; Caimmi, Davide; Miraglia del Giudice, Michele; Leonardi, Salvatore; La Rosa, Mario; Marseglia, Gian Luigi

    2013-07-29

    The exact prevalence of food allergy in the general population is unknown, but almost 12% of pediatric population refers a suspicion of food allergy. IgE mediated reactions to food are actually the best-characterized types of allergy, and they might be particularly harmful especially in children. According to the "hygiene hypothesis" low or no exposure to exogenous antigens in early life may increase the risk of allergic diseases by both delaying the development of the immune tolerance and limiting the Th2/Th1 switch. The critical role of intestinal microbiota in the development of immune tolerance improved recently the interest on probiotics, prebiotics, antioxidants, polyunsaturated fatty acid, folate and vitamins, which seem to have positive effects on the immune functions.Probiotics consist in bacteria or yeast, able to re-colonize and restore microflora symbiosis in intestinal tract. One of the most important characteristics of probiotics is their safety for human health. Thanks to their ability to adhere to intestinal epithelial cells and to modulate and stabilize the composition of gut microflora, probiotics bacteria may play an important role in the regulation of intestinal and systemic immunity. They actually seem capable of restoring the intestinal microbic equilibrium and modulating the activation of immune cells.Several studies have been recently conducted on the role of probiotics in preventing and/or treating allergic disorders, but the results are often quite contradictory, probably because of the heterogeneity of strains, the duration of therapy and the doses administered to patients. Therefore, new studies are needed in order to clarify the functions and the utility of probiotics in food allergies and ion other types of allergic disorders.

  16. Kids with Food Allergies

    MedlinePlus

    ... Us Living With Food Allergies Allergens Peanut Allergy Tree Nut Allergy Milk Allergy Egg Allergy Soy Allergy ... Gluten Substitutions for Soy Substitutions for Peanuts and Tree Nuts Substitutions for Corn Menu Planning for the ...

  17. Food Allergies

    MedlinePlus

    ... delicious dessert, but then you see the crushed peanuts on top. Darn! You're allergic to peanuts. Maybe just one little bite? Nope. If you ... alone. These foods cause the most food allergies: peanuts and other nuts seafood, such as shrimp milk, ...

  18. Differentiating food allergies from food intolerances.

    PubMed

    Guandalini, Stefano; Newland, Catherine

    2011-10-01

    Adverse reactions to foods are extremely common, and generally they are attributed to allergy. However, clinical manifestations of various degrees of severity related to ingestion of foods can arise as a result of a number of disorders, only some of which can be defined as allergic, implying an immune mechanism. Recent epidemiological data in North America showed that the prevalence of food allergy in children has increased. The most common food allergens in the United States include egg, milk, peanut, tree nuts, wheat, crustacean shellfish, and soy. This review examines the various forms of food intolerances (immunoglobulin E [IgE] and non-IgE mediated), including celiac disease and gluten sensitivity. Immune mediated reactions can be either IgE mediated or non-IgE mediated. Among the first group, Immediate GI hypersensitivity and oral allergy syndrome are the best described. Often, but not always, IgE-mediated food allergies are entities such as eosinophilic esophagitis and eosinophilic gastroenteropathy. Non IgE-mediated immune mediated food reactions include celiac disease and gluten sensitivity, two increasingly recognized disorders. Finally, non-immune mediated reactions encompass different categories such as disorders of digestion and absorption, inborn errors of metabolism, as well as pharmacological and toxic reactions.

  19. What's new in the diagnosis and management of food allergy in children?

    PubMed Central

    Turner, Paul J

    2013-01-01

    This article reviews the recent advances in the diagnosis and management of IgE mediated food allergy in children. It will encompass the emerging technology of component testing; moves to standardization of the allergy food challenge; permissive diets which allow for inclusion of extensively heated food allergens with allergen avoidance; and strategies for accelerating tolerance and food desensitization including the use of adjuvants for specific tolerance induction. PMID:23667831

  20. Food allergy in childhood (infancy to school age).

    PubMed

    Bergmann, Marcel M; Eigenmann, Philippe A

    2015-01-01

    Food allergy is a potentially life-threatening condition affecting almost 10% of children, with an increasing incidence in the last few decades. It is defined as an immune reaction to food, and its pathogenesis may be IgE mediated, mixed IgE and non-IgE mediated, or non-IgE mediated. Potentially all foods can cause food allergy, but a minority of foods are responsible for the vast majority of reactions reported. A good clinical history is crucial for an accurate diagnosis. Allergy tests, including the skin prick test and measurement of specific IgE antibodies, are useful tools in the case of IgE-mediated or mixed allergy but have not been shown to be of any help in delayed allergic reactions to foods.

  1. Clinical spectrum of food allergies: a comprehensive review.

    PubMed

    Ho, Marco H-K; Wong, Wilfred H-S; Chang, Christopher

    2014-06-01

    Food allergy is defined as an adverse immune response towards food proteins or as a form of a food intolerance associated with a hypersensitive immune response. It should also be reproducible by a double-blind placebo-controlled food challenge. Many reported that food reactions are not allergic but are intolerances. Food allergy often presents to clinicians as a symptom complex. This review focuses on the clinical spectrum and manifestations of various forms of food allergies. According to clinical presentations and allergy testing, there are three types of food allergy: IgE mediated, mixed (IgE/Non-IgE), and non-IgE mediated (cellular, delayed type hypersensitivity). Recent advances in food allergy in early childhood have highlighted increasing recognition of a spectrum of delayed-onset non-IgE-mediated manifestation of food allergy. Common presentations of food allergy in infancy including atopic eczema, infantile colic, and gastroesophageal reflux. These clinical observations are frequently associated with food hypersensitivity and respond to dietary elimination. Non-IgE-mediated food allergy includes a wide range of diseases, from atopic dermatitis to food protein-induced enterocolitis and from eosinophilic esophagitis to celiac disease. The most common food allergies in children include milk, egg, soy, wheat, peanut, treenut, fish, and shellfish. Milk and egg allergies are usually outgrown, but peanut and treenut allergy tends to persist. The prevalence of food allergy in infancy is increasing and may affect up to 15-20 % of infants. The alarming rate of increase calls for a public health approach in the prevention and treatment of food allergy in children.

  2. Addressing Food Allergies

    ERIC Educational Resources Information Center

    DeVoe, Jeanne Jackson

    2008-01-01

    Since 1960, the incidence of food allergies in children has grown fivefold, from 1 in 100 children to 1 in 20 children, according to the Food Allergy Initiative. Food allergies cause anaphylactic shock, the most severe type of allergic reaction, which can lead to death within minutes if left untreated. While there are no standard guidelines from…

  3. Addressing Food Allergies

    ERIC Educational Resources Information Center

    DeVoe, Jeanne Jackson

    2008-01-01

    Since 1960, the incidence of food allergies in children has grown fivefold, from 1 in 100 children to 1 in 20 children, according to the Food Allergy Initiative. Food allergies cause anaphylactic shock, the most severe type of allergic reaction, which can lead to death within minutes if left untreated. While there are no standard guidelines from…

  4. Recent Advances in Management of Pediatric Food Allergy

    PubMed Central

    Anagnostou, Katherine; Swan, Kate; Fox, Adam T.

    2015-01-01

    Many children now suffer with a food allergy, immunoglobulin E (IgE) and/or non-IgE mediated. Food allergies have a significant impact on the child’s quality of life, as well as that of their family, due to the resultant dietary restrictions and the constant threat of a potentially life-threatening reaction. At present, there is no cure for food allergies, but there are exciting advances occurring in the management of IgE mediated allergies, including a more active approach to management with anticipatory screening testing, early introduction of common food allergens, active tolerance induction, use of biologics and active risk management. These areas will be discussed in this review. PMID:27417375

  5. Food allergy and probiotics in childhood.

    PubMed

    del Giudice, Michele Miraglia; Leonardi, Salvatore; Maiello, Nunzia; Brunese, Francesco Paolo

    2010-09-01

    Food allergy is a frequent problem in childhood and its prevalence is increasing. In most cases food allergy is an IgE-mediated hypersensitivity response that cause skin reactions as urticaria. Subacute or chronic disorders have generally a not IgE mediated mechanism. Milk is the most common food allergen in USA and UK followed by egg, peanut and walnuts. Sensitization to milk or egg in infancy is associated with an increased risk to develop house dust mite sensitization and asthma later in childhood. Commensal gut flora play a role in induction of oral tolerance and the importance of the intestinal microbiota in the development of food allergy is essential in early ages, when the mucosal barrier and immune system are still immature. Probiotics interact with the mucosal immune system by the same pathways as commensal bacteria. Recent study show that probiotic bacteria induced in vivo increased plasma levels IL-10 and total IgA in children with allergic predisposition. Many clinical studies reporting significant benefits by probiotics supplementation in food allergy prevention and management but not everyone agree on their effectiveness. These differences are probably related to differences in selected populations and in probiotic strains used.

  6. Food allergy: an overview.

    PubMed

    Kagan, Rhoda Sheryl

    2003-02-01

    Food allergy affects between 5% and 7.5% of children and between 1% and 2% of adults. The greater prevalence of food allergy in children reflects both the increased predisposition of children to develop food allergies and the development of immunologic tolerance to certain foods over time. Immunoglobulin (Ig) E-mediated food allergies can be classified as those that persist indefinitely and those that are predominantly transient. Although there is overlap between the two groups, certain foods are more likely than others to be tolerated in late childhood and adulthood. The diagnosis of food allergy rests with the detection of food-specific IgE in the context of a convincing history of type I hypersensitivity-mediated symptoms after ingestion of the suspected food or by eliciting IgE-mediated symptoms after controlled administration of the suspected food. Presently, the only available treatment of food allergies is dietary vigilance and administration of self-injectable epinephrine.

  7. ICON: food allergy.

    PubMed

    Burks, A Wesley; Tang, Mimi; Sicherer, Scott; Muraro, Antonella; Eigenmann, Philippe A; Ebisawa, Motohiro; Fiocchi, Alessandro; Chiang, Wen; Beyer, Kirsten; Wood, Robert; Hourihane, Jonathan; Jones, Stacie M; Lack, Gideon; Sampson, Hugh A

    2012-04-01

    Food allergies can result in life-threatening reactions and diminish quality of life. In the last several decades, the prevalence of food allergies has increased in several regions throughout the world. Although more than 170 foods have been identified as being potentially allergenic, a minority of these foods cause the majority of reactions, and common food allergens vary between geographic regions. Treatment of food allergy involves strict avoidance of the trigger food. Medications manage symptoms of disease, but currently, there is no cure for food allergy. In light of the increasing burden of allergic diseases, the American Academy of Allergy, Asthma & Immunology; European Academy of Allergy and Clinical Immunology; World Allergy Organization; and American College of Allergy, Asthma & Immunology have come together to increase the communication of information about allergies and asthma at a global level. Within the framework of this collaboration, termed the International Collaboration in Asthma, Allergy and Immunology, a series of consensus documents called International Consensus ON (ICON) are being developed to serve as an important resource and support physicians in managing different allergic diseases. An author group was formed to describe the natural history, prevalence, diagnosis, and treatment of food allergies in the context of the global community.

  8. Food Allergy

    MedlinePlus

    ... Shellfish, such as shrimp, lobster and crab Peanuts Tree nuts, such as walnuts and pecans Fish Eggs ... commonly triggered by proteins in: Eggs Milk Peanuts Tree nuts Wheat Food intolerance and other reactions There ...

  9. Food Allergy

    MedlinePlus

    ... trigger allergic reactions include fish, shellfish, peanuts, and tree nuts, such as walnuts. Problem foods for children can include eggs, milk, peanuts, tree nuts, soy, and wheat. The allergic reaction may ...

  10. Food allergy: current concerns

    SciTech Connect

    Fries, J.H.

    1981-05-01

    This commentary focuses on the author's concerns with various aspects of food allergy. Strict criteria should be applied to the definition of food allergy and its diagnostic techniques. Industrial inhalational exposures, food contaminations and cross-sensitization all are important influences which demand studious attention.

  11. Food allergies (image)

    MedlinePlus

    ... upon subsequent exposure to the substance. An actual food allergy, as opposed to simple intolerance due to the lack of digesting enzymes, is indicated by the production of antibodies to the food allergen, and by the release of histamines and ...

  12. [Food allergy in adulthood].

    PubMed

    Werfel, Thomas

    2016-06-01

    Food allergies can newly arise in adulthood or persist following a food allergy occurring in childhood. The prevalence of primary food allergy is basically higher in children than in adults; however, in the routine practice food allergies in adulthood appear to be increasing and after all a prevalence in Germany of 3.7 % has been published. The clinical spectrum of manifestations of food allergies in adulthood is broad. Allergy symptoms of the immediate type can be observed as well as symptoms occurring after a delay, such as indigestion, triggering of hematogenous contact eczema or flares of atopic dermatitis. The same principles for diagnostics apply in this group as in childhood. In addition to the anamnesis, skin tests and in vitro tests, as a rule elimination diets and in particular provocation tests are employed. Molecular allergy diagnostics represent a major step forward, which allow a better assessment of the risk of systemic reactions to certain foodstuffs (e.g. peanuts) and detection of cross-reactions in cases of apparently multiple sensitivities. Current German and European guidelines from 2015 are available for the practical approach to clarification of food allergies. The most frequent food allergies in adults are nuts, fruit and vegetables, which can cross-react with pollen as well as wheat, shellfish and crustaceans. The therapy of allergies involves a consistent avoidance of the allogen. Detailed dietary plans are available with avoidance strategies and instructions for suitable food substitutes. A detailed counseling of affected patients by specially trained personnel is necessary especially in order to avoid nutritional deficiencies and to enable patients to enjoy a good quality of life.

  13. [Food allergy in childhood].

    PubMed

    Beyer, Kirsten; Niggemann, Bodo

    2016-06-01

    IgE-mediated immediate type reactions are the most common form of food allergy in childhood. Primary (often in early childhood) and secondary (often pollen-associated) allergies can be distinguished by their level of severity. Hen's egg, cow's milk and peanut are the most common elicitors of primary food allergy. Tolerance development in hen's egg and cow's milk allergy happens frequently whereas peanut allergy tends toward a lifelong disease. For the diagnostic patient history, detection of sensitization and (in many cases) oral food challenges are necessary. Especially in peanut and hazelnut allergy component-resolves diagnostic (measurement of specific IgE to individual allergens, e. g. Ara h 2) seem to be helpful. In regard to therapy elimination diet is still the only approved approach. Patient education through dieticians is extremely helpful in this regard. Patients at risk for anaphylactic reactions need to carry emergency medications including an adrenaline auto-injector. Instruction on the usage of the adrenaline auto-injector should take place and a written management plan handed to the patient. Moreover, patients or caregivers should be encouraged to attending a structured educational intervention on knowledge and emergency management. In parallel, causal therapeutic options such as oral, sublingual or epicutaneous immunotherapies are currently under development. In regard to prevention of food allergy current guidelines no longer advise to avoid highly allergenic foods. Current intervention studies are investigating wether early introduction of highly allergic foods is effective and safe to prevent food allergy. It was recently shown that peanut introduction between 4 and 11  months of age in infants with severe atopic dermatitis and/or hen's egg allergy (if they are not already peanut allergic) prevents peanut allergy in a country with high prevalence.

  14. Food Allergy in Children

    PubMed Central

    Shenassa, M. Medhi

    1988-01-01

    The purpose of this review is to establish a rational approach to the assessment of children with food allergy related to an immunologic state in which alteration of response to antigenic material has developed after repeated exposure. The author offers a practical approach to the problem of food allergy in children, dispels some of the myths surrounding the disorder, and discusses some of the popular but unproven and controversial practices relating to its management. PMID:21253178

  15. [Food allergies in paediatrics: Current concepts].

    PubMed

    Plaza-Martin, Ana María

    2016-07-01

    The concept of allergic reaction currently includes all those where an immunological reaction depends on a reaction mediated by IgE, as well as those that involve other immune mechanisms, such as T-cell regulators. There are many different clinical situations, like the classic immediate reactions (IgE mediated) such as urticaria, angioedema, immediate vomiting, abdominal pain, both upper respiratory (aphonia or rhinitis) and lower (wheezing or dyspnoea) symptom, and cardiovascular symptoms. The reactions that involve more than one organ, such as anaphylaxis, which could be an anaphylactic shock if there is cardiovascular involvement. The clinical signs and symptoms produced by non-IgE mediated reactions are usually more insidious in how they start, such as vomiting hours after the ingestion of food in enterocolitis, diarrhoea after days or weeks from starting food, dermatitis sometime after starting food. In these cases it is more difficult to associate these clinical symptoms directly with food. In this article, we attempt to clarify some concepts such as sensitisation/allergy, allergen/allergenic source, or the relationship of different clinical situations with food allergy, in order to help the paediatrician on the one hand, to prescribe strict diets in case of a suspicion based on the cause/effect relationship with the food, and on the other hand not to introduce unnecessary diets that very often have to last an excessively long time, and could lead to nutritional deficiencies in the children. Copyright © 2016 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  16. Mechanisms of food allergy.

    PubMed

    Helm, R M; Burks, A W

    2000-12-01

    The prevalence of food allergy continues to rise, particularly in 'westernized' societies; it has been linked to the 'hygiene hypothesis' and the increased diversity of food consumption worldwide. The pathogenic mechanisms and Th1/Th2 paradigm are being closely examined with respect to the occurrence of inflammatory and injury/repair responses at different mucosal sites. Genetically modified plants as potential food sources and allergenicity are current topics of controversy.

  17. Gastrointestinal food allergies.

    PubMed

    Heine, Ralf G

    2015-01-01

    Gastrointestinal food allergies present during early childhood with a diverse range of symptoms. Cow's milk, soy and wheat are the three most common gastrointestinal food allergens. Several clinical syndromes have been described, including food protein-induced enteropathy, proctocolitis and enterocolitis. In contrast with immediate, IgE-mediated food allergies, the onset of gastrointestinal symptoms is delayed for at least 1-2 hours after ingestion in non-IgE-mediated allergic disorders. The pathophysiology of these non-IgE-mediated allergic disorders is poorly understood, and useful in vitro markers are lacking. The results of the skin prick test or measurement of the food-specific serum IgE level is generally negative, although low-positive results may occur. Diagnosis therefore relies on the recognition of a particular clinical phenotype as well as the demonstration of clear clinical improvement after food allergen elimination and the re-emergence of symptoms upon challenge. There is a significant clinical overlap between non-IgE-mediated food allergy and several common paediatric gastroenterological conditions, which may lead to diagnostic confusion. The treatment of gastrointestinal food allergies requires the strict elimination of offending food allergens until tolerance has developed. In breast-fed infants, a maternal elimination diet is often sufficient to control symptoms. In formula-fed infants, treatment usually involves the use an extensively hydrolysed or amino acid-based formula. Apart from the use of hypoallergenic formulae, the solid diets of these children also need to be kept free of specific food allergens, as clinically indicated. The nutritional progress of infants and young children should be carefully monitored, and they should undergo ongoing, regular food protein elimination reassessments by cautious food challenges to monitor for possible tolerance development.

  18. Immunotherapy in food allergy.

    PubMed

    Kamdar, Toral; Bryce, Paul J

    2010-05-01

    Food allergies are caused by immune responses to food proteins and represent a breakdown of oral tolerance. They can range from mild pruritus to life-threatening anaphylaxis. The only current consensus for treatment is food avoidance, which is fraught with compliance issues. For this reason, there has been recent interest in immunotherapy, which may induce desensitization and possibly even tolerance. Through these effects, immunotherapy may decrease the potential for adverse serious reactions with accidental ingestions while potentially leading to an overall health benefit. In this review, we discuss the mechanisms of food allergy and give an overview of the various immunotherapeutic options and current supporting evidence, as well as look towards the future of potential novel therapeutic modalities.

  19. Immunotherapy in food allergy

    PubMed Central

    Kamdar, Toral; Bryce, Paul J

    2010-01-01

    Food allergies are caused by immune responses to food proteins and represent a breakdown of oral tolerance. They can range from mild pruritis to life-threatening anaphylaxis. The only current consensus for treatment is food avoidance, which is fraught with compliance issues. For this reason, there has been recent interest in immunotherapy, which may induce desensitization and possibly even tolerance. Through these effects, immunotherapy may decrease the potential for adverse serious reactions with accidental ingestions while potentially leading to an overall health benefit. In this review, we discuss the mechanisms of food allergy and give an overview of the various immunotherapeutic options and current supporting evidence, as well as look towards the future of potential novel therapeutic modalities. PMID:20543886

  20. The potential link between gut microbiota and IgE-mediated food allergy in early life.

    PubMed

    Molloy, John; Allen, Katrina; Collier, Fiona; Tang, Mimi L K; Ward, Alister C; Vuillermin, Peter

    2013-12-16

    There has been a dramatic rise in the prevalence of IgE-mediated food allergy over recent decades, particularly among infants and young children. The cause of this increase is unknown but one putative factor is a change in the composition, richness and balance of the microbiota that colonize the human gut during early infancy. The coevolution of the human gastrointestinal tract and commensal microbiota has resulted in a symbiotic relationship in which gut microbiota play a vital role in early life immune development and function, as well as maintenance of gut wall epithelial integrity. Since IgE mediated food allergy is associated with immune dysregulation and impaired gut epithelial integrity there is substantial interest in the potential link between gut microbiota and food allergy. Although the exact link between gut microbiota and food allergy is yet to be established in humans, recent experimental evidence suggests that specific patterns of gut microbiota colonization may influence the risk and manifestations of food allergy. An understanding of the relationship between gut microbiota and food allergy has the potential to inform both the prevention and treatment of food allergy. In this paper we review the theory and evidence linking gut microbiota and IgE-mediated food allergy in early life. We then consider the implications and challenges for future research, including the techniques of measuring and analyzing gut microbiota, and the types of studies required to advance knowledge in the field.

  1. The Potential Link between Gut Microbiota and IgE-Mediated Food Allergy in Early Life

    PubMed Central

    Molloy, John; Allen, Katrina; Collier, Fiona; Tang, Mimi L. K.; Ward, Alister C.; Vuillermin, Peter

    2013-01-01

    There has been a dramatic rise in the prevalence of IgE-mediated food allergy over recent decades, particularly among infants and young children. The cause of this increase is unknown but one putative factor is a change in the composition, richness and balance of the microbiota that colonize the human gut during early infancy. The coevolution of the human gastrointestinal tract and commensal microbiota has resulted in a symbiotic relationship in which gut microbiota play a vital role in early life immune development and function, as well as maintenance of gut wall epithelial integrity. Since IgE mediated food allergy is associated with immune dysregulation and impaired gut epithelial integrity there is substantial interest in the potential link between gut microbiota and food allergy. Although the exact link between gut microbiota and food allergy is yet to be established in humans, recent experimental evidence suggests that specific patterns of gut microbiota colonization may influence the risk and manifestations of food allergy. An understanding of the relationship between gut microbiota and food allergy has the potential to inform both the prevention and treatment of food allergy. In this paper we review the theory and evidence linking gut microbiota and IgE-mediated food allergy in early life. We then consider the implications and challenges for future research, including the techniques of measuring and analyzing gut microbiota, and the types of studies required to advance knowledge in the field. PMID:24351744

  2. Epidemiology of childhood food allergy.

    PubMed

    Dyer, Ashley A; Gupta, Ruchi

    2013-06-01

    Food allergy is a public health problem that affects nearly 6 million children in the United States. The extent to which children, families, and communities live with food allergies varies as much as the range of clinical symptoms associated with the disease itself. Food allergy is defined as the reproducible adverse event that elicits a pathologic immunoglobulin E (IgE)-mediated or non-IgE-mediated reaction. Once an allergic child ingests a specific food allergen, the reaction can result in clinical symptoms ranging from mild hives to life-threatening anaphylaxis.Not surprisingly, food allergies have been shown to limit social interactions and impair children's quality of life due to the ubiquity of food where children live, learn, and play. To ensure the safety of our children, the development of sound policy, clinical practice, and health programs must be informed by current research characterizing childhood food allergy at the population level. To set the stage for understanding the current evidence base, this article reviews: 1) epidemiology of childhood food allergy; 2) severity of symptoms; 3) geographic distribution of childhood food allergy; 4) tolerance; 5) economic impact of childhood food allergy; and 6) future directions in childhood food allergy epidemiological research.

  3. Food Allergy Treatment for Hyperkinesis.

    ERIC Educational Resources Information Center

    Rapp, Doris J.

    1979-01-01

    Eleven hyperactive children (6 to 15 years old) were treated with a food extract after titration food allergy testing. They remained improved for 1 to 3 months while ingesting the foods to which they were sensitive. (Author)

  4. Food Allergy Treatment for Hyperkinesis.

    ERIC Educational Resources Information Center

    Rapp, Doris J.

    1979-01-01

    Eleven hyperactive children (6 to 15 years old) were treated with a food extract after titration food allergy testing. They remained improved for 1 to 3 months while ingesting the foods to which they were sensitive. (Author)

  5. Clinical Management of Food Allergy

    PubMed Central

    Wright, Benjamin L.; Walkner, Madeline; Vickery, Brian P.; Gupta, Ruchi S.

    2016-01-01

    Synopsis Food allergies have become a growing public health concern. Currently the standard of care focuses on avoidance of trigger foods, education, and treatment of symptoms following accidental ingestions. Here we provide a framework for primary care physicians and allergists for the diagnosis, management, and treatment of pediatric food allergy. PMID:26456440

  6. Food Allergies and Eczema.

    PubMed

    Santiago, Sabrina

    2015-07-01

    Eczema is one of the most common skin conditions of childhood. Patients with eczema suffer in a chronic cycle of itch, scratch, and inflammation. For children with severe eczema, constant itching and scratching can have many consequences including skin infections, behavioral issues, and sleep problems. Parents often find themselves searching for a trigger for their child's eczema flare, and after they have switched detergents, applied a thick moisturizer and topical steroids, and removed all wool clothing from their child's wardrobe, they wonder, "Could food allergies be playing a role?"

  7. Food allergy: is prevalence increasing?

    PubMed

    Tang, Mimi L K; Mullins, Raymond J

    2017-03-01

    It is generally accepted that the prevalence of food allergy has been increasing in recent decades, particularly in westernised countries, yet high-quality evidence that is based on challenge confirmed diagnosis of food allergy to support this assumption is lacking because of the high cost and potential risks associated with conducting food challenges in large populations. Accepting this caveat, the use of surrogate markers for diagnosis of food allergy (such as nationwide data on hospital admissions for food anaphylaxis or clinical history in combination with allergen-specific IgE (sIgE) measurement in population-based cohorts) has provided consistent evidence for increasing prevalence of food allergy at least in western countries, such as the UK, United States and Australia. Recent reports that children of East Asian or African ethnicity who are raised in a western environment (Australia and United States respectively) have an increased risk of developing food allergy compared with resident Caucasian children suggest that food allergy might also increase across Asian and African countries as their economies grow and populations adopt a more westernised lifestyle. Given that many cases of food allergy persist, mathematical principles would predict a continued increase in food allergy prevalence in the short to medium term until such time as an effective treatment is identified to allow the rate of disease resolution to be equal to or greater than the rate of new cases.

  8. Prevalence of IgE mediated cow's milk and egg allergy in children under 2 years of age in Sanliurfa, Turkey: the city that isn't almost allergic to cow's milk.

    PubMed

    Zeyrek, D; Koruk, I; Kara, B; Demir, C; Cakmak, A

    2015-12-01

    Food allergy is a common problem in children and adults. The aim of this study was to determine the frequency of cow's milk and egg allergy based on skin prick test and oral food challenge results We recruited 614 children aged 1 month-2 years in from different areas of Sanliurfa. An interview was conducted with each parents and family demographic, and prenatal-antenatal-postnatal information was recorded, then skin prick test was applied to the children for egg white, egg yolk and cow's milk. Cases that are required, sIgE levels for cow's milk, egg white and egg yolk were measured and food challenge tests were applied. Cow's milk and egg allergy was determined in 1 case (0.16%) and 8 cases (1.30%) respectively from the results of the tests applied. Six cases (0.97%) were accepted as sensitive to egg white and egg yolk. Within the factors which were questioned, (only the egg allergy evaluation was made without the cow's milk allergy case) of those with parental consanguinity was determined at a statistically significantly high level (OR=5.8, 95% CI: 1.2-27.2, P=0.01). The prevalence of cow's milk allergy in Sanliurfa is the lowest reported prevalence rate to date in children under 2 years of age. When infants develop a food allergy, this takes the form of egg allergy. Within the several factors evaluated to explain this situation, a significant relationship was determined only with parental consanguinity. However, as reported above, to date there is no genetic or epidemiological study to explain this situation.

  9. Food Allergies: The Basics

    PubMed Central

    Valenta, Rudolf; Hochwallner, Heidrun; Linhart, Birgit; Pahr, Sandra

    2015-01-01

    IgE-associated food allergy affects approximately 3% of the population and has severe effects on the daily life of patients—manifestations occur not only in the gastrointestinal tract but also affect other organ systems. Birth cohort studies have shown that allergic sensitization to food allergens develops early in childhood. Mechanisms of pathogenesis include cross-linking of mast cell– and basophil-bound IgE and immediate release of inflammatory mediators, as well as late-phase and chronic allergic inflammation, resulting from T-cell, basophil, and eosinophil activation. Researchers have begun to characterize the molecular features of food allergens and have developed chip-based assays for multiple allergens. These have provided information about cross-reactivity among different sources of food allergens, identified disease-causing food allergens, and helped us to estimate the severity and types of allergic reactions in patients. Importantly, learning about the structure of disease-causing food allergens has allowed researchers to engineer synthetic and recombinant vaccines. PMID:25680669

  10. Food allergies: the basics.

    PubMed

    Valenta, Rudolf; Hochwallner, Heidrun; Linhart, Birgit; Pahr, Sandra

    2015-05-01

    IgE-associated food allergy affects approximately 3% of the population and has severe effects on the daily life of patients-manifestations occur not only in the gastrointestinal tract but also affect other organ systems. Birth cohort studies have shown that allergic sensitization to food allergens develops early in childhood. Mechanisms of pathogenesis include cross-linking of mast cell- and basophil-bound IgE and immediate release of inflammatory mediators, as well as late-phase and chronic allergic inflammation, resulting from T-cell, basophil, and eosinophil activation. Researchers have begun to characterize the molecular features of food allergens and have developed chip-based assays for multiple allergens. These have provided information about cross-reactivity among different sources of food allergens, identified disease-causing food allergens, and helped us to estimate the severity and types of allergic reactions in patients. Importantly, learning about the structure of disease-causing food allergens has allowed researchers to engineer synthetic and recombinant vaccines.

  11. Infant Allergies and Food Sensitivities

    MedlinePlus

    ... Text Size Email Print Share Infant Allergies and Food Sensitivities Page Content Article Body Human breast milk ... tell your pediatrician about your family’s medical history. Food Sensitivities A few mothers notice minor reactions to ...

  12. Severe forms of food allergy.

    PubMed

    Sarinho, Emanuel; Lins, Maria das Graças Moura

    2017-09-21

    To guide the diagnostic and therapeutic management of severe forms of food allergy. Search in the Medline database using the terms "severe food allergy," "anaphylaxis and food allergy," "generalized urticaria and food allergy," and "food protein-induced enterocolitis syndrome" in the last ten years, searching in the title, abstract, or keyword fields. Food allergy can be serious and life-threatening. Milk, eggs, peanuts, nuts, walnuts, wheat, sesame seeds, shrimp, fish, and fruit can precipitate allergic emergencies. The severity of reactions will depend on associated cofactors such as age, drug use at the onset of the reaction, history and persistence of asthma and/or severe allergic rhinitis, history of previous anaphylaxis, exercise, and associated diseases. For generalized urticaria and anaphylaxis, intramuscular epinephrine is the first and fundamental treatment line. For the treatment in acute phase of food-induced enterocolitis syndrome in the emergency setting, prompt hydroelectrolytic replacement, administration of methylprednisolone and ondansetron IV are necessary. It is important to recommend to the patient with food allergy to maintain the exclusion diet, seek specialized follow-up and, in those who have anaphylaxis, to emphasize the need to carry epinephrine. Severe food allergy may occur in the form of anaphylaxis and food-protein-induced enterocolitis syndrome, which are increasingly observed in the pediatric emergency room; hence, pediatricians must be alert so they can provide the immediate diagnosis and treatment. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  13. [Food allergies in early childhood. 1. General concepts, etiopathogenesis, and main clinical features].

    PubMed

    Vigi, V; Fanaro, S

    2000-04-01

    Abnormal immune reactions to food antigens are a rather common event during infancy. Adverse reactions to milk proteins occur in 2.5% of suckling infants. Both IgE and non IgE-mediated allergic mechanisms may be involved in the pathogenesis of food allergy. IgE mediated allergic responses are the most dramatic and the most often diagnosed types. Non IgE mediated food allergy is usually more difficult to diagnose and its clinical course is more chronic. Food induced allergic reactions mediate a variety of symptoms, involving the gastrointestinal and respiratory tract and the skin. A limited number of foods are responsible for the vast majority of allergic reactions: cow milk proteins, egg, fish and peanuts are the main causes. The vast majority of infants with formula-protein intolerance will outgrow their symptoms by the third year of age. Eliminating the food allergens is the only means of dealing with the problem. In part I of this series, immunopathogenic mechanisms and clinical disorders are described.

  14. The management of food allergy in Indonesia

    PubMed Central

    Muktiarti, Dina

    2013-01-01

    Prevalence of allergic diseases is increasing worldwide, including food allergy. It is different between countries because food allergy can vary by culture and population. Prevalence of food allergy in Indonesia is unknown; therefore it is not known yet the burden and impact of food allergy in our population. However, we already start to formulate guidelines for diagnosis and management of food allergy, especially cow's milk allergy. PMID:23403763

  15. Atopic eczema and food allergy.

    PubMed

    Wassmann, Anja; Werfel, Thomas

    2015-01-01

    Approximately one-third of children with severe atopic eczema suffer from a food allergy, whereas in adult patients, food allergies are rare. In child patients, three different clinical reaction patterns can be differentiated as follows: (1) immediate-type reactions, (2) isolated late eczematous reactions, and (3) combined immediate-type and late eczematous reactions. In childhood food allergies, food allergens, such as cow's milk or hen's egg, are primarily responsible for allergic reactions, while in adolescents and adults, food allergies often develop consecutively after primary sensitization to pollen allergens. Dysfunctions in the epidermal barrier seem to be vitally important in the development of food allergies in patients with atopic eczema by facilitating sensitization after epicutaneous allergen exposure. Further investigation is required to determine the role of intestinal epithelial barrier defects in the pathogenesis of these allergies as well as the genetic characteristics associated with an increased risk of food allergy. The diagnosis of eczematous reactions to food requires a careful diagnostic procedure, taking into account a patient's history and sensitization patterns. The clinical relevance of sensitization often has to be proven by an oral food challenge, with the rating of the skin condition by validated scores after 24 h and the later evaluation of the eczematous reaction.

  16. Adult-onset food allergy.

    PubMed

    Kivity, Shmuel

    2012-01-01

    The prevalence of food allergy is increasing in both the pediatric and adult populations. While symptom onset occurs mostly during childhood, there are a considerable number of patients whose symptoms first begin to appear after the age of 18 years. The majority of patients with adult-onset food allergy suffer from the pollen-plant allergy syndromes. Many of them manifest their allergy after exercise and consuming food to which they are allergic. Eosinophilic esophagitis, an eosinophilic inflammation of the esophagus affecting individuals of all ages, recently emerged as another allergic manifestation, with both immediate and late response to the ingested food. This review provides a condensed update of the current data in the literature on adult-onset allergy.

  17. Food Allergy Research and Education (FARE)

    MedlinePlus

    ... Basics Facts and Statistics NIAID Resources Allergens Peanut Tree Nuts Milk Egg Wheat Soy Fish Shellfish Sesame ... Stories Beth F. Food Allergy Mom Christina P. Tree Nut Allergy Mary A. Food Allergy Mom Danielle ...

  18. Comparison of School Food Allergy Emergency Plans to the Food Allergy and Anaphylaxis Network's Standard Plan

    ERIC Educational Resources Information Center

    Powers, Jill; Bergren, Martha Dewey; Finnegan, Lorna

    2007-01-01

    Eighty-four percent of children with food allergies have a reaction in school, and 25% of first food reactions occur in schools. An evaluation was conducted comparing food allergy emergency plans to the Food Allergy and Anaphylaxis Network's (FAAN) Food Allergy Action Plan. Of the 94 respondents, 60 provided food allergy emergency plans for…

  19. Comparison of School Food Allergy Emergency Plans to the Food Allergy and Anaphylaxis Network's Standard Plan

    ERIC Educational Resources Information Center

    Powers, Jill; Bergren, Martha Dewey; Finnegan, Lorna

    2007-01-01

    Eighty-four percent of children with food allergies have a reaction in school, and 25% of first food reactions occur in schools. An evaluation was conducted comparing food allergy emergency plans to the Food Allergy and Anaphylaxis Network's (FAAN) Food Allergy Action Plan. Of the 94 respondents, 60 provided food allergy emergency plans for…

  20. Future therapies for food allergies.

    PubMed

    Nowak-Węgrzyn, Anna; Sampson, Hugh A

    2011-03-01

    Food allergy is an increasingly prevalent problem in westernized countries, and there is an unmet medical need for an effective form of therapy. A number of therapeutic strategies are under investigation targeting foods that most frequently provoke severe IgE-mediated anaphylactic reactions (peanut, tree nuts, and shellfish) or are most common in children, such as cow's milk and hen's egg. Approaches being pursued are both food allergen specific and nonspecific. Allergen-specific approaches include oral, sublingual, and epicutaneous immunotherapy (desensitization) with native food allergens and mutated recombinant proteins, which have decreased IgE-binding activity, coadministered within heat-killed Escherichia coli to generate maximum immune response. Diets containing extensively heated (baked) milk and egg represent an alternative approach to food oral immunotherapy and are already changing the paradigm of strict dietary avoidance for patients with food allergy. Nonspecific approaches include monoclonal anti-IgE antibodies, which might increase the threshold dose for food allergen in patients with food allergy, and a Chinese herbal formulation, which prevented peanut-induced anaphylaxis in a murine model and is currently being investigated in clinical trials. The variety of strategies for treating food allergy increases the likelihood of success and gives hope that accomplishing an effective therapy for food allergy is within reach. Copyright © 2011 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

  1. Primary Prevention of Food Allergy.

    PubMed

    Greenhawt, Matthew J; Fleischer, David M

    2017-04-01

    Food allergy is estimated to affect approximately 8% of children in the USA. This is a disease without any known treatment or cure and, for some, a disease that can be quite severe, even life-threatening. While recent advances in potential treatment have made remarkable strides, with two food-targeted immunotherapy products now in phase III trials, perhaps the biggest gains in the field have come in the advent of potential preventative strategies to avoid the development of food allergy in high-risk individuals. There have been multiple, randomized, controlled trials (RCTs) performed in the past 5 years that have demonstrated significant risk reduction from early allergen introduction. These include two trials for early peanut introduction and five trials for early egg introduction in the first year of life. The results indicate that primary prevention of food allergy through early allergen introduction may represent a strategy that could potentially avert tens of thousands of children from becoming food allergic. In support of the data for peanut, the National Institute of Allergy and Infectious Diseases recently sponsored an addendum to the 2010 food allergy guidelines, specifically recommending peanut be introduced in both high- and standard-risk infants to reduce the risk of developing peanut allergy. To date, no formal recommendations have been made for egg, however. This review will focus on the latest evidence supporting early introduction as a strategy to prevent food allergy, as well as on practical aspects for its successful implementation.

  2. Nutrition basics in food allergy.

    PubMed

    Christie, L

    2001-01-01

    Strict elimination of foods because of food allergies can interfere with good nutrition. It is essential that the diagnosis of a food allergy be proven thoroughly to avoid unnecessary food restrictions. Comprehensive education should show where allergenic foods are found, how to find appropriate substitutes for the eliminated foods and corresponding nutrients, and how to avoid accidental ingestion of allergenic foods. A nutrition assessment is an essential part of the clinical follow-up. Identifying nutrition-related problems early can correct difficult situations and prevent long-term health consequences.

  3. Food Allergy: Tips to Remember

    MedlinePlus

    ... milk, eggs, peanuts, wheat, soy, fish, shellfish and tree nuts. In some food groups, especially tree nuts and seafood, an allergy to one member ... a history of a severe reaction. However,peanut, tree nut fish and shellfish allergy tends to persist ...

  4. Managing Food Allergies in School.

    ERIC Educational Resources Information Center

    Munoz-Furlong, Anne

    1997-01-01

    The number of students with food allergies is increasing, with peanuts the leading culprit. Peer pressure and allergens hidden in baked goods can pose problems for school staff. Children with documented life-threatening allergies are covered by the Americans with Disabilities Act. Principals should reassure parents and use Section 504 guidelines…

  5. Managing Food Allergies in School.

    ERIC Educational Resources Information Center

    Munoz-Furlong, Anne

    1997-01-01

    The number of students with food allergies is increasing, with peanuts the leading culprit. Peer pressure and allergens hidden in baked goods can pose problems for school staff. Children with documented life-threatening allergies are covered by the Americans with Disabilities Act. Principals should reassure parents and use Section 504 guidelines…

  6. Novel approaches to food allergy.

    PubMed

    Yang, Yao-Hsu; Chiang, Bor-Luen

    2014-06-01

    Food allergies have increased in recent decades. However, they cannot be effectively treated by the current management, which is limited to the identification and avoidance of foods that induce allergies and to the use of medicines for symptoms relief. To meet the medical need of prevention and cure of food allergies, several therapeutic strategies are under investigation. Some newly developed biologics such as anti-IgE antibody and anti-interleukin (IL)-5 antibody directed against significant molecules in the allergic process have shown their potential for the treatment of food allergies. Allergen-specific immunotherapy is the therapy that induces immune tolerance and may reduce the need for conventional medication, severity of allergic symptoms and eliminate hypersensitivity. In this article, clinical studies of immunotherapy via subcutaneous, oral, sublingual, and epicutaneous routes are extensively reviewed for their safety and effectiveness on various food allergies. In addition, to reduce the risk of anaphylaxis and increase toleragenic immunity, many studies are focusing on the modification of traditional allergens used for immunotherapy. Moreover, a Chinese herbal formulation with potential anti-allergic effects is being evaluated for its efficacy in patients with peanut allergy. Although more studies are needed, accumulated data of current studies represent compelling evidence of curative effects of some strategies and give a hope that food allergies are likely to be successfully treated in the future.

  7. Food allergy: epidemiology and natural history.

    PubMed

    Savage, Jessica; Johns, Christina B

    2015-02-01

    The prevalence of food allergy is rising for unclear reasons, with prevalence estimates in the developed world approaching 10%. Knowledge regarding the natural course of food allergies is important because it can aid the clinician in diagnosing food allergies and in determining when to consider evaluation for food allergy resolution. Many food allergies with onset in early childhood are outgrown later in childhood, although a minority of food allergy persists into adolescence and even adulthood. More research is needed to improve food allergy diagnosis, treatment, and prevention.

  8. Geographical differences in food allergy.

    PubMed

    Bartra, Joan; García-Moral, Alba; Enrique, Ernesto

    2016-06-01

    Food allergy represents a health problem worldwide and leads to life-threatening reactions and even impairs quality of life. Epidemiological data during the past decades is very heterogeneous because of the use of different diagnostic procedures, and most studies have only been performed in specific geographical areas. The aim of this article is to review the available data on the geographical distribution of food allergies at the food source and molecular level and to link food allergy patterns to the aeroallergen influence in each area. Systematic reviews, meta-analysis, studies performed within the EuroPrevall Project and EAACI position papers regarding food allergy were analysed. The prevalence of food allergy sensitization differs between geographical areas, probably as a consequence of differences among populations, their habits and the influence of the cross-reactivity of aeroallergens and other sources of allergens. Geographical differences in food allergy are clearly evident at the allergenic molecular level, which seems to be directly influenced by the aeroallergens of each region and associated with specific clinical patterns.

  9. Food allergies in rural areas

    PubMed Central

    Stoma, Monika; Ślaska-Grzywna, Beata; Kostecka, Małgorzata; Bojanowska, Monika; Dudziak, Agnieszka; Kuna-Broniowska, Agnieszka; Adamczuk, Piotr; Sobczak, Paweł; Andrejko, Dariusz

    2016-01-01

    Introduction A food allergy is a group of symptoms occurring in the organism and resulting from consuming some food, where the problems are conditioned by immunological mechanisms. The symptoms may become apparent first in adulthood and they may be an initial manifestation of a latent allergy. Typical symptoms of a food allergy occur in different organs, thus not only in the digestive system, but also in the skin, respiratory system and circulatory system. Aim To assess the frequency of food allergy onset in rural areas of the Lublin region as well as to determine which factors induce such allergies. Material and methods A survey was conducted, involving the participation of 340 inhabitants of rural areas. The study monitored the knowledge and situation of the disease, concerning allergens, allergy symptoms, methods of treatment and opinions regarding such treatment. Results The analysis focused on 124 people with diagnosed allergies. Conclusions Introducing a diet did not result in a statistically significant difference regarding elimination of the symptoms, as compared to the patients who did not follow any diet. On the other hand, pharmacological treatment causes statistically worse results than using other methods or not being treated at all. The patients in whom allergy symptoms disappeared were more convinced about the positive character of their diet than those in whom the symptoms were not eliminated. The age when the allergy becomes evident does not affect its duration, yet it matters as to the time of its later elimination. The more symptoms were experienced by a patient, the longer the duration of the allergy was. PMID:27605899

  10. Future therapies for food allergy

    PubMed Central

    McWilliams, Laurie M.; Mousallem, Talal; Burks, A. Wesley

    2012-01-01

    Food allergy affects 3.9% of US children and is increasing in prevalence. The current standard of care involves avoidance of the triggering food and treatment for accidental ingestions. While there is no current curative treatment, there are a number of therapeutic strategies under investigation. Allergen specific therapies include oral and sublingual immunotherapy with native food protein as well as recombinant food proteins. Allergen non-specific therapies include a Chinese herbal formula (FAHF-2) and the use of anti-IgE monoclonal antibody therapy. Although none of these treatments are ready for clinical use, these therapeutic strategies present promising options for the future of food allergy. PMID:22894951

  11. Food allergy overview in children.

    PubMed

    Ramesh, Sujatha

    2008-04-01

    Food allergies have increased significantly in the past decade. An accurate history is crucial in approaching the management. At the outset, food intolerance must be distinguished from food allergies and, furthermore, these allergies should be classified into either an IgE, Non-IgE, or a mixed response. The clinical features vary from life-threatening anaphylaxis to milder IgE-mediated responses, atopic dermatitis, and gastrointestinal symptoms. The severity of the reaction and the potential risk for anaphylaxis on reexposure should be assessed. Milk, soy, egg, wheat, and peanut allergies are common in children, whereas peanut, tree nut, fish, shell fish allergies, and allergies to fruits and vegetables are common in adults. Structural proteins are important determinants of the severity of the reactions and may often predict the natural history and cross reactivity. Diagnostic work up must be guided by the clinical history. Skin testing and food-specific IgE done by standard methods are very useful, whereas oral challenges may be indicated in some situations. Majority of the patients outgrow their allergies to milk, soy, egg, and wheat, and some to peanut also, therefore, patients should be periodically reassessed. Novel diagnostic techniques which detect specific allergenic epitopes have been developed. Several newer therapies are promising.

  12. Gastrointestinal food allergy and intolerance.

    PubMed

    Assa'ad, Amal H

    2006-10-01

    GI symptoms are a common manifestation of food allergy and intolerance. The primary physician is the first to evaluate these symptoms. A systematic evaluation using an accurate and detailed history, tests to identify the offending food(s), and procedures that may identify underlying pathologic disorders of the GI tract would lead to an accurate diagnosis and better targeted therapeutic interventions.

  13. Mucosal immunology of food allergy.

    PubMed

    Berin, M Cecilia; Sampson, Hugh A

    2013-05-06

    Food allergies are increasing in prevalence at a higher rate than can be explained by genetic factors, suggesting a role for as yet unidentified environmental factors. In this review, we summarize the state of knowledge about the healthy immune response to antigens in the diet and the basis of immune deviation that results in immunoglobulin E (IgE) sensitization and allergic reactivity to foods. The intestinal epithelium forms the interface between the external environment and the mucosal immune system, and emerging data suggest that the interaction between intestinal epithelial cells and mucosal dendritic cells is of particular importance in determining the outcome of immune responses to dietary antigens. Exposure to food allergens through non-oral routes, in particular through the skin, is increasingly recognized as a potentially important factor in the increasing rate of food allergy. There are many open questions on the role of environmental factors, such as dietary factors and microbiota, in the development of food allergy, but data suggest that both have an important modulatory effect on the mucosal immune system. Finally, we discuss recent developments in our understanding of immune mechanisms of clinical manifestations of food allergy. New experimental tools, particularly in the field of genomics and the microbiome, are likely to shed light on factors responsible for the growing clinical problem of food allergy.

  14. Mucosal Immunology of Food Allergy

    PubMed Central

    Berin, M. Cecilia; Sampson, Hugh A.

    2013-01-01

    Food allergies are increasing in prevalence at a higher rate than can be explained by genetic factors, suggesting a role for as yet unidentified environmental factors. In this review, we summarize the state of knowledge about the healthy immune response to antigens in the diet and the basis of immune deviation that results in IgE sensitization and allergic reactivity to foods. The intestinal epithelium forms the interface between the external environment and the mucosal immune system, and emerging data suggest that the interaction between intestinal epithelial cells and mucosal dendritic cells is of particular importance in determining the outcome of immune responses to dietary antigens. Exposure to food allergens through non-oral routes, in particular through the skin, is increasingly recognized as a potentially important factor in the increasing rate of food allergy. There are many open questions on the role of environmental factors such as dietary factors and microbiota in the development of food allergy, but data suggest that both have an important modulatory effect on the mucosal immune system. Finally, we discuss recent developments in our understanding of immune mechanisms of clinical manifestations of food allergy. New experimental tools, particularly in the field of genomics and microbiome, are likely to shed light on factors responsible for the growing clinical problem of food allergy. PMID:23660362

  15. Food Allergy: An Enigmatic Epidemic

    PubMed Central

    Berin, M. Cecilia; Sampson, Hugh A.

    2014-01-01

    Food allergy is a common disease that is rapidly increasing in prevalence for reasons that remain unknown. Current research efforts are focused on understanding the immune basis of food allergy, identifying environmental factors that may contribute to its rising prevalence, and developing immunotherapeutic approaches to re-establish immune tolerance to foods. Technological advances such as peptide microarray and MHC class II tetramers have begun to provide a comprehensive profile of the immune response to foods. The burgeoning field of mucosal immunology has provided intriguing clues to the role of the diet and the microbiota as risk factors in the development of food allergy. The purpose of this review is to highlight significant gaps in our knowledge that need answers in order to stem the progression of this disorder that is reaching epidemic proportions. PMID:23648309

  16. Food Allergy Research and Education (FARE)

    MedlinePlus

    ... Allergies Getting Started Newly Diagnosed Emergency Care Plan Food Labels Mislabeled Products Tips for Managing Food Allergies Resources ... Emergency Care Plan Emotional & Social Issues Facts & Statistics Food Labels Laws & Regulations Research Support Groups Treatment & Managing Reactions ...

  17. Knowledge and attitudes of primary care physicians regarding food allergy and anaphylaxis in Turkey.

    PubMed

    Erkoçoğlu, M; Civelek, E; Azkur, D; Özcan, C; Öztürk, K; Kaya, A; Metin, A; Kocabaş, C N

    2013-01-01

    Food allergy, which becomes an important public health problem, can lead to important morbidity and mortality. Patients with food allergies are more likely to first present to their primary care physicians. We aimed to determine the knowledge of primary care physicians with regard to management of food allergies and anaphylaxis. Primary care physicians were surveyed via a questionnaire aimed to document their knowledge and attitudes about food allergy and anaphylaxis management. A total of 297 participants completed questionnaires, 55.6% of which were female. Participating physicians had a mean of 17.0 ± 6.1 years of experience. Participants answered 47.2% of knowledge-based items correctly. Overall, participants fared poorly with regard to their knowledge on the treatment of food allergies and anaphylaxis. For example while 60.7% knew that a child can die from the milk allergy reaction, only 37.5% were aware that a child with IgE mediated milk allergies cannot eat yoghourts/cheese with milk. Besides, 53.1% of them chose epinephrine as their first treatment of choice in case of anaphylaxis, yet only 16.6% gave the correct answer about its dosage. Nearly a third of participants (36.7%) felt they were knowledgeable enough regarding the management of patients with food allergies, while 98.2% extended their request for future periodic educational meetings on allergic disorders. Knowledge of food allergy and anaphylaxis among primary care physicians was unsatisfactory. Provision or periodic educational programmes should be aimed at improving the standard of practice as acknowledged by the participants. Copyright © 2012 SEICAP. Published by Elsevier Espana. All rights reserved.

  18. Managing food allergies in schools.

    PubMed

    Portnoy, Jay M; Shroba, Jodi

    2014-10-01

    Food allergies are estimated to affect as many as 8 % of children with 2.5 % being allergic to peanut products. Based on the results of recent surveys, this prevalence has been increasing over the last few decades for unknown reasons. As children with food allergies reach school age, the issue is becoming more common in schools. For that reason, schools are now required to be prepared to take responsibility for the safety of food-allergic students. This review discusses the common problems surrounding management of food allergies in the school setting along with reasonable recommendations for addressing those problems. The most important component of food allergy management is for the student to get an accurate diagnosis and to then discuss development of an anaphylaxis action plan with their health-care provider. Each school should insist that a copy of such a plan be provided for each student with food allergy and that epinephrine is readily available should a student have an anaphylactic reaction. In addition to epinephrine, it is essential that school personnel be properly trained to recognize and treat allergic reactions should they occur. Known deficiencies in school preparedness have been documented in previous literature, and consequently, both state and the federal government have begun to implement policies to help with school preparedness.

  19. Food Allergy in Atopic Dermatitis

    PubMed Central

    Dhar, Sandipan; Srinivas, Sahana M

    2016-01-01

    Food allergy in atopic dermatitis (AD) is debatable from decades. Role of diet in the cause and treatment of AD is controversial and is not well-defined. Allergists and pediatricians are convinced about the food allergy in AD whereas many dermatologists are contrary for this. However, there are studies in the Indian and western literature supporting the evidence that elimination diet may improve the severe type of AD. There is increasing awareness and lot of misconception among caregivers about food allergy and hence careful understanding about this concept is necessary to counsel parents. Recent evidence-based literature suggests avoidance of proven food allergens in AD could be beneficial in moderate to severe type of AD. PMID:27904183

  20. Determinants of Food Allergy

    PubMed Central

    Masilamani, Madhan; Commins, Scott; Shreffler, Wayne

    2012-01-01

    SUMMARY Much has been learned by identifying the molecules that can be recognized by IgE from patients with allergies. Increasingly, by correlating patterns of sensitization with clinical features, it has become possible to distinguish molecules responsible for primary sensitization (complete allergens) from those that are more likely cross-reactive targets. In the case of animal allergens, evolutionary distance seems to be an important factor in determining allergenicity. However, until more is understood regarding the mechanistic details of primary sensitization, including the participation of molecules that stimulate innate immune responses and the repertoire of T-cell antigens, molecules that may or may not themselves be important B-cell antigens, we will not be able to explain fundamental questions, such as why peanut allergy is more severe than soy allergy or why tick exposure is associated with clinically relevant sensitization to a carbohydrate epitope. PMID:22244230

  1. Getting the Facts on Food Allergy Testing

    MedlinePlus

    Getting the Facts on Food Allergy Testing This article has been reviewed by Thanai Pongdee, MD, FAAAAI If you have ever experienced red, itchy skin, swell- ... food, you may wonder if you have a food allergy. While diagnosing food allergies can be tricky, an ...

  2. Communicating with Parents about Food Allergies

    ERIC Educational Resources Information Center

    Cohen, Belinda

    2008-01-01

    About 3 million children in the United States have food allergies. Each year violent reactions to food kill almost 150 people. For teachers dealing with the food allergies of young children these can be frightening statistics. To keep students safe, they must familiarize themselves with food allergy facts so they can communicate openly and often…

  3. Communicating with Parents about Food Allergies

    ERIC Educational Resources Information Center

    Cohen, Belinda

    2008-01-01

    About 3 million children in the United States have food allergies. Each year violent reactions to food kill almost 150 people. For teachers dealing with the food allergies of young children these can be frightening statistics. To keep students safe, they must familiarize themselves with food allergy facts so they can communicate openly and often…

  4. Future Therapies for Food Allergies

    PubMed Central

    Nowak-Węgrzyn, Anna; Sampson, Hugh A.

    2011-01-01

    Food allergy is an increasingly prevalent problem in westernized countries and there is an unmet medical need for an effective form of therapy . A number of therapeutic strategies are under investigation targeting foods that most frequently provoke severe IgE-mediated anaphylactic reactions (peanut, tree nuts, shellfish) or are most common in children, such as cow’s milk and hen’s egg. Approaches being pursued are both food allergen-specific and non-specific. Allergen-specific approaches include oral, sublingual and epicutaneous immunotherapy (desensitization) with native food allergens, and mutated recombinant proteins, which have decreased IgE-binding activity, co-administered within heat-killed E.coli to generate maximum immune response. Diets containing extensively heated (baked) milk and egg represent an alternative approach to food oral immunotherapy and are already changing the paradigm of strict dietary avoidance for food-allergic patients. Non-specific approaches include monoclonal anti-IgE antibodies, which may increase the threshold dose for food allergen in food-allergic patients, and a Chinese herbal formulation, which prevented peanut-induced anaphylaxis in a mouse model, and is currently being investigated in clinical trials. The variety of strategies for treating food allergy increases the likelihood of success and gives hope that accomplishing an effective therapy for food allergy is within reach. PMID:21277625

  5. Food allergy and atopic eczema.

    PubMed

    Worth, Allison; Sheikh, Aziz

    2010-06-01

    To review recent developments on the inter-relationship between food allergy and atopic eczema, with a particular focus on understanding the role of filaggrin gene defects. Filaggrin gene defects have recently been identified as a major risk factor for the development of atopic eczema. These skin barrier defects increase the risk of early onset, severe and persistent forms of atopic eczema. They also increase the risk of allergic sensitization, and asthma and allergic rhinitis in those with co-existent eczema. These skin barrier defects are also likely to increase the risk of food allergy. Atopic dermatitis and food allergy are frequently herald conditions for other manifestations of 'the allergic march'. They commonly co-exist, particularly in those with early onset, severe and persistent atopic eczema. Filaggrin gene defects substantially increase the risk of atopic eczema. The increased skin permeability may increase the risk of sensitization to food and other allergens, this pointing to the possible role of cutaneous allergen avoidance in early life to prevent the onset of atopic eczema and food allergy. Emerging evidence also indicates that oral exposure to potentially allergenic foods may be important for inducing immunological tolerance.

  6. Prevalence of food allergies in South Asia.

    PubMed

    Arakali, Schweta R; Green, Todd D; Dinakar, Chitra

    2017-01-01

    To evaluate the published medical literature on the prevalence and types of food allergies in South Asia. A PubMed search was performed using the keywords India and food allergy, Asia and food allergy, and South Asia and food allergy for any period. Articles cited in selected studies were reviewed for their appropriateness of inclusion into this review. Publications were included that were original research and fit the topic of food allergy and South Asia. South Asia is defined as region inclusive of India, Pakistan, Bangladesh, and Sri Lanka. A total of 169 articles were initially identified, and 47 were reviewed in detail for inclusion in this review. The primary focus was placed on 10 studies that consisted of case reports of newly reported or documented food allergy, survey studies that investigated food allergy prevalence in specific demographics, and prospective and cross-sectional studies with case controls, all of which investigated food allergy prevalence by allergy testing in a selected population. The medical literature on the prevalence and types of food allergy in South Asia indicates that there is a variety of unusual and unique allergens and an overall low incidence of food allergy. There is also an association of increased food allergy prevalence in individuals who live in metropolitan regions or who migrate to communities that have adopted westernization. Copyright © 2016 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  7. [Food allergy, food intolerance or functional disorder?].

    PubMed

    Wüthrich, B

    2009-04-01

    The term "food allergy" is widely misused for all sorts of symptoms and diseases caused by food. Food allergy (FA) is an adverse reaction to food (food hypersensitivity) occurring in susceptible individuals, which is mediated by a classical immune mechanism specific for the food itself. The best established mechanism in FA is due to the presence of IgE antibodies against the offending food. Food intolerance (FI) are all non-immune-mediated adverse reactions to food. The subgroups of FI are enzymatic (e.g. lactose intolerance due to lactase deficiency), pharmacological (reactions against biogenic amines, histamine intolerance), and undefined food intolerance (e.g. against some food additives). The diagnosis of an IgE-mediated FA is made by a carefully taken case history, supported by the demonstration of an IgE sensitization either by skin prick tests or by in vitro tests, and confirmed by positive oral provocation. For scientific purposes the only accepted test for the confirmation of FA/FI is a properly performed double-blind, placebo-controlled food challenge (DBPCFC). A panel of recombinant allergens, produced as single allergenic molecules, may in future improve the diagnosis of IgE-mediated FA. Due to a lack of causal treatment possibilities, the elimination of the culprit "food allergen" from the diet is the only therapeutic option for patients with real food allergy.

  8. Managing the Student with Severe Food Allergies

    ERIC Educational Resources Information Center

    Robinson, Joanne M.; Ficca, Michelle

    2012-01-01

    School nurses play a key role in managing students with food allergies. It is becoming more common to encounter students with severe allergies to multiple foods, putting them at risk for anaphylaxis. It is essential that the school nurse have a clear understanding of food allergies and how to effectively manage students in the school setting.…

  9. Managing the Student with Severe Food Allergies

    ERIC Educational Resources Information Center

    Robinson, Joanne M.; Ficca, Michelle

    2012-01-01

    School nurses play a key role in managing students with food allergies. It is becoming more common to encounter students with severe allergies to multiple foods, putting them at risk for anaphylaxis. It is essential that the school nurse have a clear understanding of food allergies and how to effectively manage students in the school setting.…

  10. Biotechnology and food allergy.

    PubMed

    Helm, Ricki M

    2002-01-01

    The production of genetically modified foods for an increasingly informed and selective consumer requires the coordinated activities of both the companies developing the transgenic food and regulatory authorities to ensure that these foods are at least as safe as the traditional foods they are supplementing in the diet. Although the size and complexity of the food sector ensures that no single player can control the process from seed production through farming and processing to final products marketed in a retail outlet, checks and balances are in place to ensure that transgenic foods will provide a convenient, wholesome, tasty, safe, affordable food source. Ultimately, it is the responsibility of companies developing the genetically modified food to provide relevant data to regulatory agencies, such as the US Department of Agriculture, Environmental Protection Agency, and Food and Drug Administration, to confirm that the transgenic product is reasonably safe for the consumer, as zero risk from allergen sensitization is nonexistent.

  11. Impact of Food Allergy on Asthma in Children

    MedlinePlus

    ... allergy was common, with 24% of the asthmatic students having food allergy, and 12% having multiple food allergies. The ... burden in these inner-city school children. Specifically, students with food allergies and asthma reported more asthma symptoms, were ...

  12. Potential treatments for food allergy.

    PubMed

    Albin, Stephanie; Nowak-Węgrzyn, Anna

    2015-02-01

    This article presents an overview of potential treatments of food allergy, with an emphasis on various forms of immunotherapy (including oral immunotherapy, sublingual immunotherapy, epicutaneous immunotherapy, immunotherapy with modified food antigens, and immunotherapy with a recombinant peanut vaccine). Allergen nonspecific treatments, such as Chinese herbal formulas, probiotics/prebiotics, helminths, monoclonal antibodies, and toll-like receptor agonists, are also summarized. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Managing the student with severe food allergies.

    PubMed

    Robinson, Joanne M; Ficca, Michelle

    2012-06-01

    School nurses play a key role in managing students with food allergies. It is becoming more common to encounter students with severe allergies to multiple foods, putting them at risk for anaphylaxis. It is essential that the school nurse have a clear understanding of food allergies and how to effectively manage students in the school setting. Effective communication between families, health care providers, faculty, staff, and students, is of utmost importance when developing a plan of care to ensure the safety of the student with food allergies. Using an interdisciplinary approach to case management, the school nurse can develop comprehensive individualized health care plans for all students with food allergies.

  14. Japanese guidelines for food allergy 2017.

    PubMed

    Ebisawa, Motohiro; Ito, Komei; Fujisawa, Takao

    2017-04-01

    Five years have passed since the Japanese Pediatric Guideline for Food Allergy (JPGFA) was first revised in 2011 from its original version. As many scientific papers related to food allergy have been published during the last 5 years, the second major revision of the JPGFA was carried out in 2016. In this guideline, food allergies are generally classified into four clinical types: (1) neonatal and infantile gastrointestinal allergy, (2) infantile atopic dermatitis associated with food allergy, (3) immediate-type of food allergy (urticaria, anaphylaxis, etc.), and (4) special forms of immediate-type of food allergy such as food-dependent exercise-induced anaphylaxis and oral allergy syndrome (OAS). Much of this guideline covers the immediate-type of food allergy that is seen during childhood to adolescence. Infantile atopic dermatitis associated with food allergy type is especially important as the onset of most food allergies occurs during infancy. We have discussed the neonatal and infantile gastrointestinal allergy and special forms of immediate type food allergy types separately. Diagnostic procedures are highlighted, such as probability curves and component-resolved diagnosis, including the recent advancement utilizing antigen-specific IgE. The oral food challenge using a stepwise approach is recommended to avoid complete elimination of causative foods. Although oral immunotherapy (OIT) has not been approved as a routine treatment by nationwide insurance, we included a chapter for OIT, focusing on efficacy and problems. Prevention of food allergy is currently the focus of interest, and many changes were made based on recent evidence. Finally, the contraindication between adrenaline and antipsychotic drugs in Japan was discussed among related medical societies, and we reached an agreement that the use of adrenaline can be allowed based on the physician's discretion. In conclusion, this guideline encourages physicians to follow the principle to let patients

  15. Active treatment for food allergy.

    PubMed

    Kobernick, Aaron K; Burks, A Wesley

    2016-10-01

    Food allergy has grown in rapidly in prevalence, currently affecting 5% of adults and 8% of children. Management strategy is currently limited to 1) food avoidance and 2) carrying and using rescue intramuscular epinephrine/adrenaline and oral antihistamines in the case of accidental ingestion; there is no FDA approved treatment. Recently, oral, sublingual and epicutaneous immunotherapy have been developed as active treatment of food allergy, though none have completed phase 3 study. Efficacy and safety studies of immunotherapy have been variable, though there is clearly signal that immunotherapy will be a viable option to desensitize patients. The use of bacterial adjuvants, anti-IgE monoclonal antibodies, and Chinese herbal formulations either alone or in addition to immunotherapy may hold promise as future options for active treatment. Active prevention of food allergy through early introduction of potentially offending foods in high-risk infants will be an important means to slow the rising incidence of sensitization. Copyright © 2016 Japanese Society of Allergology. Production and hosting by Elsevier B.V. All rights reserved.

  16. Wheat allergy: diagnosis and management

    PubMed Central

    Cianferoni, Antonella

    2016-01-01

    Triticum aestivum (bread wheat) is the most widely grown crop worldwide. In genetically predisposed individuals, wheat can cause specific immune responses. A food allergy to wheat is characterized by T helper type 2 activation which can result in immunoglobulin E (IgE) and non-IgE mediated reactions. IgE mediated reactions are immediate, are characterized by the presence of wheat-specific IgE antibodies, and can be life-threatening. Non-IgE mediated reactions are characterized by chronic eosinophilic and lymphocytic infiltration of the gastrointestinal tract. IgE mediated responses to wheat can be related to wheat ingestion (food allergy) or wheat inhalation (respiratory allergy). A food allergy to wheat is more common in children and can be associated with a severe reaction such as anaphylaxis and wheat-dependent, exercise-induced anaphylaxis. An inhalation induced IgE mediated wheat allergy can cause baker’s asthma or rhinitis, which are common occupational diseases in workers who have significant repetitive exposure to wheat flour, such as bakers. Non-IgE mediated food allergy reactions to wheat are mainly eosinophilic esophagitis (EoE) or eosinophilic gastritis (EG), which are both characterized by chronic eosinophilic inflammation. EG is a systemic disease, and is associated with severe inflammation that requires oral steroids to resolve. EoE is a less severe disease, which can lead to complications in feeding intolerance and fibrosis. In both EoE and EG, wheat allergy diagnosis is based on both an elimination diet preceded by a tissue biopsy obtained by esophagogastroduodenoscopy in order to show the effectiveness of the diet. Diagnosis of IgE mediated wheat allergy is based on the medical history, the detection of specific IgE to wheat, and oral food challenges. Currently, the main treatment of a wheat allergy is based on avoidance of wheat altogether. However, in the near future immunotherapy may represent a valid way to treat IgE mediated reactions to

  17. Wheat allergy: diagnosis and management.

    PubMed

    Cianferoni, Antonella

    2016-01-01

    Triticum aestivum (bread wheat) is the most widely grown crop worldwide. In genetically predisposed individuals, wheat can cause specific immune responses. A food allergy to wheat is characterized by T helper type 2 activation which can result in immunoglobulin E (IgE) and non-IgE mediated reactions. IgE mediated reactions are immediate, are characterized by the presence of wheat-specific IgE antibodies, and can be life-threatening. Non-IgE mediated reactions are characterized by chronic eosinophilic and lymphocytic infiltration of the gastrointestinal tract. IgE mediated responses to wheat can be related to wheat ingestion (food allergy) or wheat inhalation (respiratory allergy). A food allergy to wheat is more common in children and can be associated with a severe reaction such as anaphylaxis and wheat-dependent, exercise-induced anaphylaxis. An inhalation induced IgE mediated wheat allergy can cause baker's asthma or rhinitis, which are common occupational diseases in workers who have significant repetitive exposure to wheat flour, such as bakers. Non-IgE mediated food allergy reactions to wheat are mainly eosinophilic esophagitis (EoE) or eosinophilic gastritis (EG), which are both characterized by chronic eosinophilic inflammation. EG is a systemic disease, and is associated with severe inflammation that requires oral steroids to resolve. EoE is a less severe disease, which can lead to complications in feeding intolerance and fibrosis. In both EoE and EG, wheat allergy diagnosis is based on both an elimination diet preceded by a tissue biopsy obtained by esophagogastroduodenoscopy in order to show the effectiveness of the diet. Diagnosis of IgE mediated wheat allergy is based on the medical history, the detection of specific IgE to wheat, and oral food challenges. Currently, the main treatment of a wheat allergy is based on avoidance of wheat altogether. However, in the near future immunotherapy may represent a valid way to treat IgE mediated reactions to

  18. Oral Immunotherapy for Food Allergies.

    PubMed

    Feuille, Elizabeth; Nowak-Węgrzyn, Anna

    2016-01-01

    Oral immunotherapy (OIT) is a promising investigational therapy for food allergy. Clinical trials in peanut, milk, egg, and wheat allergy provide evidence that OIT can effectively desensitize a majority of individuals to a food allergen. While a portion of subjects demonstrate sustained unresponsiveness, the majority regain sensitivity with allergen avoidance. The safety and tolerability of OIT continue to limit its use in some patients. Virtually all studies report adverse reactions that are more frequent during dose escalation but may also occur during maintenance therapy. Recent studies have identified adjunctive therapies (such as omalizumab) which may mitigate adverse effects. There is a paucity of data on the long-term safety and efficacy of OIT. Further study is required before OIT is ready for routine clinical practice. This review is intended to provide the reader with an up-to-date understanding of OIT, including its mechanisms, efficacy, safety profile, and potential utility in clinical practice. © 2016 S. Karger AG, Basel.

  19. Allergic rhinitis caused by food allergies.

    PubMed

    Cingi, Cemal; Demirbas, Duygu; Songu, Murat

    2010-09-01

    Food allergies occur in 1-2% of adults and in 8% of children under 6 years of age. Food-induced allergies are immunological reactions that cause a variety of symptoms affecting the skin, gastrointestinal tract, and respiratory tract. The reactions are mediated by both IgE- and non-IgE-dependent (cellular) mechanisms. Isolated food-induced allergic rhinitis is not common as it frequently occurs together with other food allergy symptoms such as asthma, eczema, oral allergic manifestations, urticaria, and gastrointestinal symptoms. The present paper provides an overview of food allergies and food-induced allergic rhinitis.

  20. Food and environmental allergies.

    PubMed

    Huffman, Miranda M

    2015-03-01

    Immunoglobulin E-mediated allergic responses to food and environmental allergens can cause symptoms ranging from mild allergic rhinitis and rashes to gastrointestinal distress and, most seriously, anaphylaxis. The diagnosis can be difficult, as it relies on complex interplay between patient history and diagnostic tests with low specificity. Adding to the difficulty in confirming the diagnosis is an increased public interest in food intolerances, which can be inappropriately attributed to an allergic response. Treatment of allergic diseases with avoidance strategies and pharmacologic treatments can improve quality of life and control of other chronic conditions, such as asthma and eczema.

  1. Food allergy is associated with recurrent respiratory tract infections during childhood

    PubMed Central

    Woicka-Kolejwa, Katarzyna; Zaczeniuk, Magdalena; Majak, Paweł; Pawłowska-Iwanicka, Kamila; Kopka, Monika; Stelmach, Wlodzimierz; Jerzyńska, Joanna

    2016-01-01

    Introduction To find out whether children with food allergy have an increased risk of recurrent upper and lower respiratory tract infections and of asthma. Aim To describe the clinical profile of children diagnosed with food allergy referred to the Allergy Clinic. Material and methods We conducted a retrospective study to assess the patients’ demographic, anthropometric and clinical data. The analysis included data of all children by the age of 10 years (registered with the Allergy Clinic between 2012 and 2013) in whom IgE mediated food allergy had been diagnosed during 18 months of observation. Results We included 280 children into the analysis. Recurrent respiratory tract infections (rRTI), asthma and gastrointestinal (GI) symptoms were observed in 153 (54.6%), 96 (34.3%), 39 (13.9%), respectively, with a significant increasing trend across age-subgroups. In children from 1 to 2 years old, sensitization to β-lactoglobulin increased the risk of rRTI (OR = 3.91; 95% CI: 1.03–14.87). In older children sensitization to allergens other than milk or egg decreases the risk of rRTI (OR = 0.25; 95% CI: 0.10–0.62); sensitization to egg decreased the risk of asthma diagnosis (OR = 0.09; 95% CI: 0.01–0.75). We did not identify food allergens which change the risk of GI symptoms in children. This finding was consistent throughout all age-subgroups. Conclusions Sensitization to β-lactoglobulin increased the risk of rRTI in children under 2 years of age nearly four times. The presence of sensitization to food allergens above 3 years of age did not increase the risk of developing clinical presentation of food allergy other than atopic dermatitis. PMID:27279819

  2. [The diagnosis of food allergies].

    PubMed

    Michel, O; Doyen, V

    2015-09-01

    The prevalence of food allergies is more than 5 %, rising currently. The clinical presentations are polymorphic and involve the skin, respiratory, vascular and gut systems. The diagnosis is based on the consistancy between the allergic history and the results of the specific IgE investigations. When the relationship between the history and the IgE sensitization is not significant, an oral challenge test with food is indicated under supervision of a reference center. New approach, based on dosage of specific IgE to different constituent (recombinant protein) of each allergen, can predict the severity of the reaction and the cross reactivity between allergens, in some patients.

  3. Food Allergy: Present and Future Management

    PubMed Central

    2009-01-01

    Food allergy poses a significant burden on patients, families, health care providers, and the medical system. The increased prevalence of food allergy has brought about investigation as to its cause and new treatments. Currently, the only treatment available is to avoid the food and symptomatically treat any reactions. There are multiple clinical and murine models of food allergy treatment that use allergen specific and nonspecific pathways. Allergen specific treatments use mucosal antigen exposure as a method of inducing desensitization and tolerance. Allergen nonspecific methods act via a more global TH2 suppressive mechanism and may be useful for those patients with multiple food allergies. PMID:23282314

  4. Japanese Guideline for Food Allergy 2014.

    PubMed

    Urisu, Atsuo; Ebisawa, Motohiro; Ito, Komei; Aihara, Yukoh; Ito, Setsuko; Mayumi, Mitsufumi; Kohno, Yoichi; Kondo, Naomi

    2014-09-01

    A food allergy is defined as "a phenomenon in which adverse reactions are caused through antigen-specific immunological mechanisms after exposure to given food." Various symptoms of food allergy occur in many organs. Food allergies are classified roughly into 4 clinical types: (1) neonatal and infantile gastrointestinal allergy, (2) infantile atopic dermatitis associated with food allergy, (3) immediate-type food allergy (urticaria, anaphylaxis, etc.), and (4) food dependent exercise-induced anaphylaxis and oral allergy syndrome (i.e., specific forms of immediate food allergy). The therapy for food allergies includes treatment of and prophylactic measures against hypersensitivity such as anaphylaxis. A fundamental prophylactic measure is the elimination diet. However, elimination diets should be used only if necessary because of the patient-related burden. For this purpose, it is very important that causative foods be accurately identified. There are a number of means available to identify causative foods, including the history taking, a skin prick test, detection of antigen-specific IgE antibodies in the blood, the basophil histamine release test, the elimination diet test, and the oral challenge test, etc. Of these, the oral challenge test is the most reliable. However, it should be conducted under the supervision of experienced physicians because it may cause adverse reactions, such as anaphylaxis.

  5. Allergies

    MedlinePlus

    ... treat some allergies using medicines and allergy shots. Avoidance In some cases, as with food allergies, avoiding ... that might contain even tiny traces of them. Avoidance can help protect people against non-food or ...

  6. Food allergy and infantile autism.

    PubMed

    Lucarelli, S; Frediani, T; Zingoni, A M; Ferruzzi, F; Giardini, O; Quintieri, F; Barbato, M; D'Eufemia, P; Cardi, E

    1995-09-01

    The etiopathogenesis of infantile autism is still unknown. Recently some authors have suggested that food peptides might be able to determine toxic effects at the level of the central nervous system by interacting with neurotransmitters. In fact a worsening of neurological symptoms has been reported in autistic patients after the consumption of milk and wheat. The aim of the present study has been to verify the efficacy of a cow's milk free diet (or other foods which gave a positive result after a skin test) in 36 autistic patients. We also looked for immunological signs of food allergy in autistic patients on a free choice diet. We noticed a marked improvement in the behavioural symptoms of patients after a period of 8 weeks on an elimination diet and we found high levels of IgA antigen specific antibodies for casein, lactalbumin and beta-lactoglobulin and IgG and IgM for casein. The levels of these antibodies were significantly higher than those of a control group which consisted of 20 healthy children. Our results lead us to hypothesise a relationship between food allergy and infantile autism as has already been suggested for other disturbances of the central nervous system.

  7. Food allergy: immune mechanisms, diagnosis and immunotherapy.

    PubMed

    Yu, Wong; Freeland, Deborah M Hussey; Nadeau, Kari C

    2016-12-01

    Food allergy is a pathological, potentially deadly, immune reaction triggered by normally innocuous food protein antigens. The prevalence of food allergies is rising and the standard of care is not optimal, consisting of food-allergen avoidance and treatment of allergen-induced systemic reactions with adrenaline. Thus, accurate diagnosis, prevention and treatment are pressing needs, research into which has been catalysed by technological advances that are enabling a mechanistic understanding of food allergy at the cellular and molecular levels. We discuss the diagnosis and treatment of IgE-mediated food allergy in the context of the immune mechanisms associated with healthy tolerance to common foods, the inflammatory response underlying most food allergies, and immunotherapy-induced desensitization. We highlight promising research advances, therapeutic innovations and the challenges that remain.

  8. Food allergy: immune mechanisms, diagnosis and immunotherapy

    PubMed Central

    Nadeau, Kari C.

    2016-01-01

    Food allergy is a pathological, potentially deadly, immune reaction triggered by normally innocuous food protein antigens. The prevalence of food allergies is rising and the standard of care is not optimal, consisting of food-allergen avoidance and treatment of allergen-induced systemic reactions with adrenaline. Thus, accurate diagnosis, prevention and treatment are pressing needs, research into which has been catalysed by technological advances that are enabling a mechanistic understanding of food allergy at the cellular and molecular levels. We discuss the diagnosis and treatment of IgE-mediated food allergy in the context of the immune mechanisms associated with healthy tolerance to common foods, the inflammatory response underlying most food allergies, and immunotherapy-induced desensitization. We highlight promising research advances, therapeutic innovations and the challenges that remain. PMID:27795547

  9. Update on food allergy in adults.

    PubMed

    Chaudhry, Rabia Quddus; Oppenheimer, John J

    2012-08-01

    Though much has been studied and written about food allergy, the majority of the available literature focuses on food allergies in the pediatric population. Unfortunately, it is likely that in regard to food allergies, adults are not just big children, and extrapolating findings from pediatric to adult patient populations might lead to erroneous assumptions. Thus, it is important to validate the correlation between pediatric and adult data, gather data regarding adult food allergy and understand the specific nuances of subsets of adults to better treat their food allergy. This review was conducted by identifying potentially relevant studies regarding food allergies in adults through electronic databases, including PubMed, Medline, and Google Scholar. The search terms included "allergy", "food" and "adults". Parameters of 19+ years of age were added to search terms and all journals were written in or translated to English. From these search results, focus was placed on studies from 2010 to 2012. This systematic update on food allergy in adults found that the evidence regarding prevalence, diagnosis and management of food allergies is very limited, with the majority of data derived from children and young adults.

  10. The changing geoepidemiology of food allergies.

    PubMed

    Leung, Patrick S C; Shu, Shang-An; Chang, Christopher

    2014-06-01

    The science of food allergy has been rapidly evolving before our eyes in the past half century. Like other allergic disorders, the prevalence of food allergies has dramatically increased, and coupled with the increased public awareness of anaphylaxis due to food allergy, this has driven an explosion in basic and clinical research in this extremely broad subject. Treatment of food allergies has evolved and practices such as food challenges have become an integral part of an allergy practice. The impact of the increase of food allergy has driven package labeling laws, legislation on emergency treatment availability in schools and other public places, and school policy. But to this day, our knowledge of the pathogenesis of food allergy is still incomplete. There are the most obvious IgE-mediated immediate hypersensitivity reactions, but then multiple previously unidentified conditions such as eosinophilic esophagitis, food protein-induced enterocolitis syndrome, milk protein allergy, food-induced atopic dermatitis, oral allergy syndrome, and others have complicated the diagnosis and management of many of our patients who are unable to tolerate certain foods. Many of these conditions are not IgE-mediated, but may be T cell-driven diseases. The role of T regulatory cells and immune tolerance and the newly discovered immunological role of vitamin D have shed light on the variable clinical presentation of food allergy and the development of new methods of immunotherapy in an example of bench-to-bedside research. Component-resolved diagnostic techniques have already begun to allow us to more precisely define the epitopes that are targeted in food allergic patients. The development of biological modulators, research on genomics and proteomics, and epigenetic techniques all offer promising avenues for new modes of therapy of food allergy in the twenty-first century.

  11. Food allergies--leads from Ayurveda.

    PubMed

    Arora, Deepa; Kumar, M

    2003-02-01

    Food allergy being a common health problem needs attention. The experience of Ayurveda can be utilized to accelerate our understanding and management of food allergies and related phenomenon like allergic tension fatigue syndrome, intolerance and indigestion associated with certain foods. Prevention of food allergies by carefully selecting the foods in accordance with the individual's body constitution and seasonal alterations, is considered as the best strategy in Ayurveda. If possible, the concept of prakriti and properties of food as described in Ayurveda, should be interpreted in modern terminology. Moreover, to scientifically validate them, an appropriate correlation with modern concepts is required along with scientific studies on modern parameters. Rasayanas may also prove helpful in the management of food allergies. It is obvious that there, is an urgent need for multidimensional and planned investigations of these Ayurvedic rasayanas in management of food allergies. The clinical acceptability of rasayanas for the treatment of food allergies entirely rests on such studies. Food intolerance and allergies are common health problems which are difficult to diagnose and still more difficult to treat. This problem is well addressed in Ayurveda and guidelines are available for their management. This paper aims to present the Ayurvedic concepts in the management of food intolerance/ allergies and its correlation with the evidences available from modem scientific laboratories. The understanding of this ancient wisdom may prove to be of immense importance in patient care.

  12. Food allergy in Africa: myth or reality?

    PubMed

    Kung, Shiang-Ju; Steenhoff, Andrew P; Gray, Claudia

    2014-06-01

    Food allergy has been traditionally perceived as being rare in Africa. However, the prevalence of other allergic manifestations such as asthma and atopic dermatitis continue to rise in the higher-income African countries. Since the food allergy epidemic in westernized countries has lagged behind that of allergic respiratory conditions, we hypothesize that food allergy is increasing in Africa. This article systematically reviews the evidence for food allergy in Africa, obtained through searching databases including PubMed, Medline, MD Consult, and scholarly Google. Articles are divided into categories based on strength of methodological diagnosis of food allergy. Information was found for 11 African countries: Botswana, Democratic Republic of Congo, Ghana, Kenya, Morocco, Mozambique, Nigeria, South Africa, Tanzania, Tunisia, and Zimbabwe. Most studies reflect sensitization to food or self-reported symptoms. However, a few studies had more stringent diagnostic testing that is convincing for food allergy, mostly conducted in South Africa. Apart from the foods that commonly cause allergy in westernized countries, other regionally significant or novel food allergens may include pineapple (Ghana), okra (Nigeria), and mopane worm (Botswana). Food allergy is definitely an emerging disease in Africa and resources need to be diverted to study, diagnose, treat, and prevent this important disease.

  13. The Natural History of Food Allergy.

    PubMed

    Savage, Jessica; Sicherer, Scott; Wood, Robert

    2016-01-01

    On a population level, it is well recognized that some IgE-mediated childhood food allergies, such as milk and egg allergies, are more likely to resolve than others, such as peanut and tree nuts allergies. Unfortunately, some studies suggest that resolution rates may have slowed compared with impressions from past decades. The clinician can apply the knowledge of the epidemiology of these allergies to describe likely patient outcomes, and direct management in a general manner. However, the ability to evaluate and predict the natural course of specific food allergies for individual patients is essential to inform personalized patient care. Data are accumulating to assist in identifying whether a child's allergy has likely resolved, informing the timing of oral food challenges or subsequent testing. Exciting recent studies are increasingly identifying early prognostic markers as well. Emerging food allergy therapies carry risks and costs. Identifying which egg-allergic patient has likely persistent allergy, and which patient with peanut allergy may experience natural resolution, is becoming an important goal to identify the best candidates for these therapies. Although more work needs to be done to identify reliable predictive markers and validate them, there is already much known about the natural course of food allergies that can be applied by the clinician to improve patient care.

  14. Food allergy and food intolerance: towards a sociological agenda.

    PubMed

    Nettleton, Sarah; Woods, Brian; Burrows, Roger; Kerr, Anne

    2009-11-01

    This article asks what sociological insights an analysis of food allergy and food intolerance might afford. We outline the parameters of debates around food allergy and food intolerance in the immunological, clinical and epidemiological literatures in order to identify analytic strands which might illuminate our sociological understanding of the supposed increase in both. Food allergy and food intolerance are contested and contingent terms and it is salient that the term true food allergy is replete throughout medico-scientific, epidemiological and popular discourses in order to rebuff spurious or 'nonallergic' claims of food-related symptoms. Complexity theory is introduced as a means of gaining analytic purchase on the food allergy debate. The article concludes that the use of this perspective provides a contemporary example of the 'double hermeneutic', in that the meanings and interpretations of contemporary explanations of food allergy are both permeated by, and can be made sense of, through recourse to complexity thinking.

  15. Promising treatments in development for food allergies.

    PubMed

    Rancé, Fabienne

    2004-11-01

    Up to 6% of young children and 2% of adults suffer from food allergy. Among them many have IgE-mediated food allergy, a condition with potentially fatal allergic reactions. The only proven treatment is avoidance of the offending food, which can be identified using standardised allergic tests. However, several studies have addressed possible definite treatment options for food allergy. Immunotherapy, administered orally or by systemic injections, shows promising preliminary results, but these therapeutics are based on studies with insufficient scientific support, or are associated with a high risk of severe side effects. At present, no studies can support pharmacotherapy. However, promising results were recently published with anti-IgE antibodies in a human trial, and various approaches in a mouse model of food allergy (chinese herbal medicine, specific modulation of the T-cell response). Rapidly evolving findings might provide hope for a cure for food allergy in the near future.

  16. Food allergy in adults and children.

    PubMed

    Mahoney, Elizabeth J; Veling, Maria C; Mims, James W

    2011-06-01

    Food allergy is defined as an adverse health effect arising from a specific immune response that occurs reproducibly on exposure to a given food and is distinct from food intolerance. Clinical manifestations of food allergy are varied and involve many systems including respiratory, cutaneous, and gastrointestinal. The double-blinded placebo-controlled oral food challenge remains the gold standard for the diagnosis of IgE-mediated food allergy. Areas of ongoing research include improved understanding of determinants for the development of tolerance versus sensitization for foods, the role of diagnostic testing for specific epitopes for food allergens, and the use of oral immunotherapy for IgE-mediated food allergy. Copyright © 2011 Elsevier Inc. All rights reserved.

  17. Food allergies developing after solid organ transplant.

    PubMed

    Needham, J M; Nicholas, S K; Davis, C M

    2015-12-01

    The development of food allergy is an increasingly recognized form of morbidity after solid organ transplant. It occurs more commonly in liver transplant recipients, although it has also been reported in heart, lung, kidney, and intestinal transplants. Pediatric transplant recipients are more likely to develop symptoms compared to adults, and reports of frequency vary widely from 5% to 38% in pediatric liver transplant recipients. Multiple mechanisms have been proposed in the literature, although no single mechanism can yet account for all reported observations. As food allergy can have at worst potentially fatal consequences, and at best require lifestyle adjustment through food avoidance, it is important for recipients to be aware of the donor's food allergies and particularly in pediatrics, the possibility of completely de novo allergies. This review explores the recent reports surrounding food allergy after solid organ transplant, including epidemiology, proposed mechanisms, and implications for practice.

  18. Nonallergen-specific treatments for food allergy.

    PubMed

    Lieberman, Jay A; Wang, Julie

    2012-06-01

    This review summarizes recent reports on nonallergen-specific therapies for food allergy. These therapies are especially appealing for food allergy because unlike allergen-specific immunotherapy, they would allow the treatment of multiple food allergies in a single patient with one therapy. Chinese herbal therapy, anti-IgE, probiotics, engineered lactic acid bacteria, and helminth therapy are all examples of allergen nonspecific therapies that have been investigated in recent years. Although some have only been studied in animal models of food allergy, some are undergoing rigorous, human clinical trials. Increasing amounts of research are examining the efficacy and safety of nonallergen-specific therapies for food allergy. There is hope that clinicians will have effective treatments either as an alternative or as an adjunct to immunotherapy.

  19. Have Food Allergies? Read the Label

    MedlinePlus

    ... For Consumers Home For Consumers Consumer Updates Have Food Allergies? Read the Label Share Tweet Linkedin Pin ... been much easier for people allergic to certain foods to avoid packaged products that contain them, says ...

  20. Food allergy: temporal trends and determinants.

    PubMed

    Ben-Shoshan, Moshe; Turnbull, Elizabeth; Clarke, Ann

    2012-08-01

    This review summarizes studies discussing temporal trends in the prevalence of food allergy as well as potential factors associated with the development of food allergy. In addition, we will address the potential hypotheses accounting for the apparent increase in food allergy prevalence. Studies suggest increased prevalence of food allergy. However, relatively little is known about its pathogenesis. This review aims to assess temporal trends in the prevalence of food allergy and discuss potential genetic, environmental, and demographic determinants. The search strategy examined the medical literature database MEDLINE (using PubMed) for the time period of January 1, 2002 to January 31, 2012. In recent decades, the prevalence of food allergy in general has increased by 0.60 % [95 % confidence interval (CI), 0.59 %-0.61 %] and the prevalence of peanut allergy by 0.027 % (95 % CI, 0.026 %-0.028 %), but it has now likely stabilized in developed countries. Genes, the environment, and demographic characteristics play a role in the pathogenesis of food allergy. Numerous environmental and demographic factors as well as gene-environment interactions may account for this increase in prevalence, but further studies are required to tease out their relative contribution.

  1. Allergies

    MedlinePlus

    ... For Consumers Consumer Information by Audience For Women Allergies Share Tweet Linkedin Pin it More sharing options ... clear up within a week. Learn More about Allergies Food Allergies: What You Need to Know Environmental ...

  2. Reducing food allergy: is there promise for food applications?

    USDA-ARS?s Scientific Manuscript database

    The incidence of food allergy has been increasing in recent years. Food allergy can be deadly, and strict avoidance of foods containing allergenic proteins is the only effective way to prevent food-induced allergic reaction. This approach poses challenges, because allergens are not always accurately...

  3. Managing childhood food allergies and anaphylaxis.

    PubMed

    Hu, Wendy; Kemp, Andrew

    2005-01-01

    Food allergies in children are becoming more common causing concern for parents, child carers, teachers and school principals. This article aims to provide practical information on childhood food allergies and their ongoing management including assessment, prescription of self or carer administered adrenaline, emergency action plans, patient education, school based strategies, and family support. With most schools, preschools and child care centres having at least one child with food allergies, general practitioners are increasingly likely to be involved in school liaison and education, as well as caring for families with food allergic children.

  4. Maize food allergy: a double-blind placebo-controlled study.

    PubMed

    Scibilia, J; Pastorello, E A; Zisa, G; Ottolenghi, A; Ballmer-Weber, B; Pravettoni, V; Scovena, E; Robino, A; Ortolani, C

    2008-12-01

    Maize allergy is not very common especially in Europe. The number of studies that address IgE mediated maize allergy is all too few. Evaluate subjects with a history of maize allergy by double-blind, placebo-controlled food challenge; identify the spectrum of symptoms manifested during challenge; determine the lowest provocation dose (PD) during challenge; determine the performance characteristics of maize skin prick test and specific IgE. Twenty-seven patients with a history of maize allergy were enrolled to be evaluated by skin test, specific IgE and double-blind placebo-controlled maize challenge. Forty-eight percent of the patients were challenge positive. PD range was 0.1-25 g. Fifty-four percent of the maize allergic subjects had a PD that was < or = 2.5 g; two subjects reacted to 100 mg of maize. Comparison of maize specific IgE levels and skin test results to the challenge results revealed the following (specific IgE level/skin testing): sensitivity 1.00/0.846, specificity 0.077/0.384, positive predictive value 0.520/0.579, and negative predictive value 1.00/0.714. Maize is a cause of IgE-mediated allergic reactions to foods in adults and children. Nearly half of the subjects recruited were confirmed by challenge to be allergic to maize. Twenty-three percent of the positive challenge patients manifested symptoms that involved two organ systems, thus fulfilling the criteria for maize induced anaphylaxis. Maize is allergenic and can pose a risk for symptomatic food allergy at a dose of 100 mg.

  5. Nearly 4 Percent of Americans Suffer from Food Allergies

    MedlinePlus

    ... html Nearly 4 Percent of Americans Suffer From Food Allergies Study finds most common allergy is to shellfish, ... shows. Approximately 4 percent of Americans have a food allergy, with women and Asians the most affected, the ...

  6. Altered fecal microbiota composition associated with food allergy in infants.

    PubMed

    Ling, Zongxin; Li, Zailing; Liu, Xia; Cheng, Yiwen; Luo, Yueqiu; Tong, Xiaojuan; Yuan, Li; Wang, Yuezhu; Sun, Jinbo; Li, Lanjuan; Xiang, Charlie

    2014-04-01

    Increasing evidence suggests that perturbations in the intestinal microbiota composition of infants are implicated in the pathogenesis of food allergy (FA), while the actual structure and composition of the intestinal microbiota in human beings with FA remain unclear. Microbial diversity and composition were analyzed with parallel barcoded 454 pyrosequencing targeting the 16S rRNA gene hypervariable V1-V3 regions in the feces of 34 infants with FA (17 IgE mediated and 17 non-IgE mediated) and 45 healthy controls. Here, we showed that several key FA-associated bacterial phylotypes, but not the overall microbiota diversity, significantly changed in infancy fecal microbiota with FA and were associated with the development of FA. The proportion of abundant Bacteroidetes, Proteobacteria, and Actinobacteria phyla were significantly reduced, while the Firmicutes phylum was highly enriched in the FA group (P < 0.05). Abundant Clostridiaceae 1 organisms were prevalent in infants with FA at the family level (P = 0.016). FA-enriched phylotypes negatively correlated with interleukin-10, for example, the genera Enterococcus and Staphylococcus. Despite profound interindividual variability, levels of 20 predominant genera were significantly different between the FA and healthy control groups (P < 0.05). Infants with IgE-mediated FA had increased levels of Clostridium sensu stricto and Anaerobacter and decreased levels of Bacteroides and Clostridium XVIII (P < 0.05). A positive correlation was observed between Clostridium sensu stricto and serum-specific IgE (R = 0.655, P < 0.001). The specific microbiota signature could distinguish infants with IgE-mediated FA from non-IgE-mediated ones. Detailed microbiota analysis of a well-characterized cohort of infants with FA showed that dysbiosis of fecal microbiota with several FA-associated key phylotypes may play a pathogenic role in FA.

  7. Altered Fecal Microbiota Composition Associated with Food Allergy in Infants

    PubMed Central

    Ling, Zongxin; Li, Zailing; Liu, Xia; Cheng, Yiwen; Luo, Yueqiu; Tong, Xiaojuan; Yuan, Li; Wang, Yuezhu; Sun, Jinbo

    2014-01-01

    Increasing evidence suggests that perturbations in the intestinal microbiota composition of infants are implicated in the pathogenesis of food allergy (FA), while the actual structure and composition of the intestinal microbiota in human beings with FA remain unclear. Microbial diversity and composition were analyzed with parallel barcoded 454 pyrosequencing targeting the 16S rRNA gene hypervariable V1-V3 regions in the feces of 34 infants with FA (17 IgE mediated and 17 non-IgE mediated) and 45 healthy controls. Here, we showed that several key FA-associated bacterial phylotypes, but not the overall microbiota diversity, significantly changed in infancy fecal microbiota with FA and were associated with the development of FA. The proportion of abundant Bacteroidetes, Proteobacteria, and Actinobacteria phyla were significantly reduced, while the Firmicutes phylum was highly enriched in the FA group (P < 0.05). Abundant Clostridiaceae 1 organisms were prevalent in infants with FA at the family level (P = 0.016). FA-enriched phylotypes negatively correlated with interleukin-10, for example, the genera Enterococcus and Staphylococcus. Despite profound interindividual variability, levels of 20 predominant genera were significantly different between the FA and healthy control groups (P < 0.05). Infants with IgE-mediated FA had increased levels of Clostridium sensu stricto and Anaerobacter and decreased levels of Bacteroides and Clostridium XVIII (P < 0.05). A positive correlation was observed between Clostridium sensu stricto and serum-specific IgE (R = 0.655, P < 0.001). The specific microbiota signature could distinguish infants with IgE-mediated FA from non-IgE-mediated ones. Detailed microbiota analysis of a well-characterized cohort of infants with FA showed that dysbiosis of fecal microbiota with several FA-associated key phylotypes may play a pathogenic role in FA. PMID:24532064

  8. Exploration into the Genetics of Food Allergy

    DTIC Science & Technology

    2012-10-01

    Eosinophilic Esophagitis, a non-IgE mediated disease . This work has examined the genetics of food allergy looking at both IgE and non-IgE mediated...atopic dermatitis to another. The understanding that genetics play a role in allergic disease and asthma has been recognized for more than 100... disease as compared with controls4, 5. Follow-up studies have shown that if one parent has allergies, a child has a 33% chance of developing allergies

  9. Prevention of food allergy - Early dietary interventions.

    PubMed

    Du Toit, George; Foong, Ru-Xin M; Lack, Gideon

    2016-10-01

    The prevalence of food allergy has increased over the last 30 years and remains a disease, which significantly impacts on the quality of life of children and their families. Several hypotheses have been formulated to explain the increasing prevalence; this review will focus on the hypothesis that dietary factors may influence the development of food allergy. Historically, the prevention of food allergy has focused on allergen avoidance. However, recent findings from interventional studies have prompted a shift in the mind set from avoidance to early introduction of potentially allergenic foods. This review aims to facilitate a better understanding of contemporary research studies that make use of early introduction of common allergenic foods into infant diets as a preventative strategy against the development of food allergy.

  10. Attitudes and preferences of consumers toward food allergy labeling practices by diagnosis of food allergies.

    PubMed

    Ju, Se-Young; Park, Jong-Hwan; Kwak, Tong-Kyoung; Kim, Kyu-Earn

    2015-10-01

    The objective of this study was to investigate food allergens and prevalence rates of food allergies, followed by comparison of consumer attitudes and preferences regarding food allergy labeling by diagnosis of food allergies. A total of 543 individuals living in Seoul and Gyeonggi area participated in the survey from October 15 to 22 in 2013. The results show that the prevalence of doctor-diagnosed food allergies was 17.5%, whereas 6.4% of respondents self-reported food allergies. The most common allergens of doctor-diagnosed and self-reported food allergy respondents were peaches (30.3%) and eggs (33.3%), respectively, followed by peanuts, cow's milk, and crab. Regarding consumer attitudes toward food labeling, checking food allergens as an item was only significantly different between allergic and non-allergic respondents among all five items (P < 0.001). All respondents reported that all six items (bold font, font color, box frame, warning statement, front label, and addition of potential allergens) were necessary for an improved food allergen labeling system. PLSR analysis determined that the doctor-diagnosed group and checking of food allergens were positively correlated, whereas the non-allergy group was more concerned with checking product brands. An effective food labeling system is very important for health protection of allergic consumers. Additionally, government agencies must develop policies regarding prevalence of food allergies in Korea. Based on this information, the food industry and government agencies should provide clear and accurate food labeling practices for consumers.

  11. [Current features of food allergies: the need of allergy surveillance].

    PubMed

    Moneret-Vautrin, D A

    2001-01-01

    The prevalence of food allergy in European populations has been evaluated at between 1.8 and 4.4%. In the French population it is 3.24%. This frequency, as well as the gravity of some manifestations, has already led to preventive and curative measures being taken in school settings. This increase is related to multiple environmental factors: changes in intestinal microflora, early diversification of foods in children, interference of drugs favoring clinical severity in adults. Allergenicity can be modified by food industry techniques. The appearance of novel foods (exotic proteins or those derived from animal feed, and soon GMOs), the growing use of food proteins as ingredients, constitute new risks. The absence of validated experimental methods for evaluating the allergic risk of food proteins makes it necessary to implement a policy of allergy vigilance for novel foods. Studies concerning the allergic risk for lupin flour, a new ingredient used in baked goods, are given as an example. They indicate the frequency of sensitization and cross peanut-lupin flour allergy, the low reactive threshold, indicating the risk of the level of incorporation presently allowed. They make possible current screening for this allergy in the population. Allergy vigilance is a recent concept that aims to set up surveillance of food allergy risks in a manner analogous to that of pharmacovigilance for drugs. A project for creating such a structure is being discussed. Although the central structure remains at the initiative of the Agence Française de Sécurité Sanitaire de l'Alimentation (French Agency for Food Safety) and the Institut de Veille Sanitaire (Institute of Health) the authors specify what a peripheral network of allergists should be, analyze the desired content of the bi-directional flow of information, and propose envisaging an intermediate regulatory organization, specialized in the diagnosis and treatment of food allergies. The ongoing idea is that environmental

  12. Food Allergy - Multiple Languages: MedlinePlus

    MedlinePlus

    ... V W XYZ List of All Topics All Food Allergy - Multiple Languages To use the sharing features on this page, please enable JavaScript. Chinese - Simplified (简体中文) Chinese - Traditional (繁體中文) Spanish (español) Chinese - Simplified (简体中文) Common Allergies ...

  13. Food specific oral immunotherapy: a potential treatment for food allergy.

    PubMed

    Burbank, Allison J; Burks, Wesley

    2015-01-01

    Food allergy is a potentially life-threatening condition affecting up to 8% of children and up to 2% of adults in westernized countries. There are currently no approved treatments for food allergy apart from avoidance. The apparent increase in incidence of food allergies over the past few decades calls attention to the need for effective, disease-modifying therapies for food allergies. Oral immunotherapy (OIT) is a promising experimental treatment in which food allergic patients consume increasing quantities of food in attempt to increase their threshold for allergic reaction. Studies are ongoing to determine whether OIT is capable of safely inducing not only desensitization but also tolerance to the allergenic foods. This article focuses on recent relevant studies of OIT for the treatment of common food allergies.

  14. EAACI Food Allergy and Anaphylaxis Guidelines. Food allergy health-related quality of life measures.

    PubMed

    Muraro, A; Dubois, A E J; DunnGalvin, A; Hourihane, J O'B; de Jong, N W; Meyer, R; Panesar, S S; Roberts, G; Salvilla, S; Sheikh, A; Worth, A; Flokstra-de Blok, B M J

    2014-07-01

    Instruments have been developed and validated for the measurement of health-related quality of life in patients with food allergy. This guideline has been prepared by the European Academy of Allergy and Clinical Immunology's (EAACI) Guidelines for Food Allergy and Anaphylaxis Group. It draws on a systematic review of the literature on quality of life instruments for food allergy and the Appraisal of Guidelines for Research & Evaluation (AGREE II) guideline development process. Guidance is provided on the use of such instruments in research, and the current limitations of their use in clinical practice are described. Gaps in current knowledge as well as areas of future interest are also discussed. This document is relevant to healthcare workers dealing with food-allergic patients, scientists engaging in food allergy research and policy makers involved in regulatory aspects concerning food allergy and safety. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Managing food allergies in schools and camps.

    PubMed

    Mudd, Kim; Wood, Robert A

    2011-04-01

    Managing food allergy in school and camp environments involves creating an individualized plan that addresses safety, and supports growth and development of the food-allergic child. The result is a dynamic strategy that meets the needs of a food-allergic child and promotes the development of a food-allergic adolescent. Copyright © 2011 Elsevier Inc. All rights reserved.

  16. Stress and food allergy: mechanistic considerations

    PubMed Central

    Schreier, Hannah M.C.; Wright, Rosalind J.

    2014-01-01

    Recent years have seen a marked increase in food allergy prevalence among children, particularly in Western countries, that cannot be explained by genetic factors alone. This has resulted in an increased effort to identify environmental risk factors underlying food allergies and to understand how these factors may be modified through interventions. Food allergy is an immune-mediated adverse reaction to food. Consequently, considerations of candidate risk factors have begun to focus on environmental influences that perturb the healthy development of the emerging immune system during critical periods of development (eg, prenatally and during early childhood), particularly in the gut. Given that psychosocial stress is known to play an important role in other allergic and inflammatory diseases, such as asthma, its potential role in food allergy is a growing area of research. However, research to date has largely focused on animal studies. This review synthesizes relevant animal research and epidemiological data, providing proof of concept for moderating influences of psychological stress on food allergy outcomes in humans. Pathways that may underlie associations between psychosocial stress and the expression of food allergy are discussed. PMID:24428964

  17. Nonmurine animal models of food allergy.

    PubMed

    Helm, Ricki M; Ermel, Richard W; Frick, Oscar L

    2003-02-01

    Food allergy can present as immediate hypersensitivity [manifestations mediated by immunoglobulin (Ig)E], delayed-type hypersensitivity (reactions associated with specific T lymphocytes), and inflammatory reactions caused by immune complexes. For reasons of ethics and efficacy, investigations in humans to determine sensitization and allergic responses of IgE production to innocuous food proteins are not feasible. Therefore, animal models are used a) to bypass the innate tendency to develop tolerance to food proteins and induce specific IgE antibody of sufficient avidity/affinity to cause sensitization and upon reexposure to induce an allergic response, b) to predict allergenicity of novel proteins using characteristics of known food allergens, and c) to treat food allergy by using immunotherapeutic strategies to alleviate life-threatening reactions. The predominant hypothesis for IgE-mediated food allergy is that there is an adverse reaction to exogenous food proteins or food protein fragments, which escape lumen hydrolysis, and in a polarized helper T cell subset 2 (Th2) environment, immunoglobulin class switching to allergen-specific IgE is generated in the immune system of the gastrointestinal-associated lymphoid tissues. Traditionally, the immunologic characterization and toxicologic studies of small laboratory animals have provided the basis for development of animal models of food allergy; however, the natural allergic response in large animals, which closely mimic allergic diseases in humans, can also be useful as models for investigations involving food allergy.

  18. Exploration into the Genetics of Food Allergy

    DTIC Science & Technology

    2013-10-01

    treatment of IgE-mediated food allergy, we have shown that compenent testing maybe a better diagnostic test for food allergy than standard skin ...alone is in sufficient to induce fibrosis in specific model systems. In a murine model of systemic sclerosis, Mori et al. found that skin fibrosis was...protected against steatohepatitis and liver fibrosis compared to wild type controls [49]. Likewise, TNF-a has been implicated in skin EMT [50

  19. Epidemiology of food allergy in Latin America.

    PubMed

    Sánchez, J; Sánchez, A

    2015-01-01

    Food allergy is growing worldwide at an alarming rate. A group of eight foods account for over 90% of the reactions in Europe and the United States. However, little is known about the frequency of sensitization to these foods in Latin American, and if other native foods from this region are an important source of sensitization. The objective of this review was to analyse the epidemiological studies in Latin America about food allergy and to compare them with the studies in the United States and Europe.

  20. Immunotherapy for food allergies in children.

    PubMed

    Martinolli, Francesco; Carraro, Silvia; Berardi, Mariangela; Ferraro, Valentina; Baraldi, Eugenio; Zanconato, Stefania

    2014-01-01

    Food allergy is an increasingly prevalent problem all over the world and especially in westernized countries, and there is an unmet medical need for an effective form of therapy. During childhood natural tolerance development is frequent, but some children with cow's milk or hen's egg allergy and the majority of children with peanut allergy will remain allergic until adulthood, limiting not only the diet of patients but also their quality of life. Within the last several years, the usefulness of immunotherapy for food allergies has been investigated in food allergic patients. Several food immunotherapies are being developed; these involve oral, sublingual, epicutaneous, or subcutaneous administration of small amounts of native or modified allergens to induce immune tolerance. The approach generally follows the same principles as immunotherapy of other allergic disorders and involves administering small increasing doses of food during an induction phase followed by a maintenance phase with regular intake of a maximum tolerated amount of food. Oral immunotherapy seems to be a promising approach for food allergic patients based on results from small uncontrolled and controlled studies. Diet containing heated milk and egg may represent an alternative approach to oral immunomodulation for cow's milk and egg allergic subjects. However, oral food immunotherapy remains an investigational treatment to be further studied before advancing into clinical practice. Additional bigger, multicentric and hopefully randomized-controlled studies must answer multiple questions including optimal dose, ideal duration of immunotherapy, degree of protection, efficacy for different ages, severity and type of food allergy responsive to treatment.

  1. Oral tolerance induction for human food allergy.

    PubMed

    Noh, Geunwoong; Lee, Jae Ho

    2012-04-01

    Food allergies are classified as IgE-mediated and non-IgE mediated type. The number of successful reports of immunotherapy, namely tolerance induction for food allergy (TIFA) are increasing, bringing hope for meaningful positive and radical treatment of food allergy. Therapeutic characteristics of the clinical course in TIFA for NFA are different from TIFA for IFA. Cytokines including IL-10, TGF-β and IFN-γ and regulatory cells such as Treg and Breg, are involved in immune tolerance. IFN-γ has been used for tolerance induction of food allergy as an immunomodulatory biologics. A definitive distinction between IgE-mediated and non-IgE-mediated food allergies is absolutely essential for diagnostic and therapeutic purposes. Original SOTI using IFN-γ is more effective then conventional SOTI without IFN-γ. Especially, IFN-γ is absolutely necessary for the tolerance induction of NFA. This review highlights and updates the advances in the conceptual immunological background and the clinical characteristics of oral tolerance induction for food allergy.

  2. Use of biologics in severe food allergies.

    PubMed

    Fiocchi, Alessandro; Pecora, Valentina; Valluzzi, Rocco L; Fierro, Vincenzo; Mennini, Maurizio

    2017-06-01

    Severe cases of food allergy account for the majority of the burden in terms of risks, quality of life, and resource expenditure. The traditional approach to these forms has been strict avoidance. More recently, Oral ImmunoTherapy (OIT) has gained a role in their management. However, in severe food allergies OIT is often infeasible. Case reports, observational, and prospective studies have recently proposed different approaches to severe food allergy. The majority of them include the use of biologics. Omalizumab has been the most studied drug for severe food allergies, and its role as adjuvant treatment to OIT is well established. Interest has been raised on other biologics, as dupilumab, reslizumab, and mepolizumab. Toll-like receptor agonists, and gene therapy using adeno-associated virus coding for Omalizumab are promising alternatives. The recent studies are deeply influencing the clinical practice. We review the modifications of the clinical approach to severe food allergies so far available. We indicate the possible evolutions of treatment with biologics in severe food allergies.

  3. [Immunological background and pathomechanisms of food allergies].

    PubMed

    Schülke, Stefan; Scheurer, Stephan

    2016-06-01

    Recent advances in immunology have greatly improved our understanding of the pathomechanisms of food allergies. Food allergies are caused and maintained by complex interactions of the innate and adaptive immune system involving antigen-presenting cells (APC), T cells, group 2 innate lymphoid cells (ILC2), epithelial cells (EC) and effectors cells. Additionally, epigenetic factors, the intestinal microbiome and nutritional factors modulating the gastrointestinal lymphatic tissue probably have a significant impact on allergy development. However, why certain individuals develop tolerance while others mount allergic responses, the factors defining the allergenicity of food proteins, as well as the immunological mechanisms triggering allergy development have yet to be analyzed in detail.

  4. Camel milk for food allergies in children.

    PubMed

    Shabo, Yosef; Barzel, Reuben; Margoulis, Mark; Yagil, Reuven

    2005-12-01

    Food allergies in children are often very serious and can lead to anaphylactic reactions. Observations that camel milk ameliorates allergic reactions were noted over the years. The effect of camel milk is probably related to its special composition. To investigate the effect of camel milk in several children with severe food (mainly milk) allergies. We studied eight children with food allergies who did not benefit from conventional treatment. Their parents, or their physicians, decided to try camel milk as a last resort. The parents were advised by the authors - who have considerable experience with the use of camel milk - regarding how much and when the children should drink the milk. The parents reported daily on the progress of their children. All eight children in this study reacted well to the milk and recovered fully from their allergies. These encouraging results should be validated by large-scale clinical trials.

  5. Infant food allergy: where are we now?

    PubMed

    Joneja, Janice M

    2012-01-01

    For many years, the prevailing maxim for prevention of food allergy in at-risk infants was to reduce allergic sensitization by avoiding exposure to highly allergenic foods until the baby's immune and digestive systems were sufficiently developed to cope with the allergen. Current thinking is completely different: exposure to food in the early stages of development may be the way to induce tolerance. Exclusive breastfeeding until 4-6 months, followed by introduction of complementary foods individually, is recommended. Any restrictions on mother's diet, other than avoidance of her own allergens during pregnancy and breastfeeding, are contraindicated. If a baby at high risk for allergy (defined as having 1 first-degree relative with diagnosed allergy) cannot be exclusively breastfed to 4-6 months of age, the preferred method of feeding for the prevention of atopic disease is an extensively hydrolyzed formula. There appears to be no value in delaying the introduction of any food beyond 6 months of age. Most food allergy is outgrown in childhood, but allergy to some foods tends to persist. Induction of tolerance to foods to which a child is allergic may be achieved by low-dose exposure in a process known as specific oral tolerance induction (SOTI). Early results indicate that some probiotic strains of bacteria, such as Lactobacillus rhamnosus GG or Lactobacillus F19, may reduce allergic sensitization.

  6. Coping with Food Allergies | NIH MedlinePlus the Magazine

    MedlinePlus

    ... soy products, and wheat. Allergies to peanuts or tree nuts often are lifelong. An allergy that begins ... common food allergies are to eggs, milk, peanuts, tree nuts, wheat, crustaceans (shellfish), fish, and soy products. ...

  7. South African food allergy consensus document 2014.

    PubMed

    Levin, M E; Gray, C L; Goddard, E; Karabus, S; Kriel, M; Lang, A C; Manjra, A I; Risenga, S M; Terblanche, A J; van der Spuy, D A

    2015-01-01

    The prevalence of food allergy is increasing worldwide and is an important cause of anaphylaxis. There are no local South African food allergy guidelines. This document was devised by the Allergy Society of South Africa (ALLSA), the South African Gastroenterology Society (SAGES) and the Association for Dietetics in South Africa (ADSA). Subjects may have reactions to more than one food, and different types and severity of reactions to different foods may coexist in one individual. A detailed history directed at identifying the type and severity of possible reactions is essential for every food allergen under consideration. Skin-prick tests and specific immunoglobulin E (IgE) (ImmunoCAP) tests prove IgE sensitisation rather than clinical reactivity. The magnitude of sensitisation combined with the history may be sufficient to ascribe causality, but where this is not possible an incremental oral food challenge may be required to assess tolerance or clinical allergy. For milder non-IgE-mediated conditions a diagnostic elimination diet may be followed with food re-introduction at home to assess causality. The primary therapy for food allergy is strict avoidance of the offending food/s, taking into account nutritional status and provision of alternative sources of nutrients. Acute management of severe reactions requires prompt intramuscular administration of adrenaline 0.01 mg/kg and basic resuscitation. Adjunctive therapy includes antihistamines, bronchodilators and corticosteroids. Subjects with food allergy require risk assessment and those at increased risk for future severe reactions require the implementation of risk-reduction strategies, including education of the patient, families and all caregivers (including teachers), the provision of a written emergency action plan, a MedicAlert necklace or bracelet and injectable adrenaline (preferably via auto-injector) where necessary.

  8. Does Your Child Really Have a Food Allergy?

    MedlinePlus

    ... 167372.html Does Your Child Really Have a Food Allergy? Food sensitivity and intolerance may be mistaken for ... 24, 2017 (HealthDay News) -- Many people misunderstand what food allergies are, and even doctors can be confused about ...

  9. Adverse reactions to food: allergies and intolerances.

    PubMed

    Montalto, Massimo; Santoro, Luca; D'Onofrio, Ferruccio; Curigliano, Valentina; Gallo, Antonella; Visca, Dina; Cammarota, Giovanni; Gasbarrini, Antonio; Gasbarrini, Giovanni

    2008-01-01

    All the anomalous reactions secondary to food ingestion are defined as 'adverse reactions to food'. In 1995 the European Academy of Allergology and Clinical Immunology suggested a classification on the basis of the responsible pathogenetic mechanism; according to this classification, non-toxic reactions can be divided into 'food allergies' when they recognize immunological mechanisms, and 'food intolerances' when there are no immunological implications. The diagnostic approach to adverse reactions to food is based on accurate clinical history and objective examination, and further execution of specific tests when allergy or intolerance is suspected. The therapy for food allergies is the elimination of the food to which hypersensibility has been found; this strategy can lead, especially in pediatric age, to tolerance. If elimination diets cannot be completely performed, or if it is not possible to identify the food to eliminate, some drugs (e.g. antihistaminics, steroids, etc.) can be administered. Specific allergen immunotherapy has been recently introduced. Fundamental is food allergy prevention, especially in high-risk subjects. The therapeutic approach to secondary food intolerances is based principally on primitive disease resolution; on the other hand, some specific treatments (e.g. beta-galactosidases in lactose malabsorption) are available in case of primary intolerance. 2008 S. Karger AG, Basel.

  10. Prospects for Prevention of Food Allergy.

    PubMed

    Allen, Katrina J; Koplin, Jennifer J

    2016-01-01

    A rise in both prevalence and public awareness of food allergy in developed countries means that clinicians and researchers are frequently asked to explain reasons for the increase in food allergy, and families are eager to know whether they can take steps to prevent food allergy in their children. In this review, we outline leading theories on risk factors for early life food allergy. We summarize the leading hypotheses to explain the increase in food allergy as "the 5 Ds": dry skin, diet, dogs, dribble (shared microbial exposure), and vitamin D. We discuss currently available evidence for these theories and how these can be translated into clinical recommendations. With the exception of dietary intervention studies, evidence for each of these theories is observational, and we describe the implications of this for explaining risk to families. Current infant feeding recommendations are that infants should be introduced to solids around the age of 4 to 6 months irrespective of family history risk and that allergenic solids do not need to be avoided, either by infants at the time of solid food introduction or by mothers whilst pregnant or lactating. Additional potential strategies currently being explored include optimization of early life skin barrier function through a decrease in drying soaps and detergents and an increase in the use of nonallergenic moisturizers. The investigation of the role of microbiota and vitamin D is ongoing and cannot yet be translated into clinical recommendations.

  11. Food allergy knowledge, perception of food allergy labeling, and level of dietary practice: A comparison between children with and without food allergy experience.

    PubMed

    Choi, Yongmi; Ju, Seyoung; Chang, Hyeja

    2015-02-01

    The prevalence of food allergies in Korean children aged 6 to 12 years increased from 10.9% in 1995 to 12.6% in 2012 according to nationwide population studies. Treatment for food allergies is avoidance of allergenic-related foods and epinephrine auto-injector (EPI) for accidental allergic reactions. This study compared knowledge and perception of food allergy labeling and dietary practices of students. The study was conducted with the fourth to sixth grade students from an elementary school in Yongin. A total of 437 response rate (95%) questionnaires were collected and statistically analyzed. The prevalence of food allergy among respondents was 19.7%, and the most common food allergy-related symptoms were urticaria, followed by itching, vomiting and nausea. Food allergens, other than 12 statutory food allergens, included cheese, cucumber, kiwi, melon, clam, green tea, walnut, grape, apricot and pineapple. Children with and without food allergy experience had a similar level of knowledge on food allergies. Children with food allergy experience thought that food allergy-related labeling on school menus was not clear or informative. To understand food allergies and prevent allergic reactions to school foodservice among children, schools must provide more concrete and customized food allergy education.

  12. Food allergy knowledge, perception of food allergy labeling, and level of dietary practice: A comparison between children with and without food allergy experience

    PubMed Central

    Choi, Yongmi; Ju, Seyoung

    2015-01-01

    BACKGROUND/OBJECTIVES The prevalence of food allergies in Korean children aged 6 to 12 years increased from 10.9% in 1995 to 12.6% in 2012 according to nationwide population studies. Treatment for food allergies is avoidance of allergenic-related foods and epinephrine auto-injector (EPI) for accidental allergic reactions. This study compared knowledge and perception of food allergy labeling and dietary practices of students. SUBJECTS/METHODS The study was conducted with the fourth to sixth grade students from an elementary school in Yongin. A total of 437 response rate (95%) questionnaires were collected and statistically analyzed. RESULTS The prevalence of food allergy among respondents was 19.7%, and the most common food allergy-related symptoms were urticaria, followed by itching, vomiting and nausea. Food allergens, other than 12 statutory food allergens, included cheese, cucumber, kiwi, melon, clam, green tea, walnut, grape, apricot and pineapple. Children with and without food allergy experience had a similar level of knowledge on food allergies. Children with food allergy experience thought that food allergy-related labeling on school menus was not clear or informative. CONCLUSION To understand food allergies and prevent allergic reactions to school foodservice among children, schools must provide more concrete and customized food allergy education. PMID:25671074

  13. Attitudes and preferences of consumers toward food allergy labeling practices by diagnosis of food allergies

    PubMed Central

    Ju, Se-young; Park, Jong-Hwan; Kim, Kyu-earn

    2015-01-01

    BACKGROUND/OBJECTIVES The objective of this study was to investigate food allergens and prevalence rates of food allergies, followed by comparison of consumer attitudes and preferences regarding food allergy labeling by diagnosis of food allergies. SUBJECTS/METHODS A total of 543 individuals living in Seoul and Gyeonggi area participated in the survey from October 15 to 22 in 2013. RESULTS The results show that the prevalence of doctor-diagnosed food allergies was 17.5%, whereas 6.4% of respondents self-reported food allergies. The most common allergens of doctor-diagnosed and self-reported food allergy respondents were peaches (30.3%) and eggs (33.3%), respectively, followed by peanuts, cow's milk, and crab. Regarding consumer attitudes toward food labeling, checking food allergens as an item was only significantly different between allergic and non-allergic respondents among all five items (P < 0.001). All respondents reported that all six items (bold font, font color, box frame, warning statement, front label, and addition of potential allergens) were necessary for an improved food allergen labeling system. PLSR analysis determined that the doctor-diagnosed group and checking of food allergens were positively correlated, whereas the non-allergy group was more concerned with checking product brands. CONCLUSIONS An effective food labeling system is very important for health protection of allergic consumers. Additionally, government agencies must develop policies regarding prevalence of food allergies in Korea. Based on this information, the food industry and government agencies should provide clear and accurate food labeling practices for consumers. PMID:26425282

  14. Sunlight, vitamin D and food allergy.

    PubMed

    Rudders, Susan A; Camargo, Carlos A

    2015-08-01

    The role of vitamin D in the development of food allergy is unclear. We summarize recent data on the epidemiologic link between sunlight (UVB) and food allergy, and evidence for and against a specific role for vitamin D status. Since 2007, most epidemiologic studies have supported low sunlight (as measured by season of birth and latitude) as a risk factor for food allergy. Investigators have also looked directly at vitamin D status (as measured by serum 25OHD level) and its potential role. Although conflicting, the vitamin D studies suggest a more complicated association than a linear dose response in all individuals, with some studies indicating different associations based on host characteristics (e.g. concominant eczema, genetic polymorphisms, country of birth). Most studies have not fully examined the myriad effects of sunlight but have instead focused on a single maternal, neonatal or childhood 25OHD level. Many studies have linked sunlight with the development of food allergy but whether this is directly related to vitamin D status or a myriad of other sunlight-derived, seasonal and/or geographic factors remains uncertain. More studies are needed to investigate the role of sunlight and vitamin D status in food allergy because of their potential for primary prevention and disease modification.

  15. Preventing Food Allergies by Tricking Dendritic Cells

    USDA-ARS?s Scientific Manuscript database

    Food allergies are adverse responses to components (usually proteins) within the foods we eat, which result in a self-damaging response from our immune system. A myriad of cellular and molecular components are involved in the decision to tolerate or respond to foreign molecules that pass through the...

  16. Diagnosing and managing food allergy in children.

    PubMed

    Holloway, Edward; Fox, Adam; Fitzsimons, Roisin

    2011-06-01

    The prevalence of food allergy in children in the UK is now around 5%. The number of children put on restricted diets by their parents because of presumed allergy is likely to be much higher. Accurate diagnosis of food allergy is essential in order to ensure that the correct foods are carefully avoided while safe foods are not excluded unnecessarily. IgE-mediated (immediate type) reactions are the result of mast cell degranulation leading to histamine release. The typical signs of lip swelling, urticaria and possible progression to respiratory compromise (anaphylaxis) are usually clearly described, occurring within minutes of exposure to the food. Non IgE-mediated (delayed type) responses tend to start 2-6 hours, occasionally longer, after exposure and cause less specific signs/symptoms, less obviously allergic in origin. Where an immediate type allergic reaction is suspected on clinical history, allergy testing should be performed to confirm the diagnosis. This could involve either skin prick testing or specific IgE blood tests. Results must be interpreted in the context of the clinical history. The mainstay of management is allergen avoidance. The child and carers also need to know how to recognise and treat any future allergic reactions. There should be a written emergency plan in place. The plan should include advice to take a fast-acting antihistamine if any accidental exposure and reactions occur. Where there is a history of anaphylactic reaction or ongoing asthma, adrenaline auto-injectors should be prescribed as these are the major risk factors for future severe reactions. Non IgE-mediated food allergy is most common in early infancy. The diagnosis of non IgE-mediated food allergy relies on a two-stage process: strict exclusion of suspected allergen(s), only one at a time; re-challenge with suspected allergen(s), one at a time, to see if symptoms recur.

  17. Immunotherapy in food allergy: towards new strategies.

    PubMed

    Sato, Sakura; Yanagida, Noriyuki; Ogura, Kiyotake; Asaumi, Tomoyuki; Okada, Yu; Koike, Yumi; Iikura, Katsuhito; Syukuya, Akinori; Ebisawa, Motohiro

    2014-09-01

    Allergen avoidance is the standard treatment for managing food allergies. Complete avoidance is difficult, and accidental exposure often occurs. Immunotherapy is a significant focus for treating food allergies, and oral immunotherapy (OIT) appears to be particularly effective in inducing desensitization. The majority of patients who receive OIT show increased threshold doses of their food allergen. The efficacy of OIT is different among food antigen, and milk OIT is relatively difficult to achieve tolerance. OIT may induce mild to moderate symptoms during the therapy, widespread acceptance of OIT for long-term therapy is unclear. Recently, novel immunotherapies for food allergies, such as sublingual immunotherapy (SLIT), and epicutaneous immunotherapy (EPIT) and using an anti-IgE monoclonal antibody (omalizumab), have been assessed. In addition, a combination of OIT with omalizumab, which was found to increase the threshold doses of the offending foods without producing adverse reactions, may be effective and useful in the treatment of food allergies. These treatments have been used only in research settings; further studies in large numbers of patients are needed to demonstrate their long-term safety and benefits in clinical practice.

  18. EAACI food allergy and anaphylaxis guidelines: diagnosis and management of food allergy.

    PubMed

    Muraro, A; Werfel, T; Hoffmann-Sommergruber, K; Roberts, G; Beyer, K; Bindslev-Jensen, C; Cardona, V; Dubois, A; duToit, G; Eigenmann, P; Fernandez Rivas, M; Halken, S; Hickstein, L; Høst, A; Knol, E; Lack, G; Marchisotto, M J; Niggemann, B; Nwaru, B I; Papadopoulos, N G; Poulsen, L K; Santos, A F; Skypala, I; Schoepfer, A; Van Ree, R; Venter, C; Worm, M; Vlieg-Boerstra, B; Panesar, S; de Silva, D; Soares-Weiser, K; Sheikh, A; Ballmer-Weber, B K; Nilsson, C; de Jong, N W; Akdis, C A

    2014-08-01

    Food allergy can result in considerable morbidity, impact negatively on quality of life, and prove costly in terms of medical care. These guidelines have been prepared by the European Academy of Allergy and Clinical Immunology's (EAACI) Guidelines for Food Allergy and Anaphylaxis Group, building on previous EAACI position papers on adverse reaction to foods and three recent systematic reviews on the epidemiology, diagnosis, and management of food allergy, and provide evidence-based recommendations for the diagnosis and management of food allergy. While the primary audience is allergists, this document is relevant for all other healthcare professionals, including primary care physicians, and pediatric and adult specialists, dieticians, pharmacists and paramedics. Our current understanding of the manifestations of food allergy, the role of diagnostic tests, and the effective management of patients of all ages with food allergy is presented. The acute management of non-life-threatening reactions is covered in these guidelines, but for guidance on the emergency management of anaphylaxis, readers are referred to the related EAACI Anaphylaxis Guidelines. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Special considerations for managing food allergies.

    PubMed

    Hays, Tiffani

    2012-01-01

    When caring for patients with severe, multiple food allergies, special considerations are necessary for achieving the best quality of care. The most important consideration is to confirm all food allergies so that the patient does not unnecessarily restrict foods. Retest or challenge any foods with a questionable diagnosis. Second, because strict allergen avoidance remains the appropriate treatment for food allergy, provide the patient and family with adequate education about allergen avoidance and include plans for reintroduction of foods during follow-up care. Following a strict allergen avoidance diet often places the patient at nutrition risk. Another consideration includes conducting a complete nutrition assessment and monitoring for nutrient deficiencies on an ongoing basis. Food substitutions and hypoallergenic formulas and supplements are often required to meet the patient's needs. Last, consider evaluating medication ingredients as causes of persistent symptoms in extremely sensitive food allergic patients. Including the above considerations will result in food allergic patients enjoying the safest variety of foods and reaching their full growth potential.

  20. Prevalence of celiac disease in patients with severe food allergy.

    PubMed

    Pillon, R; Ziberna, F; Badina, L; Ventura, A; Longo, G; Quaglia, S; De Leo, L; Vatta, S; Martelossi, S; Patano, G; Not, T; Berti, I

    2015-10-01

    The association between food allergy and celiac disease (CD) is still to be clarified. We screened for CD 319 patients with severe food allergy (IgE > 85 kU/l against food proteins and a history of severe allergic reactions) who underwent specific food oral immunotherapy (OIT), together with 128 children with mild allergy who recovered without OIT, and compared the prevalence data with our historical data regarding healthy schoolchildren. Sixteen patients (5%) with severe allergy and one (0.8%) with mild allergy tested positive for both genetic and serological CD markers, while the prevalence among the schoolchildren was 1%. Intestinal biopsies were obtained in 13/16 patients with severe allergy and in the one with mild allergy, confirming the diagnosis of CD. Sufferers from severe food allergy seem to be at a fivefold increased risk of CD. Our findings suggest that routine screening for CD should be recommended in patients with severe food allergy.

  1. An update on immunotherapy for food allergy

    PubMed Central

    Scurlock, Amy M.; Jones, Stacie M.

    2013-01-01

    Purpose of the review Recent investigation has resulted in significant advances toward definitive therapeutic options for food allergy. In this review, we will explore novel immunotherapeutic interventions for the active treatment of food allergy. Recent findings Because the injection route for allergen immunotherapy to foods has been associated with an unacceptable risk of severe anaphylactic reactions, use of mucosally targeted therapeutic strategies is of significant interest for food allergy. Allergen-specific immunotherapeutic approaches such as oral, sublingual, epicutaneous, and peptide immunotherapy have demonstrated efficacy in increasing threshold dose and inducing immunologic changes associated with both desensitization and oral tolerance in animal and human trials. More global immunomodulatory strategies, such as Traditional Chinese Medicine and anti-IgE therapy have been shown to effectively target the allergic response, and clinical trials are ongoing to determine the efficacy and safety in human food allergy. Summary The advent of therapies that target the mucosal immune response to promote oral tolerance have shown great promise in the treatment of food hypersensitivity. However, there is still significant risk of adverse reactions associated with these therapeutic strategies and further study is needed to carefully advance these therapeutic modalities toward general clinical implementation. PMID:20856110

  2. Oral and sublingual immunotherapy for food allergy.

    PubMed

    Wang, Julie; Sampson, Hugh A

    2013-09-01

    Food allergies continue to be an increasingly common disorder, however, no treatment strategies are currently approved for the routine management of individuals with food allergies. Encouraging results from early open-label studies have sparked great interest in oral and sublingual immunotherapy, and thus several randomized controlled trials have recently been conducted to establish the safety and efficacy of these treatment strategies. The aim of this review is to examine the recent studies for peanut, milk and egg allergies. Open-label and randomized control trials are discussed. Studies focusing on peanut, milk and egg allergies are included. Current evidence indicates that desensitization is possible for the majority of subjects who undergo oral immunotherapy. Clinical improvement has been associated with favorable immunologic changes, including smaller skin prick test wheal sizes and increased allergen-specific IgG4 levels. Adverse reactions are common, however, and thus safety concerns remain. Sublingual immunotherapy thus far has not proven to be as effective as oral immune-therapy. Oral and sublingual immunotherapy are promising treatments for food allergy. Optimization and standardization of protocols, along with additional assessments of safety are still needed.

  3. Molecular and Cellular Mechanisms of Food Allergy and Food Tolerance

    PubMed Central

    Boyd, Scott D.; Galli, Stephen J.; Nadeau, Kari C.

    2016-01-01

    Ingestion of innocuous antigens, including food proteins, normally results in local and systemic immune nonresponsiveness in a process termed oral tolerance. Oral tolerance to food proteins is likely to be intimately linked to mechanisms that are responsible for gastrointestinal tolerance to large numbers of commensal microbes. Here, we review our current understanding of the immune mechanisms responsible for oral tolerance and how perturbations in these mechanisms may promote the loss of oral tolerance and development of food allergies. Roles for the commensal microbiome in promoting oral tolerance, and the association of intestinal dysbiosis with food allergy, are discussed. Growing evidence supports cutaneous sensitization to food antigens as one possible mechanism leading to the failure to develop or loss of oral tolerance. A goal of immunotherapy for food allergies is to induce sustained desensitization, or even true long-term oral tolerance, to food allergens through mechanisms that may in part overlap with those associated with the development of natural oral tolerance. PMID:27059726

  4. Co-factor-enhanced food allergy.

    PubMed

    Cardona, V; Luengo, O; Garriga, T; Labrador-Horrillo, M; Sala-Cunill, A; Izquierdo, A; Soto, L; Guilarte, M

    2012-10-01

    Alcohol, exercise or non-steroidal anti-inflamatory drugs (NSAID) are frequently mentioned as amplifiers of food allergic reactions but only individual cases or small series have been previously published. Descriptive study including 74 cases of suspected co-factor enhanced food allergy, assessed by skin-prick tests, specific IgE and oral challenges. Anaphylaxis accounted for 85.1% of reactions. In 99% of cases culprit food allergens were plant-derived, mainly vegetables and cereals. NSAID were involved in 58%, exercise in 52.7% and alcohol in 12.2%. Lipid transfer protein was the most frequently involved allergen. Co-factor enhanced food allergy should be considered when assessing food, alcohol, exercise and NSAID allergic reactions. © 2012 John Wiley & Sons A/S.

  5. [Food hyposensitization--new approach and treatment for food allergies].

    PubMed

    Mäkelä, Mika; Kulmala, Petri; Pelkonen, Anna; Remes, Sami; Kuitunen, Mikael

    2011-01-01

    Although most infants will recover from food allergy within the early years of life, at least one fifth will carry on with the disease until school age. Recent studies have managed to develop increased tolerance in children with food allergy by food hyposensitization with slowly increasing orally administered doses. In these studies either complete or partial increase of food tolerance for 80% of subjects has been achieved. The clinical results seem promising, and immunologic changes upon food hyposensitization look similar to those observed with other hyposensitization therapies.

  6. Perfluoroalkyl substances and food allergies in adolescents.

    PubMed

    Buser, Melanie C; Scinicariello, Franco

    2016-03-01

    Perfluoroalkyl and polyfluoroalkyl substances (PFASs) are a class of organic compounds that are persistent in the environment due to their stable carbon-fluorine backbone, which is not susceptible to degradation. Research suggests these chemicals may exert an immunotoxic effect. The aim of this study is to investigate the associations between four PFASs - perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), and perfluorohexane sulfonic acid (PFHxS) - with food sensitization and food allergies in adolescent participants (ages 12-19years) in the National Health and Nutrition Examination Survey (NHANES) 2005-2006 and 2007-2010, respectively. We performed multivariate logistic regression to analyze the association between individual PFASs with food sensitization (defined as having at least 1 food-specific IgE level≥0.35kU/L) in NHANES 2005-2006 and food allergies (self-reported) in NHANES 2007-2010. Serum PFOA, PFOS, and PFHxS were statistically significantly associated with higher odds to have self-reported food allergies in NHANES 2007-2010. When using IgE levels as a marker of food sensitization, we found that serum PFNA was inversely associated with food sensitization (NHANES 2005-2006). In conclusion, we found that serum levels of PFASs were associated with higher odds to have self-reported food allergies. Conversely, adolescents with higher serum PFNA were less likely to be sensitized to food allergens. These results, along with previous studies, warrant further investigation, such as well-designed longitudinal studies.

  7. Food Allergies: Being Aware and Planning for Care

    ERIC Educational Resources Information Center

    Graville, Iris

    2010-01-01

    In recent years, parents and early childhood educators have become increasingly aware of food allergies in childhood. And since food allergies account for about 150 deaths a year, there is good reason to be concerned. The early childhood program can provide valuable learning for those without food allergies through explanations about why certain…

  8. Food Allergies: Being Aware and Planning for Care

    ERIC Educational Resources Information Center

    Graville, Iris

    2010-01-01

    In recent years, parents and early childhood educators have become increasingly aware of food allergies in childhood. And since food allergies account for about 150 deaths a year, there is good reason to be concerned. The early childhood program can provide valuable learning for those without food allergies through explanations about why certain…

  9. What Principals Should Know About Food Allergies.

    ERIC Educational Resources Information Center

    Munoz-Furlong, Anne

    2002-01-01

    Describes what principals should know about recent research findings on food allergies (peanuts, tree nuts, milk, eggs, soy, wheat) that can produce severe or life-threatening reactions in children. Asserts that every school should have trained staff and written procedures for reacting quickly to allergic reactions. (PKP)

  10. What Principals Should Know About Food Allergies.

    ERIC Educational Resources Information Center

    Munoz-Furlong, Anne

    2002-01-01

    Describes what principals should know about recent research findings on food allergies (peanuts, tree nuts, milk, eggs, soy, wheat) that can produce severe or life-threatening reactions in children. Asserts that every school should have trained staff and written procedures for reacting quickly to allergic reactions. (PKP)

  11. Common methodologies in the evaluation of food allergy: pitfalls and prospects of food allergy prevalence studies.

    PubMed

    Shu, Shang-an; Chang, Christopher; Leung, Patrick S C

    2014-06-01

    Global and regional studies on the prevalence of food allergies are plagued by inconsistent methodologies, variations in interpretation of results, and non-standardized study design. Hence, it becomes difficult to compare the prevalence of food allergies in different communities. This information would be useful in providing critical data that will enhance research to elucidate the nature of food allergies, and the role of gene-environment interactions in the sensitization of children and adults to foods. Testing methodologies range from questionnaires to objective in vitro and in vivo testing, to the gold standard, double-blind placebo-controlled food challenge (DBPCFC). Although considered the most accurate and reliable method in detecting the prevalence of food allergy, DBPCFC is not always practical in epidemiological studies of food allergy. On the other hand, multiple logistic regression studies have been done to determine predictability of the outcome of food challenges, and it appears that skin prick testing and in vitro-specific serum IgE are the best predictors. Future studies directed towards confirming the validity of these methods as well as developing algorithms to predict the food challenge outcomes are required, as they may someday become accessory tools to complement DBPCFC.

  12. Platanus acerifolia pollinosis and food allergy.

    PubMed

    Enrique, E; Cisteró-Bahíma, A; Bartolomé, B; Alonso, R; San Miguel-Moncín, M M; Bartra, J; Martínez, A

    2002-04-01

    In Mediterranean areas, oral allergy syndrome (OAS) occurs independently of an associated birch pollinosis; moreover, on occasions it presents with no other associated pollinosis. The aim of this study was to assess the possible association of OAS with Platanus acerifolia pollinosis. We evaluated consecutive patients seen for pollinosis in an allergy department. Seven hundred and twenty patients were selected on the basis of seasonal or perennial rhinitis, or asthma, or both. Respiratory and food allergies were studied in all patients. Clinical history was recorded and examinations and skin prick tests were performed with a battery of available common inhalant allergens and plant-derived food allergens. Specific IgE levels to P. acerifolia pollen extract and food allergens tested were measured. Molecular masses of the IgE-binding proteins and cross-reactivity among the P. acerifolia pollen and different food extracts were also determined. Of the 720 patients evaluated, 61 (8.48%) were sensitized to P. acerifolia pollen. Food allergy was observed in 32 (52.45%) of the 61 patients sensitized to P. acerifolia pollen. Food allergens most frequently implicated were hazelnuts, peach, apple, peanuts, maize, chickpea and lettuce. Enzyme allergosorbent (EAST)-inhibition showed high inhibition values when P. acerifolia pollen extract was used as free phase. On the contrary low inhibition was observed when plant-derived food allergens were used as free phase and P. acerifolia pollen extract as solid phase. Cross-reactivity was observed among P. acerifolia pollen and plant-derived foods. OAS in these patients may have been caused by primary respiratory sensitization.

  13. The Prevalence and Natural History of Food Allergy.

    PubMed

    Kattan, Jacob

    2016-07-01

    Numerous studies have demonstrated that the prevalence of food allergy is increasing. Not only are more children being diagnosed with food allergies, but studies suggest that when people outgrow their food allergies, it is taking longer than was previously thought. Studies in recent years have noted factors that may lead to a lower likelihood of developing a food allergy, including the early introduction of common food allergens, having a sufficient vitamin D level, or having a higher maternal intake of peanut early in pregnancy. Given a recent report that sensitization to common food allergens did not increase from the late 1980s/early 1990s to the mid-2000s, further studies will need to examine if the rise in food allergy prevalence is due to a change in the relationship between sensitization and clinical allergy or changes in the recognition and diagnosis of food allergy.

  14. [Diagnostics and management of food allergies in childhood and adolescence].

    PubMed

    Szépfalusi, Zsolt; Spiesz, Karin; Huttegger, Isidor

    2015-09-01

    Food allergies can result in life-threatening reactions and diminish quality of life. The prevalence of food allergies is increasing with large regional variability. A few food allergens cover the majority of food-related reactions (cow`s milk, egg, wheat, soy, fish, crustacean, nuts and peanut). Food reactions can be categorized in IgE-mediated and non-IgE-mediated, the latter of which remaining often a clue in the diagnosis. Treatment of food allergy involves mainly strict avoidance of the trigger food. Medications help to manage symptoms of disease, but currently, there is no cure for food allergy.

  15. Food allergy: opportunities and challenges in the clinical practice of allergy and immunology.

    PubMed

    James, John M

    2004-10-01

    Food allergy offers numerous opportunities and challenges for the allergy and clinical immunology specialist. Physicians with board certification in allergy and clinical immunology should be the main source of reliable clinical information to educate patients with food-related disorders. There has been a wealth of reliable information published related to food allergy that can be utilized by health care providers in clinical practice. This includes information about the cross-reactivity of food allergens, the evaluation of potential new therapies, and the practical application of new diagnostic methods and management strategies. This article addresses some of the new developments in food allergy, with an emphasis on cross-reactvity of food allergens, recombinant food allergens, and potential future therapies for food allergy.

  16. Towards a Cure for Food Allergy

    PubMed Central

    Skripak, Justin M.; Sampson, Hugh A.

    2008-01-01

    Summary of recent advances Over the past two decades, food allergies have become both more prevalent and long-lasting. This burgeoning problem has not been met with any therapeutic options to date, and patients must attempt to avoid known allergenic foods and treat any allergic reactions with “as-needed” medications. There are a number of promising emerging therapeutic modalities for food allergy, including allergen-specific and allergen non-specific immunotherapeutic approaches. Although the allergen-specific approaches have some distinct differences, they all attempt to induce tolerance by exposing the patient to an allergen via the mucosal route (oral tolerance induction). Allergen non-specific approaches include biologics to suppress free total IgE levels (e.g. anti-IgE antibody) or to induce more general immune suppression (Chinese Herbal medication). PMID:18848884

  17. EAACI food allergy and anaphylaxis guidelines. Primary prevention of food allergy.

    PubMed

    Muraro, A; Halken, S; Arshad, S H; Beyer, K; Dubois, A E J; Du Toit, G; Eigenmann, P A; Grimshaw, K E C; Hoest, A; Lack, G; O'Mahony, L; Papadopoulos, N G; Panesar, S; Prescott, S; Roberts, G; de Silva, D; Venter, C; Verhasselt, V; Akdis, A C; Sheikh, A

    2014-05-01

    Food allergy can have significant effects on morbidity and quality of life and can be costly in terms of medical visits and treatments. There is therefore considerable interest in generating efficient approaches that may reduce the risk of developing food allergy. This guideline has been prepared by the European Academy of Allergy and Clinical Immunology's (EAACI) Taskforce on Prevention and is part of the EAACI Guidelines for Food Allergy and Anaphylaxis. It aims to provide evidence-based recommendations for primary prevention of food allergy. A wide range of antenatal, perinatal, neonatal, and childhood strategies were identified and their effectiveness assessed and synthesized in a systematic review. Based on this evidence, families can be provided with evidence-based advice about preventing food allergy, particularly for infants at high risk for development of allergic disease. The advice for all mothers includes a normal diet without restrictions during pregnancy and lactation. For all infants, exclusive breastfeeding is recommended for at least first 4-6 months of life. If breastfeeding is insufficient or not possible, infants at high-risk can be recommended a hypoallergenic formula with a documented preventive effect for the first 4 months. There is no need to avoid introducing complementary foods beyond 4 months, and currently, the evidence does not justify recommendations about either withholding or encouraging exposure to potentially allergenic foods after 4 months once weaning has commenced, irrespective of atopic heredity. There is no evidence to support the use of prebiotics or probiotics for food allergy prevention.

  18. Reducing food allergy: is there promise for food applications?

    PubMed

    Chung, Si-Yin; Reed, Shawndrika

    2014-01-01

    Food allergy is on the rise and has become a growing food safety concern. The main treatment is strictly avoiding allergens in the diet. However, this is difficult to do because foods are sometimes contaminated with allergens due to processing of different foods with the same machinery. For this reason, accidental ingestion of trace amount of allergenic proteins is common. For children with severe food allergy, this could be life-threatening. Food products with reduced allergenic proteins, if developed, could be beneficial and may raise the threshold of the amount of allergenic proteins required to trigger an allergic reaction. As a result, the number of serious allergic reactions may decrease. Moreover, such less allergenic products may be useful or replace regular products in studies such as oral tolerance induction or early exposure experiments, where children with severe peanut allergy are usually excluded due to their severe intolerance. This review focuses on recent findings and progress made in approaches to reduce allergenic proteins in foods. Modifying methods may include physical and chemical treatments as well as lifestyle changes and the use of supplements. We discuss the benefits and drawbacks these methods present for production of hypoallergenic food products and food allergy prevention.

  19. Food allergy: Epidemiology, pathogenesis, diagnosis, and treatment.

    PubMed

    Sicherer, Scott H; Sampson, Hugh A

    2014-02-01

    This review focuses on advances and updates in the epidemiology, pathogenesis, diagnosis, and treatment of food allergy over the past 3 years since our last comprehensive review. On the basis of numerous studies, food allergy likely affects nearly 5% of adults and 8% of children, with growing evidence of an increase in prevalence. Potentially rectifiable risk factors include vitamin D insufficiency, unhealthful dietary fat, obesity, increased hygiene, and the timing of exposure to foods, but genetics and other lifestyle issues play a role as well. Interesting clinical insights into pathogenesis include discoveries regarding gene-environment interactions and an increasing understanding of the role of nonoral sensitizing exposures causing food allergy, such as delayed allergic reactions to carbohydrate moieties in mammalian meats caused by sensitization from homologous substances transferred during tick bites. Component-resolved diagnosis is being rapidly incorporated into clinical use, and sophisticated diagnostic tests that indicate severity and prognosis are on the horizon. Current management relies heavily on avoidance and emergency preparedness, and recent studies, guidelines, and resources provide insight into improving the safety and well-being of patients and their families. Incorporation of extensively heated (heat-denatured) forms of milk and egg into the diets of children who tolerate these foods, rather than strict avoidance, represents a significant shift in clinical approach. Recommendations about the prevention of food allergy and atopic disease through diet have changed radically, with rescinding of many recommendations about extensive and prolonged allergen avoidance. Numerous therapies have reached clinical trials, with some showing promise to dramatically alter treatment. Ongoing studies will elucidate improved prevention, diagnosis, and treatment.

  20. Genetically modified foods and allergy.

    PubMed

    Lee, T H; Ho, H K; Leung, T F

    2017-06-01

    2015 marked the 25th anniversary of the commercial use and availability of genetically modified crops. The area of planted biotech crops cultivated globally occupies a cumulative two billion hectares, equivalent to twice the land size of China or the United States. Foods derived from genetically modified plants are widely consumed in many countries and genetically modified soybean protein is extensively used in processed foods throughout the industrialised countries. Genetically modified food technology offers a possible solution to meet current and future challenges in food and medicine. Yet there is a strong undercurrent of anxiety that genetically modified foods are unsafe for human consumption, sometimes fuelled by criticisms based on little or no firm evidence. This has resulted in some countries turning away food destined for famine relief because of the perceived health risks of genetically modified foods. The major concerns include their possible allergenicity and toxicity despite the vigorous testing of genetically modified foods prior to marketing approval. It is imperative that scientists engage the public in a constructive evidence-based dialogue to address these concerns. At the same time, improved validated ways to test the safety of new foods should be developed. A post-launch strategy should be established routinely to allay concerns. Mandatory labelling of genetically modified ingredients should be adopted for the sake of transparency. Such ingredient listing and information facilitate tracing and recall if required.

  1. Early feeding practices and development of food allergies.

    PubMed

    Lack, Gideon; Penagos, Martin

    2011-01-01

    Despite increasing efforts to prevent food allergies in children, IgE-mediated food allergies continue to rise in westernized countries. Previous preventive strategies such as prolonged exclusive breastfeeding and delayed weaning onto solid foods have more recently been called into question. The present review discusses possible risk factors and theories for the development of food allergy. An alternative hypothesis is proposed, suggesting that early cutaneous exposure to food protein through a disrupted skin barrier leads to allergic sensitization and that early oral exposure of food allergen induces tolerance. Novel interventional strategies to prevent the development of food allergies are also discussed.

  2. Allergen avoidance approaches in food allergy management.

    PubMed

    Koletzko, Sibylle; Koletzko, Berthold

    2009-01-01

    Dietary elimination of causative food ingredients, usually food proteins, is the basis of treating food hypersensitivity. Proper diagnostic assessment is essential to avoid burdening children with unnecessary dietary restrictions with potential adverse effects. Diagnosis requires a detailed history, allergen elimination, and re-challenge with suspected foods. Complete elimination of causative food components depends on professional counseling and training of the patient and family, and transparent labeling of food products. Elimination diets carry the risk of inducing insufficient supplies of critical nutrients with adverse effects on health and wellbeing, particularly in children with exclusion of foods that provide a major part of dietary supply and patients with multiple food allergies. Infants and young children with cow's milk allergy, who have not been fully breastfed, require milk substitutes based on extensively hydrolyzed protein or amino acids. Elimination diets must be supervised and monitored to a similar degree as drug treatments, and the need for continued dietary elimination should be reviewed on a regular basis and re-challenges considered.

  3. Sublingual vs Oral Immunotherapy for Food Allergy

    PubMed Central

    Narisety, Satya D.; Keet, Corinne A.

    2013-01-01

    The incidence of food allergy in developed countries has increased in recent years, escalating the need to find a suitable form of treatment as an alternative to current management, which includes strict avoidance and ready availability of injectable epinephrine (adrenaline). Allergen immunotherapy is currently being studied for use in the treatment of IgE-mediated food allergy to the most common foods, including peanut, tree nut, milk and egg. Two modalities, oral immunotherapy (OIT) and sublingual immunotherapy (SLIT), have shown great promise. Both OIT and SLIT have been able to desensitize subjects to varying degrees, but the two treatment methods differ in doses that can be achieved, duration of treatment, safety profile and ease of use outside the research setting, among other aspects. More research is needed to conclude which mode of treatment is more effective in inducing long-term tolerance with the least amount of serious adverse reactions. However, OIT and SLIT show great promise, and a widespread treatment for food allergy may be within reach. PMID:23009174

  4. The future of food allergy therapeutics.

    PubMed

    Henson, Michele; Burks, A Wesley

    2012-09-01

    Food allergy is increasing in prevalence in westernized countries, leading to significant morbidity including nutritional deficiencies and growth delay as well as psychosocial burdens and the potential for fatal anaphylaxis. There is currently no effective form of therapy, and the mainstay of treatment remains strict avoidance. However, there are a number of promising therapeutic strategies currently being investigated for the treatment of food allergies. Allergen-specific approaches, such as various forms of immunotherapy, have been a major focus of investigation and appear to be promising methods of desensitization. More recently, the addition of anti-IgE monoclonal antibodies (mAbs) to immunotherapy regimens has been studied. Early work with antigen-fixed leukocytes in a murine model has shown promise in inducing tolerance, as have vaccines containing modified recombinant food proteins coadministered with heat-killed Escherichia coli. Nonspecific approaches include a Chinese herbal formulation, anti-IgE mAbs, and Trichuris suis ova therapy. The array of treatment modalities currently being investigated increases the likelihood of finding one or more effective therapies for the treatment of food allergy.

  5. The future of food allergy therapeutics

    PubMed Central

    Henson, Michele; Burks, A. Wesley

    2012-01-01

    Food allergy is increasing in prevalence in westernized countries, leading to significant morbidity including nutritional deficiencies and growth delay as well as psychosocial burdens and the potential for fatal anaphylaxis. There is currently no effective form of therapy, and the mainstay of treatment remains strict avoidance. However, there are a number of promising therapeutic strategies currently being investigated for the treatment of food allergies. Allergen-specific approaches, such as various forms of immunotherapy, have been a major focus of investigation and appear to be promising methods of desensitization. More recently, the addition of anti-IgE monoclonal antibodies (mAbs) to immunotherapy regimens has been studied. Early work with antigen-fixed leukocytes in a murine model has shown promise in inducing tolerance, as have vaccines containing modified recombinant food proteins coadministered with heat-killed Escherichia coli. Nonspecific approaches include a Chinese herbal formulation, anti-IgE mAbs, and Trichuris suis ova therapy. The array of treatment modalities currently being investigated increases the likelihood of finding one or more effective therapies for the treatment of food allergy. PMID:22735939

  6. Food Allergies: Novel Mechanisms and Therapeutic Perspectives.

    PubMed

    Di Costanzo, Margherita; Paparo, Lorella; Cosenza, Linda; Di Scala, Carmen; Nocerino, Rita; Aitoro, Rosita; Canani, Roberto Berni

    2016-01-01

    Childhood food allergy (FA) rates have rapidly increased with significant direct medical costs for the health care system and even larger costs for the families with a food-allergic child. The possible causes of food allergy become the target of intense scrutiny in recent years. Increasing evidence underline the importance in early life of gut microbiome in the development of allergic diseases. There are a range of factors in the modern environment that may be associated with changes to both the gut microbiome and risk of FA, such as mode of delivery, antibiotic exposure, infant feeding practices, farming environment, and country of origin. Knowledge of the relationship between early life gut microbiome and allergic diseases may facilitate development of novel preventive and treatment strategies. Based on our current knowledge, there are no currently available approved therapies for food allergy. More studies are needed to evaluate the safety and efficacy of allergen-specific and allergen-nonspecific approaches, as well as combination approaches.

  7. Childhood food allergies: current diagnosis, treatment, and management strategies.

    PubMed

    Gupta, Ruchi S; Dyer, Ashley A; Jain, Namrita; Greenhawt, Matthew J

    2013-05-01

    Food allergy is a growing public health concern in the United States that affects an estimated 8% of children. Food allergy is defined as an adverse health effect arising from a specific immune response that occurs reproducibly on exposure to a specific food. Nearly 40% of children with food allergy have a history of severe reactions that if not treated immediately with proper medication can lead to hospitalization or even death. The National Institute of Allergy and Infectious Diseases (NIAID) convened an expert panel in 2010 to develop guidelines outlining evidence-based practices in diagnosing and managing food allergy. The purpose of this review is to aid clinicians in translating the NIAID guidelines into primary care practice and includes the following content domains: (1) the definition and mechanism of childhood food allergy, (2) differences between food allergy and food intolerance, (3) the epidemiology of childhood food allergy in the United States, (4) best practices derived from the NIAID guidelines focused on primary care clinicians' management of childhood food allergy, (5) emerging food allergy treatments, and (6) future directions in food allergy research and practice. Articles focused on childhood food allergy were considered for inclusion in this review. Studies were restricted to the English language and to those published within the past 40 years. A cross-listed combination of the following words, phrases, and MeSH terms was searched in PubMed and Google Scholar to identify relevant articles: food allergy, food hypersensitivity, child, pediatric, prevalence, and epidemiology. Additional sources were identified through the bibliographies of the retrieved articles. Copyright © 2013 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  8. Atopic dermatitis and food allergy.

    PubMed

    Resano, A; Crespo, E; Fernández Benítez, M; Sanz, M L; Oehling, A

    1998-01-01

    In order to determine the importance of food sensitization in the etiopathogenesis of atopic dermatitis, we performed a study on 74 patients who fulfilled a previously suggested diagnosis criteria. Of these patients, 17.5% presented allergic rhinitis and 62.2% had associated bronchial asthma. We found that in 64.9% of the patients there was a food sensitization, with milk (36.5%), egg (35.1%) and fish (21.6%) being the most frequently involved. We also observed that 34% of the patients were sensitized to Dermatophagoides pteronyssinus and 24.3% to pollen. These sensitizations were confirmed by means of skin tests, specific IgE and antigen-specific histamine release test. The patients underwent a 3-year follow-up in order to find out the clinical evolution once the causal food was avoided and/or a symptomatic treatment was prescribed. The group of patients with no food sensitization was significantly different from the group with food sensitization: in the first group only 20% of the patients presented a very good clinical evolution (asymptomatic), while in the second group, in 71.4% of the patients the symptoms completely stopped. Nevertheless, in the first year follow-up, we found no significant differences between the two groups. In conclusion, a diet avoiding the causal food combined with a suitable symptomatic treatment, led to an important remission of the skin manifestations in children diagnosed with atopic dermatitis.

  9. Recent advancements in the therapeutics of food allergy.

    PubMed

    Kumar, Sandeep; Gupta, Kriti; Das, Mukul; Dwivedi, Premendra D

    2013-12-01

    Food allergy is a health complication induced by certain food in the susceptible individuals. Due to lack of permanent cure and the global prevalence, the preventive approach is highly required for food allergy. Recently published patents have shown significant improvements in the food allergy research. In this review, an attempt has been done to highlight the recently developed patents related to the detection of allergens in food mixture. Also, patents regarding treatment options like use of herbal therapy, antihistamines, pre-, pro and synbiotics, nanocarriers, hypoallergens and several immune molecules towards amelioration of food allergy have been reviewed in this article.

  10. Misdiagnosed food allergy resulting in severe malnutrition in an infant.

    PubMed

    Alvares, Michael; Kao, Leon; Mittal, Vineeta; Wuu, Alice; Clark, April; Bird, J Andrew

    2013-07-01

    As food allergies become increasingly prevalent and testing methods to identify "food allergy" increase in number, the importance of careful diagnosis has become even more critical. Misdiagnosis of food allergy and inappropriate use of unproven testing modalities may lead to a harmful food-elimination diet. This case is an example of an infant who was placed on an overly restrictive elimination diet at the recommendation of her health care providers, resulting in kwashiorkor and acquired acrodermatitis enteropathica.

  11. Food allergy in Asia: how does it compare?

    PubMed Central

    Lee, Alison Joanne; Thalayasingam, Meera

    2013-01-01

    Asia is a populous and diverse region and potentially an important source of information on food allergy. This review aims to summarize the current literature on food allergy from this region, comparing it with western populations. A PubMed search using strategies "Food allergy AND Asia", "Food anaphylaxis AND Asia", and "Food allergy AND each Asian country" was made. Overall, 53 articles, published between 2005 and 2012, mainly written in English were reviewed. The overall prevalence of food allergy in Asia is somewhat comparable to the West. However, the types of food allergy differ in order of relevance. Shellfish is the most common food allergen from Asia, in part due to the abundance of seafood in this region. It is unique as symptoms vary widely from oral symptoms to anaphylaxis for the same individual. Data suggest that house dust mite tropomysin may be a primary sensitizer. In contrast, peanut prevalence in Asia is extremely low compared to the West for reasons not yet understood. Among young children and infants, egg and cow's milk allergy are the two most common food allergies, with prevalence data comparable to western populations. Differences also exist within Asia. Wheat allergy, though uncommon in most Asian countries, is the most common cause of anaphylaxis in Japan and Korea, and is increasing in Thailand. Current food allergy data from Asia highlights important differences between East and West, and within the Asian region. Further work is needed to provide insight on the environmental risk factors accounting for these differences. PMID:23403837

  12. Current concepts: diagnosis and management of food allergy in children.

    PubMed

    Mims, James W

    2016-06-01

    Advances in the prevention and treatment of food allergy have been published in the last few years and are placed in context using a review format. Preventing food allergy has been studied for years with questions of whether avoidance or exposure was a better strategy. Recent research has suggested that peanut allergy can be substantially reduced in high-risk infants through intentional oral exposure. For children with food allergy, the primary treatment remains avoidance, but controlled trials have shown some success with oral immunotherapy and sublingual immunotherapy. Providers who see children with food allergies should be aware of the newer recommendations of preventing peanut allergy and the emerging therapies for children with immunoglobulin E-mediated food allergy.

  13. Food allergy: a practice parameter update-2014.

    PubMed

    Sampson, Hugh A; Aceves, Seema; Bock, S Allan; James, John; Jones, Stacie; Lang, David; Nadeau, Kari; Nowak-Wegrzyn, Anna; Oppenheimer, John; Perry, Tamara T; Randolph, Christopher; Sicherer, Scott H; Simon, Ronald A; Vickery, Brian P; Wood, Robert; Bernstein, David; Blessing-Moore, Joann; Khan, David; Lang, David; Nicklas, Richard; Oppenheimer, John; Portnoy, Jay; Randolph, Christopher; Schuller, Diane; Spector, Sheldon; Tilles, Stephen A; Wallace, Dana; Sampson, Hugh A; Aceves, Seema; Bock, S Allan; James, John; Jones, Stacie; Lang, David; Nadeau, Kari; Nowak-Wegrzyn, Anna; Oppenheimer, John; Perry, Tamara T; Randolph, Christopher; Sicherer, Scott H; Simon, Ronald A; Vickery, Brian P; Wood, Robert

    2014-11-01

    This parameter was developed by the Joint Task Force on Practice Parameters, representing the American Academy of Allergy, Asthma & Immunology (AAAAI); the American College of Allergy, Asthma & Immunology (ACAAI); and the Joint Council of Allergy, Asthma & Immunology (JCAAI). The AAAAI and the ACAAI have jointly accepted responsibility for establishing "Food Allergy: A practice parameter update-2014." This is a complete and comprehensive document at the current time. The medical environment is a changing one, and not all recommendations will be appropriate for all patients. Because this document incorporated the efforts of many participants, no single individual, including those who served on the Joint Task Force, is authorized to provide an official AAAAI or ACAAI interpretation of these practice parameters. Any request for information about or an interpretation of these practice parameters by the AAAAI or ACAAI should be directed to the Executive Offices of the AAAAI, ACAAI, and JCAAI. These parameters are not designed for use by pharmaceutical companies in drug promotion. Copyright © 2014. Published by Elsevier Inc.

  14. Living with food allergy: allergen avoidance.

    PubMed

    Kim, Jennifer S; Sicherer, Scott H

    2011-04-01

    The primary treatment of food allergy is to avoid the culprit foods. This is a complex undertaking that requires education about reading the labels of manufactured products, understanding how to avoid cross-contact with allergens during food preparation, and communicating effectively with persons who are providing allergen-safe meals including relatives and restaurant personnel. Successful avoidance also requires a knowledge of nuances such as appropriate cleaning practices, an understanding of the risks of ingestion compared to skin contact or inhalation, that exposure could occur through unanticipated means such as through sharing utensils or passionate kissing, and that food may be a component of substances that are not ingested such as cosmetics, bath products, vaccines and medications. The authors review the necessary tools of avoidance that physicians and medical practitioners can use to guide their patients through the complexities of food avoidance.

  15. Allergy to jackfruit: a novel example of Bet v 1-related food allergy.

    PubMed

    Bolhaar, S T H P; Ree, R; Bruijnzeel-Koomen, C A F M; Knulst, A C; Zuidmeer, L

    2004-11-01

    Jackfruit allergy has been reported just once. It is unknown whether this food allergy is caused by direct sensitization or cross-sensitization to pollen allergens. Establish whether jackfruit allergy is linked to birchpollen allergy. Two jackfruit allergic patients and five patients with birchpollen-related apple allergy were recruited. Sensitization to pollen and plant foods was assessed by skin prick test (SPT), radio-allergosorbent test (RAST) and immunoblot. RAST analysis was performed for Bet v 1 and Mal d 1. Cross-reactivity was evaluated by RAST and immunoblot-inhibition. Biological activity of immunoglobulin E (IgE) was measured by basophil histamine release. Allergy to jackfruit was evaluated by double-blind placebo-controlled food challenge (DBPCFC) or open challenge (OC). In both patients DBPCFC confirmed the reported jackfruit allergy. SPT was 41 and 27 mm2 and specific IgE to jackfruit was 5.9 and 0.8 IU/ml, respectively. Immunoblot analysis revealed IgE reactivity at Mr of approximately 17 kDa. The Bet v 1-related nature of this allergen in jackfruit was demonstrated by RAST and immunoblot inhibition. To assess whether jackfruit allergy might be common in patients with combined birchpollen-fruit allergy, five such patients underwent an OC with jackfruit. All five had OA-like symptoms. Jackfruit allergy can be added to the list of birchpollen-related food allergies. Increased consumption of this fruit will result in a rise in allergic reactions. Copyright 2004 Blackwell Munksgaard

  16. Genetically engineered foods: implications for food allergy.

    PubMed

    Taylor, Steve L; Hefle, Susan L

    2002-06-01

    The products of agricultural biotechnology, including such common foods as corn and soybeans, are already reaching the consumer marketplace. Consumer exposure to such foods is already fairly significant, particularly in the USA. Thus far, no reports exist regarding allergic reactions to the crops that have been approved for introduction into the food supply. These crops have been modified to only a minor extent by comparison with their traditional counterparts, and the level of expression of new and novel proteins is quite low. Thus, consumer exposure to these novel proteins is very low and unlikely to result in allergic sensitization. Nevertheless, foods produced through agricultural biotechnology must be assessed for safety, including their potential allergenicity, before they may be approved by worldwide regulatory agencies for entry into the food supply. However, the adequacy of the current approach to the assessment of the potential allergenicity of foods produced through agricultural biotechnology has been the subject of considerable scientific and regulatory debate.

  17. Management of the Patient with Multiple Food Allergies

    PubMed Central

    Wang, Julie

    2011-01-01

    Food allergies affect 6% of children and 3% to 4% of adults in the United States. Although several studies have examined the prevalence of food allergy, little information is available regarding the prevalence of multiple food allergies. Estimates of prevalence of people allergic to multiple foods is difficult to ascertain because those with allergy to one food may avoid additional foods for concerns related to cross-reactivity, positive tests, or prior reactions, or they may be reluctant to introduce foods known to be common allergens. Diagnosis relies on an accurate history and selective IgE testing. It is important to understand the limitations of the available tests and the role of cross-reactivity between allergens. Allergen avoidance and readily accessible emergency medications are the cornerstones of management. In addition, a multidisciplinary approach to management of individuals with multiple food allergies may be needed, as avoidance of several food groups can have nutritional, developmental, and psychosocial consequences. PMID:20431971

  18. A practical view of immunotherapy for food allergy

    PubMed Central

    2016-01-01

    Food allergy is common and sometimes life threatening for Korean children. The current standard treatment of allergen avoidance and self-injectable epinephrine does not change the natural course of food allergy. Recently, oral, sublingual, and epicutaneous immunotherapies have been studied for their effectiveness against food allergy. While various rates of desensitization (36% to 100%) and tolerance (28% to 75%) have been induced by immunotherapies for food allergy, no single established protocol has been shown to be both effective and safe. In some studies, immunologic changes after immunotherapy for food allergy have been revealed. Adverse reactions to these immunotherapies have usually been localized, but severe systemic reactions have been observed in some cases. Although immunotherapy cannot be recommended for routine practice yet, results from recent studies demonstrate that immunotherapies are promising for the treatment of food allergy. PMID:26958062

  19. Diet and nutritional status of children with food allergies.

    PubMed

    Flammarion, Sophie; Santos, Clarisse; Guimber, Dominique; Jouannic, Lyne; Thumerelle, Caroline; Gottrand, Frédéric; Deschildre, Antoine

    2011-03-01

    The aim of the present study was to assess the food intakes and nutritional status of children with food allergies following an elimination diet. We conducted a cross sectional study including 96 children (mean age 4.7 ± 2.5 years) with food allergies and 95 paired controls (mean age 4.7 ± 2.7 years) without food allergies. Nutritional status was assessed using measurements of weight and height and Z scores for weight-for-age, height-for-age and weight-for-height. Nutrient intakes assessment was based on a 3-day diet record. Children with food allergies had weight-for-age and height-for-age Z scores lower than controls (0.1 versus 0.6 and 0.2 versus 0.8 respectively). Children with 3 or more food allergies were smaller than those with 2 or less food allergies (p = 0.04). A total of 62 children with food allergies and 52 controls completed usable diet records. Energy, protein and calcium intakes were similar in the two groups. Children with food allergies were smaller for their age than controls even when they received similar nutrient intakes. Nutritional evaluation is essential for the follow up of children with food allergies.

  20. Food Allergy: State of the Science--Allergy, Asthma and Immunology Committee.

    PubMed

    Reisacher, William; Damask, Cecelia; Calhoun, Karen; Veling, Maria

    2011-11-01

    In the past several years, food allergies have taken center stage in the media and have become a topic of great concern for our patients and their families. Whether or not this is due to a rise in the prevalence of food allergies or just a heightened awareness, it is our responsibility as clinicians and scientists to critically analyze the current evidence available concerning the epidemiology, manifestations, diagnosis, and management of this disease. In 2010, the National Institute of Allergy and Infectious Diseases (NIAID) published guidelines concerning the diagnosis and management of food allergies. Since 2009, the Allergy, Asthma and Immunology Committee of the American Academy of Otolaryngology-Head and Neck Surgery has sponsored a miniseminar titled, "Food Allergy: State of the Science." This commentary focuses on the highlights from the 2010 meeting and provides some thoughts on what this latest publication means to otolaryngologists.

  1. Challenging adverse reactions in children with food allergies.

    PubMed

    Waring, Gillian; Levy, David

    2010-07-01

    The Department of Health (2006) has highlighted that food allergy is increasing in prevalence. In response, Tameside General Hospital in Greater Manchester has developed a dedicated children's allergy service. By using skin tests, followed by oral consumption of a particular food, the clinic is able to establish allergies and prevent future adverse reactions. This article summarises the findings of an audit of food challenges that were undertaken at the clinic.

  2. Food allergy diagnosis and therapy: where are we now?

    PubMed Central

    Syed, Aleena; Kohli, Arunima; Nadeau, Kari C

    2014-01-01

    Food allergy is a growing worldwide epidemic that adversely effects up to 10% of the population. Causes and risk factors remain unclear and diagnostic methods are imprecise. There is currently no accepted treatment for food allergy. Therefore, there is an imminent need for greater understanding of food allergies, revised diagnostics and development of safe, effective therapies. Oral immunotherapy provides a particularly promising avenue, but is still highly experimental and not ready for clinical use. PMID:23998729

  3. Quality of Life in Food Allergy Patients and Their Families.

    PubMed

    Walkner, Madeline; Warren, Christopher; Gupta, Ruchi S

    2015-12-01

    Pediatric food allergy is a growing health problem in the United States that has been found to adversely impact the quality of life of both affected children and their caregivers. This article provides a review of how food allergy affects the quality of life of patients and their families within the domains of school, social activities, relationships, and daily life. Efforts to improve food allergy-related quality of life among caregivers are also discussed.

  4. Induction of Food Allergy in Mice by Allergen Inhalation

    DTIC Science & Technology

    2014-10-01

    14. ABSTRACT The purpose of this project is to test the hypothesis that food allergy may develop in response to antigen inhalation. Studies in a...relative timing of antigen ingestion vs. antigen inhalation to lead to food allergy development. We are also testing whether exposure to aerosolized...antigen will reverse or exacerbate established food allergy to that antigen. Studies in year 1 of this project demonstrate that: 1) initial inhalation

  5. Mechanisms of Oral Tolerance Breakdown in Food Allergy

    DTIC Science & Technology

    2014-11-01

    1 AWARD NUMBER: W81XWH-11-1-0553 TITLE: Mechanisms of Oral Tolerance Breakdown in Food Allergy PRINCIPAL INVESTIGATOR: Dr. Talal...AND SUBTITLE Mechanisms of Oral Tolerance Breakdown in Food Allergy 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-11-1-0553 5c. PROGRAM ELEMENT...mast cell expansion perpetuates oral intolerance to allergen, and that their acute depletion enables tolerance induction in established food allergy

  6. Patterns of adaptation to children's food allergies.

    PubMed

    Fedele, D A; McQuaid, E L; Faino, A; Strand, M; Cohen, S; Robinson, J; Atkins, D; Hourihane, J O'B; Klinnert, M D

    2016-04-01

    Families with food allergy (FA) are at risk of reduced quality of life and elevated anxiety. A moderate level of anxiety may be beneficial to sustain vigilance for food avoidance; however, excessive anxiety may increase risk for burden and maladjustment. The current study presents a framework for understanding the patterns of adaptation to FA across families and to identify typologies of families that would benefit from intervention. Participants included 57 children, 6-12 years old with documented FA, and their mothers. Families were assessed using the Food Allergy Management and Adaptation Scale. Families also completed measures of quality of life, anxiety, FA management, and psychosocial impairment. A hierarchical cluster analysis revealed that 56 of the 57 families of food-allergic children were categorized into four groups that differed on their adequacy of family FA management, levels of anxiety, and balanced psychosocial functioning: balanced responders (n = 23; 41%), high responders (n = 25; 45%), and low responders (n = 3; 5%). The fourth group, anxious high responders (n = 5; 9%), was characterized by extremely high maternal FA anxiety scores and low scores for balanced integration of FA management and psychosocial functioning. Families in clusters differed across illness and psychosocial outcome variables. Families with FA were characterized by patterns of FA management, anxiety, and ability to integrate FA demands into daily life. Identified adaptation patterns correspond with clinical impressions and provide a framework for identifying families in need of intervention. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Treatments for food allergy: how close are we?

    PubMed

    Wang, Julie; Sampson, Hugh A

    2012-12-01

    Food allergy continues to be a challenging health problem, with prevalence continuing to increase and anaphylaxis still an unpredictable possibility. While improvements in diagnosis are more accurately identifying affected individuals, treatment options remain limited. The cornerstone of treatment relies on strict avoidance of the offending allergens and education regarding management of allergic reactions. Despite vigilance in avoidance, accidental ingestions and reactions continue to occur. With recent advances in the understanding of humoral and cellular immune responses in food allergy and mechanisms of tolerance, several therapeutic strategies for food allergies are currently being investigated with the hopes of providing a cure or long-term remission from food allergy.

  8. Breast Milk and Food Allergy: Connections and Current Recommendations.

    PubMed

    Hoyt, Alice E W; Medico, Tegan; Commins, Scott P

    2015-12-01

    Breast milk, a living source of nutrition for babies, complements a baby's immune system, supplementing undeveloped defenses with immune factors while creating the foundation for the innate and adaptive immune systems. Such immune development includes tolerance of the environment and, in the case of food allergy, a lack of tolerance. Recent research questions the previous opinion that breast milk is protective against food allergy. This article reviews the immature immune system, the immunology and nutrition of breast milk, the literature exploring breast milk and food allergy, and the current recommendations regarding breast milk and the prevention of food allergy.

  9. The stress of food allergy issues in daily life.

    PubMed

    Peniamina, Rana L; Mirosa, Miranda; Bremer, Philip; Conner, Tamlin S

    2016-06-01

    Food allergies are a growing health concern, but their implications for daily psychological functioning are unknown. This micro-longitudinal study investigated the daily frequency of food allergy issues and how this related to experiences of stress, mood and physical energy. One hundred and eight adults with physician-diagnosed food allergies completed an initial Internet survey followed by a 2-week Internet daily diary survey. The initial survey collected socio-demographic and food allergy information. The daily survey collected information about the participants' experiences of stress, mood, physical energy and food allergy issues during that day. Commonly experienced allergy issues included negative physical symptoms, higher food prices, anxiety about safety of food, trouble maintaining a healthy diet and anxiety/stress at social occasions. Furthermore, multilevel modelling analyses showed that stress and negative mood were significantly higher on days with more allergy issues. Older adults experienced lower positive mood and physical energy on days with more issues. This is the first study to incorporate near to real-time tracking to examine the frequency of food allergy issues and the implications for daily psychological functioning. Targeting the issues we identified could reduce stress in patients with food allergies and improve their overall quality of life.

  10. Molecular and cellular mechanisms of food allergy and food tolerance.

    PubMed

    Chinthrajah, R Sharon; Hernandez, Joseph D; Boyd, Scott D; Galli, Stephen J; Nadeau, Kari C

    2016-04-01

    Ingestion of innocuous antigens, including food proteins, normally results in local and systemic immune nonresponsiveness in a process termed oral tolerance. Oral tolerance to food proteins is likely to be intimately linked to mechanisms that are responsible for gastrointestinal tolerance to large numbers of commensal microbes. Here we review our current understanding of the immune mechanisms responsible for oral tolerance and how perturbations in these mechanisms might promote the loss of oral tolerance and development of food allergies. Roles for the commensal microbiome in promoting oral tolerance and the association of intestinal dysbiosis with food allergy are discussed. Growing evidence supports cutaneous sensitization to food antigens as one possible mechanism leading to the failure to develop or loss of oral tolerance. A goal of immunotherapy for food allergies is to induce sustained desensitization or even true long-term oral tolerance to food allergens through mechanisms that might in part overlap with those associated with the development of natural oral tolerance. Published by Elsevier Inc.

  11. Chinese Herbal Therapy for the Treatment of Food Allergy

    PubMed Central

    Li, Xiu-Min

    2014-01-01

    Traditional Chinese medicine (TCM) has been widely used in China to treat various diseases for thousands of years. Given its reputed effectiveness, low cost, and favorable safety profile, TCM is attracting great interest in Western societies as a source of therapy for an array of illnesses, including allergies and asthma. Although food allergy has not been described in the TCM literature, a novel treatment for food allergy, named the food allergy herbal formula-2 (FAHF-2), was developed using TCM principles. Using a well-characterized murine model of peanut allergy, FAHF-2 has been shown to be highly effective in providing long-term protection against peanut-induced anaphylaxis, with a high safety margin. Phase 1 human trials have demonstrated the safety of FAHF-2 in food allergic individuals. Currently, a phase 2 trial examining efficacy of FAHF-2 is on-going. Other TCMs also show a potential for treating food allergies in preclinical studies. PMID:22581122

  12. Novel foods to treat food allergy and gastrointestinal infection.

    PubMed

    Perr, Hilary A

    2006-03-01

    The gastrointestinal tract communicates directly with the external environment. Necessary nutrients must be absorbed and commensal bacteria tolerated, and foreign proteins, antigens, and pathogens must be simultaneously excluded or destroyed. Immaturity or disruption of the mucosal immune defenses increases vulnerability to food allergy, intolerance, and infectious disease. Diseases resulting from ingested foreign proteins and organisms are increasing and cause morbidity and mortality worldwide. There is no specific treatment for food allergy other than avoidance. Vaccination for infectious disease is limited by the cost and logistics of distribution and administration, particularly in developing countries. Novel strategies are being explored to modulate the gut mucosal immune system by altering protein expression in food. Crops are being developed to remove deleterious allergens to prevent immunogenic exposure while preserving nutritional quality. Local food plants that express protein fragments of pathogens might provide an effective means to stimulate gut mucosal immunity while increasing vaccine accessibility.

  13. EAACI food allergy and anaphylaxis guidelines: managing patients with food allergy in the community.

    PubMed

    Muraro, A; Agache, I; Clark, A; Sheikh, A; Roberts, G; Akdis, C A; Borrego, L M; Higgs, J; Hourihane, J O'B; Jorgensen, P; Mazon, A; Parmigiani, D; Said, M; Schnadt, S; van Os-Medendorp, H; Vlieg-Boerstra, B J; Wickman, M

    2014-08-01

    The European Academy of Allergy and Clinical Immunology (EAACI) Food Allergy and Anaphylaxis Guidelines, managing patients with food allergy (FA) in the community, intend to provide guidance to reduce the risk of accidental allergic reactions to foods in the community. This document is intended to meet the needs of early-childhood and school settings as well as providers of non-prepackaged food (e.g., restaurants, bakeries, takeaway, deli counters, and fast-food outlets) and targets the audience of individuals with FA, their families, patient organizations, the general public, policymakers, and allergists. Food allergy is the most common trigger of anaphylaxis in the community. Providing children and caregivers with comprehensive information on food allergen avoidance and prompt recognition and management of allergic reactions are of the utmost importance. Provision of adrenaline auto-injector devices and education on how and when to use these are essential components of a comprehensive management plan. Managing patients at risk of anaphylaxis raises many challenges, which are specific to the community. This includes the need to interact with third parties providing food (e.g., school teachers and restaurant staff) to avoid accidental exposure and to help individuals with FA to make safe and appropriate food choices. Education of individuals at risk and their families, their peers, school nurses and teachers as well as restaurant and other food retail staff can reduce the risk of severe/fatal reactions. Increased awareness among policymakers may improve decision-making on legislation at local and national level. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. Food allergy training event for restaurant staff; a pilot evaluation.

    PubMed

    Bailey, Samuel; Billmeier Kindratt, Tiffany; Smith, Helen; Reading, David

    2014-01-01

    A previous cross-sectional survey highlighted that restaurant staff in Brighton had gaps in their knowledge of food allergy, which could lead to the provision of unsafe meals to food-allergic customers. A food allergy training event was developed by a multi-disciplinary team (health service researcher, clinician, teacher and patient group representative) to equip restaurant staff with the knowledge and skills necessary to safely serve food-allergic customers. This evaluation summarises the training event's impact on participants' knowledge of food allergy and their satisfaction with the event. No attendee had previously attended any formal training on food allergy. The percentage of participants who answered all true-false questions correctly increased from 82% before the training event to 91% afterwards. The percentage of participants who were able to name at least three common allergens increased from 9% to 64%. Both quantitative and qualitative feedback was positive. Restaurant staff require a good understanding of food allergy to ensure that food-allergic customers are kept safe, and their restaurants operate within the law. This food allergy training event improved participants' absolute knowledge of food allergy, and attendees changed practice. Recommendations are made which could improve the impact and uptake of future food allergy training events.

  15. Food allergy training event for restaurant staff; a pilot evaluation

    PubMed Central

    2014-01-01

    A previous cross-sectional survey highlighted that restaurant staff in Brighton had gaps in their knowledge of food allergy, which could lead to the provision of unsafe meals to food-allergic customers. A food allergy training event was developed by a multi-disciplinary team (health service researcher, clinician, teacher and patient group representative) to equip restaurant staff with the knowledge and skills necessary to safely serve food-allergic customers. This evaluation summarises the training event’s impact on participants’ knowledge of food allergy and their satisfaction with the event. No attendee had previously attended any formal training on food allergy. The percentage of participants who answered all true-false questions correctly increased from 82% before the training event to 91% afterwards. The percentage of participants who were able to name at least three common allergens increased from 9% to 64%. Both quantitative and qualitative feedback was positive. Restaurant staff require a good understanding of food allergy to ensure that food-allergic customers are kept safe, and their restaurants operate within the law. This food allergy training event improved participants’ absolute knowledge of food allergy, and attendees changed practice. Recommendations are made which could improve the impact and uptake of future food allergy training events. PMID:25225607

  16. Food Allergy Educational Needs of Pediatric Dietitians: A Survey by the Consortium of Food Allergy Research

    ERIC Educational Resources Information Center

    Groetch, Marion E.; Christie, Lynn; Vargas, Perla A.; Jones, Stacie M.; Sicherer, Scott H.

    2010-01-01

    Objective: To determine pediatric dietitians' self-reported proficiency, educational needs, and preferences regarding food allergy (FA) management. Design and Setting: An Internet-based, anonymous survey was distributed to the Pediatric Nutrition Practice Group (PNPG) of the American Dietetic Association. Participants: Respondents (n = 311) were…

  17. Food Allergy Educational Needs of Pediatric Dietitians: A Survey by the Consortium of Food Allergy Research

    ERIC Educational Resources Information Center

    Groetch, Marion E.; Christie, Lynn; Vargas, Perla A.; Jones, Stacie M.; Sicherer, Scott H.

    2010-01-01

    Objective: To determine pediatric dietitians' self-reported proficiency, educational needs, and preferences regarding food allergy (FA) management. Design and Setting: An Internet-based, anonymous survey was distributed to the Pediatric Nutrition Practice Group (PNPG) of the American Dietetic Association. Participants: Respondents (n = 311) were…

  18. Update on Early Nutrition and Food Allergy in Children.

    PubMed

    Lee, Sun Eun; Kim, Hyeyoung

    2016-05-01

    With growing evidence of an increase in the prevalence, food allergy has been emerged as a new public health problem. As treatment and management of food allergy remain challenging, more attention has been paid to the importance of prevention of food allergy. Although the exact mechanism of recent epidemic is not fully understood, it is suggested that nutritional exposure in early life may play an important role in food allergy development. The underlying hypothesis is that nutritional status or food exposure in the critical period of fetal development can affect the programming of immune system and modify the risk of immunologic reactions to foods in postnatal life. We review accumulating epidemiological studies to examine an association between nutritional exposure during pregnancy or early infancy and food allergy development in children. We also discuss recent advances in the studies of the genetic and epigenetic regulation of food allergy and evaluate the role of early nutrition in food allergy development to provide a new perspective on the prevention of food allergy.

  19. Update on Early Nutrition and Food Allergy in Children

    PubMed Central

    Lee, Sun Eun

    2016-01-01

    With growing evidence of an increase in the prevalence, food allergy has been emerged as a new public health problem. As treatment and management of food allergy remain challenging, more attention has been paid to the importance of prevention of food allergy. Although the exact mechanism of recent epidemic is not fully understood, it is suggested that nutritional exposure in early life may play an important role in food allergy development. The underlying hypothesis is that nutritional status or food exposure in the critical period of fetal development can affect the programming of immune system and modify the risk of immunologic reactions to foods in postnatal life. We review accumulating epidemiological studies to examine an association between nutritional exposure during pregnancy or early infancy and food allergy development in children. We also discuss recent advances in the studies of the genetic and epigenetic regulation of food allergy and evaluate the role of early nutrition in food allergy development to provide a new perspective on the prevention of food allergy. PMID:26996550

  20. Food allergy animal models: an overview.

    PubMed

    Helm, Ricki M

    2002-05-01

    Specific food allergy is characterized by sensitization to innocuous food proteins with production of allergen-specific IgE that binds to receptors on basophils and mast cells. Upon recurrent exposure to the same allergen, an allergic response is induced by mediator release following cross-linking of cell-bound allergen-specific IgE. The determination of what makes an innocuous food protein an allergen in predisposed individuals is unknown; however, mechanistic and protein allergen predictive models are being actively investigated in a number of animal models. Currently, there is no animal model that will actively profile known food allergens, predict the allergic potential of novel food proteins, or demonstrate clinically the human food allergic sensitization/allergic response. Animal models under investigation include mice, rats, the guinea pig, atopic dog, and neonatal swine. These models are being assessed for production of IgE, clinical responses to re-exposure, and a ranking of food allergens (based on potency) including a nonfood allergen protein source. A selection of animal models actively being investigated that will contribute to our understanding of what makes a protein an allergen and future predictive models for assessing the allergenicity of novel proteins is presented in this review.

  1. Developing A Food Allergy Curriculum for Parents

    PubMed Central

    Vargas, Perla A.; Sicherer, Scott H.; Christie, Lynn; Keaveny, Maureen; Noone, Sally; Watkins, Debra; Carlisle, Suzanna K; Jones, Stacie M

    2014-01-01

    Food allergy (FA) is potentially severe and requires intensive education to master allergen avoidance and emergency care. There is evidence suggesting the need for a comprehensive curriculum for food allergic families. This paper describes the results of focus groups conducted to guide the development of a curriculum for parents of food allergic children. The focus groups were conducted using standard methodology with experienced parents of food allergic children. Participants were parents (n=36) with experience managing FA recruited from allergy clinics at two academic centers. Topics identified by parents as key for successful management included as expected: 1) early signs/symptoms, 2) “cross-contamination”, 3) label-reading, 4) self-injectable epinephrine; and 5) becoming a teacher and advocate. Participants also recommended developing a “one pageroad map” to the information, and to provide the information early and be timed according to developmental stages/needs. Suggested first points for curriculum dissemination were emergency rooms, obstetrician and pediatrician offices. Participants also recommended targeting pediatricians, emergency physicians, school personnel, and the community-at-large in educational efforts. Parents often sought FA information from non-medical sources such as the Internet and support groups. These resources were also accessed to find ways to cope with stress. Paradoxically, difficulties gaining access to resources and uncertainty regarding reliability of the information added to the stress experience. Based on reports from experienced parents of food allergic children, newly diagnosed parents could benefit from a comprehensive FA management curriculum. Improving access to clear and concise educational materials would likely reduce stress/anxiety and improve quality of life. PMID:21332804

  2. Food allergy in schools: The importance of government involvement.

    PubMed

    Lawlis, Tanya; Bakonyi, Sarah; Williams, Lauren T

    2017-02-01

    Children have the highest rates of food-related allergic reactions. While 85% of children outgrow allergies including cow's milk and eggs by five years of age, allergies to peanuts and seafood continue into adulthood. The school setting poses a high-risk environment for allergen exposure. The aim of the present study was to examine the availability, drivers and communication of school food allergy awareness and management policies/guidelines in one Australian education jurisdiction. A cross-sectional study comprising an online survey of principals on school allergy awareness (n = 100) was conducted in public, catholic and independent primary and high schools in an Australian education jurisdiction between August 2011 and November 2012. Sixty-three per cent (17/27) of schools responding to the survey reported using food allergy management guidelines. An average of 13 students per school were reported to have a food allergy with 93% of schools reported having students with at least one food allergy. Parents, not government policy, were identified as primary drivers of food allergy guideline implementation and a third of schools provided anaphylaxis training annually. Communication of food allergy management was limited with only 42 school websites either providing access to policies/guidelines or providing a food allergy statement. Detailed awareness and management guidelines are integral for schools to adequately manage food-induced allergic reactions, including anaphylaxis, in the school environment. To enable this, national government support through legislation and policy is needed to ensure a consistent, up-to-date and policed approach to food allergy management in the Australian education sector. © 2015 Dietitians Association of Australia.

  3. New perspectives for use of native and engineered recombinant food proteins in treatment of food allergy.

    PubMed

    Nowak-Wegrzyn, Anna

    2007-02-01

    Food allergy has emerged as an important target for research on curative treatment and prevention, with most efforts focusing on peanut, cow's milk, and egg allergy. This article reviews the recent developments in the potential treatments for IgE-mediated food allergy using native and engineered recombinant food proteins.

  4. Labial food challenge in children with food allergy.

    PubMed

    Rance, F; Dutau, G

    1997-02-01

    The current increase in the prevalence of food allergies appears to have several causes including better screening, improved diagnosis and changes in both the techniques used by food manufacturers and eating habits. Labial food challenge (LFC)is simple, rapid to perform and is associated with only low risks of systemic reaction. It is thus an appealing alternative to the oral food challenge (OFC) for pediatric use. We report a series of 202 LFC performed over two years in 142 children with food allergy suspected from the case history, positive skin prick tests and specific serum IgE assays: 156 LFC were positive; and 46 negative, followed by positive single-blind, placebo-controlled food challenges (SBPCFC). The foods provoking reactions were egg white (75 cases), peanut (60 cases), mustard (23 cases), cow's milk (13 cases), cod (8 cases), kiwi fruit, shrimp (4 cases each), chicken, peanut oil (3 cases each), hazel nuts (2 cases), and snails, apple, fennel, garlic, chilli peppers, pepper, and duck (1 case each). LFC positivity was mostly (89.7% of cases) manifested as a labial edema with contiguous urticaria. There were systemic reactions in 4.5% of cases: generalized urticaria, hoarseness and rapid-onset and generalized eczema. The 46 infants with negative LFC results had positive SBPCFC. The reactions were in 34 cases generalized urticaria, 10 cases asthma attacks, 2 cases early and generalized eczema, and in one case general anaphylactic shock. The sensitivity of the LFC was 77%. The LFC was easy to perform with children. Positive results indicate the presence of food allergy, but negative results require further investigations preferably double-blind, placebo-controlled food challenge (DBPCFC).

  5. Parental self-efficacy in managing food allergy and mental health predicts food allergy-related quality of life.

    PubMed

    Knibb, Rebecca C; Barnes, Christopher; Stalker, Carol

    2016-08-01

    Food allergy has been shown to have a significant impact on quality of life (QoL) and can be difficult to manage in order to avoid potentially life-threatening reactions. Parental self-efficacy (confidence) in managing food allergy for their child might explain variations in QoL. This study aimed to examine whether self-efficacy in parents of food allergic children was a good predictor of QoL of the family. Parents of children with clinically diagnosed food allergy completed the Food Allergy Self-Efficacy Scale for Parents (FASE-P), the Food Allergy Quality of Life Parental Burden Scale (FAQL-PB), the GHQ-12 (to measure mental health) and the Food Allergy Independent Measure (FAIM), which measures perceived likelihood of a severe allergic reaction. A total of 434 parents took part. Greater parental QoL was significantly related to greater self-efficacy for food allergy management, better mental health, lower perceived likelihood of a severe reaction, older age in parent and child and fewer number of allergies (all p < 0.05). Food allergy self-efficacy explained more of the variance in QoL than any other variable and self-efficacy related to management of social activities and precaution and prevention of an allergic reaction appeared to be the most important aspects. Parental self-efficacy in management of a child's food allergy is important and is associated with better parental QoL. It would be useful to measure self-efficacy at visits to allergy clinic in order to focus support; interventions to improve self-efficacy in parents of food allergic children should be explored. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. Food allergy: a practical update from the gastroenterological viewpoint.

    PubMed

    Ferreira, Cristina Targa; Seidman, Ernest

    2007-01-01

    To present an up-to-date and critical review regarding food allergies, focusing mainly on treatment and prevention. Review of published literature searched on MEDLINE database; those data which were the most up-to-date and representative were selected (2000-2006). The search included the European Society of Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and the American Academy of Pediatrics (AAP). The prevalence of allergic diseases has increased over the last decades, and food allergy seems to be part of this increase. Food allergy is much more common in pediatrics and has a significant medical, financial and social impact on young children and their families. Treatment and prevention of food allergy is a major challenge for public health, scientific and medical communities. There is a lot of misinformation and the medical management of this condition is still discussable. We present and discuss the guidelines regarding criteria for the prevention of food allergy and atopic diseases published by the Nutrition Committees of ESPGHAN jointly with the European Society for Pediatric Allergy and Clinical Immunology (ESPACI) and AAP. The overdiagnosis of food allergy is quite prevalent. There is a need for standardization of definitions and diagnostic procedures. The primary goal of therapy should be to first establish effective means of preventing food allergies. There is a need for accurate diagnostic methods to confirm or rule out the diagnosis. Patients need appropriate treatment by eliminating foods that cause symptoms, while avoiding the nutritional side effects and the cost of inappropriate diets.

  7. Deciphering the black box of food allergy mechanisms.

    PubMed

    Sampath, Vanitha; Tupa, Dana; Graham, Michelle Toft; Chatila, Talal A; Spergel, Jonathan M; Nadeau, Kari C

    2017-01-01

    To review our current understanding of immunotherapy, the immune mechanisms underlying food allergy, and the methodological advances that are furthering our understanding of the role of immune cells and other molecules in mediating food allergies. Literature searches were performed using the following combination of terms: allergy, immunotherapy, food, and mechanisms. Data from randomized clinical studies using state-of-the-art mechanistic tools were prioritized. Articles were selected based on their relevance to food allergy. Current standard of care for food allergies is avoidance of allergenic foods and the use of epinephrine in case of severe reaction during unintentional ingestion. During the last few decades, great strides have been made in understanding the cellular and molecular mechanisms underlying food allergy, and this information is spearheading the development of exciting new treatments. Immunotherapy protocols are effective in desensitizing individuals to specific allergens; however, recurrence of allergic sensitization is common after discontinuation of therapy. Interestingly, in a subset of individuals, immunotherapy is protective against allergens even after discontinuation of immunotherapy. Whether this protection is permanent is currently unknown because of inadequate long-term follow-up data. Research on understanding the underlying mechanisms may assist in modifying protocols to improve outcome and enable sustained unresponsiveness, rather than a temporary relief against food allergies. The cellular changes brought about by immunotherapy are still a black box, but major strides in our understanding are being made at an exciting pace. Copyright © 2016 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  8. Diagnosis, management, and investigational therapies for food allergies.

    PubMed

    Kulis, Mike; Wright, Benjamin L; Jones, Stacie M; Burks, A Wesley

    2015-05-01

    Food allergies have increased in prevalence over the past 20 years, now becoming an important public health concern. Although there are no therapies currently available for routine clinical care, recent reports have indicated that immunotherapies targeting the mucosal immune system may be effective. Oral immunotherapy is conducted by administering small, increasing amounts of food allergen; it has shown promise for desensitizing individuals with peanut, egg, or milk allergies. Sublingual immunotherapy also desensitizes allergic patients to foods-2 major studies have examined the effects of sublingual immunotherapy in subjects with peanut allergies. We review the complex nature of IgE-mediated food allergies and the therapies being evaluated in clinical trials. We focus on the diagnosis and management of food allergies and investigational therapies.

  9. American College of Allergy, Asthma & Immunology

    MedlinePlus

    ... Why Anaphylaxis Types of Allergies: Ragweed Allergy Pine Tree Allergy Hives (Urticaria) Food Allergy Types of Food ... Fish Allergy Eosinophilic Esophagitis Egg Allergy Corn Allergy Tree Nut Allergy Food Allergy Diagnosis Food Allergy Avoidance ...

  10. Food Allergy Education for School Nurses: A Needs Assessment Survey by the Consortium of Food Allergy Research

    ERIC Educational Resources Information Center

    Carlisle, Suzanna K.; Vargas, Perla A.; Noone, Sally; Steele, Pam; Sicherer, Scott H.; Burks, A. Wesley; Jones, Stacie M.

    2010-01-01

    Food allergy is increasing in school-age children. School nurses are a primary health care resource for children with food allergy and must be prepared to manage allergen avoidance and respond in the event of an allergic reaction. An anonymous survey was administered to school nurses attending their association meetings to determine their…

  11. Food Allergy Education for School Nurses: A Needs Assessment Survey by the Consortium of Food Allergy Research

    ERIC Educational Resources Information Center

    Carlisle, Suzanna K.; Vargas, Perla A.; Noone, Sally; Steele, Pam; Sicherer, Scott H.; Burks, A. Wesley; Jones, Stacie M.

    2010-01-01

    Food allergy is increasing in school-age children. School nurses are a primary health care resource for children with food allergy and must be prepared to manage allergen avoidance and respond in the event of an allergic reaction. An anonymous survey was administered to school nurses attending their association meetings to determine their…

  12. Diagnosis of food allergies: the impact of oral food challenge testing.

    PubMed

    Ito, Komei

    2013-01-01

    A diagnosis of food allergies should be made based on the observation of allergic symptoms following the intake of suspected foods and the presence of allergen-specific IgE antibodies. The oral food challenge (OFC) test is the most reliable clinical procedure for diagnosing food allergies. Specific IgE testing of allergen components as well as classical crude allergen extracts helps to make a more specific diagnosis of food allergies. The Japanese Society of Pediatric Allergy and Clinical Immunology issued the 'Japanese Pediatric Guideline for Food Allergy 2012' to provide information regarding the standardized diagnosis and management of food allergies. This review summarizes recent progress in the diagnosis of food allergies, focusing on the use of specific IgE tests and the OFC procedure in accordance with the Japanese guidelines.

  13. Did food allergy develop in the process of animal evolution?

    PubMed Central

    Nabavizadeh, Seyed Hesamedin; Nabavizadeh, Sara Sadat; Anushiravani, Amir

    2016-01-01

    Food allergy is pathophysiologic ally based on stimulation of the immune system at the first exposure, and allergic reactions develop during following exposures. Therefore, memory is the cornerstone of an allergy, as seen in the adaptive immune system. The adaptive immune system was first introduced during evolution in vertebrates, so we can say that invertebrates do not have allergic reactions. We can conclude that food allergy is a complication of animal evolution. Evolution also can cause diseases and complications; therefore, understanding it may help in allergy treatment. PMID:28163859

  14. Food allergy prevalence: new possibilities for therapy and prevention.

    PubMed

    Ma, Yan

    2012-12-01

    Food allergy is an important clinical problem of increasing prevalence worldwide. Immunoglobulin E (IgE)-mediated allergic responses are the most widely recognized form of food allergy. The prevalence of food allergy is influenced by country, age, culture, and dietary habits. Strategies for the prevention of food allergy have been extensively studied. There is currently no standard treatment for food allergy and allergen-specific immunotherapy has been hindered by severe side effects in the past. A mutated recombinant major apple allergen is clinically hypoallergenic, which paves the way toward safer immunotherapy for the treatment of food-allergic patients.Traditional Chinese medicine (TCM) is one of the oldest medical practices in the world. A Chinese Food Allergy Herbal Formula-2 (FAHF-2) has been used as a therapy for food allergy patients. FAHF-2 was shown to be remarkably effective against food anaphylaxis in an animal model and in human clinical trial with the potential to be a long-lasting therapy.

  15. Children’s Food Allergies: Development of the Food Allergy Management and Adaptation Scale

    PubMed Central

    McQuaid, Elizabeth L.; Fedele, David A.; Faino, Anna; Strand, Matthew; Robinson, Jane; Atkins, Dan; Fleischer, David M.; O’B. Hourihane, Jonathan; Cohen, Sophia; Fransen, Hannah

    2015-01-01

    Objective Develop a measure that evaluates effective pediatric food allergy (FA) management, child and parent FA anxiety, and integration of FA into family life. Methods A semistructured family interview was developed to evaluate FA management using a pilot sample (n = 27). Rating scales evaluated eight dimensions of FA management (FAMComposite), child anxiety, parent anxiety, and overall balanced integration (BI). Families of children with IgE-mediated food allergies (n = 60, child age: 6–12) were recruited for interview and rating scale validation. Results FAMComposite was correlated with physician ratings for families’ food avoidance and reaction response readiness. FA anxiety was correlated with general anxiety measures for children, but not parents. Parents’ FA anxiety was correlated with expectations of negative outcomes from FA. Low BI was associated with poor quality of life and negative impact on family functioning. Conclusions Preliminary analyses support Food Allergy Management and Adaptation Scale validity as a measure of family adaptation to pediatric FA. PMID:25797945

  16. Children's Food Allergies: Development of the Food Allergy Management and Adaptation Scale.

    PubMed

    Klinnert, Mary D; McQuaid, Elizabeth L; Fedele, David A; Faino, Anna; Strand, Matthew; Robinson, Jane; Atkins, Dan; Fleischer, David M; Hourihane, Jonathan O'B; Cohen, Sophia; Fransen, Hannah

    2015-07-01

    Develop a measure that evaluates effective pediatric food allergy (FA) management, child and parent FA anxiety, and integration of FA into family life. A semistructured family interview was developed to evaluate FA management using a pilot sample (n = 27). Rating scales evaluated eight dimensions of FA management (FAMComposite), child anxiety, parent anxiety, and overall balanced integration (BI). Families of children with IgE-mediated food allergies (n = 60, child age: 6-12) were recruited for interview and rating scale validation. FAMComposite was correlated with physician ratings for families' food avoidance and reaction response readiness. FA anxiety was correlated with general anxiety measures for children, but not parents. Parents' FA anxiety was correlated with expectations of negative outcomes from FA. Low BI was associated with poor quality of life and negative impact on family functioning. Preliminary analyses support Food Allergy Management and Adaptation Scale validity as a measure of family adaptation to pediatric FA. © The Author 2015. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  17. Recurrent aphthous stomatitis caused by food allergy.

    PubMed

    Wardhana; Datau, E A

    2010-10-01

    Recurrent Aphthous Stomatitis (RAS) is one of the most common oral lesions which occur either in single or multiple forms in oral mucosa. The mouth is subjected to a wide spectrum of antigenic agents, including foodstuff, and allergic reactions to such antigens may manifest in a number of diverse ways. Food allergy, however, has not been widely investigated as the cause of RAS. The main complaint of RAS typically is pain, and the main therapy is still corticosteroids, besides avoiding allergenic foodstuff. In RAS, there is often a genetic basis. More than 42 percent of patients with RAS have first-degree relatives with RAS. The likelihood of RAS is 90 percent when both parents are affected, but only 20 percent when neither parent has RAS, and it is also likely to be more severe and to start at an earlier age in patients with a positive family history. The primary goals of therapy of RAS are relief of pain, reduction of ulcer duration, and restoration of normal oral function. The secondary goals include reduction in frequency and severity of recurrences and maintenance of remission. Diagnostic elimination diets are frequently utilized both in diagnosis and management of RAS caused by food allergy. Patients with RAS may have increased levels of CD8+ T-lymphocytes and/or decreased CD4+ T-lymphocytes. There may be a reduced percentage of "virgin" T-cells and an increased of "memory" T-lymphocytes. Patients with active RAS have an increased proportion of gd T-cells compared with healthy control subjects and RAS patients with inactive disease. The gd T-cells may play a role in ADCC and it is believed that gd T-cells play a role in immunological damages. Preventive treatment is a consideration for patients with RAS caused by food allergy who report regular exacerbations of their condition. It focuses on dietary modifications, the earliest stage, the prodromal stage, and attempts to intercept ulcer development again by the use of topical immunosuppressant and particularly

  18. Birth order effect on childhood food allergy.

    PubMed

    Kusunoki, Takashi; Mukaida, Kumiko; Morimoto, Takeshi; Sakuma, Mio; Yasumi, Takahiro; Nishikomori, Ryuta; Heike, Toshio

    2012-05-01

    Higher birth order is associated with a smaller risk of allergy (birth order effect). The purpose of this study was to compare the significance of the birth order effect on the prevalence of specific allergic diseases [bronchial asthma (BA), atopic dermatitis (AD), allergic rhinitis (AR), allergic conjunctivitis (AC), and food allergy (FA)] among schoolchildren. A questionnaire survey dealing with the prevalence of allergic diseases was administered to the parents of 14,669 schoolchildren aged 7-15 yr. Based on the data, the prevalence of each allergic disease was compared according to birth order (1st, 2nd, and 3rd or later). Multiple regression analysis was performed to test the significance of the differences. There was no significant difference in the prevalence of BA or AD according to birth order. The prevalence of AR, AC, and FA decreased significantly as birth order increased. The prevalence of FA among those with 1st, 2nd, and 3rd or later birth order was 4.0%, 3.4%, and 2.6%, respectively (p = 0.01). With respect to symptoms in infancy, the prevalence of wheeze increased significantly and that of FA and eczema in infancy decreased significantly as birth order increased. The present data show a significant birth order effect on FA. The effect was also observed for the prevalence of FA and eczema in infancy. These data support the concept of early, non-allergen-specific programming of IgE-mediated immunity.

  19. Food allergy--towards predictive testing for novel foods.

    PubMed

    Oehlschlager, S; Reece, P; Brown, A; Hughson, E; Hird, H; Chisholm, J; Atkinson, H; Meredith, C; Pumphrey, R; Wilson, P; Sunderland, J

    2001-12-01

    The risks associated with IgE-mediated food allergy highlight the need for methods to screen for potential food allergens. Clinical and immunological tests are available for the diagnosis of food allergy to known food allergens, but this does not extend to the evaluation, or prediction of allergenicity in novel foods. This category, includes foods produced using novel processes genetically modified (GM) foods, and foods that might be used as alternatives to traditional foods. Through the collation and analysis of the protein sequences of known allergens and their epitopes, it is possible to identify related groups which correlate with observed clinical cross-reactivities. 3-D modelling extends the use of sequence data and can be used to display eptiopes on the surface of a molecule. Experimental models support sequence analysis and 3-D modelling. Observed cross-reactivities can be examined by Western blots prepared from native 2-D gels of a whole food preparation (e.g. hazelnut, peanut), and common proteins identified. IgEs to novel proteins can be raised in Brown Norway rat (a high IgE responder strain) and the proteins tested in simulated digest to determine epitope stability. Using the CSL serum bank, epitope binding can be examined through the ability of an allergen to cross-link the high affinity IgE receptor and thereby release mediators using in vitro cell-based models. This range of methods, in combination with data mining, provides a variety of screening options for testing the potential of a novel food to be allergenic, which does not involve prior exposure to the consumer.

  20. Food allergy in children with refractory gastroesophageal reflux disease.

    PubMed

    Yukselen, Ayfer; Celtik, Coskun

    2016-04-01

    Gastroesophageal reflux disease (GERD) and food allergy are frequent disorders of childhood. The purpose of this study was to determine the frequency of food allergy in children with refractory GERD. A total of 151 children resistant to pharmacologic GERD treatment underwent skin prick test, specific immunoglobulin E, eosinophil count, atopy patch test (APT), and oral food challenge, and were then divided into three groups according to the results of oral milk challenge and allergy work-up: group A1, positive oral milk challenge and positive IgE-mediated allergy test; group A2, positive milk challenge and negative IgE-mediated allergy test; and group B, negative oral milk challenge and negative allergy tests. There were 35, 30 and 86 patients in group A1, group A2 and group B, respectively. A total of 28 of 35 patients in group A1 had cow's milk allergy and the other seven patients had egg allergy. APT positivity was more common in group A2. Endoscopic esophagitis was observed in six group A1 patients and in four group A2 patients. Bloody stools, atopic dermatitis and recurrent wheezing episodes were significantly more common in group A1 than in group A2 and group B (P < 0.001, for both). Cow's milk allergy was observed frequently in children resistant to pharmacologic GERD treatment. Combined skin prick and specific IgE tests, APT and oral food challenge is essential for avoidance of unnecessary elimination diet. © 2015 Japan Pediatric Society.

  1. Diagnosis, Management, and Investigational Therapies for Food Allergies

    PubMed Central

    Kulis, Mike; Wright, Benjamin L.; Jones, Stacie M.; Burks, A. Wesley

    2016-01-01

    Food allergies have increased in prevalence over the past 20 years, now becoming an important public health concern. Although there are no therapies currently available for routine clinical care, recent reports have indicated that immunotherapies targeting the mucosal immune system may be effective. Oral immunotherapy is conducted by administering small, increasing amounts of food allergen; it has shown promise for desensitizing individuals with peanut, egg, or milk allergies. Sublingual immunotherapy also desensitizes allergic patients to foods—2 major studies have examined the effects of sublingual immunotherapy in subjects with peanut allergies. We review the complex nature of IgE-mediated food allergies and the therapies being evaluated in clinical trials. We focus on the diagnosis and management of food allergies and investigational therapies. PMID:25633563

  2. Food allergy update: more than a peanut of a problem.

    PubMed

    Husain, Zain; Schwartz, Robert A

    2013-03-01

    Food allergies have become a significant medical and legal concern for children worldwide, as there is a rising incidence of potentially fatal hypersensitivity reactions. The most common foods implicated include cow milk, wheat, egg, soy, peanut, tree nuts such as walnuts, hazelnuts, almonds, cashews, pecans, and pistachios, fish and shellfish. The majority of food allergies represent an IgE-mediated hypersensitivity reaction to specific proteins found in foods. Peanut allergy, in particular, is a significant food allergy responsible for the majority of patients with food-induced anaphylaxis. Even trace quantities to food proteins in the sensitized individual can lead to fatal reactions. There is often a rapid onset of symptoms after exposure, with prominent cutaneous findings of urticaria, angioedema, or diffuse nonspecific dermatitis. The majority of children outgrow allergies to milk, soy, egg, and wheat. However, allergy to peanuts, tree nuts, and seafood are usually lifelong conditions, as few outgrow it. Children with food allergies and their families should be knowledgeable of management strategies for the condition, including carrying and properly administering self-injectable epinephrine. New immunotherapeutic options are being investigated and appear promising. © 2013 The International Society of Dermatology.

  3. Interpreting IgE sensitization tests in food allergy.

    PubMed

    Chokshi, Niti Y; Sicherer, Scott H

    2016-01-01

    Food allergies are increasing in prevalence, and with it, IgE testing to foods is becoming more commonplace. Food-specific IgE tests, including serum assays and prick skin tests, are sensitive for detecting the presence of food-specific IgE (sensitization), but specificity for predicting clinical allergy is limited. Therefore, positive tests are generally not, in isolation, diagnostic of clinical disease. However, rationale test selection and interpretation, based on clinical history and understanding of food allergy epidemiology and pathophysiology, makes these tests invaluable. Additionally, there exist highly predictive test cutoff values for common allergens in atopic children. Newer testing methodologies, such as component resolved diagnostics, are promising for increasing the utility of testing. This review highlights the use of IgE serum tests in the diagnosis of food allergy.

  4. The impact of food allergies on quality of life.

    PubMed

    Bacal, Liane R

    2013-07-01

    CME EDUCATIONAL OBJECTIVES 1. Recognize and appreciate the impact of food allergies on psychosocial health. 2. List the factors that have been shown to negatively affect health-related quality of life. 3. Understand how physicians can directly help to improve a child's quality of life while living with food allergies. Food allergy is a serious problem affecting a growing number of children worldwide. There is a large body of evidence supporting the detrimental effects that food allergy can have on a child's quality of life. With validated tools, we can identify these children and focus on how to protect, guide, and help them to live a safe life. Recent research articulates how food allergies impact health-related quality of life (HRQL). There are studies reported from the child's perspective, as well as studies reported from the parent's perspective. With the development of validated disease and age-specific questionnaires, researchers can reliably gather data on the psychological aspect of children with food allergies. The purpose of this article is to provide a review of the literature examining the psycho-social impact of food allergies on children. This article was designed to outline suggestions to help physicians care for the whole child - both mind and body.

  5. Characterization of food allergies in patients with atopic dermatitis.

    PubMed

    Kwon, Jaryoung; Kim, Jungyun; Cho, Sunheui; Noh, Geunwoong; Lee, Sang Sun

    2013-04-01

    We examined the characteristics of food allergy prevalence and suggested the basis of dietary guidelines for patients with food allergies and atopic dermatitis. A total of 2,417 patients were enrolled in this study. Each subject underwent a skin prick test as well as serum immunoglobulin E (IgE) measurement. A double-blind, placebo-controlled food challenge was conducted using milk, eggs, wheat, and soybeans, and an oral food challenge was performed using beef, pork, and chicken. Food allergy prevalence was found among 50.7% in patients with atopic dermatitis. Among patients with food allergies (n = 1,225), the prevalence of non-IgE-mediated food allergies, IgE-mediated food allergies, and mixed allergies was discovered in 94.9%, 2.2%, and 2.9% of the patients, respectively. Food allergy prevalence, according to food item, was as follows: eggs = 21.6%, milk = 20.9%, wheat = 11.8%, soybeans = 11.7%, chicken = 11.7%, pork = 8.9% and beef = 9.2%. The total number of reactions to different food items in each patient was also variable at 45.1%, 30.6%, 15.3%, 5.8%, 2.2%, and 1.0% for 1 to 6 reactions, respectively. The most commonly seen combination in patients with two food allergies was eggs and milk. The clinical severity of the reactions observed in the challenge test, in the order of most to least severe, were wheat, beef, soybeans, milk, pork, eggs, and chicken. The minimum and maximum onset times of food allergy reactions were 0.2-24 hrs for wheat, 0.5-48 hrs for beef, 1.0-24 hrs for soybeans, 0.7-24 hrs for milk, 3.0-24 hrs for pork, 0.01-72 hrs for eggs, and 3.0-72 hrs for chicken. In our study, we examined the characteristics of seven popular foods. It will be necessary, however, to study a broader range of foods for the establishment of a dietary guideline. Our results suggest that it may be helpful to identify food allergies in order to improve symptoms in patients with atopic dermatitis.

  6. Characterization of food allergies in patients with atopic dermatitis

    PubMed Central

    Kwon, Jaryoung; Kim, Jungyun; Cho, Sunheui; Noh, Geunwoong

    2013-01-01

    We examined the characteristics of food allergy prevalence and suggested the basis of dietary guidelines for patients with food allergies and atopic dermatitis. A total of 2,417 patients were enrolled in this study. Each subject underwent a skin prick test as well as serum immunoglobulin E (IgE) measurement. A double-blind, placebo-controlled food challenge was conducted using milk, eggs, wheat, and soybeans, and an oral food challenge was performed using beef, pork, and chicken. Food allergy prevalence was found among 50.7% in patients with atopic dermatitis. Among patients with food allergies (n = 1,225), the prevalence of non-IgE-mediated food allergies, IgE-mediated food allergies, and mixed allergies was discovered in 94.9%, 2.2%, and 2.9% of the patients, respectively. Food allergy prevalence, according to food item, was as follows: eggs = 21.6%, milk = 20.9%, wheat = 11.8%, soybeans = 11.7%, chicken = 11.7%, pork = 8.9% and beef = 9.2%. The total number of reactions to different food items in each patient was also variable at 45.1%, 30.6%, 15.3%, 5.8%, 2.2%, and 1.0% for 1 to 6 reactions, respectively. The most commonly seen combination in patients with two food allergies was eggs and milk. The clinical severity of the reactions observed in the challenge test, in the order of most to least severe, were wheat, beef, soybeans, milk, pork, eggs, and chicken. The minimum and maximum onset times of food allergy reactions were 0.2-24 hrs for wheat, 0.5-48 hrs for beef, 1.0-24 hrs for soybeans, 0.7-24 hrs for milk, 3.0-24 hrs for pork, 0.01-72 hrs for eggs, and 3.0-72 hrs for chicken. In our study, we examined the characteristics of seven popular foods. It will be necessary, however, to study a broader range of foods for the establishment of a dietary guideline. Our results suggest that it may be helpful to identify food allergies in order to improve symptoms in patients with atopic dermatitis. PMID:23610604

  7. Food allergy knowledge and attitude of restaurant personnel in Turkey.

    PubMed

    Sogut, Ayhan; Kavut, Ayşe Baççıoğlu; Kartal, İbrahim; Beyhun, Ercument Nazim; Çayır, Atilla; Mutlu, Mehmet; Özkan, Behzat

    2015-02-01

    The incidence of food-induced allergic reactions is gradually increasing. Most of these allergic reactions occur in restaurants. Therefore, this study aims to investigate the awareness of restaurant personnel about food allergy. The training, knowledge levels on food allergy, and comfort level in providing safe food of 351 restaurant personnel in Erzurum Province, Turkey, were assessed through a face-to-face survey. Among the participants, 81.5% were male (mean age 28.5 ± 8.5 years). Among them, 17.1% were chefs, 11.1% managers, 5.7% owners, and 66.1% waiters. Food allergy training was reported by 17.1% of the participants. The rates of restaurant personnel who gave the correct answers to the 4 questionnaire items, "Customers with food allergies can safely consume a small amount of that food/Food allergic reaction can cause death/If a customer is having an allergic reaction, it is appropriate to immediately serve them water to 'dilute' the allergen/Removing an allergen from a finished meal (eg, taking off nuts) may be all that is necessary to provide a safe meal for an allergic customer," which measure food allergy knowledge levels, were 46.4%, 65.7%, 55.0%, and 65.7%, respectively. According to our study, there are gaps in the food allergy knowledge of restaurant personnel. Because preparing and serving safe meals to patients with food allergy in restaurants is important, the training of restaurant personnel in food allergy is necessary. © 2014 ARS-AAOA, LLC.

  8. Hygiene factors associated with childhood food allergy and asthma.

    PubMed

    Gupta, Ruchi S; Singh, Anne Marie; Walkner, Madeline; Caruso, Deanna; Bryce, Paul J; Wang, Xiaobin; Pongracic, Jacqueline A; Smith, Bridget M

    2016-11-01

    Childhood food allergy and asthma rates are increasing. The hygiene hypothesis has been proposed as an explanation for the increased incidence of allergic disease. To describe the association of childhood food allergy and asthma with hygiene factors, such as the number of siblings, antibiotic use, infection history, pet exposure, child care exposure, and maternalchild factors. Children ages 021 years old (N = 1359) were recruited for a cross-sectional family-based study, including children with food allergy and children without food allergy, and their siblings. We assessed the associations between childhood food allergy and asthma with hygiene factors. Of the 1359 children, 832 (61.2%) had food allergy, and 406 (30%) had asthma. In the adjusted analysis, the prevalence of food allergy was increased if there was a history of skin infection (prevalence ratio [RRR] 1.12 [95% confidence interval {CI}, 1.011.24]) or eczema (RRR 1.89 [95% CI, 1.702.10]). The prevalence of asthma was increased with a history of respiratory syncytial virus infection (RRR 1.60 [95% CI, 1.341.90]) or eczema (RRR 1.54 [95% CI, 1.271.86]). A greater number of siblings were associated with a decreased prevalence of food allergy (RRR 0.79 [95% CI, 0.750.84]) and asthma (RRR 0.82 [95% CI, 0.740.91]). Our findings supported the accumulating evidence of an association between skin infections and eczema with food allergy. Because these results could be subject to recall bias, additional prospective studies are needed to substantiate these findings.

  9. Hygiene factors associated with childhood food allergy and asthma

    PubMed Central

    Singh, Anne Marie; Walkner, Madeline; Caruso, Deanna; Bryce, Paul J.; Wang, Xiaobin; Pongracic, Jacqueline A.; Smith, Bridget M.

    2016-01-01

    Background: Childhood food allergy and asthma rates are increasing. The hygiene hypothesis has been proposed as an explanation for the increased incidence of allergic disease. Objective: To describe the association of childhood food allergy and asthma with hygiene factors, such as the number of siblings, antibiotic use, infection history, pet exposure, child care exposure, and maternal–child factors. Methods: Children ages 0–21 years old (N = 1359) were recruited for a cross-sectional family-based study, including children with food allergy and children without food allergy, and their siblings. We assessed the associations between childhood food allergy and asthma with hygiene factors. Results: Of the 1359 children, 832 (61.2%) had food allergy, and 406 (30%) had asthma. In the adjusted analysis, the prevalence of food allergy was increased if there was a history of skin infection (prevalence ratio [RRR] 1.12 [95% confidence interval {CI}, 1.01–1.24]) or eczema (RRR 1.89 [95% CI, 1.70–2.10]). The prevalence of asthma was increased with a history of respiratory syncytial virus infection (RRR 1.60 [95% CI, 1.34–1.90]) or eczema (RRR 1.54 [95% CI, 1.27–1.86]). A greater number of siblings were associated with a decreased prevalence of food allergy (RRR 0.79 [95% CI, 0.75–0.84]) and asthma (RRR 0.82 [95% CI, 0.74–0.91]). Conclusion: Our findings supported the accumulating evidence of an association between skin infections and eczema with food allergy. Because these results could be subject to recall bias, additional prospective studies are needed to substantiate these findings.

  10. [Food allergy:definitions, prevalence, diagnosis and therapy].

    PubMed

    van Ree, Ronald; Poulsen, Lars K; Wong, Gary Wk; Ballmer-Weber, Barbara K; Gao, Zhongshan; Jia, Xudong

    2015-01-01

    Food allergy is phenotypically an extremely heterogeneous group of diseases affecting multiple organs, sometimes in an isolated way, sometimes simultaneously, with the severity of reactions ranging from mild and local to full-blown anaphylaxis. Mechanistically, it is defined as a Th2-driven immune disorder in which food-specific IgE antibodies are at the basis of immediate-type adverse reactions. The sites of sensitization and symptoms do not necessarily overlap. Food allergy, which is the theme of this paper, is often confused with other adverse reactions to food of both animmune (e.g., celiac disease) and non-immune (e.g., lactose intolerance) nature. To reliably diagnose food allergy, a careful history (immediate-type reactions) needs to be complemented with demonstration of specific IgE (immune mechanism) and confirmed by an oral challenge. Co-factors such as exercise, medication, and alcohol may help trigger food allergy and further complicate accurate diagnosis. Where food extract-based diagnostic tests are poorly correlated to symptom severity, new generation molecular diagnostics that measure IgE against individual food allergens provide clinicians and patients with more reliable symptom severity risk profiles. Molecular diagnostics also support establishing whether food sensitization originates directly from exposure to food or indirectly (cross-reactivity) from pollen sensitization. Epidemiological surveys have indicated that allergy to peach primarily originates from peach consumption in Europe, whereas in China it is the result of primary sensitization to mugwort pollen, in both cases mediated by an allergen molecule from the same family. Epidemiological surveys give insight into the etiology of food allergy, the size of the problem (prevalence), and the risk factors involved, which together support evidence-based strategies for prevention. Over the past decade, food allergy has increased in the affluent world. Economic growth and urbanization in

  11. Impact of Food Allergies on School Nursing Practice

    ERIC Educational Resources Information Center

    Weiss, Christopher; Munoz-Furlong, Anne; Furlong, Terence J.; Arbit, Julie

    2004-01-01

    Food allergies affect 11 million Americans, including 6-8% of children. The rate of peanut allergies in children doubled from 1997 to 2002. There is no cure; therefore, strict avoidance of the allergen is the only way to avoid a reaction. Fatalities are associated with delays in or lack of epinephrine administration. Severe reactions, called…

  12. Impact of Food Allergies on School Nursing Practice

    ERIC Educational Resources Information Center

    Weiss, Christopher; Munoz-Furlong, Anne; Furlong, Terence J.; Arbit, Julie

    2004-01-01

    Food allergies affect 11 million Americans, including 6-8% of children. The rate of peanut allergies in children doubled from 1997 to 2002. There is no cure; therefore, strict avoidance of the allergen is the only way to avoid a reaction. Fatalities are associated with delays in or lack of epinephrine administration. Severe reactions, called…

  13. Equine allergy therapy: update on the treatment of environmental, insect bite hypersensitivity, and food allergies.

    PubMed

    Marsella, Rosanna

    2013-12-01

    Allergies are common in horses. It is important to identify and correct as many factors as possible to control pruritus and make the patient comfortable. Culicoides hypersensitivity is a common component in allergic horses. The main treatment continues to be rigorous fly control and avoidance of insect bites. Environmental allergies are best addressed by early identification of the offending allergens and formulation of allergen-specific immunotherapy to decrease the need for rescue medications. Food allergy is best managed with food avoidance. Urticaria is one of the manifestations of allergic disease wherein detection of the triggering cause is essential for management.

  14. Oral Immunotherapy for Food Allergy: Towards a New Horizon

    PubMed Central

    Khoriaty, Evelyne

    2013-01-01

    Food allergy has increased dramatically in prevalence over the past decade in westernized countries, and is now a major public health problem. Unfortunately for patients with food allergy, there is no effective therapy beyond food allergen avoidance, and rapid medical treatment for accidental exposures. Recently, oral immunotherapy (OIT) has been investigated as a treatment for this problem. In this review, we will discuss the progress in developing OIT for food allergy, including a novel approach utilizing Xolair (anti-IgE monoclonal antibody, omalizumab) in combination with OIT. This combination may enhance both the safety and efficacy of oral immunotherapy, and could lead to a widely available and safe therapy for food allergy. PMID:23277873

  15. Impairing oral tolerance promotes allergy and anaphylaxis: A new murine food allergy model

    PubMed Central

    Ganeshan, Kirthana; Neilsen, Colleen V.; Hadsaitong, April; Schleimer, Robert P.; Luo, Xunrong; Bryce, Paul J.

    2009-01-01

    Background Food allergy is a disorder in which antigenic food proteins elicit immune responses. Animal models of food allergy have several limitations that influence their utility, including failure to recapitulate several key immunologic hallmarks. Consequently, little is known regarding the pathogenesis and mechanisms leading to food allergy. Staphylococcus aureus–derived enterotoxins, a common cause of food contamination, are associated with antigen responses in atopic dermatitis. Objective We hypothesized that S aureus–derived enterotoxins might influence the development of food allergy. We examined the influence of administration of staphylococcal enterotoxin B (SEB) with food allergens on immunologic responses and compared these responses with those elicited by a cholera toxin–driven food allergy model. Methods Oral administration of ovalbumin or whole peanut extract with or without SEB was performed once weekly. After 8 weeks, mice were challenged with oral antigen alone, and the physiologic and immunologic responses to antigen were studied. Results SEB administered with antigen resulted in immune responses to the antigen. Responses were highly TH2 polarized, and oral challenge with antigen triggered anaphylaxis and local and systemic mast cell degranulation. SEB-driven sensitization induced eosinophilia in the blood and intestinal tissues not observed with cholera toxin sensitization. SEB impaired tolerance specifically by impairing expression of TGF-b and regulatory T cells, and tolerance was restored with high-dose antigen. Conclusions We demonstrate a new model of food allergy to oral antigen in common laboratory strains of mice that recapitulates many features of clinical food allergy that are not seen in other models. We demonstrate that SEB impairs oral tolerance and permits allergic responses. PMID:19022495

  16. Infant Feeding: Foods, Nutrients and Dietary Strategies to Prevent Allergy.

    PubMed

    Beyer, Kirsten

    2016-01-01

    Food allergy is a common disease. In recent years, recommendations for the prevention of food allergy have been shifted from avoidance strategies to active oral tolerance induction. Due to evidence from observational studies, it has been suggested that sensitization occurs via the skin especially in children with atopic dermatitis due to skin barrier defects, whereas early oral introduction of the allergenic food(s) will promote tolerance. The current evidence does not justify recommendations about either withholding or encouraging exposure to potentially allergenic food(s) after 4 months once weaning has commenced, irrespective of atopic heredity. However, intervention studies are currently conducted to prove this hypothesis generated by observational studies.

  17. The importance of educating postgraduate pediatric physicians about food allergy

    PubMed Central

    Adeli, Mehdi; Hendaus, Mohamed A; Abdurrahim, Lukman I; Alhammadi, Ahmed H

    2016-01-01

    Background Food allergy is an increasing public health burden, and is considered among the most common chronic noncommunicable diseases in children. Proper diagnosis and management of food allergy by a health care provider is crucial in keeping affected children safe while simultaneously averting unnecessary avoidance. Objective The rationale of the study was to estimate the knowledge of pediatric residents and academic general pediatric fellows with regard to food allergies in children. Methods A cross-sectional and prospective study was carried out at Hamad Medical Corporation, the only tertiary care, academic and teaching hospital in the State of Qatar. The study took place between January 1, 2015 and September 30, 2015. Results Out of the 68 questionnaires distributed, 68 (100%) were returned by the end of the study. Among the participants, 15 (22%) were in post-graduate year-1 (PGY-1), 16 (23.5%) in PGY-2, 17 (25%) in PGY-3, 12 (16%) in PGY-4, and 8 (12%) were academic general pediatric fellows. Our trainees answered 60.14% of knowledge based questions correctly. In the section of treatment and management of food allergy in childhood, 23 (34%) of respondents’ main concern when taking care of a patient with food allergies was making sure the patient is not exposed to food allergen, while 22 (33%) reported no concerns. In the section of treatment and management of food allergy in childhood, 22 (33%) of participants reported no concerns in taking care of a child with food allergy, while 23 (34%) of respondents’ main concern was making sure the patient is not exposed to food allergen. In the teaching and training section, 56% of participants stated that they have not received formal education on how to recognize and treat food allergies, while 59% claimed not being trained on how to administer injectable epinephrine. Furthermore, approximately 60% of all participants expressed the need of additional information about recognizing and treating food allergies and

  18. The effects of food allergy on quality of life.

    PubMed

    DunnGalvin, Audrey; Dubois, A E J; Flokstra-de Blok, B M J; Hourihane, J O'B

    2015-01-01

    The majority of research on food allergy has been bio-medical in orientation, focusing on issues such as the molecular structure of allergens, or aimed at methods of diagnosis. In the last decade, there has been a growing interest in the development of questionnaires that measure the impact of food allergy on health-related quality of life (HRQL). These studies have provided insight into the everyday burden of living with food allergy and have suggested ways that HRQL can be improved. The EuroPrevall project (europrevall@bbsrc.ac.uk) has given great impetus to research in the area of HRQL. In addition to clinical research on the prevalence, mechanisms and causes of food allergy, research output in the area of psycho-social impact has included HRQL measures for all age groups and examination of the socio-economic impact of food allergy. In this chapter, we review the literature on the impact of food allergy on children, teens and their parents; the majority of this data was generated over the life of the EuroPrevall project. We then examine both quantitative and qualitative research findings to provide an in-depth picture of the impact of food allergy on the concerns and everyday lives of children, teens, adults and parents. Research on factors that are related to and impact HRQL is also discussed. There is a strong emphasis throughout the chapter on developmental considerations of food allergy, spanning from infants to adults. We conclude by discussing methodological issues in relation to the measurement of HRQL in relation to food allergy. We offer some recommendations for future research and practice on HRQL so that HRQL measures can reach their full potential in research, practice and policy, with the help of the findings in this review. Overall, the findings suggest that food allergy has a strong impact on HRQL in terms of social, dietary, and psychological factors. 'Rules' and restrictions ostensibly apply to food, but because food is such an integral part of

  19. Single and multiple food allergies in infants with proctocolitis.

    PubMed

    Koksal, B T; Barıs, Z; Ozcay, F; Yilmaz Ozbek, O

    2017-07-21

    Food protein-induced allergic proctocolitis is a frequent cause of rectal bleeding in infants. Characteristics of infants with multiple food allergies have not been defined. This study aimed to identify characteristics of infants with proctocolitis and compare infants with single and multiple food allergies. A total of 132 infants with proctocolitis were evaluated retrospectively. All of the infants were diagnosed by a paediatric allergist and/or a paediatric gastroenterologist according to guidelines. Clinical features of the infants, as well as results of a complete blood count, skin prick test, specific immunoglobulin E, and stool examinations or colonoscopy were recorded. Cow's milk (97.7%) was the most common allergen, followed by egg (22%). Forty-five (34.1%) infants had allergies to more than one food. Infants with multiple food allergies had a higher eosinophil count (613±631.2 vs. 375±291.9) and a higher frequency of positive specific IgE and/or positive skin prick test results than that of patients with a single food allergy. Most of the patients whose symptoms persisted after two years of age had multiple food allergies. There is no difference in clinical presentations between infants with single and multiple food allergies. However, infants with multiple food allergies have a high blood total eosinophil count and are more likely to have a positive skin prick test and/or positive specific IgE results. Copyright © 2017 SEICAP. Published by Elsevier España, S.L.U. All rights reserved.

  20. EAACI Food Allergy and Anaphylaxis Guidelines. Protecting consumers with food allergies: understanding food consumption, meeting regulations and identifying unmet needs.

    PubMed

    Muraro, A; Hoffmann-Sommergruber, K; Holzhauser, T; Poulsen, L K; Gowland, M H; Akdis, C A; Mills, E N C; Papadopoulos, N; Roberts, G; Schnadt, S; van Ree, R; Sheikh, A; Vieths, S

    2014-11-01

    Individuals suffering from IgE-mediated food allergy usually have to practise life-long food allergen avoidance. This document aims to provide an overview of recent evidence-based recommendations for allergen risk assessment and management in the food industry and discusses unmet needs and expectations of the food allergic consumer in that context. There is a general duty of care on the food industry and obligations in European Union legislation to reduce and manage the presence of allergens alongside other food hazards. Current evidence enables quantification of allergen reference doses used to set-up reliable food safety management plans for some foods. However, further work is required to include a wider variety of foods and to understand the impact of the food matrix as well as additional factors which affect the progression and severity of symptoms as a function of dose. Major concerns have been raised by patients, carers and patient groups about the use of precautionary 'may contain' labelling to address the issue of unintended presence of allergens; these therefore need to be reconsidered. New and improved allergen detection methods should be evaluated for their application in food production. There is an urgent requirement for effective communication between healthcare professionals, patient organizations, food industry representatives and regulators to develop a better approach to protecting consumers with food allergies.

  1. The psychosocial impact of life-threatening childhood food allergies.

    PubMed

    Broome-Stone, S Brantlee

    2012-01-01

    The purpose of this integrated literature review was to bring understanding to medical professionals of the psychosocial impact of parenting a child with life-threatening food allergies. Prevalence of life-threatening food allergy among children is increasing, and families continue to navigate the effects it can have on all members of a family. A comprehensive literature review was performed related to chronic childhood illnesses and life-threatening food allergies. Commonalities among the conditions exist related to stress, coping, and adaptive responses when parental perceptions and experiences are considered. This information may provide a conceptual context for the adaptation process involved with parenting a young child with life-threatening food allergies, revealing areas where nursing can serve to intervene and support this process.

  2. Understanding Food Allergy | NIH MedlinePlus the Magazine

    MedlinePlus

    ... recently took place in the United Kingdom. This led to changes in food allergy guidelines from NIH. ... a followup study, LEAP-ON, an expert panel led by NIAID reviewed the available evidence and recommended ...

  3. IgE-mediated food allergy in children.

    PubMed

    Longo, Giorgio; Berti, Irene; Burks, A Wesley; Krauss, Baruch; Barbi, Egidio

    2013-11-16

    Food allergy is a serious health issue affecting roughly 4% of children, with a substantial effect on quality of life. Prognosis is good for the most frequent allergens with almost all children outgrowing their allergy. However, the long-term implications for disease burden are substantial for children with persistent allergies (eg, peanuts, tree nuts, fish, and shellfish) and for those with high concentrations of milk, egg, and wheat IgE. Antigen avoidance has been the time-honoured approach both for prevention and treatment. However, findings from studies done in the past 5 years show that early contact with food can induce tolerance and desensitisation to foods. We review the epidemiology, natural history, and management of food allergy, and discuss the areas of controversy and future directions in research and clinical practice.

  4. [Diagnosis and treatment of food allergies in preschool children].

    PubMed

    Ferrari, G; Eng, P

    2012-04-01

    The prevalence of food allergies in preschool children has increased in the last few decades. Depending on the triggering allergen, children may outgrow many hypersensitivity reactions to food proteins by the age of 3 - 5 years. Despite improved diagnosis and knowledge, food allergies are still restricting the quality of life in affected subjects and their families. There is a wide spectrum of clinical manifestation from mild cutaneous symptoms to life-threatening anaphylactic reaction. Food proteins are the most frequent cause of anaphylactic reactions in childhood and adolescence. The task of primary care physicians includes identification of at-risk patients, early diagnosis and advice to family members concerning preventive measures and emergency treatment (e. g. adrenaline) in case of accidental ingestion of the culprit food. There is still no causal treatment of food allergy available. Therefore, strict avoidance of the causative food remains the most important measure to date.

  5. Oral immunotherapy for food allergy: mechanisms and role in management.

    PubMed

    Nowak-Węgrzyn, A; Albin, S

    2015-02-01

    With the emergence of food allergy as an important public health problem, it has become clear that there is an unmet need in regard to treatment. In particular, IgE-mediated food allergy that is associated with risk of fatal anaphylaxis has been the subject of multiple studies in the past decade. The growing body of evidence derived from multiple centres and various study designs indicates that for IgE-mediated food allergy, immunomodulation through food immunotherapy is possible; however, the extent of protection afforded by such treatment is highly variable. At this time, the capacity for food immunotherapy to restore permanent tolerance to food has not been demonstrated conclusively. This review will discuss these topics as they apply to the most important studies of food oral immunotherapy. © 2014 John Wiley & Sons Ltd.

  6. Managing Food Allergies in School: What Educators Need to Know

    ERIC Educational Resources Information Center

    Garrow, Eleanor

    2011-01-01

    An estimated 2.2 million school-age children in the United States have food allergies, and that number seems to be on the rise. What's more, survey studies indicate that one out of six kids with food allergies will have an allergic reaction while in school and that 25% of these reactions will be first-time reactions. If a district has not yet…

  7. Immunology in the Clinic Review Series; focus on allergies: immunotherapy for food allergy.

    PubMed

    Mousallem, T; Burks, A W

    2012-01-01

    There is no approved therapy for food allergy. The current standard of care is elimination of the triggering food from the diet and accessibility to epinephrine. Immunotherapy is a promising treatment approach. While desensitization to most foods seems feasible, it remains unclear if a permanent state of tolerance is achievable. The research team at Duke is pioneering immunotherapy for food allergies. Work here has evolved over time from small open-label pilot studies to larger randomized designs. Our data show that immunological changes associated with immunotherapy include reduction in mast cell reactivity, decreased basophil responses, decreased specific-immunoglobulin (Ig)E, increased IgG4 and induction of regulatory T cells. Immunotherapy has generated much excitement in the food allergy community; however, further studies are needed before it is ready for clinical use.

  8. Immunology in the Clinic Review Series; focus on allergies: immunotherapy for food allergy

    PubMed Central

    Mousallem, T; Burks, A W

    2012-01-01

    OTHER THEMES PUBLISHED IN THIS IMMUNOLOGY IN THE CLINIC REVIEW SERIES Metabolic Diseases, Host Responses, Cancer, Autoinflammatory Diseases, Type 1 diabetes and viruses. There is no approved therapy for food allergy. The current standard of care is elimination of the triggering food from the diet and accessibility to epinephrine. Immunotherapy is a promising treatment approach. While desensitization to most foods seems feasible, it remains unclear if a permanent state of tolerance is achievable. The research team at Duke is pioneering immunotherapy for food allergies. Work here has evolved over time from small open-label pilot studies to larger randomized designs. Our data show that immunological changes associated with immunotherapy include reduction in mast cell reactivity, decreased basophil responses, decreased specific-immunoglobulin (Ig)E, increased IgG4 and induction of regulatory T cells. Immunotherapy has generated much excitement in the food allergy community; however, further studies are needed before it is ready for clinical use. PMID:22132881

  9. Therapeutics in food allergy: the current state of the art.

    PubMed

    Otsu, Kanao; Fleischer, David M

    2012-02-01

    Food allergy is an increasing public health dilemma in Westernized countries, yet no viable treatments are currently available for those who are afflicted. The only options available for patients with food allergies are prevention of reactions by strict avoidance of the offending food(s) and symptomatic treatment of any adverse effects from accidental exposures. Approaches are being pursued to develop treatments, and allergen-specific therapies such as oral immunotherapy, sublingual immunotherapy, and epicutaneous immunotherapy with different foods have shown promise. Other modalities are also being investigated, potentially leading to the discovery of novel therapeutic options.

  10. Food Allergy in Korean Patients with Chronic Urticaria

    PubMed Central

    Chung, Bo Young; Cho, Yong Se; Kim, Hye One

    2016-01-01

    Background The etiology of chronic urticaria (CU) remains unknown in most patients. Possible causes in some cases include food, but the role of allergy to food antigens in patients with CU remains controversial. Objective The aim of this study was to evaluate the association between food allergy and CU. Methods Korean patients with CU were assessed for a previous history of food allergy that caused symptoms of CU. Blood samples were taken from 350 patients to measure food allergen-specific IgE. Based on history and laboratory results, open oral food challenge (OFC) tests were performed. Results Of 350 participants, 46 (13.1%) claimed to have experienced previous food hypersensitivity. Pork (n=16) was the main food mentioned, followed by beef (n=7), shrimp (n=6), and mackerel (n=6). We found that 73 participants (20.9%) had elevated levels of food-specific IgE, with pork (n=30), wheat (n=25), and beef (n=23) being the most common. However, when the open OFC tests were conducted in 102 participants with self-reported food hypersensitivity or raised levels of food-specific IgE, only four participants showed a positive reaction to pork (n=3) or crab (n=1). Conclusion Although some participants claimed to have a history of CU related to food intake, when an open OFC test was conducted, few of them had positive results. We therefore conclude that food allergy is an uncommon cause of chronic CU. PMID:27746634

  11. Nutritional outcomes in infants with food allergy after cardiac surgery.

    PubMed

    Luo, Wen-Yi; Xu, Zhuo-Ming; Hong, Li; Wu, Qian-Yue; Zhang, Yue-Yue

    2017-06-09

    Food allergy is a rapidly growing public health concern because of its increasing prevalence, as well as life-threatening potential. There is limited knowledge on the nutritional status for the pediatric congenital heart disease (CHD) patients with food allergy. This study investigated both clinical and nutritional outcomes according to the CHD infants with food allergy. Forty CHD infants with food allergy and 39 controls were recruited in Shanghai, China. The height and weight for age and weight for height were converted to z-scores to evaluate their effects on nutritional status before and after CHD operation. Cow's milk showed the most frequently sensitized food allergen. The WHZ in the ≥2 allergen group was different before operation and after operation (P = .040). The number of sensitized food allergens significantly correlated with the WHZ (r = -0.431, P = .001), WAZ (r = -0.465, P = .000), and HAZ (r = -0.287, P = .025). Infection and NT-BNP showing negative correlation with WHZ and WAZ of infants with food allergy. The increased number of sensitized food allergens is associated with negative effects on both short-term and long-term nutritional status in infants with CHD. Therefore, the meticulous and continuous evaluation and management of both growth and nutritional status should be considered in CHD patients with a high number of sensitized food allergens. © 2017 Wiley Periodicals, Inc.

  12. Factors influencing the incidence and prevalence of food allergy.

    PubMed

    Cochrane, S; Beyer, K; Clausen, M; Wjst, M; Hiller, R; Nicoletti, C; Szepfalusi, Z; Savelkoul, H; Breiteneder, H; Manios, Y; Crittenden, R; Burney, P

    2009-09-01

    Food allergy is an increasing problem in Europe and elsewhere and severe reactions to food are also becoming more common. As food allergy is usually associated with other forms of allergic sensitisation it is likely that many risk factors are common to all forms of allergy. However the potential severity of the disease and the specific public heath measures required for food allergy make it important to identify the specific risk factors for this condition. Food allergy is unusual in that it often manifests itself very early in life and commonly remits with the development of tolerance. Hypotheses that explain the distribution of food allergy include specific genetic polymorphisms, the nature of the allergens involved and the unique exposure to large quantities of allergen through the gut. Progress has been made in developing more specific and testable hypotheses but the evidence for any of these is still only preliminary. Further collaborative research is required to develop an appropriate public health response to this growing problem.

  13. Food Allergy in childhood: phenotypes, prevention and treatment.

    PubMed

    Sánchez-García, Silvia; Cipriani, Francesca; Ricci, Giampaolo

    2015-12-01

    The prevalence of food allergy in childhood increased in the last decades, especially in Westernized countries where this phenomenon has been indicated as a second wave of the allergic epidemic. In parallel, scientific interest also increased with the effort to explain the reasons of this sudden rise and to identify potential protective and risk factors. A great attention has been focused on early exposures to allergenic foods, as well as on other nutritional factors or supplements that may influence the immune system in a positive direction. Both interventions on maternal diet before birth or during breastfeeding and then directly on infant nutrition have been investigated. Furthermore, the natural history of food allergy also seems to be changing over time; IgE-mediated cow's milk allergy and egg allergy seem to be more frequently a persistent rather than a transient disease in childhood, as described in the last years. Food avoidance and the emergency drugs in case of an adverse event, such as epinephrine self-injector, are currently the first-line treatment in patients with food allergies, with a resulting impairment in the quality of life and social behaviour. During the last decade, oral immunotherapy emerged as an optional treatment with remarkable results, offering a novel perspective in the treatment for and management of food allergy.

  14. Food allergy: practical approach on education and accidental exposure prevention.

    PubMed

    Pádua, I; Moreira, A; Moreira, P; Barros, R

    2016-09-01

    Food allergies are a growing problem and currently the primary treatment of food allergy is avoidance of culprit foods. However, given the lack of information and education and also the ubiquitous nature of allergens, accidental exposures to food allergens are not uncommon. The fear of potential fatal reactions and the need of a proper avoidance leads in most of the cases to the limitation of leisure and social activities. This review aims to be a practical approach on education and accidental exposure prevention regarding activities like shopping, eating out, and travelling. The recommendations are focused especially on proper reading of food labels and the management of the disease, namely in restaurants and airplanes, concerning cross-contact and communication with other stakeholders. The implementation of effective tools is essential to manage food allergy outside home, avoid serious allergic reactions and minimize the disease's impact on individuals' quality of life.

  15. Food allergy and food-based therapies in neurodevelopmental disorders.

    PubMed

    de Theije, Caroline G M; Bavelaar, Bas M; Lopes da Silva, Sofia; Korte, Sijmen Mechiel; Olivier, Berend; Garssen, Johan; Kraneveld, Aletta D

    2014-05-01

    Autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) are neurodevelopmental disorders which occur in childhood and may persist into adulthood. Although the etiology of these disorders is largely unknown, genetic and environmental factors are thought to play a role in the development of ASD and ADHD. Allergic immune reactions, in prenatal and postnatal phases, are examples of these environmental factors, and adverse reactions to foods are reported in these children. In this review, we address the clinical and preclinical findings of (food) allergy in ASD and ADHD and suggest possible underlying mechanisms. Furthermore, opportunities for nutritional interventions in neurodevelopmental disorders are provided. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Immunotherapy for food allergies: a myth or a reality?

    PubMed

    Praticò, Andrea D; Leonardi, Salvatore

    2015-01-01

    Food allergy is a worldwide issue, with an estimated prevalence of 2-10%. An effective treatment is not available for people affected and the only management is the avoidance of the allergen. Oral immunotherapy and sublingual immunotherapy have been tested by several authors, in particular for milk, egg and peanuts allergy, with significant results in term of desensitization induction. The achievement of tolerance is by the contrary doubtful, with different results obtained. In this review, we reviewed protocols of oral and sublingual immunotherapy for food allergy published in literature, mainly against milk, egg and peanut. At present, immunotherapy does not represent the gold standard in the treatment of food allergy, even if it can desensitize patients.

  17. Diagnostic accuracy of patch test in children with food allergy.

    PubMed

    Caglayan Sozmen, Sule; Povesi Dascola, Carlotta; Gioia, Edoardo; Mastrorilli, Carla; Rizzuti, Laura; Caffarelli, Carlo

    2015-08-01

    The gold standard test for confirming whether a child has clinical hypersensitivity reactions to foods is the oral food challenge. Therefore, there is increasing interest in simpler diagnostic markers of food allergy, especially in children, to avoid oral food challenge. The goal of this study was to assess the diagnostic accuracy of atopy patch test in comparison with oral food challenge. We investigated 243 children (mean age, 51 months) referred for evaluation of suspected egg or cow's milk allergy. Skin prick test and atopy patch test were carried out, and after a 2 weeks elimination diet, oral food challenge was performed. Two hundred and forty-three children underwent OFC to the suspected food. We found clinically relevant food allergies in 40 (65%) children to egg and in 22 (35%) to cow's milk. The sensitivity of skin prick test for both milk and egg was 92%, specificity 91%, positive predictive value 35%, and negative predictive value of 93%. Sensitivity, specificity, positive predictive value, and negative predictive value of atopy patch test for both milk and egg were 21%, 73%, 20%, and 74%, respectively. Our study suggests that there is insufficient evidence for the routine use of atopy patch test for the evaluation of egg and cow's milk allergy. OFC remains gold standard for the diagnosis of egg and milk allergy even in the presence of high costs in terms of both time and risks during application. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. Modifying the infant's diet to prevent food allergy.

    PubMed

    Grimshaw, Kate; Logan, Kirsty; O'Donovan, Sinead; Kiely, Mairead; Patient, Karine; van Bilsen, Jolanda; Beyer, Kirsten; Campbell, Dianne E; Garcia-Larsen, Vanessa; Grabenhenrich, Linus; Lack, Gideon; Mills, Clare; Wal, Jean-Michel; Roberts, Graham

    2017-02-01

    Recommendations and guidelines on the prevention of food allergy have changed in recent decades. The aim of this review of the current evidence and ongoing studies is to provide a comprehensive and up to date picture of prevention of food allergy for healthcare professionals. The review was undertaken as part of the European Union funded Integrated Approaches to Food Allergy and Allergen Management (iFAAM) study. This is a wide ranging project bringing together expertise across the breadth of food allergy research. Specifically, the review discusses dietary manipulation in food allergy prevention, and covers the possible preventive strategies of allergen avoidance, early allergen introduction, general nutrition and supplements, as well as other strategies, such as prebiotics and probiotics. The review concludes that despite agreement that allergen avoidance strategies should not be undertaken for allergy prevention, there is currently no consensus regarding what actions should be recommended beyond exclusive breastfeeding for the first 4-6 months of life. Recent and upcoming trial results, which are detailed in this review, should help inform the debate and add clarity to the topic. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  19. Does concurrent breastfeeding alongside the introduction of solid food prevent the development of food allergy?

    PubMed

    Venter, Carina; Maslin, Kate; Dean, Taraneh; Arshad, Syed Hasan

    2016-01-01

    The timing of introduction of solid food on the subsequent development of food allergy is under debate and the role of concurrent breastfeeding is unclear. The aim of the present study was to investigate the role of solid food introduction whilst concurrently breastfeeding on food allergy outcome, with a specific focus on cows' milk allergy. Prospectively collected infant feeding data from a birth cohort were analysed. Participants with histories suggestive of food allergy underwent diagnostic food challenges. Children with food allergy were matched to control participants for age and sex. Mann-Whitney U tests, χ(2), Fisher exact tests and logistic regression calculations were undertaken. A total of thirty-nine food-allergic children and seventy-eight matched controls were identified, including twenty-two cows' milk-allergic children and forty-four matched controls. The control group introduced solid food earlier than the food-allergic group (P < 0·05). There was no effect of concurrent breastfeeding alongside cows' milk introduction or other food allergens on the development of food allergy. Due to small numbers, it was not possible to explore differences for food allergy phenotype. We have therefore found no evidence that introducing solids, or food allergens, whilst breastfeeding has an allergy-preventative effect; however, the results should be interpreted with caution due to sample size. Recommendations regarding infant feeding and food allergy should be carefully considered. Although breastfeeding should be promoted for many health reasons, larger studies looking at the introduction of food allergens on the development of food allergy are needed to make a final conclusion.

  20. Quality of life in patients with food allergy.

    PubMed

    Antolín-Amérigo, Darío; Manso, Luis; Caminati, Marco; de la Hoz Caballer, Belén; Cerecedo, Inmaculada; Muriel, Alfonso; Rodríguez-Rodríguez, Mercedes; Barbarroja-Escudero, José; Sánchez-González, María José; Huertas-Barbudo, Beatriz; Alvarez-Mon, Melchor

    2016-01-01

    Food allergy has increased in developed countries and can have a dramatic effect on quality of life, so as to provoke fatal reactions. We aimed to outline the socioeconomic impact that food allergy exerts in this kind of patients by performing a complete review of the literature and also describing the factors that may influence, to a greater extent, the quality of life of patients with food allergy and analyzing the different questionnaires available. Hitherto, strict avoidance of the culprit food(s) and use of emergency medications are the pillars to manage this condition. Promising approaches such as specific oral or epicutaneous immunotherapy and the use of monoclonal antibodies are progressively being investigated worldwide. However, even that an increasing number of centers fulfill those approaches, they are not fully implemented enough in clinical practice. The mean annual cost of health care has been estimated in international dollars (I$) 2016 for food-allergic adults and I$1089 for controls, a difference of I$927 (95 % confidence interval I$324-I$1530). A similar result was found for adults in each country, and for children, and interestingly, it was not sensitive to baseline demographic differences. Cost was significantly related to severity of illness in cases in nine countries. The constant threat of exposure, need for vigilance and expectation of outcome can have a tremendous impact on quality of life. Several studies have analyzed the impact of food allergy on health-related quality of life (HRQL) in adults and children in different countries. There have been described different factors that could modify HRQL in food allergic patients, the most important of them are perceived disease severity, age of the patient, peanut or soy allergy, country of origin and having allergy to two or more foods. Over the last few years, several different specific Quality of Life questionnaires for food allergic patients have been developed and translated to different

  1. Management of food allergy: a survey of Australian paediatricians.

    PubMed

    Morawetz, Deborah Y; Hiscock, Harriet; Allen, Katrina J; Davies, Sarah; Danchin, Margie H

    2014-06-01

    The prevalence of Immunoglobulin E (IgE)-mediated food allergy in the developed world is increasing, overwhelming tertiary allergy services. Alternative models of care are required. General paediatricians could provide this care but may require further training to do so. We aimed to determine Australian general paediatricians': (i) knowledge and management of IgE-mediated food allergy; (ii) access to and use of diagnostic services; and (iii) interest in further training. Members of the Australian Paediatric Research Network completed an online survey in 2011/12. A case study elicited paediatrician's knowledge of diagnostic history taking, testing and key management principles. Study-designed questions assessed paediatricians' current practice, access to allergy services and interest in further training. One hundred sixty-eight (43%) of 390 paediatricians responded; 93 paediatricians reported managing food allergy. Diagnostic and management practices varied widely. Paediatricians had high levels of agreement (>90%) for only three of 13 questions pertaining to diagnosis and management. Only 56 (61%) correctly identified that a diagnosis of IgE-mediated food allergy requires a history consistent with a clinical reaction and a positive specific serum IgE antibody or skin prick test result. Reported waiting times for tertiary allergy services ranged from 5.4 (private) to 10.6 months (public). Most (91%) paediatricians expressed interest in further training. General paediatricians would benefit from further training if they are to practice allergy care as their diagnosis and management is often inconsistent with international guidelines. Training could be delivered online to maximise reach and uptake. If effective, such a model could relieve some of the burden experienced by Australian tertiary allergy services. © 2014 The Authors. Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  2. Evaluation of food allergy in patients with atopic dermatitis.

    PubMed

    Bergmann, Marcel M; Caubet, Jean-Christoph; Boguniewicz, Mark; Eigenmann, Philippe A

    2013-01-01

    Atopic dermatitis (AD) is a common skin disease characterized by inflammatory, chronically relapsing and pruritic eczematous flares. Its estimated incidence is 10% to 30% in children. Food allergy has been well documented in approximately one-third of children with a moderate-to-severe AD. Cow's milk, hen's egg, peanut, wheat, soy, nuts, and fish are responsible for >90% of food allergy in children with AD. The incidence and type of food can vary with age. In infants, cow's milk, hen's egg, peanut, and soy and, in older children, wheat, fish, tree nuts, and shellfish are the most common food allergens. Birch-associated foods have also been described as potential triggers of AD in children as well as in adults. The diagnosis of food allergy in AD is currently based on the clinical history, skin prick tests, or blood test screening, followed by an elimination diet and/or standardized oral food challenge. Once an underlying food allergy is confirmed, the avoidance of the incriminated food is generally recommended and usually leads to an improvement of the AD. Follow-up clinical evaluation with a detailed history and tracking of the level of specific IgE to implicated foods are typically used to evaluate the development of clinical tolerance, further confirmed by an oral food challenge.

  3. [Update on Current Care Guideline: Food allergy (children)].

    PubMed

    Mäkelä, Mika; Jartti, Tuomas; Kolho, Kaija-Leena; Poikonen, Sanna; Remes, Sami; Schwab, Ursula; Sipilä, Raija; Tulonen-Tapio, Johanna; Voutilainen, Helena

    2015-01-01

    This guideline, targeted to healthcare workers dealing with food-allergic children, provides a review on the clinical aspects of pediatric food allergy. The main updates include: elimination diets are not recommended for breast-feeding mothers; probiotics are not recommended for allergy prevention or treatment; food challenges are the basis of the diagnosis, but it can be improved by IgE component diagnostics. The treatment for severe symptoms is specific food avoidance, mildly symptomatic children should continue with versatile diet. Specific oral tolerance induction is a safe and effective treatment in most of the pediatric patients.

  4. Review article: the diagnosis and management of food allergy and food intolerances.

    PubMed

    Turnbull, J L; Adams, H N; Gorard, D A

    2015-01-01

    Adverse reactions to food include immune mediated food allergies and non-immune mediated food intolerances. Food allergies and intolerances are often confused by health professionals, patients and the public. To critically review the data relating to diagnosis and management of food allergy and food intolerance in adults and children. MEDLINE, EMBASE and the Cochrane Database were searched up until May 2014, using search terms related to food allergy and intolerance. An estimated one-fifth of the population believe that they have adverse reactions to food. Estimates of true IgE-mediated food allergy vary, but in some countries it may be as prevalent as 4-7% of preschool children. The most common food allergens are cow's milk, egg, peanut, tree nuts, soy, shellfish and finned fish. Reactions vary from urticaria to anaphylaxis and death. Tolerance for many foods including milk and egg develops with age, but is far less likely with peanut allergy. Estimates of IgE-mediated food allergy in adults are closer to 1-2%. Non-IgE-mediated food allergies such as Food Protein-Induced Enterocolitis Syndrome are rarer and predominantly recognised in childhood. Eosinophilic gastrointestinal disorders including eosinophilic oesophagitis are mixed IgE- and non-IgE-mediated food allergic conditions, and are improved by dietary exclusions. By contrast food intolerances are nonspecific, and the resultant symptoms resemble other common medically unexplained complaints, often overlapping with symptoms found in functional disorders such as irritable bowel syndrome. Improved dietary treatments for the irritable bowel syndrome have recently been described. Food allergies are more common in children, can be life-threatening and are distinct from food intolerances. Food intolerances may pose little risk but since functional disorders are so prevalent, greater efforts to understand adverse effects of foods in functional disorders are warranted. © 2014 John Wiley & Sons Ltd.

  5. A European perspective on immunotherapy for food allergies.

    PubMed

    Beyer, Kirsten

    2012-05-01

    Food allergies are common, and frequently, the only treatment option is strict avoidance. Unfortunately, many patients accidentally ingest allergenic foods, which can result in severe anaphylactic reactions. Several immunotherapies are being developed for food allergies; these involve oral, sublingual, epicutaneous, or subcutaneous administration of small amounts of native or modified allergens to induce immune tolerance. Oral immunotherapy seems to be the most promising approach based on results from small uncontrolled and controlled studies. However, it is a challenge to compare results among immunotherapy trials because of differences in protocols. Studies conducted thus far have tested the most prevalent food allergens: it is not clear whether their results can be extended to other allergens. Sublingual administration of immunotherapy has shown some efficacy and fewer side effects than oral administration in some trials, yet neither approach can be recommended for routine practice. Controlled studies with larger numbers of subjects are needed to determine short- and long-term efficacy and side effects. In Europe immunotherapy trials for food allergies face many ethical and regulatory issues. Guidelines from the European Medicine Agency on the clinical development of products for specific immunotherapy of allergic diseases do not adequately address immunotherapy for food allergies, especially for therapies that orally administer native food or that include pediatric patients. Copyright © 2012 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

  6. Food allergy in breastfeeding babies. Hidden allergens in human milk.

    PubMed

    Martín-Muñoz, M F; Pineda, F; García Parrado, G; Guillén, D; Rivero, D; Belver, T; Quirce, S

    2016-07-01

    Food allergy is a rare disorder among breastfeeding babies. Our aim was to identify responsible allergens in human milk. We studied babies developing allergic symptoms at the time they were breastfeeding. Skin prick tests (SPT) were performed with breast milk and food allergens. Specific IgE was assessed and IgE Immunoblotting experiments with breast milk were carried out to identify food allergens. Clinical evolution was evaluated after a maternal free diet. Five babies had confirmed breast milk allergy. Peanut, white egg and/or cow's milk were demonstrated as the hidden responsible allergens. No baby returned to develop symptoms once mother started a free diet. Three of these babies showed tolerance to other food allergens identified in human milk. A maternal free diet should be recommended only if food allergy is confirmed in breastfed babies.

  7. Growth and Nutritional Concerns in Children with Food Allergy

    PubMed Central

    Mehta, Harshna; Groetch, Marion; Wang, Julie

    2014-01-01

    Purpose of review To describe the potential effect that avoidance diets for food allergy may have on nutrition and growth in children. Recent Findings We report here findings from previous studies suggesting impairment of growth and nutritional deficiencies due to elimination diets for food allergy. Feeding difficulties have also been reported, particularly in children with eosinophilic esophagitis that may further impact nutrient intake. Summary Food allergies are becoming more prevalent and better recognized. Treatment options typically include strict dietary elimination of major food allergens such as milk, eggs, wheat, soy, peanut, tree nuts, fish and shellfish. Monitoring growth and guiding food allergic patients in choosing appropriate alternatives to supply necessary nutrients becomes crucial to avoid deficiencies and retardation in growth. PMID:23510952

  8. The Prevalence of Food Allergies in Children Referred to a Multidisciplinary Feeding Program.

    PubMed

    Yeung, Karla Au; Taylor, Tessa; Scheimann, Ann; Carvalho, Ryan; Reinhardt, Elsie; Girolami, Peter; Wood, Robert

    2015-10-01

    To assess the prevalence of food allergy in children presenting to a multidisciplinary feeding program. A retrospective chart review was conducted from 302 patients. We recorded history of food reaction, family history of any atopic disease, radioallergosorbent testing, prematurity, birth weight, breastfeeding history, Z-scores, age, and gastrointestinal mucosal biopsy reports with eosinophilic infiltrate. Three categories of possible food allergy were stratified based on increasing evidence of allergy. Possible food allergy was found for 18% (n = 54), likely food allergy for 6% (n = 18), and very likely food allergy for 16% (n = 47) for a total of 40% classified in a food allergy group. Having been breastfed correlated with likelihood of food allergy but tube-feeding dependence did not. This study revealed a higher proportion of children in a feeding program with food allergy compared to the general population, but larger prospective studies are needed to confirm the association. © The Author(s) 2015.

  9. Going to School with Food Allergies

    MedlinePlus

    ... name and type of allergies, consider including that epinephrine should be given in case of a severe ... is a severe allergic reaction, they should give epinephrine immediately, then call 911. Make plans for different ...

  10. The oral food desensitization in the Italian allergy centres.

    PubMed

    Meglio, P; Caminiti, L; Pajno, G B; Dello Iacono, I; Tripodi, S; Verga, M C; Martelli, A

    2015-05-01

    Attempts aimed at inducing food tolerance through oral food desensitization (OFD) for the treatment of IgE-mediated food allergies are increasing. In Italy, a number of allergy centres offer this procedure. To collect information on how these centres are organized, how patients are selected, the methods used to administer OFD and how adverse reactions are managed. A questionnaire was e-mailed to all the Italian allergy centres offering OFD. The survey shows a high degree of variability between centres. A correct diagnosis of food allergy is crucial for selecting patients for OFD. In the Italian allergy centres, oral food challenges are mostly open label (84%), but in 16% of cases they are single-blind (8%) or double-blind (8%). A high proportion of allergy centres (83%) offer OFD to children presenting forms of anaphylaxis triggered by traces--or very low doses--of food allergen. The majority of allergy centres (76%) enroll patients over 3 years of age, with 44% enrolling patients above the age of 5. Not-controlled asthma, unreliability of parents in the management of OFD and/or risk of adverse events, are the main reasons for exclusion from the procedure. Although OFD may sometimes be successful and may be considered a valid alternative to an elimination diet, further randomized controlled trials are needed, in order to clarify some controversial points, such as the characteristics of the child undergoing OFD, and the methods of food preparation and administration. Moreover, further studies should further investigate OFD safety, efficacy and costs.

  11. The rise of food allergy: Environmental factors and emerging treatments.

    PubMed

    Benedé, Sara; Blázquez, Ana Belen; Chiang, David; Tordesillas, Leticia; Berin, M Cecilia

    2016-05-01

    Food allergy has rapidly increased in prevalence, suggesting an important role for environmental factors in disease susceptibility. The immune response of food allergy is characterized by IgE production, and new findings from mouse and human studies indicate an important role of the cytokine IL-9, which is derived from both T cells and mast cells, in disease manifestations. Emerging evidence suggests that route of exposure to food, particularly peanut, is important. Exposure through the skin promotes sensitization while early exposure through the gastrointestinal tract promotes tolerance. Evidence from mouse studies indicate a role of the microbiome in development of food allergy, which is supported by correlative human studies showing a dysbiosis in food allergy. There is no approved treatment for food allergy, but emerging therapies are focused on allergen immunotherapy to provide desensitization, while pre-clinical studies are focused on using adjuvants or novel delivery approaches to improve efficacy and safety of immunotherapy. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

  12. The SAFE project: 'plant food allergies: field to table strategies for reducing their incidence in Europe' an EC-funded study.

    PubMed

    Hoffmann-Sommergruber, K

    2005-04-01

    The true prevalence of food allergy as an IgE mediated reaction is still under discussion. Using apple as a model allergen source a multidisciplinary consortium worked together at developing various strategies for reducing the incidence of fruit allergies in an EC-funded project. Patient allergen profiles were established using in vitro and in vivo tests with respect to geographic area and mild or severe symptoms. Apple allergens (Mal d 1-Mal d 4) were characterised, variants identified, cloned and sequenced. These individual allergens were used to increase the sensitivity and specificity of diagnosis. Furthermore, they provided better prognosis of disease severity. RT-PCR and ELISA were developed for determining the allergen specific mRNA and expressed allergenic protein in a large number of apple cultivars. Similarly, changes in allergen characteristics from harvest through storage to processing and the impact of agronomic practices were investigated. Allergen genes were mapped on a molecular linkage map of apple. The biological function of Mal d 1 was studied using the RNA interference strategy. Finally, consumer attitudes in Northern, Central and Southern Europe were gauged on the acceptability of low allergen cultivars or a GMO and its impact on product quality.

  13. Retrospective analysis on the agreement between skin prick test and serum food specific IgE antibody results in adults with suspected food allergy.

    PubMed

    Ling, Ling; Ospina, Maria B; Sideri, Kyriaki; Vliagoftis, Harissios

    2016-01-01

    Food allergy is a common clinical problem in adults. Given logistical barriers to conducting food challenges, the use of skin prick test (SPT) and specific IgE (sIgE) are important in establishing the diagnosis. The purpose of this study is to investigate the agreement of SPT and sIgE results in adults presenting to an allergy clinic with suspected food allergy. Retrospective analysis of medical records at the University of Alberta Allergy Clinic between September 2013 and May 2015 was performed. Demographic, medical history as well as SPT and specific IgE results were recorded. Agreement of SPT and sIgE for individual food allergens was analyzed by Kappa statistics. Data from 260 patients was collected. The population was predominantly female, often having other atopic diseases. Very few food challenges were performed; IgE mediated food allergy was diagnosed in a minority (29.6 %) of cases. Kappa values which reached statistical significance were moderate for peanut ĸ = 0.535 (p = 0.0002, CI 0.364-0.707), walnut ĸ = 0.408 (p = 0.001 CI 0.159-0.657), pecan ĸ = 0.530 (p = 0.001 CI 0.211-0.848), and lobster ĸ = 0.543 (p = 0.004 CI 0.197-0.889), substantial for pistachio ĸ = 0.657 (p = 0.023 CI 0.224-1.000), codfish ĸ = 0.770 (p = 0.0002 CI 0.558-0.983), shrimp ĸ = 0.627 (p = 0.0006 CI 0.383-0.871) and egg white ĸ = 0.625 (p = 0.002 CI 0.293-0.957), almost perfect for cashew ĸ = 0.894 (p = 0.0008 CI 0.693-1.000) and salmon ĸ = 0.874 (p = 0.004 CI 0.705-1.000). The agreement between SPT and sIgE results on adults being evaluated for food allergy is at least moderate or better for peanut, walnut, pecan, pistachio, cashew, lobster, shrimp, codfish, salmon and egg white. This should be reassuring for patients who have contraindications or restricted access to either test as the results for the above allergens will likely agree. These findings may suggest that these tests could possibly be interchangeable in adults being

  14. Role of immunoglobulin G antibodies in diagnosis of food allergy

    PubMed Central

    Bartuzi, Zbigniew

    2016-01-01

    This paper presents current views on the role of immunoglobulin G (IgG) antibodies in the reactions with food antigens in the digestive tract and their role in the diagnosis of food allergy based on the assays of specific IgG class antibodies, with a special focus on contemporary practice guidelines. In the light of current scientific knowledge, the IgG-specific antibody-mediated reactions are a body's natural and normal defensive reactions to infiltrating food antigens, which are considered as pathogens. On the other hand, specific IgG antibodies against food allergens play a crucial role in the induction and maintaining of immunological tolerance to food antigens. The statements of many scientific societies stress that sIgG are of no significant importance in the diagnosis of food allergy since their presence is associated with a normal immune response to food allergens and attests to a protracted exposure to food antigens. PMID:27605894

  15. Malnutrition in children with food allergies in the UK.

    PubMed

    Meyer, R; De Koker, C; Dziubak, R; Venter, C; Dominguez-Ortega, G; Cutts, R; Yerlett, N; Skrapak, A-K; Fox, A T; Shah, N

    2014-06-01

    The mainstay of dietary management of food allergies remains the elimination diet. However, the removal of major food groups may predispose children to an inadequate nutrient intake. We therefore set out to establish growth status in food allergic children receiving dietetic input in the UK. Dietitians were approached via the Food Allergy and Intolerance Specialist Group from the British Dietetic Association and asked to submit anthropometrical data for children with food allergies. Data collected related to the systems involved and number of foods excluded. Malnutrition was defined according to World Health Organization standards. Data from 13 different centres yielded 97 patients (51 male and 46 female) of which 66 excluded ≤2 foods and 31 excluded ≥3 foods. Data indicated that 8.5% had a weight for age ≤ -2 Z-score and, conversely, 8.5% were ≥2 Z-score. For height for age, 11.1% were ≤ -2 Z-score and, for weight for height, 3.7% were ≤ -2 Z-score and 7.5% ≥2 Z-score. Type of allergy, system involved and specific food elimination did not impact on the level of malnutrition. However, the elimination of ≥3 foods significantly impacted on weight for age (P = 0.044). The present study demonstrates that children with food allergies are more underweight than the general UK population, which appears to be linked to the number of foods excluded. However, the impact of the disease process itself should not be disregarded. Additionally, obesity can also occur in this population despite dietary elimination. © 2013 The British Dietetic Association Ltd.

  16. The impact of plant biotechnology on food allergy.

    PubMed

    Herman, Eliot M; Burks, A Wesley

    2011-04-01

    Concerns about food allergy and its societal growth are intertwined with the growing advances in plant biotechnology. The knowledge of plant genes and protein structures provides the key foundation to understanding biochemical processes that produce food allergy. Biotechnology offers the prospect of producing low-allergen or allergen null plants that could mitigate the allergic response. Modified low-IgE binding variants of allergens could be used as a vaccine to build immunotolerance in sensitive individuals. The potential to introduce new allergens into the food supply by biotechnology products is a regulatory concern. Copyright © 2010 Elsevier Ltd. All rights reserved.

  17. Diagnosing and managing common food allergies: a systematic review.

    PubMed

    Chafen, Jennifer J Schneider; Newberry, Sydne J; Riedl, Marc A; Bravata, Dena M; Maglione, Margaret; Suttorp, Marika J; Sundaram, Vandana; Paige, Neil M; Towfigh, Ali; Hulley, Benjamin J; Shekelle, Paul G

    2010-05-12

    There is heightened interest in food allergies but no clear consensus exists regarding the prevalence or most effective diagnostic and management approaches to food allergies. To perform a systematic review of the available evidence on the prevalence, diagnosis, management, and prevention of food allergies. Electronic searches of PubMed, Cochrane Database of Systematic Reviews, Cochrane Database of Abstracts of Reviews of Effects, and Cochrane Central Register of Controlled Trials. Searches were limited to English-language articles indexed between January 1988 and September 2009. Diagnostic tests were included if they had a prospective, defined study population, used food challenge as a criterion standard, and reported sufficient data to calculate sensitivity and specificity. Systematic reviews and randomized controlled trials (RCTs) for management and prevention outcomes were also used. For foods where anaphylaxis is common, cohort studies with a sample size of more than 100 participants were included. Two investigators independently reviewed all titles and abstracts to identify potentially relevant articles and resolved discrepancies by repeated review and discussion. Quality of systematic reviews and meta-analyses was assessed using the AMSTAR criteria, the quality of diagnostic studies using the QUADAS criteria most relevant to food allergy, and the quality of RCTs using the Jadad criteria. A total of 12,378 citations were identified and 72 citations were included. Food allergy affects more than 1% to 2% but less than 10% of the population. It is unclear if the prevalence of food allergies is increasing. Summary receiver operating characteristic curves comparing skin prick tests (area under the curve [AUC], 0.87; 95% confidence interval [CI], 0.81-0.93) and serum food-specific IgE (AUC, 0.84; 95% CI, 0.78-0.91) to food challenge showed no statistical superiority for either test. Elimination diets are the mainstay of therapy but have been rarely studied

  18. Prevalence of fish and shellfish allergy: A systematic review.

    PubMed

    Moonesinghe, Harriet; Mackenzie, Heather; Venter, Carina; Kilburn, Sally; Turner, Paul; Weir, Kellyn; Dean, Taraneh

    2016-09-01

    Accurate information on the prevalence of food allergy facilitates a more evidence-based approach to planning of allergy services and can identify important geographic variations. To conduct a systematic review to assess the age-specific prevalence of fish and shellfish allergy worldwide. Searches were conducted using Web of Science and PubMed. Population-based cross-sectional studies and cohort studies that examined the prevalence of fish and shellfish allergy (IgE mediated and non-IgE mediated) at an identifiable point in time were eligible for inclusion in the study. Reviewers extracted general study information and study design, type of food allergy considered, food(s) assessed, method of diagnosis, sampling strategy, and sample characteristics. Raw data were extracted and percentage prevalence and 95% confidence intervals calculated. A total of 7,333 articles were identified of which 61 studies met the inclusion criteria and were included in this review. The prevalence of fish allergy ranged from 0% to 7% and the prevalence of shellfish allergy from 0% to 10.3%, depending on the method of diagnosis. Where food challenges were used, the prevalence for fish allergy was found to be 0% to 0.3% and for shellfish allergy was 0% to 0.9%. Few studies have established the prevalence of fish or shellfish allergy using the gold standard double-blind, placebo-controlled challenge criteria, with most instead relying on self-reported questionnaire-based methods. The limited data available suggest that fish allergy prevalence is similar worldwide; however, shellfish allergy prevalence may be higher in the Southeast Asia region. Copyright © 2016 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  19. Succesful treatment of food allergy with Nambudripad's Allergy Elimination Techniques (NAET) in a 3-year old: A case report.

    PubMed

    Terwee, Caroline B

    2008-09-19

    Food allergy may constitute a major burden to children and their families. A 3-year-old girl was intolerant to milk, sugar, egg white, pork meat, and other foods, causing eczema and dyspnoe. She was treated with Nambudripad's Allergy Elimnation Technique (NAET), a combination of kinesiology and acupressure. After 7 treatment sessions (within 4 weeks) she was free of symptoms. After three years, she can still eat everything without symptoms. This case report highlights the possible benefit of NAET for children with food allergy. Randomized clinical trials should be encouraged to study the effectiveness of NAET in treating food allergy.

  20. The Impact of Family History of Allergy on Risk of Food Allergy: A Population-Based Study of Infants

    PubMed Central

    Koplin, Jennifer J.; Allen, Katrina J.; Gurrin, Lyle C.; Peters, Rachel L.; Lowe, Adrian J.; Tang, Mimi L. K.; Dharmage, Shyamali C.

    2013-01-01

    The apparent rapid increase in IgE-mediated food allergy and its implications are now widely recognized, but little is known about the relationship between family history (an indirect measure of genetic risk) and the risk of food allergy. In a population-based study of 5,276 one year old infants (HealthNuts), the prevalence of oral food challenge-confirmed food allergy was measured. Associations between family history of allergic disease and food allergy in infants were examined using multiple logistic regression. Food allergy was diagnosed in 534 infants. Compared to those with no family history of allergic disease, children meeting the current definition of “high risk” for allergic disease (one immediate family member with a history of any allergic disease) showed only a modest increase (OR 1.4, 95% CI 1.1–1.7) in food allergy, while having two or more allergic family members was more strongly predictive of food allergy in the child (OR 1.8, 95% CI 1.5–2.3). There were also differences in the associations between family history and egg and peanut allergy in the child. Re-defining “high risk” as two or more allergic family members may be more useful for identification of groups with a significantly increased risk of food allergy both clinically and within research studies. PMID:24284354

  1. Allergen Component Testing in the Diagnosis of Food Allergy.

    PubMed

    Schussler, Edith; Kattan, Jacob

    2015-09-01

    IgE-mediated food allergies are an important public health problem, affecting 5 % of adults and 8 % of children, with numerous studies indicating that the prevalence is increasing. Food allergic reactions can range in severity from mild to severe and life threatening. Accurate diagnosis of food allergy is necessary not only to provide appropriate and potentially life-saving preventive measures but also to prevent unwarranted dietary restrictions. The diagnosis of food allergy has traditionally been based on clinical history and food specific IgE (sIgE) testing, including skin prick testing (SPT), serum tests, or both. These tests tend to be extremely sensitive, but positive test results to foods that are tolerated are common. Studies of allergen component-resolved diagnostics (CRD) show that adjuvant use of this modality may provide a more accurate assessment in the diagnosis of food allergy, though the reported benefits are questionable for a number of major allergens. Furthermore, diagnostic cutoff values have been difficult to determine for allergens where component testing has been demonstrated to be beneficial.

  2. [Food Allergy and Intolerance : Distinction, Definitions and Delimitation].

    PubMed

    Kleine-Tebbe, Jörg; Waßmann-Otto, Anja; Mönnikes, Hubert

    2016-06-01

    Immunologically mediated hypersensitivity to foods is defined as food allergy, mainly due to immunglobulins of class E (IgE) triggering immediate reactions (type I hypersensitivity) with possible involvement of mucosa, skin, airways, intestinal tract, and the vascular system. Primary food allergy is based on (early) IgE sensitization against animal (e. g., cow's milk, hen's eggs) or plant proteins (e. g. peanut, hazelnut or wheat). In the case of secondary food allergies, IgE against pollen proteins (e. g., birch) reacts to structurally related food proteins (with cross-reactions to stone and pit fruits). Non-immunological food intolerance reactions are mostly based on carbohydrate malassimilation (e. g., lactose intolerance, fructose malabsorption) and are rarely due to pseudo-allergies (e. g., flavors, dyes, preservatives) primarily in patients with chronic urticaria. Common intestinal symptoms are mainly due to functional disorders (e. g., irritable bowel disease), rarely because of inflammatory intestinal diseases (e. g., celiac disease). Histamine intolerance, gluten hypersensitivity, and so-called food type III hypersensitivities are controversial diagnoses. The aforementioned disease entities/models are of variable importance for the affected individuals, the public health system, and society in general.

  3. Oral immunotherapy for the treatment of food allergy

    PubMed Central

    Begin, Philippe; Chinthrajah, R Sharon; Nadeau, Kari C

    2014-01-01

    Oral immunotherapy (OIT) is an emerging new therapy for food allergy. With multiple small exploratory trials and some large randomized-controlled phase 2 trials recently published and under way, there is a clear progress and interest toward making this a treatment option for patients suffering from food allergies. However, there are still many questions to be answered and parameters to fine-tune before OIT becomes an accepted option outside of the research setting. This review covers the main milestones in the development of OIT for food allergy and further discusses important specific issues that will have direct impact on its clinical application. More specifically, previous publications showing evidence for the induction of tolerance are specifically reviewed and varying safety, tolerability and efficacy parameters from previous reports are also discussed. PMID:25424935

  4. A prospective microbiome-wide association study of food sensitization and food allergy in early childhood.

    PubMed

    Savage, Jessica H; Lee-Sarwar, Kathleen A; Sordillo, Joanne; Bunyavanich, Supinda; Zhou, Yanjiao; O'Connor, George; Sandel, Megan; Bacharier, Leonard B; Zeiger, Robert; Sodergren, Erica; Weinstock, George M; Gold, Diane R; Weiss, Scott T; Litonjua, Augusto A

    2017-06-20

    Alterations in the intestinal microbiome are prospectively associated with the development of asthma; less is known regarding the role of microbiome alterations in food allergy development. Intestinal microbiome samples were collected at age 3-6 months in children participating in the follow-up phase of an interventional trial of high-dose vitamin D given during pregnancy. At age 3, sensitization to foods (milk, egg, peanut, soy, wheat, walnut) was assessed. Food allergy was defined as caretaker report of healthcare provider-diagnosed allergy to the above foods prior to age 3 with evidence of IgE sensitization. Analysis was performed using Phyloseq and DESeq2; P-values were adjusted for multiple comparisons. Complete data were available for 225 children; there were 87 cases of food sensitization and 14 cases of food allergy. Microbial diversity measures did not differ between food sensitization and food allergy cases and controls. The genera Haemophilus (log2 fold change -2.15, P=.003), Dialister (log2 fold change -2.22, P=.009), Dorea (log2 fold change -1.65, P=.02), and Clostridium (log2 fold change -1.47, P=.002) were underrepresented among subjects with food sensitization. The genera Citrobacter (log2 fold change -3.41, P=.03), Oscillospira (log2 fold change -2.80, P=.03), Lactococcus (log2 fold change -3.19, P=.05), and Dorea (log2 fold change -3.00, P=.05) were underrepresented among subjects with food allergy. The temporal association between bacterial colonization and food sensitization and allergy suggests that the microbiome may have a causal role in the development of food allergy. Our findings have therapeutic implications for the prevention and treatment of food allergy. © 2017 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.

  5. Low Food Allergy Prevalence Despite Delayed Introduction of Allergenic Foods-Data from the GUSTO Cohort.

    PubMed

    Tham, Elizabeth Huiwen; Lee, Bee Wah; Chan, Yiong Huak; Loo, Evelyn Xiu Ling; Toh, Jia Ying; Goh, Anne; Teoh, Oon Hoe; Yap, Fabian; Tan, Kok Hian; Godfrey, Keith M; Chong, Mary Foong Fong; Van Bever, Hugo P S; Chong, Yap Seng; Shek, Lynette Pei-Chi

    2017-07-19

    There is mounting evidence that early introduction of allergenic food decreases the risk of food allergy development, especially in high-risk infants with eczema. However, there is a lack of data to suggest whether this association holds true in Asian populations. To investigate the relationship between the timing of introduction of allergenic foods and food allergy outcomes in infants in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study. The GUSTO cohort recruited 1152 mothers of Chinese, Malay, and Indian ethnicity who had singleton, naturally conceived pregnancies and followed their offspring prospectively. Information on demographic characteristics, child health, infant feeding practices, and a convincing history of IgE-mediated food allergy was obtained from interviewer-administered questionnaires at multiple time points. Corroborative skin prick tests to food allergens were performed at 18 and 36 months. Most of the infants were introduced to egg (49.6%), peanut (88.7%), and shellfish (90.2%) after age 10 months. Food allergy prevalence was, however, very low between age 12 and 48 months: egg, 0.35% to 1.8%; peanut allergy, 0.1% to 0.3%; and shellfish, 0.2% to 0.9%. There were no significant associations between the timing of introduction of allergenic foods and the development of food allergy, adjusted for confounders including breast-feeding and eczema. Food allergy rates in Singapore are low despite delayed introduction of allergenic foods. Early introduction of allergenic foods may thus not be necessary in populations in which overall food allergy prevalence is low, and thus infant feeding recommendations should be carefully tailored to individual populations. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. All rights reserved.

  6. Food Allergy in Infants With Atopic Dermatitis: Limitations of Food-Specific IgE Measurements.

    PubMed

    Spergel, Jonathan M; Boguniewicz, Mark; Schneider, Lynda; Hanifin, Jon M; Paller, Amy S; Eichenfield, Lawrence F

    2015-12-01

    Children with atopic dermatitis (AD) have a higher risk for development of food allergies. The objective of this study was to examine incidence of food allergy development in infants with AD and the predictive value of food-antigen-specific immunoglobulin E measurements. This trial examined the long-term safety and efficacy of pimecrolimus cream 1% in >1000 infants (3-18 months) with mild-to-severe AD without a history of food allergy. Food allergy development was followed throughout a 36-month randomized double-blind phase followed by an open-label (OL) phase up to 33 months. Additionally, sIgE for cow's milk, egg white, peanut, wheat, seafood mix, and soybean was measured by ImmunoCAP at baseline, end of the double-blind phase, and end of OL phase. By the end of the OL phase, 15.9% of infants with AD developed at least 1 food allergy; allergy to peanut was most common (6.6%), followed by cow's milk (4.3%) and egg white (3.9%). Seafood, soybean, and wheat allergies were rare. Levels of sIgE for milk, egg, and peanut increased with severity of AD, as determined by Investigator's Global Assessment score. We assigned sIgE decision points for the 6 foods and tested their ability to predict definite food allergy in this population. Positive predictive values for published and newly developed sIgE decision points were low (<0.6 for all values tested). In a large cohort of infants at risk for development of food allergy, sIgE levels were not clinically useful for predicting food allergy development. Copyright © 2015 by the American Academy of Pediatrics.

  7. Food allergy educational needs of pediatric dietitians: a survey by the Consortium of Food Allergy Research.

    PubMed

    Groetch, Marion E; Christie, Lynn; Vargas, Perla A; Jones, Stacie M; Sicherer, Scott H

    2010-01-01

    To determine pediatric dietitians' self-reported proficiency, educational needs, and preferences regarding food allergy (FA) management. An Internet-based, anonymous survey was distributed to the Pediatric Nutrition Practice Group (PNPG) of the American Dietetic Association. Respondents (n = 311) were registered dietitians and members of the PNPG. Results are presented using descriptive statistics. Chi-square tests were applied for subgroup analyses. Percentage responses were calculated per question based on the number of respondents answering the question. On a 4-point scale of proficiency ("high," "moderate," "low," and "none"), respondents primarily rated themselves "moderate" for educating families, creating diets, and evaluating safe food items, and "low" for creating diagnostic food challenges. Education was primarily self-taught (75%). Preferences for future resources included handbooks (77%) and Web-based instructional programs (53%). On a 4-point scale ("very" to "not at all" needed) among practices that included >10% patients with FA, ratings of "very" were defined as need resources to update FA knowledge (87%) and need for a FA "tool kit" (84%). Pediatric dietitians manage FA for a substantial patient base although their self-reported proficiency is overall only moderate. Dietitians would prefer and likely benefit from Internet-accessible management handbooks and patient handouts. Copyright 2010 Society for Nutrition Education. Published by Elsevier Inc. All rights reserved.

  8. The Maillard reaction and food allergies: is there a link?

    PubMed

    Toda, Masako; Heilmann, Monika; Ilchmann, Anne; Vieths, Stefan

    2014-01-01

    Food allergies are abnormal responses to a food triggered by the immune system. The majority of allergenic foods are often subjected to thermal processing before consumption. The Maillard reaction is a non-enzymatic reaction between reducing sugars and compounds with free amino groups such as amino acids and proteins, and takes place during thermal processing and storage of foods. Among many other effects the reaction leads to modification of proteins with various types of glycation structures such as Nε-(carboxymethyl-)lysine (CML), pentosidine, pyrraline and methylglyoxal-H1, which are collectively called advanced glycation end-products (AGEs). Notably, evidence has accumulated that some glycation structures of AGEs function as immune epitopes. Here we discuss the possible involvement of food allergen AGEs in the pathogenesis of food allergies.

  9. Cytotoxic testing for food allergy: evaluation of reproducibility and correlation.

    PubMed

    Benson, T E; Arkins, J A

    1976-10-01

    Cytotoxic food tests still present conflicting opinions concerning their validity. Nine atopic patients with or without a history of food allergy were studied along with 5 nonatopic patients. All tests were conducted in a double-blind fashion with 6 determinations for each of 10 food antigens. Reproducibility of the test (5/6 positive or negative) was demonstrated with wheat, milk, yeast, chocolate, and orange. In the nonatopic group, reproducible results were obtained for wheat, egg, yeast, chocolate, and chicken. Clinical correlation with 11 foods in 7 patients was demonstrated. However, there were 46 positive tests without correlation and 2 negative tests with positive histories. Therefore, there appears to be reproducibility of the tests to only 3 foods but no apparent correlation with clinical symptoms. At the present time, cytotoxic tests offer no reliable help in establishing the diagnosis of food allergy.

  10. Don't Sweat the Small Stuff: Food Allergy Sufferer Lives a Cautious but Normal Life

    MedlinePlus

    ... Current Issue Past Issues Home Current issue contents Food allergy sufferer lives a cautious but normal life Follow us Don’t Sweat the Small Stuff Food allergy sufferer lives a cautious but normal life Anthony ...

  11. An exploratory investigation of food choice behavior of teenagers with and without food allergies.

    PubMed

    Sommer, Isolde; Mackenzie, Heather; Venter, Carina; Dean, Taraneh

    2014-05-01

    Understanding food choice behavior in adolescence is important because many core eating habits may be tracked into adulthood. The food choices of at least 2.3% of teenagers living in the United Kingdom are determined by food allergies. However, the effect of food allergies on eating habits in teenagers has not yet been studied. To provide an understanding of how teenagers with food allergies make food choice decisions and how these differ from those of non-food-allergic teenagers. One focus group discussion with non-food-allergic teenagers (n = 11) and 14 semistructured interviewers (7 with food-allergic and 7 with non-food-allergic teenagers) were performed (age range, 12-18 years). The focus group discussion and interviews were audiorecorded, transcribed verbatim, and analyzed using thematic content analysis. Teenagers from both groups (food-allergic and non-food-allergic) named sensory characteristics of foods as the main reason for choosing them. Some food-allergic teenagers downplayed their allergy and frequently engaged in risk-taking behavior in terms of their food choices. However, they reported difficulties in trying new foods, especially when away from home. Parental control was experienced as protective by those with food allergies, whereas non-food-allergic teenagers felt the opposite. Most teenagers, including food-allergic ones, expressed the wish to eat similar foods to their friends. Other themes did not vary between the 2 groups. Food-allergic teenagers strive to be able to make similar food choices to their friends, although differences to non-food-allergic teenagers exist. It is important to address these differences to improve their dietary management. Copyright © 2014 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  12. Asthma and food allergy management in Chicago Public Schools.

    PubMed

    Gupta, Ruchi S; Rivkina, Victoria; DeSantiago-Cardenas, Lilliana; Smith, Bridget; Harvey-Gintoft, Blair; Whyte, Stephanie A

    2014-10-01

    This study aimed to characterize asthma and food allergy reporting and management in Chicago Public Schools. Demographic and health data for students who have asthma and food allergy were extracted from the Chicago Public Schools database. Demographic and geographic variability and the existence of school health management plans were analyzed, and multiple logistic regression models were computed. Home addresses were geocoded to create maps of case counts per community area. Approximately 18,000 asthmatic and 4000 food allergic students were identified. Of asthmatic students, 9.3% had a food allergy; of food allergic students, 40.1% had asthma. Asthma odds were significantly higher among black and Hispanic students (odds ratio [OR] = 2.3 and 1.3, respectively), whereas food allergy odds were significantly higher among black students (OR = 1.1; 95% confidence interval [CI], 1.0-1.3) and significantly lower among Hispanic students (OR = 0.8; 95% CI, 0.7-0.9). Only 24.3% of students who had asthma and 50.9% of students who had food allergy had a school health management plan on file. Odds of having a school health management plan were significantly higher among students with both conditions, but the likelihood of having a plan on file was significantly lower among racial/ethnic minority and low-income students, regardless of medical condition. Only 1 in 4 students who have asthma and half of food allergic students have health management plans in schools, with lower numbers among minority and low-income students. Improving chronic disease reporting and access to school health management plans is critical. Copyright © 2014 by the American Academy of Pediatrics.

  13. [Asthma and food allergy: report of 163 pediatric cases].

    PubMed

    Rancé, F; Dutau, G

    2002-08-01

    The prevalence of food as a cause for asthma is not well known. The aim of this study was to define with standardized tests the incidence of food-induced asthma, the distribution of foods allergens in asthmatic children with food allergy. The study was carried on 163 asthmatic children with food allergy followed during average of 5.5 years. Asthma has been identified with pulmonary function tests (reversibility of FEV1 to bronchodilators) and food allergy has been documented by double-blind placebo-controlled food challenge (DBPCFC). Familial atopic disease was found in 148 children (90.7%). Inhalant sensitization was documented in 132 children (81%). Positive DBPCFC were observed in 250 of 385 challenges (65%) carried on these 163 children. The most frequent offending foods were, sometimes in association, peanut (30.6%), egg (23.1%), cow's milk (9.3%), mustard (6.9%), codfish (6%), shrimp (4.5%), kiwi fruit (3.6%), hazelnut (2.7%), cashew nut (2.1%), almond (1.5%), garlic (1.2%). Symptoms occurring during DBPCFC were cutaneous (143 cases, 59%), respiratory symptoms (58 cases, 23.9%), gastrointestinal symptoms (28 cases, 11.5%) and 15 anaphylactic shock (6.1%). Respiratory symptoms were oral allergy syndrome in 13 cases (5.3%), rhinoconjunctivitis in 15 cases (6.1%), asthma in 23 cases (9.5%). Only seven of these children had asthma only (2.8% of cases). The prevalence of asthma induced by food allergy is low. In our study, asthma induced by food allergy concerned 9.5% of cases and asthma alone was identified in only 2.8% of cases. We observed new food allergens associated with respiratory symptoms such as kiwi fruit, tree-nuts (hazelnut, cashew) and spices. Diagnosis relied upon data obtained from history, skin prick-tests and specific IgE. Oral food challenge is the corner stone of the diagnosis. Asthma induced by food allergens is potentially severe leading to prescribe to these patients a first aid kit with bronchodilators and epinephrine auto-injectors.

  14. Food for thought: progress in understanding the causes and mechanisms of food allergy.

    PubMed

    Ashley, Sarah; Dang, Thanh; Koplin, Jennifer; Martino, David; Prescott, Susan

    2015-06-01

    The community burden of food allergy appears to be rising, yet the causes and mechanisms are not completely understood. The purpose of this review is to provide a snapshot of the state of play of IgE food allergies, with a focus on recent advances. There are still wide discrepancies regarding measures and definitions of food allergy. Even recent studies still rely on food sensitization, self-reporting, or parent-reporting rather than more robust measures. Population-based sampling strategies using objective measures are underway in some countries. Emerging data suggest substantial geographical and ethnic differences in food sensitization and allergy. Trans-cutaneous sensitization, particularly in those with eczema or filaggrin mutations, has been posited as a potential mechanism, as well as gut microbiota and genetics/epigenetics. Treatments for food allergy are still lacking, yet progress is being made, and immunotherapy appears more effective than dietary avoidance. Non-IgE food allergy remains drastically under-explored. Food allergy is a complex immune-mediated disease consisting of numerous environmental/genetic/epigenetic risk factors; yet interventions are likely to be simple and cost-effective.

  15. The evaluation of food allergy on behavior in autistic children.

    PubMed

    Khakzad, Mohammad Reza; Javanbakht, Maryam; Soltanifar, Atefeh; Hojati, Maryam; Delgosha, Mehrdad; Meshkat, Mojtaba

    2012-10-01

    Despite many efforts, the etiology of autism remains unknown. Food allergy has been suggested as a pathogenic factor in Autism Spectrum Disorder (ASD). Our aim in this study was to determine whether food allergy could be considered as a risk factor for autistic children. Thirty-nine autistic children were examined by the skin prick test (SPT), and total serum IgE was evaluated by ELISA. SPTs were performed for egg whites, oranges, peanuts, tomatoes, tuna fish, walnuts, aubergines, melons, grapes, and cow milk. Parents and teachers were then asked to exclude these items from the childrens' diets for six months. After the treatment period, the autistic children who tested positive for food allergies were re-assessed by a standard questionnaire to obtain further information about their medical histories. Three of the study's 39 autistic children (7.7%) tested positive on the SPT. Total serum IgE levels were elevated in 56.4% of the subjects (mean=164±24.5, cut-off >155 IU/ml). The results showed a decreased mean in the childrens' autistic behaviors on the Children Autism Rating Scale (CARS) after both eight weeks and six months; however, this decrease was not statistically significant. Food allergy may play a role in the pathophysiology of autism. We conclude that avoidance of certain foods benefits the behavior of autistic children.

  16. Active management of food allergy: an emerging concept.

    PubMed

    Anagnostou, Katherine; Stiefel, Gary; Brough, Helen; du Toit, George; Lack, Gideon; Fox, Adam T

    2015-04-01

    IgE-mediated food allergies are common and currently there is no cure. Traditionally, management has relied upon patient education, food avoidance and the provision of an emergency medication plan. Despite this, food allergy can significantly impact on quality of life. Therefore, in recent years, evolving research has explored alternative management strategies. A more active approach to management is being adopted, which includes early introduction of potentially allergenic foods, anticipatory testing, active monitoring, desensitisation to food allergens and active risk management. This review will discuss these areas in turn. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  17. Profiling families enrolled in food allergy immunotherapy studies.

    PubMed

    DunnGalvin, Audrey; Chang, Wen Chin; Laubach, Susan; Steele, Pamela H; Dubois, Anthony E J; Burks, A Wesley; Hourihane, Jonathan O'B

    2009-09-01

    Little is known about specific psychological factors that affect parents' decisions to take part in clinical studies. We examined factors, related to health-related quality of life (HRQoL), that may influence parents' decision to allow their children to participate in research on clinical food allergy. Parents of children with food allergies were offered investigational oral immunotherapy (OIT) in a regular outpatient clinic. Forty parents (group A) declined, and 25 parents (group B) agreed to take part. Both groups agreed to complete the Food Allergy Quality of Life-Parent Form and the Food Allergy Independent Measure. Children were aged between 1 and 12 years (mean: 6.5 years). Groups A and B displayed a similar and typical distribution for gender, age, number of foods, severity and number of symptoms, and socioeconomic variables. Parents who chose to enroll their children in the OIT trial reported a similar impact of food allergy on the HRQoL of their children as parents of children who did not volunteer for the study. Participating parents perceived a significantly higher likelihood (odds ratio: 6.753) of their child having a severe reaction and dying if food is ingested. By using this model, the likelihood of taking part in immunotherapy could be predicted accurately in 90% of cases. Parents who had higher anxiety about negative outcomes from accidental ingestion were more likely to consent to experimental therapy for their child. This finding has ethical implications for investigators and supports the need to create mechanisms to avoid unintended coercion in vulnerable groups.

  18. Infant Formulas for Food Allergy Treatment and Prevention.

    PubMed

    Parekh, Hetu; Bahna, Sami L

    2016-04-01

    The number of infant formulas intended for food allergy treatment or prevention has been increasing. Some products fulfill the criteria for hypoallergenicity, such as extensively hydrolyzed protein (casein or whey) and synthesized amino acid formulas (elemental diet). Numerous partially hydrolyzed formulas have been derived from bovine milk, soybean, and rice. They are not hypoallergenic and are not recommended for children allergic to the parent protein, yet certain preparations have shown efficacy for allergy prevention. Soybean-derived preparations, although not hypoallergenic, have been tolerated by a majority of children allergic to bovine milk. Studies on the addition of probiotics or prebiotics to infant formulas have shown inconsistent findings. Numerous hypoallergenic formulas or milk substitutes are available for pediatricians to choose for children with food allergy. Caution is needed in prescribing formulas that are erroneously marketed as hypoallergenic. Copyright 2016, SLACK Incorporated.

  19. Prevalence of sensitization to food allergens and challenge proven food allergy in patients visiting allergy centers in Rawalpindi and Islamabad, Pakistan.

    PubMed

    Inam, Muhammad; Shafique, Rubaba Hamid; Roohi, Nabila; Irfan, Muhammad; Abbas, Shahid; Ismail, Muhammad

    2016-01-01

    In this study, we estimated the prevalence of food allergy in the adult allergic patients of Rawalpindi and Islamabad , Pakistan, based on self-report, skin prick test (SPT) and oral food challenge test (OFC). SPT was used for the estimation of sensitization to wheat, egg, milk, beef, chicken, mutton, fish, corn, lentils, rice, soya, peanut and banana. Among 689 patients, 39.19 % showed sensitivity to one or more foods, where, sensitization to wheat (156; 22.6 %) was highest, followed by egg (148; 21.48 %) and milk (138; 20.03 %). Sensitization to various proteins ranged between 15.53-15.97 %, while lentils, corn, rice, soya and peanut sensitization was 15.4, 16, 12.5, 12 and 11.5 % respectively. Only 7.1 % patients were SPT positive for banana allergen. SPT was performed in patients with self-reported food allergy (341/689) and also with no self-reported history of food allergy (348/689). SPT results were positive in 69.8 % of the self-report group, whereas, in the patients with no self-reported food allergy 9.2 % were found sensitized to one or more tested food allergens. 101 patients were recruited for OFC, 61 % of these were confirmed of food allergy. The prevalence of food allergy in the study population was 9 %. Food specific OFC results show that wheat allergy is affecting 1.6 % (95 % CI 0.9-2.84 %) of the total allergy patients, followed by egg allergy 1.31 % (95 % CI 0.70-2.47 %). Furthermore, corn allergy, rice allergy and peanut allergy were 1.02, 0.87 and 0.73 %, respectively. In conclusion, wheat allergy is the most prevalent, followed by egg, chicken, beef and fish allergy, respectively.

  20. Allergy after inhalation and ingestion of cereals involve different allergens in allergic and celiac disease.

    PubMed

    Armentia, Alicia; Arranz, Eduardo; Hernandez, Nora; Garrote, Antonio; Panzani, Raphael; Blanco, Alfredo

    2008-01-01

    Cereals are among the major foods in type I food hypersensitivity reactions. Hypoallergenic cereals and recombinant immunotherapy have been recently patented. In celiac disease, limited information is available regarding cereal allergens responsible for allergic reactions. The allergenic reactivity of ingested and inhaled cereal allergens in allergic and celiac people are discussed in the manuscript. Allergic sensitisation IgE mediated to cereals may be observed in celiac children. Inhalation and ingestion routes causing cereal allergy seem to involve similar allergens, but, in celiac disease specific response to CM3 may be important.

  1. A Focus Group Study of Child Nutrition Professionals' Attitudes about Food Allergies and Current Training Practices

    ERIC Educational Resources Information Center

    Lee, Yee Ming; Kwon, Junehee; Sauer, Kevin

    2014-01-01

    Purpose/Objectives: The purpose of this study was to explore child nutrition professionals' (CNPs) attitudes about food allergies, current practices of food allergy training, and operational issues related to food allergy training in school foodservice operations. Methods: Three focus groups were conducted with 21 CNPs with managerial…

  2. A Focus Group Study of Child Nutrition Professionals' Attitudes about Food Allergies and Current Training Practices

    ERIC Educational Resources Information Center

    Lee, Yee Ming; Kwon, Junehee; Sauer, Kevin

    2014-01-01

    Purpose/Objectives: The purpose of this study was to explore child nutrition professionals' (CNPs) attitudes about food allergies, current practices of food allergy training, and operational issues related to food allergy training in school foodservice operations. Methods: Three focus groups were conducted with 21 CNPs with managerial…

  3. Married...with Food Allergies | NIH MedlinePlus the Magazine

    MedlinePlus

    ... of this page please turn Javascript on. Feature: Food Allergies Married...with Food Allergies Past Issues / Spring 2011 Table of Contents ... married life together and a common problem—severe food allergies. NIH MedlinePlus magazine’s Naomi Miller caught up ...

  4. Food Allergy: A Rare Cause of Recurrent Intussusception

    PubMed Central

    Beşer, Ömer Faruk

    2017-01-01

    Recurrent intussusception is a management dilemma and have many causes. We report a 22-month old boy who presented multiple times for recurrent intussusception. At diagnostic work-up he was found to be suffering from non-IgE food allergy. The child did not develop further episodes of intussusception after removal of allergenic diet. PMID:28163999

  5. Induction of Food Allergy in Mice by Allergen Inhalation

    DTIC Science & Technology

    2015-10-01

    whether and how inhaling egg white can sensitize for the development of egg white food allergy. Despite difficulties related to the complicated pregnancy ...Nothing to report 10 CHANGES/PROBLEMS: Changes in Approach: Nothing to report Delays: A significant delay has been caused by pregnancy /delivery

  6. Food Allergy: A Rare Cause of Recurrent Intussusception.

    PubMed

    Aydın, Emrah; Beşer, Ömer Faruk

    2017-01-01

    Recurrent intussusception is a management dilemma and have many causes. We report a 22-month old boy who presented multiple times for recurrent intussusception. At diagnostic work-up he was found to be suffering from non-IgE food allergy. The child did not develop further episodes of intussusception after removal of allergenic diet.

  7. Food Allergy Concerns in Primary Classrooms: Keeping Children Safe

    ERIC Educational Resources Information Center

    Thelen, Peggy; Cameron, Elizabeth Ann

    2012-01-01

    Food-allergy awareness and management have only lately come to the forefront in early childhood settings, although advocacy organizations have been working on the issue for more than a decade. A national poll (C.S. Mott Children's Hospital 2009) asked parents with children in early education settings if they were aware of what their program does…

  8. Food Allergy Concerns in Primary Classrooms: Keeping Children Safe

    ERIC Educational Resources Information Center

    Thelen, Peggy; Cameron, Elizabeth Ann

    2012-01-01

    Food-allergy awareness and management have only lately come to the forefront in early childhood settings, although advocacy organizations have been working on the issue for more than a decade. A national poll (C.S. Mott Children's Hospital 2009) asked parents with children in early education settings if they were aware of what their program does…

  9. Can we produce true tolerance in patients with food allergy?

    PubMed Central

    Berin, M. Cecilia; Mayer, Lloyd

    2013-01-01

    Immune tolerance is defined as nonresponsiveness of the adaptive immune system to antigens. Immune mechanisms preventing inappropriate immune reactivity to innocuous antigens include deletion of reactive lymphocytes and generation of regulatory T (Treg) cells. The normal response to food antigens is the generation of antigen-specific Treg cells. In patients with food allergy, the dominant immune response is a TH2-skewed T-cell response and the generation of food-specific IgE antibodies from B cells. It is not known whether a failure of the Treg cell response is behind this inappropriate immune response, but interventions that boost the Treg cell response, such as mucosal immunotherapy, might lead to a restoration of immune tolerance to foods. Tolerance has been notoriously difficult to restore in animal disease models, but limited data from human trials suggest that tolerance (sustained nonresponsiveness) can be re-established in a subset of patients. Furthermore, studies on the natural history of food allergy indicate that spontaneous development of tolerance to foods over time is not uncommon. The current challenge is to understand the mechanisms responsible for restoration of natural or induced tolerance so that interventions can be developed to more successfully induce tolerance in the majority of patients with food allergy. PMID:23265693

  10. Is mealworm or shrimp allergy indicative for food allergy to insects?

    PubMed

    Broekman, Henrike C H P; Knulst, André C; de Jong, Govardus; Gaspari, Marco; den Hartog Jager, Constance F; Houben, Geert F; Verhoeckx, Kitty C M

    2017-09-01

    The growing world population is a key driver for the exploration of sustainable protein sources to ensure food security. Mealworm and other insects are promising candidates. Previously we found that shrimp allergic patients are at risk for mealworm allergy, and that mealworm can induce a primary allergy . This study set out to investigate the allergenic potential of edible insects, suggested for human consumption by agencies such as WHO/FAO, in both the shrimp (potentially cross-reactive) and primary mealworm allergic population. The following insects were studied: mealworm, house cricket, giant mealworm, lesser mealworm, African grasshopper, large wax moth, and black soldier fly. Fifteen shrimp (mealworm sensitized or allergic) patients and four primary mealworm allergic subjects, who participated in previous studies, were included. All shrimp allergic patients were sensitized to multiple insects with similar response profiles for all insects tested. Primary mealworm allergic patients, showed IgE binding to proteins from only a few insects on immunoblot, although basophil activation test was positive for all tested insects. Shrimp allergic patients are most likely at risk of food allergy to mealworm and other insects. Primary mealworm allergy does not mean subjects are likely to react to all insects. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  11. Critical Issues in Food Allergy: A National Academies Consensus Report.

    PubMed

    Sicherer, Scott H; Allen, Katrina; Lack, Gideon; Taylor, Steve L; Donovan, Sharon M; Oria, Maria

    2017-07-24

    The National Academies of Sciences, Engineering, and Medicine convened an expert, ad hoc committee to examine critical issues related to food allergy. The authors of the resulting report, "Finding a Path to Safety in Food Allergy: Assessment of the Global Burden, Causes, Prevention, Management, and Public Policy," evaluated the scientific evidence on the prevalence, diagnosis, prevention, and management of food allergy and made recommendations to bring about a safe environment for those affected. The committee recommended approaches to monitor prevalence, explore risk factors, improve diagnosis, and provide evidence-based health care. Regarding diagnostics, emphasis was placed on utilizing allergy tests judiciously in the context of the medical history because positive test results are not, in isolation, diagnostic. Evidence-based prevention strategies were advised (for example, a strategy to prevent peanut allergy through early dietary introduction). The report encourages improved education of stakeholders for recognizing and managing as well as preventing allergic reactions, including an emphasis on using intramuscular epinephrine promptly to treat anaphylaxis. The report recommends improved food allergen labeling and evaluation of the need for epinephrine autoinjectors with a dosage appropriate for infants. The committee recommended policies and guidelines to prevent and treat food allergic reactions in a various settings and suggested research priorities to address key questions about diagnostics, mechanisms, risk determinants, and management. Identifying safe and effective therapies is the ultimate goal. This article summarizes the key findings from the report and emphasizes recommendations for actions that are applicable to pediatricians and to the American Academy of Pediatrics. Copyright © 2017 by the American Academy of Pediatrics.

  12. Food entries in a large allergy data repository.

    PubMed

    Plasek, Joseph M; Goss, Foster R; Lai, Kenneth H; Lau, Jason J; Seger, Diane L; Blumenthal, Kimberly G; Wickner, Paige G; Slight, Sarah P; Chang, Frank Y; Topaz, Maxim; Bates, David W; Zhou, Li

    2016-04-01

    Accurate food adverse sensitivity documentation in electronic health records (EHRs) is crucial to patient safety. This study examined, encoded, and grouped foods that caused any adverse sensitivity in a large allergy repository using natural language processing and standard terminologies. Using the Medical Text Extraction, Reasoning, and Mapping System (MTERMS), we processed both structured and free-text entries stored in an enterprise-wide allergy repository (Partners' Enterprise-wide Allergy Repository), normalized diverse food allergen terms into concepts, and encoded these concepts using the Systematized Nomenclature of Medicine - Clinical Terms (SNOMED-CT) and Unique Ingredient Identifiers (UNII) terminologies. Concept coverage also was assessed for these two terminologies. We further categorized allergen concepts into groups and calculated the frequencies of these concepts by group. Finally, we conducted an external validation of MTERMS's performance when identifying food allergen terms, using a randomized sample from a different institution. We identified 158 552 food allergen records (2140 unique terms) in the Partners repository, corresponding to 672 food allergen concepts. High-frequency groups included shellfish (19.3%), fruits or vegetables (18.4%), dairy (9.0%), peanuts (8.5%), tree nuts (8.5%), eggs (6.0%), grains (5.1%), and additives (4.7%). Ambiguous, generic concepts such as "nuts" and "seafood" accounted for 8.8% of the records. SNOMED-CT covered more concepts than UNII in terms of exact (81.7% vs 68.0%) and partial (14.3% vs 9.7%) matches. Adverse sensitivities to food are diverse, and existing standard terminologies have gaps in their coverage of the breadth of allergy concepts. New strategies are needed to represent and standardize food adverse sensitivity concepts, to improve documentation in EHRs. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For

  13. Food entries in a large allergy data repository

    PubMed Central

    Plasek, Joseph M.; Goss, Foster R.; Lai, Kenneth H.; Lau, Jason J.; Seger,, Diane L.; Blumenthal, Kimberly G.; Wickner, Paige G.; Slight, Sarah P.; Chang, Frank Y.; Topaz, Maxim; Bates, David W.

    2016-01-01

    Objective Accurate food adverse sensitivity documentation in electronic health records (EHRs) is crucial to patient safety. This study examined, encoded, and grouped foods that caused any adverse sensitivity in a large allergy repository using natural language processing and standard terminologies. Methods Using the Medical Text Extraction, Reasoning, and Mapping System (MTERMS), we processed both structured and free-text entries stored in an enterprise-wide allergy repository (Partners’ Enterprise-wide Allergy Repository), normalized diverse food allergen terms into concepts, and encoded these concepts using the Systematized Nomenclature of Medicine – Clinical Terms (SNOMED-CT) and Unique Ingredient Identifiers (UNII) terminologies. Concept coverage also was assessed for these two terminologies. We further categorized allergen concepts into groups and calculated the frequencies of these concepts by group. Finally, we conducted an external validation of MTERMS’s performance when identifying food allergen terms, using a randomized sample from a different institution. Results We identified 158 552 food allergen records (2140 unique terms) in the Partners repository, corresponding to 672 food allergen concepts. High-frequency groups included shellfish (19.3%), fruits or vegetables (18.4%), dairy (9.0%), peanuts (8.5%), tree nuts (8.5%), eggs (6.0%), grains (5.1%), and additives (4.7%). Ambiguous, generic concepts such as “nuts” and “seafood” accounted for 8.8% of the records. SNOMED-CT covered more concepts than UNII in terms of exact (81.7% vs 68.0%) and partial (14.3% vs 9.7%) matches. Discussion Adverse sensitivities to food are diverse, and existing standard terminologies have gaps in their coverage of the breadth of allergy concepts. Conclusion New strategies are needed to represent and standardize food adverse sensitivity concepts, to improve documentation in EHRs. PMID:26384406

  14. Immunotherapy (oral and sublingual) for food allergy to fruits.

    PubMed

    Yepes-Nuñez, Juan Jose; Zhang, Yuan; Roqué i Figuls, Marta; Bartra Tomas, Joan; Reyes, Juan Manuel; Pineda de la Losa, Fernando; Enrique, Ernesto

    2015-11-09

    Food allergy is an abnormal immunological response following exposure (usually ingestion) to a food. Elimination of the allergen is the principle treatment for food allergy, including allergy to fruit. Accidental ingestion of allergenic foods can result in severe anaphylactic reactions. Allergen-specific immunotherapy (SIT) is a specific treatment, when the avoidance of allergenic foods is problematic. Recently, studies have been conducted on different types of immunotherapy for the treatment of food allergy, including oral (OIT) and sublingual immunotherapy (SLIT). To determine the efficacy and safety of oral and sublingual immunotherapy in children and adults with food allergy to fruits, when compared with placebo or an elimination strategy. The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, and AMED were searched for published results along with trial registries and the Journal of Negative Results in BioMedicine for grey literature. The date of the most recent search was July 2015. Randomised controlled trials (RCTs) comparing OIT or SLIT with placebo or an elimination diet were included. Participants were children or adults diagnosed with food allergy who presented immediate fruit reactions. We used standard methodological procedures expected by the Cochrane Collaboration. We assessed treatment effect through risk ratios (RRs) for dichotomous outcomes. We identified two RCTs (N=89) eligible for inclusion. These RCTs addressed oral or sublingual immunotherapy, both in adults, with an allergy to apple or peach respectively. Both studies enrolled a small number of participants and used different methods to provide these differing types of immunotherapy. Both studies were judged to be at high risk of bias in at least one domain. Overall, the quality of evidence was judged to be very low due to the small number of studies and participants and possible bias. The studies were clinically heterogeneous and hence we did not pool the

  15. Current status of managing food allergies in schools in Seoul, Korea.

    PubMed

    Kim, Soyoung; Yoon, Jihyun; Kwon, Sooyoun; Kim, Jihyun; Han, Youngshin

    2012-12-01

    Recently the need to manage food allergies in schools has been growing. This study aimed to examine the current status of managing food allergies in schools in Seoul, Korea. A questionnaire survey was conducted in cooperation with the School Dietician Association during April 2009. Among the participating 154 schools, a total of 109 (71%) were determining students' food allergy status through parental surveys based on self-reported food allergies. A total of 72 (47%) had experienced student visits to a school health room due to food allergies within one year before the survey. Over 80 percent of the schools relied on self-care only without any school-wide measures for food allergies in place. Among the 890 menu items most frequently served in school lunch programs, a total of 664 (75%) were found to contain more than one food allergen. It is highly suggested that preventive plans and treatment measures should be established to manage food allergies in schools.

  16. Novel IgE Inhibitors for the Treatment of Food Allergies

    DTIC Science & Technology

    2015-10-01

    AWARD NUMBER: W81XWH-14-1-0460 TITLE: Novel IgE Inhibitors for the Treatment of Food Allergies PRINCIPAL INVESTIGATOR: Theodore Jardetzky...SUBTITLE Novel IgE Inhibitors for the Treatment of Food Allergies 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-14-1-0460 5c. PROGRAM ELEMENT NUMBER... food allergies. However, improved therapeutics are needed for the treatment of allergies. We are taking a two- pronged approach to developing

  17. National allergy programme had little impact on parent-reported food allergies in children aged 6-7 years.

    PubMed

    Palmu, Sauli; Heikkilä, Paula; Uski, Virpi; Niitty, Siina; Kurikka, Sari; Korppi, Matti

    2017-09-19

    The ten-year Finnish national allergy programme was launched in 2008 to lessen the disease and psychological burden of allergy. This study assessed the prevalence of parent-reported food allergies requiring avoidance diets at primary school in children aged six and seven years. The cohort comprised 1,937 children (51% boys) who started primary school in Tampere, Finland in August 2016. School health nurses charted parent-reported, doctor-diagnosed food allergies requiring avoidance diets as part of the routine health examination. We found that 127 (6.6%) children had parent-reported, doctor-diagnosed allergies to at least one food and 37 (1.9%) were allergic to basic foods, namely cows' milk, wheat and one other grain. All required an avoidance diet. The figure did not differ significantly from the 2.7% and 2.5% found by studies of this age group in 2009 and 2013, respectively. Allergies to fresh fruit and vegetables decreased from 5.8% in 2009 to 3.6% in 2016. We studied the national allergy programme that started in 2008 and found that there was a non-significant overall decrease in the number of children aged 6-7 on avoidance diets for allergies between 2009-2016. The only allergies that showed signficiant decreases were fresh fruit and vegetables. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  18. Safety, clinical, and immunologic efficacy of a Chinese herbal medicine (Food Allergy Herbal Formula-2) for food allergy.

    PubMed

    Wang, Julie; Jones, Stacie M; Pongracic, Jacqueline A; Song, Ying; Yang, Nan; Sicherer, Scott H; Makhija, Melanie M; Robison, Rachel G; Moshier, Erin; Godbold, James; Sampson, Hugh A; Li, Xiu-Min

    2015-10-01

    Food Allergy Herbal Formula-2 (FAHF-2) is a 9-herb formula based on traditional Chinese medicine that blocks peanut-induced anaphylaxis in a murine model. In phase I studies FAHF-2 was found to be safe and well tolerated. We sought to evaluate the safety and effectiveness of FAHF-2 as a treatment for food allergy. In this double-blind, randomized, placebo-controlled study 68 subjects aged 12 to 45 years with allergies to peanut, tree nut, sesame, fish, and/or shellfish, which were confirmed by baseline double-blind, placebo-controlled oral food challenges (DBPCFCs), received FAHF-2 (n = 46) or placebo (n = 22). After 6 months of therapy, subjects underwent DBPCFCs. For those who demonstrated increases in the eliciting dose, a repeat DBPCFC was performed 3 months after stopping therapy. Treatment was well tolerated, with no serious adverse events. By using intent-to-treat analysis, the placebo group had a higher eliciting dose and cumulative dose (P = .05) at the end-of-treatment DBPCFC. There was no difference in the requirement for epinephrine to treat reactions (P = .55). There were no significant differences in allergen-specific IgE and IgG4 levels, cytokine production by PBMCs, or basophil activation between the active and placebo groups. In vitro immunologic studies performed on subjects' baseline PBMCs incubated with FAHF-2 and food allergen produced significantly less IL-5, greater IL-10 levels, and increased numbers of regulatory T cells than untreated cells. Notably, 44% of subjects had poor drug adherence for at least one third of the study period. FAHF-2 is a safe herbal medication for subjects with food allergy and shows favorable in vitro immunomodulatory effects; however, efficacy for improving tolerance to food allergens is not demonstrated at the dose and duration used. Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  19. Allergy

    MedlinePlus

    ... use skin and blood tests to diagnose allergies. Treatments include medicines, allergy shots, and avoiding the substances that cause the reactions. NIH: National Institute of Allergy and Infectious Diseases

  20. Think twice: misleading food-induced respiratory symptoms in children with food allergy.

    PubMed

    Ahrens, B; Mehl, A; Lau, S; Kroh, L; Magdorf, K; Wahn, U; Beyer, K; Niggemann, B

    2014-03-01

    Reported food-related symptoms of patients may sometimes be misleading. A correct delineation of food-induced symptoms is often difficult and various differential diagnoses have to be considered. We report on two cases of food-induced, predominantly respiratory symptoms (in one case life-threatening) in children with food allergy. First, a two-year-old boy with no history of allergies and suspected foreign body aspiration which was finally diagnosed as an anaphylactic reaction to fish, and secondly a six-year-old girl with multiple food allergies and allergic asthma who during an electively performed oral food challenge developed severe respiratory distress, drop in blood pressure, and asphyxia not due to an anaphylactic reaction but due to choking on an unnoticed sweet. These two cases represent challenging, life-threatening symptom constellations involving food-induced reactions in food allergic children, reminding us to question first impressions. © 2013 Wiley Periodicals, Inc.

  1. Application of gamma irradiation for inhibition of food allergy

    NASA Astrophysics Data System (ADS)

    Byun, Myung-Woo; Lee, Ju-Woon; Yook, Hong-Sun; Jo, Cheorun; Kim, Hee-Yun

    2002-03-01

    This study was carried out to evaluate the application of food irradiation technology as a method for reducing food allergy. Milk β-lactoglobulin, chicken egg albumin, and shrimp tropomyosin were used as model food allergens for experiments on allergenic and molecular properties by gamma irradiation. The amount of intact allergens in an irradiated solution was reduced by gamma irradiation depending upon the dose. These results showed that epitopes on the allergens were structurally altered by radiation treatment and that the irradiation technology can be applied to reduce allergenicity of allergic foods.

  2. Food allergy--fact or fiction: a review.

    PubMed Central

    Finn, R

    1992-01-01

    Food sensitivity is a common condition presenting with various clinical syndromes including migraine, urticaria, gluten enteropathy, Crohn's disease and irritable bowel syndrome. It is a heterogeneous condition affecting different organ systems and is also aetiologically diverse with subgroups due to allergy, pharmacological reactions, enzyme deficiencies and psychological causes. Clinical acceptance of food sensitivity has been delayed by the use of dubious diagnostic techniques by a minority of practitioners and the lack of laboratory diagnostic tests, but several double blind studies have now fully validated the existence of food sensitivity syndromes. More widespread recognition of food sensitivity would be cost effective for the National Health Service. PMID:1433127

  3. Caregivers of children with no food allergy--their experiences and perception of food allergy.

    PubMed

    Yamamoto-Hanada, Kiwako; Futamura, Masaki; Takahashi, Osamu; Narita, Masami; Kobayashi, Fumio; Ohya, Yukihiro

    2015-11-01

    Food allergy (FA) is one of the most important health issues in schoolchildren. Although one of the most common places where pediatric anaphylaxis occurs is the home of a peer, the perception and experiences of caregivers who do not have a child with FA are unclear. An anonymous paper-based questionnaire was distributed to caregivers of FA children (FA caregivers) in the National Center for Child Health and Development and caregivers of non-FA children (non-FA caregivers) in public school in Tokyo. We examined the perception and experiences of FA among three groups: Group 1, non-FA caregiver who had not witnessed adverse reactions and near-miss events related to FA; Group 2, non-FA caregivers who had witnessed adverse reactions and near-miss events related to FA; and Group 3, caregivers who had a child with FA. Epinephrine auto-injector was recognized by 43.6% non-FA caregivers. Only 2.8% of non-FA caregivers had experienced a child being bullied, harassed, or refused by a school because of FA. There were more caregivers in Group 2 who thought they could take the appropriate action if they witnessed a child with adverse response to causal food than in Group 1 (p < 0.05). All groups felt anxious over adverse events related to FA. The experiences and perception of FA were lacking among non-FA caregivers. Therefore, it is also important to provide FA education for non-FA caregivers to improve the quality of life of FA children. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. Community opinions regarding oral immunotherapy for food allergies.

    PubMed

    Traister, Russell S; Green, Todd D; Mitchell, Lynda; Greenhawt, Matthew

    2012-11-01

    Food oral immunotherapy (OIT) is a promising but still investigational new therapy for food allergy. We sought to investigate beliefs and opinions among OIT participants and nonparticipants to better understand community awareness of this therapy. A 30-question on-line survey was administered to members, website visitors, and social media followers of the Kids with Food Allergy Foundation. Questions inquired about general knowledge and attitudes about OIT, its reported safety and efficacy, complications, insurance coverage, and its Food and Drug Administration (FDA) approval status. Among 1,274 survey respondents, 15.9% had discussed OIT as a treatment option with their allergy provider. Five percent (n = 64) of respondents reported that their child was currently participating in OIT, including 73.4% (n = 47) in a private practice setting. Participants reported varying degrees of being informed about OIT safety (85%), efficacy (46.4% told unrestricted ingestion), risks (relapse 53.4%, eosinophilic esophagitis 3.5%, oral allergy syndrome 10.7%, and failure 56.9%). Significantly fewer participants than nonparticipants agreed that OIT's present safety, efficacy, risks, and approval status would dissuade participation. Significantly fewer participants agreed that OIT should not be offered outside the research setting without definitive proof of both its safety and efficacy. In this exploratory study, differences in beliefs and opinions existed between OIT participants and nonparticipants. Among participants, there were also significant differences in beliefs among academic versus nonacademic participants. Accurate and complete information about OIT safety, efficacy, risks, and approval status was not universally conveyed. Copyright © 2012 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  5. Food Allergy: Our Evolving Understanding of Its Pathogenesis, Prevention, and Treatment.

    PubMed

    Iweala, Onyinye I; Burks, A Wesley

    2016-05-01

    Food allergy is defined as an IgE-mediated hypersensitivity response to ingested food with allergic symptoms ranging from urticaria to life-threatening anaphylaxis. Food allergy is thought to develop because of (1) failed induction of tolerance upon initial exposure to food antigen or (2) breakdown of established tolerance to food antigen. We review current understanding of the pathogenesis, epidemiology, and natural history of food allergy, including the unconventional IgE-mediated food allergy to mammalian meat known as alpha-gal food allergy. We highlight emerging data on food allergy treatment and prevention, emphasizing the growing appeal of manipulating the gut microenvironment using probiotics and helminth products to blunt systemic allergic responses to food.

  6. Early life exposure to bisphenol A investigated in mouse models of airway allergy, food allergy and oral tolerance.

    PubMed

    Nygaard, Unni Cecilie; Vinje, Nina Eriksen; Samuelsen, Mari; Andreassen, Monica; Groeng, Else-Carin; Bølling, Anette Kocbach; Becher, Rune; Lovik, Martinus; Bodin, Johanna

    2015-09-01

    The impact of early life exposure to bisphenol A (BPA) through drinking water was investigated in mouse models of respiratory allergy, food allergy and oral tolerance. Balb/c mice were exposed to BPA (0, 10 or 100 μg/ml), and the offspring were intranasally exposed to the allergen ovalbumin (OVA). C3H/HeJ offspring were sensitized with the food allergen lupin by intragastric gavage, after exposure to BPA (0, 1, 10 or 100 μg/ml). In separate offspring, oral tolerance was induced by gavage of 5 mg lupin one week before entering the protocol for the food allergy induction. In the airway allergy model, BPA (100 μg/ml) caused increased eosinophil numbers in bronchoalveolar lavage fluid (BALF) and a trend of increased OVA-specific IgE levels. In the food allergy and tolerance models, BPA did not alter the clinical anaphylaxis or antibody responses, but induced alterations in splenocyte cytokines and decreased mouse mast cell protease (MMCP)-1 serum levels. In conclusion, early life exposure to BPA through drinking water modestly augmented allergic responses in a mouse model of airway allergy only at high doses, and not in mouse models for food allergy and tolerance. Thus, our data do not support that BPA promotes allergy development at exposure levels relevant for humans. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. [Food allergy in pathogenesis of chronic abdominal pain in children].

    PubMed

    Ignyś, I; Bartkowiak, M; Baczyk, I; Targońska, B; Krawczyński, M

    1995-04-01

    Food allergy has been implicated lately in the etiopathogenesis of abdominal pain in children, with particular attention pain to gastritis and/or duodenitis. The aim of the study was to analyse the cause-and-effect relationship between chronic abdominal pain in children, endoscopic and histopatological picture, and food allergy, as well as to evaluate the applied elimination diet and/or antiallergic treatment on the improvement of both the clinical status and endoscopic picture. In 71 children gastrofiberoscopic examinations, food skin tests, and specific and total IgE allergen serum tests were performed. In the majority of examined children one could observe an improvement of clinical status and of the endoscopic-histopatological picture of the stomach mucous membrane after application an elimination diet and/or treatment with sodium cromoglycate.

  8. Allergy to foods in patients monosensitized to Artemisia pollen.

    PubMed

    Garcia Ortiz, J C; Cosmes, P M; Lopez-Asunsolo, A

    1996-12-01

    It is known that patients with pollinosis may display clinical characteristics caused by allergy to certain fruits and vegetables, but subjects allergic to Artemisia seem to show particularly peculiar characteristics. The clinical features of 84 patients with rhinitis, asthma, urticaria, and/or anaphylaxis whose inhalant allergy was exclusively to Artemisia vulgaris were studied and compared with a control group of 50 patients monosensitized to grass pollen. The mean age for the beginning of symptoms was 30.2 years, and this was higher than in the control group (P < 0.05). We found the main incidence to be in women (70.2%). Some 42.3% had family history of atopia, lower than in the control group (P < 0.05), while the prevalence of asthma and urticaria was significantly higher (P < 0.05). Food hypersensitivity was reported by 23 patients (27.3%) allergic to Artemisia. The foods responsible (with respective numbers of cases) were honey (14), sunflower seeds (11), camomile (four), pistachio (three), hazelnut (two), lettuce (two), pollen (two), beer (two), almond (one), peanut (one), other nuts (one), carrot (one), and apple (one). None of the patients monosensitized to grass had food allergy. CAP inhibition experiments were carried out on a single patient. Results showed the existence of common antigenic epitopes in pistachio and Artemisia pollen for this patient. We concluded that mugwort hay fever can be associated with the Compositae family of foods, but that it is not normally associated with other foods.

  9. The Natural History of IgE-Mediated Food Allergy: Can Skin Prick Tests and Serum-Specific IgE Predict the Resolution of Food Allergy?

    PubMed Central

    Peters, Rachel L.; Gurrin, Lyle C.; Dharmage, Shyamali C.; Koplin, Jennifer J.; Allen, Katrina J.

    2013-01-01

    IgE-mediated food allergy is a transient condition for some children, however there are few indices to predict when and in whom food allergy will resolve. Skin prick test (SPT) and serum-specific IgE levels (sIgE) are usually monitored in the management of food allergy and are used to predict the development of tolerance or persistence of food allergy. The aim of this article is to review the published literature that investigated the predictive value of SPT and sIgE in development of tolerance in children with a previous diagnosis of peanut, egg and milk allergy. A systematic search identified twenty-six studies, of which most reported SPT or sIgE thresholds which predicted persistent or resolved allergy. However, results were inconsistent between studies. Previous research was hampered by several limitations including the absence of gold standard test to diagnose food allergy or tolerance, biased samples in retrospective audits and lack of systematic protocols for triggering re-challenges. There is a need for population-based, prospective studies that use the gold standard oral food challenge (OFC) to diagnose food allergy at baseline and follow-up to develop SPT and sIgE thresholds that predict the course of food allergy. PMID:24132133

  10. Epinephrine autoinjector availability among children with food allergy.

    PubMed

    DeMuth, Karen A; Fitzpatrick, Anne M

    2011-01-01

    Epinephrine is the treatment of choice for anaphylaxis. Delay in administration of epinephrine is a known risk factor for food allergy reaction-related mortality; however, individuals with food allergy may not have epinephrine readily available. This study was designed to determine the percent of food-allergic children that have an epinephrine autoinjector readily available and factors associated with epinephrine autoinjector carriage rates. Parents completed a questionnaire on food allergy and food allergy preparedness. Staff recorded whether an epinephrine autoinjector and medical alert bracelet was immediately available in clinic. Parental responses from 63 food-allergic children were included. Fifty-nine percent (37/63) had an epinephrine autoinjector present in the clinic, and 79% (50/63) reported receiving training in epinephrine autoinjector use. There was no correlation between epinephrine autoinjector presence in the clinic and parental report of having an epinephrine autoinjector available at all times (phi = 0.21). Epinephrine autoinjector training was associated with increased odds of having an epinephrine autoinjector immediately available (adjusted odds ratio, 8.74 [1.69, 45.04]). Fewer school aged children (≥5 years old) reportedly had their epinephrine autoinjector with them when eating lunch (25% [8/32] versus 42% [13/31]; p = 0.002) or snacks (28% [9/32] versus 37% [13/31]; p = 0.005) when compared with those <5 years old. Many children do not have their epinephrine autoinjectors readily available despite parental report. Epinephrine autoinjector training improved the odds of having an epinephrine autoinjector readily available. Continued patient education on the importance of having an epinephrine autoinjector easily accessible, especially when eating, is important.

  11. Persistent Food Allergy and Food Allergy Coexistent with Eczema Is Associated with Reduced Growth in the First 4 Years of Life.

    PubMed

    Beck, Cara; Koplin, Jennifer; Dharmage, Shyamali; Wake, Melissa; Gurrin, Lyle; McWilliam, Vicki; Tang, Mimi; Sun, Cong; Foskey, Rebecca; Allen, Katrina J

    2016-01-01

    Food allergy has been associated with lower weight and height in cross-sectional studies in children; however, this has not been investigated in longitudinal studies to explore growth over time, and previous studies have not accounted for coexisting eczema. The objective of this study was to examine the association of IgE-mediated food allergy and eczema with anthropometric measures at 1 and 4 years of age. In the HealthNuts population-based cohort, infants recruited at age 1 year underwent a skin prick test to egg, peanut, and sesame; those sensitized had oral food challenges. Food challenges repeated at 4 years determined food allergy persistence or resolution. Eczema was defined as parent report of eczema diagnosis. Parent-reported weight and height and child health record data were used to calculate age- and sex-adjusted percentiles from World Health Organization charts. Multivariable linear regression models were fitted to examine the effect of food allergy and eczema on weight and height controlling for potential confounders. Children with both food allergy and eczema at age 1 had lower percentiles for mean weight (51.3 vs 58.3 percentile, P = .001) and height (48.4 vs 53.4, P = .028) at age 1 compared with those with neither condition. There was no difference for children with only food allergy or eczema at age 1. By age 4, children with persistent food allergy and persistent eczema, but not those with resolved food allergy, were still shorter and lighter. Children with both food allergy and eczema were shorter and lighter throughout early childhood, with more pronounced differences in those with persistent food allergy. Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  12. Food allergy and increased asthma morbidity in a School-based Inner-City Asthma Study.

    PubMed

    Friedlander, James L; Sheehan, William J; Baxi, Sachin N; Kopel, Lianne S; Gaffin, Jonathan M; Ozonoff, Al; Fu, Chunxia; Gold, Diane R; Phipatanakul, Wanda

    2013-01-01

    Children with asthma have increased prevalence of food allergies. The relationship between food allergy and asthma morbidity is unclear. We aimed to investigate the presence of food allergy as an independent risk factor for increased asthma morbidity by using the School Inner-City Asthma Study, a prospective study that evaluates risk factors and asthma morbidity among urban children. We prospectively surveyed, from inner-city schools, 300 children with physician-diagnosed asthma, followed by clinical evaluation. Food allergies were reported, which included symptoms experienced within 1 hour of food ingestion. Asthma morbidity, pulmonary function, and resource utilization were compared between children with food allergies and those without. Seventy-three of 300 children with asthma (24%) surveyed had physician-diagnosed food allergy, and 36 (12%) had multiple food allergies. Those with any food allergy independently had increased risk of hospitalization (OR [odds ratio] 2.35 [95% CI, 1.30-4.24]; P = .005) and use of controller medication (OR 1.99 [95% CI, 1.06-3.74]; P = .03). Those with multiple food allergies also had an independently higher risk of hospitalization in the past year (OR 4.10 [95% CI, 1.47-11.45]; P = .007), asthma-related hospitalization (OR 3.52 [95% CI, 1.12-11.03]; P = .03), controller medication use (OR 2.38 [95% CI, 1.00-5.66]; P = .05), and more provider visits (median, 4.5 vs 3.0; P = .008). Furthermore, lung function was significantly lower (percent predicted FEV1 and FEV1/FVC ratios) in both food allergy category groups. Food allergy is highly prevalent in inner-city school-aged children with asthma. Children with food allergies have increased asthma morbidity and health resource utilization with decreased lung function, and this association is stronger in those with multiple food allergies. Copyright © 2013 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  13. Artificial sweeteners and mixture of food additives cause to break oral tolerance and induce food allergy in murine oral tolerance model for food allergy.

    PubMed

    Yamashita, H; Matsuhara, H; Miotani, S; Sako, Y; Matsui, T; Tanaka, H; Inagaki, N

    2017-09-01

    Processed foods are part of daily life. Almost all processed foods contain food additives such as sweeteners, preservatives and colourants. From childhood, it is difficult to avoid consuming food additives. It is thought that oral tolerance for food antigens is acquired during early life. If tolerance fails, adverse immune responses to food proteins may occur. We hypothesized that food additives prevent acquisition of oral tolerance and aimed to verify the safety of food additives. We induced experimental oral tolerance in mice for ovalbumin (OVA), a food antigen, by previous oral treatment with OVA before sensitization with OVA injections. Food additives were administered at the induction of oral tolerance, and food allergy was induced by repeated administration of OVA. Symptoms of food allergy were defined as a change in body temperature and allergic diarrhoea. Saccharin sodium and a mixture of food additives inhibited acquisition of oral tolerance. Hypothermia and allergic diarrhoea with elevation of OVA-specific IgE were induced in the murine model of oral tolerance. Analyses of antigen-presenting cells in mesenteric lymph nodes showed that food additives affected their manner of migration. Additionally, food additives decreased the proportion of CD25(hi) regulatory T cells among CD4(+) T cells in the mesenteric lymph nodes. A large amount of food additives may prevent acquisition of oral tolerance. Intake of food additives in early life may increase the risk of food allergies. © 2017 John Wiley & Sons Ltd.

  14. Food Allergy and Intolerance in IBS

    PubMed Central

    Choung, Rok Son

    2006-01-01

    Irritable bowel syndrome (IBS) is a very common functional gastrointestinal disorder. IBS is likely to be a multifactorial condition resulting from a number of different mechanisms such as disordered motility, visceral hypersensitivity, abnormal central processing, psychological factors, genetic factors, gut inflammation, and dietary factors. Many patients with IBS give a history of adverse food reactions, but the foods identified to be relevant have been highly variable. Food hypersensitivity can be mediated by immunoglobulin E–dependent and –independent mechanisms involving mast cells, eosinophils, and other immune cells. Recent clinical and experimental studies suggest that there is a possible role for food hypersensitivity in IBS, with improvement of IBS symptom severity in a subset of patients on elimination diets, but the underlying mechanisms in IBS have yet to be fully understood. This review considers the evidence for the role of food hypersensitivity in IBS, based on the available epidemiologic and pathophysiologic data, and the clinical implications.

  15. Guidelines for the Diagnosis and Management of Food Allergy in the United States

    PubMed Central

    Boyce, Joshua A.; Assa'ad, Amal; Burks, A. Wesley; Jones, Stacie M.; Sampson, Hugh A.; Wood, Robert A.; Plaut, Marshall; Cooper, Susan F.; Fenton, Matthew J.; Arshad, S. Hasan; Bahna, Sami L.; Beck, Lisa A.; Byrd-Bredbenner, Carol; Camargo, Carlos A.; Eichenfield, Lawrence; Furuta, Glenn T.; Hanifin, Jon M.; Jones, Carol; Kraft, Monica; Levy, Bruce D.; Lieberman, Phil; Luccioli, Stefano; McCall, Kathleen M.; Schneider, Lynda C.; Simon, Ronald A.; Simons, F. Estelle R.; Teach, Stephen J.; Yawn, Barbara P.; Schwaninger, Julie M.

    2014-01-01

    Food allergy is an important public health problem that affects children and adults and may be increasing in prevalence. Despite the risk of severe allergic reactions and even death, there is no current treatment for food allergy: the disease can only be managed by allergen avoidance or treatment of symptoms. The diagnosis and management of food allergy also may vary from one clinical practice setting to another. Finally, because patients frequently confuse nonallergic food reactions, such as food intolerance, with food allergies, there is an unfounded belief among the public that food allergy prevalence is higher than it truly is. In response to these concerns, the National Institute of Allergy and Infectious Diseases, working with 34 professional organizations, federal agencies, and patient advocacy groups, led the development of clinical guidelines for the diagnosis and management of food allergy. These Guidelines are intended for use by a wide variety of health care professionals, including family practice physicians, clinical specialists, and nurse practitioners. The Guidelines include a consensus definition for food allergy, discuss comorbid conditions often associated with food allergy, and focus on both IgE-mediated and non-IgE-mediated reactions to food. Topics addressed include the epidemiology, natural history, diagnosis, and management of food allergy, as well as the management of severe symptoms and anaphylaxis. These Guidelines provide 43 concise clinical recommendations and additional guidance on points of current controversy in patient management. They also identify gaps in the current scientific knowledge to be addressed through future research. PMID:21134576

  16. Sublingual (SLIT) versus oral immunotherapy (OIT) for food allergy.

    PubMed

    McGowan, Emily C; Wood, Robert A

    2014-12-01

    Food allergy is a common condition for which the only currently approved treatments are avoidance of the allergenic food and the administration of emergency medications upon accidental exposure. Over the past 10 years, significant advances have been made in the field of food immunotherapy, with efforts focusing on allergen exposure via the oral mucosa. Oral immunotherapy (OIT) and sublingual immunotherapy (SLIT) are the two modalities that have been most extensively studied, and this article will review recent advances in our knowledge of the efficacy and safety of these treatments.

  17. Sublingual (SLIT) Versus Oral Immunotherapy (OIT) for Food Allergy

    PubMed Central

    McGowan, Emily C.

    2016-01-01

    Food allergy is a common condition for which the only currently approved treatments are avoidance of the allergenic food and the administration of emergency medications upon accidental exposure. Over the past 10 years, significant advances have been made in the field of food immunotherapy, with efforts focusing on allergen exposure via the oral mucosa. Oral immunotherapy (OIT) and sublingual immunotherapy (SLIT) are the two modalities that have been most extensively studied, and this article will review recent advances in our knowledge of the efficacy and safety of these treatments. PMID:25297805

  18. Food allergy: separating the science from the mythology.

    PubMed

    Brandtzaeg, Per

    2010-07-01

    Numerous genes are involved in innate and adaptive immunity and these have been modified over millions of years. During this evolution, the mucosal immune system has developed two anti-inflammatory strategies: immune exclusion by the use of secretory antibodies to control epithelial colonization of microorganisms and to inhibit the penetration of potentially harmful agents; and immunosuppression to counteract local and peripheral hypersensitivity against innocuous antigens, such as food proteins. The latter strategy is called oral tolerance when induced via the gut. Homeostatic mechanisms also dampen immune responses to commensal bacteria. The mucosal epithelial barrier and immunoregulatory network are poorly developed in newborns. The perinatal period is, therefore, critical with regard to the induction of food allergy. The development of immune homeostasis depends on windows of opportunity during which innate and adaptive immunity are coordinated by antigen-presenting cells. The function of these cells is not only orchestrated by microbial products but also by dietary constituents, including vitamin A and lipids, such as polyunsaturated omega-3 fatty acids. These factors may in various ways exert beneficial effects on the immunophenotype of the infant. The same is true for breast milk, which provides immune-inducing factors and secretory immunoglobulin A, which reinforces the gut epithelial barrier. It is not easy to dissect the immunoregulatory network and identify variables that lead to food allergy. This Review discusses efforts to this end and outlines the scientific basis for future food allergy prevention.

  19. Food allergy and anaphylaxis in pediatrics: update 2010-2012.

    PubMed

    Santos, Alexandra F; Lack, Gideon

    2012-12-01

    This review highlights the progress made in food allergy (FA) and anaphylaxis research in pediatrics published in the journal Pediatric Allergy and Immunology since 2010. Putative risk factors for FA are as follows: a family history of allergic disease, particularly in the mother, low birth order, season of birth, and severe atopic eczema. Obstetric practices, antibiotic use, and home environment are factors deserving further research. Diagnostic decision levels and component-specific IgE are useful in the diagnosis of FA; however, oral food challenges remain the gold standard and may also be a means to reduce parental anxiety and to improve education. Oral immunotherapy studies show promise in increasing the threshold of reactivity of allergic patients and therefore improving their quality of life. In single-nut-allergic patients, introduction of other nuts allows broadening the diet and thus reducing the psychological impact of allergen avoidance. Nutritional deficiencies are not uncommon in food-allergic children and should be specifically assessed. The prescription of injectable adrenaline is still insufficient and not consistent among practitioners, requiring improved training and implementation of guidelines. Current research into the epidemiology and immunological mechanisms of FA and tolerance will enable us to devise strategies to both prevent and treat food allergies.

  20. A review of food allergy and nutritional considerations in the food-allergic adult

    USDA-ARS?s Scientific Manuscript database

    In the United States, the prevalence of adults with food allergies is approximately 2 percent to 3 percent. Theoretically, any food can cause an allergic reaction; however, some foods are clearly more allergenic than others are. In adults, peanuts, tree nuts, finned fish, crustaceans, fruit, and veg...

  1. New food allergies in a European non-Mediterranean region: is Cannabis sativa to blame?

    PubMed

    Ebo, D G; Swerts, S; Sabato, V; Hagendorens, M M; Bridts, C H; Jorens, P G; De Clerck, L S

    2013-01-01

    Allergy to fruit and vegetables exhibit geographic variation regarding the severity of symptoms and depending on the sensitization profile of the patient. These sensitization profiles and routes remain incompletely understood. Cannabis is a very popular drug and derived from Cannabis sativa, a plant containing lipid transfer proteins (LTP) also known as important allergens in plant and fruit allergies. In this study we sought to elucidate a potential connection between C. sativa allergy and plant food allergies. A case-control study involving 21 patients consulting for plant food allergies. Twelve patients were cannabis allergic and 9 had a pollen or latex allergy without cannabis allergy. Testing for cannabis IgE implied measurement of specific IgE, skin testing and basophil activation tests. Allergen component analysis was performed with a microarray technique. Plant food allergy in patients with documented cannabis allergy had more severe reactions than patients without cannabis allergy and frequently implied fruits and vegetables that are not observed in a (birch) pollen-related food syndrome. With the exception of 1 patient with cannabis allergy, all were sensitized to nonspecific (ns)-LTP. Our data suggest that illicit cannabis abuse can result in cannabis allergy with sensitization to ns-LTP. This sensitization might result in various plant-food allergies. Additional collaborative studies in different geographical areas are needed to further elucidate on this hypothesis. Copyright © 2013 S. Karger AG, Basel.

  2. Food allergy: recent advances in pathophysiology and diagnosis.

    PubMed

    Dupont, Christophe

    2011-01-01

    Approximately 5% of young children and 3-4% of adults exhibit adverse immune responses to foods in westernized countries, with a tendency to increase. The pathophysiology of food allergy (FA) relies on immune reactions triggered by epitopes, i.e. small amino-acid sequences able to bind to antibodies or cells. Some food allergens share specific physicochemical characteristics that allow them to resist digestion, thus enhancing allergenicity. These allergens encounter specialized dendritic cell populations in the gut, which leads to T-cell priming. In case of IgE-mediated allergy, this process triggers the production of allergen-specific IgE by B cells. Tissue-resident reactive cells, including mast cells, then bind IgE, and allergic reactions are elicited when these cells, with adjacent IgE molecules bound to their surface, are re-exposed to allergen. Allergic reactions occurring in the absence of detectable IgE are labeled non-IgE mediated. The abrogation of oral tolerance which leads to FA is likely favored by genetic disposition and environmental factors (e.g. increased hygiene or enhanced allergenicity of some foods). For an accurate diagnosis, complete medical history, laboratory tests and, in most cases, an oral food challenge are needed. Noticeably, the detection of food-specific IgE (sensitization) does not necessarily indicate clinical allergy. Novel diagnostic methods currently under study focus on the immune responses to specific food proteins or epitopes of specific proteins. Food-induced allergic reactions represent a large array of symptoms involving the skin and gastrointestinal and respiratory systems. They can be attributed to IgE-mediated and non-IgE-mediated (cellular) mechanisms and thus differ in their nature, severity and outcome. Outcome also differs according to allergens. Copyright © 2011 S. Karger AG, Basel.

  3. Prevalence of food allergies and intolerances documented in electronic health records.

    PubMed

    Acker, Warren W; Plasek, Joseph M; Blumenthal, Kimberly G; Lai, Kenneth H; Topaz, Maxim; Seger, Diane L; Goss, Foster R; Slight, Sarah P; Bates, David W; Zhou, Li

    2017-05-23

    Food allergy prevalence is reported to be increasing, but epidemiological data using patients' electronic health records (EHRs) remain sparse. We sought to determine the prevalence of food allergy and intolerance documented in the EHR allergy module. Using allergy data from a large health care organization's EHR between 2000 and 2013, we determined the prevalence of food allergy and intolerance by sex, racial/ethnic group, and allergen group. We examined the prevalence of reactions that were potentially IgE-mediated and anaphylactic. Data were validated using radioallergosorbent test and ImmunoCAP results, when available, for patients with reported peanut allergy. Among 2.7 million patients, we identified 97,482 patients (3.6%) with 1 or more food allergies or intolerances (mean, 1.4 ± 0.1). The prevalence of food allergy and intolerance was higher in females (4.2% vs 2.9%; P < .001) and Asians (4.3% vs 3.6%; P < .001). The most common food allergen groups were shellfish (0.9%), fruit or vegetable (0.7%), dairy (0.5%), and peanut (0.5%). Of the 103,659 identified reactions to foods, 48.1% were potentially IgE-mediated (affecting 50.8% of food allergy or intolerance patients) and 15.9% were anaphylactic. About 20% of patients with reported peanut allergy had a radioallergosorbent test/ImmunoCAP performed, of which 57.3% had an IgE level of grade 3 or higher. Our findings are consistent with previously validated methods for studying food allergy, suggesting that the EHR's allergy module has the potential to be used for clinical and epidemiological research. The spectrum of severity observed with food allergy highlights the critical need for more allergy evaluations. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. All rights reserved.

  4. The connection between seasonal allergies, food allergies, and rhinosinusitis: what is the evidence?

    PubMed

    Dutta, Rahul; Dubal, Pariket M; Eloy, Jean Anderson

    2015-02-01

    Rhinosinusitis affects an estimated one in seven adults in the United States. Otolaryngologists are intimately involved in the care of patients with rhinosinusitis and other upper airway inflammatory conditions through procedures such as endoscopic sinus surgery and, therefore, would benefit from a deeper understanding of the associated comorbidities and their management. Recent evidence has suggested several connections between the underlying disease of rhinosinusitis, seasonal allergies, and food allergies. The authors of the present review seek to provide a focused analysis of the recent literature with respect to epidemiology, pathophysiology, and treatment options concerning these conditions. Evidence has connected the function of filaggrin, a skin barrier protein, with the pathogenesis of allergic rhinosinusitis and food allergy. Additionally, decreased levels of regulatory B cells and T cells are associated with and play a role in atopic disease. Overlapping treatment modalities between these conditions suggest similar conclusions. Future research into the role of the skin barrier, regulatory immune cell functioning, transforming growth factor-β, and other cytokine signaling, and treatment options such as omalizumab and azelastine is likely to have profound impact on clinicians' management of patients with these disorders and their comorbidities.

  5. Food allergy: Insights into etiology, prevention and treatment provided by murine models

    PubMed Central

    Oyoshi, Michiko K.; Oettgen, Hans C.; Chatila, Talal A.; Geha, Raif S.; Bryce, Paul J.

    2014-01-01

    Food allergy is a rapidly growing public health concern due to its increasing prevalence and its life threatening potential. Animal models of food allergy have emerged as a tool for identifying mechanisms involved in the development of sensitization to normally harmless food allergens as well as delineating the critical immune components of the effector phase of allergic reactions to food. However, the role animal models might play in understanding human diseases remain contentious. This review summarizes how animal models have provided insights on the etiology of human food allergy, experimental corroboration for epidemiological findings that might facilitate prevention strategies, and validation for the utility of new therapies for food allergy. Improved understanding of food allergy from the study of animal models together with human studies are likely to contribute to the development of novel strategies to prevent and treat food allergy. PMID:24636470

  6. Cow's milk protein allergy and other food hypersensitivities in infants.

    PubMed

    Venter, Carina

    2009-01-01

    Food hypersensitivity (FHS) is the umbrella term used to describe both food allergy, which involves the immune system, and food intolerances, which do not. It is therefore important that the diagnosis is made by a specialist health care professional such as a paediatrician or allergist. Some experienced dietitians and health visitors may be able to assist in making a diagnosis. The diagnostic work-up includes a medical history and blood tests/skin tests (where applicable). A food and symptom diary followed by a special test diet to identify the foods causing the infant's symptoms may also be needed. Once a diagnosis is made, dietary advice should be given to eliminate or reduce the intake of the offending foods. For cow's milk hypersensitivity in infants, this will include choosing the most appropriate specialised infant formula.

  7. Immunological mechanisms for desensitization and tolerance in food allergy1

    PubMed Central

    Rachid, Rima; Umetsu, Dale T.

    2013-01-01

    Food allergy is a major public health concern in westernized countries, estimated to affect 5% of children and 3-4 % of adults. Allergen specific immunotherapy for food allergy is currently being actively evaluated, but is still experimental. The optimal protocol, in terms of the route of administration of the food, target maintenance dose, duration of maintenance therapy and the optimal patient for these procedures are still being worked out. The mechanisms underlying successful food desensitization are also unclear, in part because there is no standard immunotherapy protocol. The mechanisms involved however, may include mast cell and basophil suppression, development of food-specific IgG4 antibodies, reduction in the food specific IgE/IgG4 ratio, up-regulation and expansion of natural or inducible regulatory T cells, a skewing from a Th2 to a Th1 profile and the development of anergy and/or deletion in antigen specific cells. Additional studies are required to elucidate and understand these mechanisms by which desensitization and tolerance are achieved, and which may reveal valuable biomarkers for evaluating and following food allergic patients on immunotherapy. PMID:22821087

  8. Parental Perception, Prevalence and Primary Care Physicians' Knowledge on Childhood Food Allergy in Croatia.

    PubMed

    Baricic, Tamara Voskresensky; Catipovic, Marija; Cetinic, Erina L; Krmek, Vlado; Horvat, Ivona

    2015-07-17

    Food allergy in children is increasing and the perception of food allergy among parents is even more common. In a questionnaire-based study of 702 children aged 6 to 48 months in four primary care settings, the aim was to determine the prevalence of perception vs. proven food allergy, parental anxiety and general pediatrician knowledge of food allergy. In 95/702 children (13.5%) parentally-reported food was associated reactions. IgE and/or skin prick test (SPT) and/or an open provocation test were performed in 48 (6.8%) and allergy was proven in 38 (5.4%) children. Discrepancy between parental perception and proven allergy is significant (p < 0.001), especially for food other than milk, egg and peanut (p < 0.001). Allergy to milk was the most common. Allergy to peanut was significantly more common in children ≥2 years (p < 0.05). Severe reactions occurred in 5/95 (5.2%) of all children and in 5/38 (13.1%) of allergic children, in 3/5 caused by peanut. Parents of children with proven allergy do not experience high degree of anxiety. The perception of food allergy among general pediatricians is limited, and in children with severe reactions precautionary measures and information to parents were insufficient. Parents and general pediatricians need additional education in food allergy.

  9. Knowing What You Eat: Researchers Are Looking for Ways to Help People Cope with Food Allergies.

    PubMed

    Grifantini, Kristina

    2016-01-01

    Food allergies and sensitivities have always been a public health problem but are becoming more prevalent worldwide. The U.S. Food and Drug Administration (FDA) reports that millions of Americans have allergic reactions to food each year. More than 17 million Europeans have a food allergy, and hospital admissions for severe reactions in children have risen sevenfold over the past decade, according to the European Academy of Allergy and Clinical Immunology.

  10. Lifetime Increased Risk of Adult Onset Atopic Dermatitis in Adolescent and Adult Patients with Food Allergy

    PubMed Central

    Yu, Hsu-Sheng; Tu, Hung-Pin; Hong, Chien-Hui; Lee, Chih-Hung

    2016-01-01

    Food allergy can result in life-threatening anaphylaxis. Atopic dermatitis (AD) causes intense itching and impaired quality of life. Previous studies have shown that patients with classical early-onset AD tend to develop food allergy and that 10% of adults with food allergies have concomitant AD. However, it is not known whether late-onset food allergy leads to adult-onset AD, a recently recognized disease entity. Using an initial cohort of one-million subjects, this study retrospectively followed-up 2851 patients with food allergy (age > 12 years) for 14 years and compared them with 11,404 matched controls. While 2.8% (81) of the 2851 food allergy patients developed AD, only 2.0% (227) of the 11,404 controls developed AD. Multivariate regression analysis showed that food allergy patients were more likely to develop AD (adjusted hazard ratio = 2.49, p < 0.0001). Controls had a 1.99% risk of developing AD, while food allergy patients had a significantly higher risk (7.18% and 3.46% for patients with ≥3 and <3 food allergy claims, respectively) of developing adult-onset AD. This is the first study to describe the chronological and dose-dependent associations between food allergy in adolescence and the development of adult-onset AD. PMID:28035995

  11. Growth comparison in children with and without food allergies in 2 different demographic populations.

    PubMed

    Mehta, Harshna; Ramesh, Manish; Feuille, Elizabeth; Groetch, Marion; Wang, Julie

    2014-10-01

    To examine the effects of food avoidance on the growth of children with food allergies. A retrospective chart review was performed for children with and without food allergies followed at 2 New York City general pediatric practices. Charts were selected based on codes from the International Classification of Diseases, 9th Revision, for well child visit, food allergy, anaphylaxis, and/or epinephrine autoinjector prescriptions. Heights and weights were obtained to calculate body mass index, height, and weight z-scores. Of the 9938 children seen, 439 (4.4%) were avoiding one or more foods. Of those with commercial insurance, children with food allergies were significantly shorter (mean height z-score = 0.06; P = .01) and weighed less (mean weight z-score -0.1; P = .006) than children without food allergies (mean height z-score = 0.42; mean weight z-score = 0.07). In contrast, children with food allergies and state insurance were not smaller in height or weight compared with children without food allergies. Among white subjects, there was a significant effect of food allergies on height and weight (ANOVA for height P = .012, for weight P = .0036) that was not observed for Hispanic/Latino, black, or Asian subjects. Children with allergies to milk weighed significantly less than children without milk allergies (P = .0006). Children with food allergies and commercial insurance have significant impairment in growth compared with those without food allergies. Additionally, children avoiding all forms of milk are shorter and weigh less than matched counterparts. Therefore, height and weight measurements should be assessed routinely in children with food allergies because there is risk for growth impairment in this population. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. Probiotics and prebiotics in preventing food allergy and eczema.

    PubMed

    Kuitunen, Mikael

    2013-06-01

    To describe the current literature on clinical trials of probiotics for eczema and food allergy prevention in view of recent new approaches and long-term follow-ups. Attempting allergy prevention by probiotic administration has been most successful when assessing atopic eczema, the most prevalent allergic disease at an early age. More than half of the published studies demonstrate a decrease in eczema prevalence until 2 years, whereas the remaining studies fail to show an effect. Effects have been most consistent with combined prenatal and direct postnatal supplementation of the infant and appear strain-specific, with Lactobacillus rhamnosus most often showing an effect. Prenatal-only and postnatal-only studies often fail to show effects. Recent long-time follow-ups have shown promising but not consistent results. A very recent follow-up of a large well conducted cohort shows that long-term effects of eczema prevention persists until age 4 and prevention of respiratory allergies might also be possible. Prevention of eczema with probiotics seem to work until age 2 years and extended effects until 4 years have been shown in high-risk for allergy cohorts. Effects are strain-specific, with L. rhamnosus showing the most consistent effects especially when combining pre and postnatal administration.

  13. Clinical and laboratory investigation of allergy to genetically modified foods.

    PubMed Central

    Bernstein, Jonathan A; Bernstein, I Leonard; Bucchini, Luca; Goldman, Lynn R; Hamilton, Robert G; Lehrer, Samuel; Rubin, Carol; Sampson, Hugh A

    2003-01-01

    Technology has improved the food supply since the first cultivation of crops. Genetic engineering facilitates the transfer of genes among organisms. Generally, only minute amounts of a specific protein need to be expressed to obtain the desired trait. Food allergy affects only individuals with an abnormal immunologic response to food--6% of children and 1.5-2% of adults in the United States. Not all diseases caused by food allergy are mediated by IgE. A number of expert committees have advised the U.S. government and international organizations on risk assessment for allergenicity of food proteins. These committees have created decision trees largely based on assessment of IgE-mediated food allergenicity. Difficulties include the limited availability of allergen-specific IgE antisera from allergic persons as validated source material, the utility of specific IgE assays, limited characterization of food proteins, cross-reactivity between food and other allergens, and modifications of food proteins by processing. StarLink was a corn variety modified to produce a (Italic)Bacillus thuringiensis(/Italic) (Bt) endotoxin, Cry9C. The Centers for Disease Control and Prevention investigated 51 reports of possible adverse reactions to corn that occurred after the announcement that StarLink, allowed for animal feed, was found in the human food supply. Allergic reactions were not confirmed, but tools for postmarket assessment were limited. Workers in agricultural and food preparation facilities have potential inhalation exposure to plant dusts and flours. In 1999, researchers found that migrant health workers can become sensitized to certain Bt spore extracts after exposure to Bt spraying. PMID:12826483

  14. Clinical and laboratory investigation of allergy to genetically modified foods.

    PubMed

    Bernstein, Jonathan A; Bernstein, I Leonard; Bucchini, Luca; Goldman, Lynn R; Hamilton, Robert G; Lehrer, Samuel; Rubin, Carol; Sampson, Hugh A

    2003-06-01

    Technology has improved the food supply since the first cultivation of crops. Genetic engineering facilitates the transfer of genes among organisms. Generally, only minute amounts of a specific protein need to be expressed to obtain the desired trait. Food allergy affects only individuals with an abnormal immunologic response to food--6% of children and 1.5-2% of adults in the United States. Not all diseases caused by food allergy are mediated by IgE. A number of expert committees have advised the U.S. government and international organizations on risk assessment for allergenicity of food proteins. These committees have created decision trees largely based on assessment of IgE-mediated food allergenicity. Difficulties include the limited availability of allergen-specific IgE antisera from allergic persons as validated source material, the utility of specific IgE assays, limited characterization of food proteins, cross-reactivity between food and other allergens, and modifications of food proteins by processing. StarLink was a corn variety modified to produce a (Italic)Bacillus thuringiensis(/Italic) (Bt) endotoxin, Cry9C. The Centers for Disease Control and Prevention investigated 51 reports of possible adverse reactions to corn that occurred after the announcement that StarLink, allowed for animal feed, was found in the human food supply. Allergic reactions were not confirmed, but tools for postmarket assessment were limited. Workers in agricultural and food preparation facilities have potential inhalation exposure to plant dusts and flours. In 1999, researchers found that migrant health workers can become sensitized to certain Bt spore extracts after exposure to Bt spraying.

  15. Immunotherapy for Food Allergy: Are We There Yet?

    PubMed

    Gernez, Yael; Nowak-Węgrzyn, Anna

    Current clinical research focuses on food allergen-specific immunotherapy through oral (OIT), sublingual (SLIT), or epicutaneous (EPIT) routes. Immunotherapy relies on the delivery of gradually increasing doses of specific allergens to induce desensitization (defined as temporary antigen hyporesponsiveness that depends on regular food ingestion) and, ultimately, tolerance (defined as the ability to ingest food without symptoms despite prolonged periods of avoidance or irregular intake). Although the majority of the patients treated with OIT achieve desensitization, only a minority achieves tolerance. OIT involves higher maintenance doses of food protein (300 mg-4g) compared with SLIT (2.5-7.5 mg) and EPIT (250-500 mcg). OIT efficacy is higher compared with SLIT, but OIT is associated with higher rate of systemic adverse events compared with SLIT and EPIT. OIT is also associated with a minor risk of eosinophilic esophagitis. Combined treatment of OIT and anti-IgE monoclonal antibody has improved safety but not efficacy compared with OIT alone. Early initiation of peanut OIT in peanut-allergic infants and young children may afford superior efficacy and safety. In this review, we discuss the allergen-specific strategies currently explored for the treatment of food allergy, including immunotherapy with native and heat-modified food proteins. Additional research employs strategies to improve the safety and efficacy of allergen immunotherapy through modifications of allergen structure and addition of immunomodulatory adjuvants. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  16. Food-specific serum immunoglobulin E measurements in children presenting with food allergy.

    PubMed

    Amin, Maryse R; Khoury, Jane C; Assa'ad, Amal H

    2014-02-01

    In children with food allergy, multiple food-specific serum IgE levels to common food allergens are frequently measured. To compare food-specific serum IgE measurements among common food allergens in children with food allergy to determine the characteristics of the measurements, their ability to discriminate between foods associated and not associated with a presenting clinical reaction, and their change over time. A retrospective analysis was conducted of food-specific serum IgE to cow's milk, egg white and yolk, peanuts, almond, and soy, for up to 3 subsequent measurements, in 291 children with food allergy. A food-specific serum IgE level lower than 0.35 kU/L was considered a negative measurement. The correlation of IgE measurements with presenting symptoms was conducted for each food in 172 children. Of 1,312 food-specific serum IgE measurements, 69.8% were positive. The median (interquartile range) IgE level for foods associated with the presenting complaint was 7.3 kU/L (2.7-31) and that for foods not associated with a clinical complaint was 2.2 kU/L (0.38-13). The difference was statistically significant (P = .01) only for cow's milk. Specific IgE levels were highest for peanuts, followed by cow's milk, eggs, soy, and almonds, and trended upward over time. In children presenting with clinical symptoms of a reaction to a food allergen, measurements of food-specific serum IgE to other common food allergens are commonly positive. An increase in food-specific serum IgE occurs over time. Copyright © 2014 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  17. Possible induction of food allergy during mite immunotherapy.

    PubMed

    van Ree, R; Antonicelli, L; Akkerdaas, J H; Garritani, M S; Aalberse, R C; Bonifazi, F

    1996-02-01

    Sera of 17 patients receiving immunotherapy for house-dust mite allergy were tested for IgE antibodies against snail and shrimp. Serum samples were taken at the start of immunotherapy and 14-20 months later. While the average IgE response to mite, Der p 1, and Der p 2 did not alter significantly, the average response to snail showed a significant increase. This included two conversions from negative to strongly positive. These novel IgE antibodies against snail were shown to be cross-reactive with mite. Three patients had a positive RAST for shrimp. For one of them, a strong increase of IgE against shrimp (and snail) was observed. In 2/3 snail/shrimp-positive sera, IgE antibodies against the cross-reactive allergen tropomyosin from mite, snail, and shrimp were demonstrated. A clear IgE response to snail (> 10% binding in a snail RAST) was confirmed by a positive skin prick test (SPT) for 6/10 patients. The two patients with antitropomyosin IgE also had a positive SPT for shrimp, and demonstrated the oral allergy syndrome (OAS) after eating shrimp. The observations in this study indicate that house-dust mite immunotherapy is accompanied by the induction of IgE against foods, including tropomyosin-reactive IgE. Food allergy (OAS) was observed in patients that had IgE antibodies against this cross-reactive allergen. In conclusion, induction of IgE during mite immunotherapy might occasionally cause allergy to foods of invertebrate animal origin.

  18. [Genetically modified food and allergies - an update].

    PubMed

    Niemann, Birgit; Pöting, Annette; Braeuning, Albert; Lampen, Alfonso

    2016-07-01

    Approval by the European Commission is mandatory for placing genetically modified plants as food or feed on the market in member states of the European Union (EU). The approval is preceded by a safety assessment based on the guidance of the European Food Safety Authority EFSA. The assessment of allergenicity of genetically modified plants and their newly expressed proteins is an integral part of this assessment process. Guidance documents for the assessment of allergenicity are currently under revision. For this purpose, an expert workshop was conducted in Brussels on June 17, 2015. There, methodological improvements for the assessment of coeliac disease-causing properties of proteins, as well as the use of complex models for in vitro digestion of proteins were discussed. Using such techniques a refinement of the current, proven system of allergenicity assessment of genetically modified plants can be achieved.

  19. Soy Allergy

    MedlinePlus

    ... Clinic Staff Allergy to soy, a product of soybeans, is a common food allergy. Often, soy allergy ... broth and vegetable starch Besides "soy," "soya" and "soybeans," other words on food labels may indicate that ...

  20. [Atopic dermatitis and food allergy in infancy and childhood].

    PubMed

    Stögmann, W; Kurz, H

    1996-01-01

    Food allergies are causal factors for atopic dermatitis (AD) in 50% in infancy, in 20 to 30% in childhood, and only in 10 to 15% after puberty and in adulthood. Cow's milk, egg, fish, wheat, soy, nuts and citrus-fruits are the most proven allergens. Pseudoallergens, especially food-additiva, have to be regarded too. For the proof of the clinical relevance that food allergy is causing AD a positive result of elimination and provocation has to be required. When by these diagnostic procedure a special food is found as causing the AD it has to be eliminated in the diet of this patient. In severe cases of AD semi-elementary respectively few foods diets may be necessary. However in most cases of AD the "diet of choice" is an age related normal nutrition. To delay respectively to avoid the manifestation of atopy special recommendations for the nutrition of high risk newborns and infants (especially long breast feeding, late solid feeding) should be considered.

  1. Recent advances in component resolved diagnosis in food allergy.

    PubMed

    Borres, Magnus P; Maruyama, Nobuyuki; Sato, Sakura; Ebisawa, Motohiro

    2016-10-01

    Due to the high prevalence of food allergic diseases globally there are increasing demands in clinical practice for managing IgE-mediated conditions. During the last decade, component resolved diagnostics has been introduced into the field of clinical allergology, providing information that cannot be obtained from extract-based tests. Component resolved data facilitate more precise diagnosis of allergic diseases and identify sensitizations attributable to cross-reactivity. Furthermore it assists risk assessment in clinical practice as sensitization to some allergenic molecules is related to persistence of clinical symptoms and systemic rather than local reactions. The information may also aid the clinician in prescription of oral immunotherapy (OIT) in patients with severe symptoms, and in giving advice on food allergen avoidance or on the need to perform food challenges. The use of allergen components is rapidly evolving and increases our possibility to treat food allergic patients with a more individual approach. Using molecular allergology, we can already now better diagnose, prognose and grade the food allergy. In summary, daily routine molecular allergy diagnostics offers a number of benefits that give us a higher diagnostic precision and allow for better management of the patient.

  2. Oral immunotherapy for food allergy: clinical and preclinical studies.

    PubMed

    Kulis, Mike; Wesley Burks, A

    2013-06-15

    Food allergies affect approximately 5% of the U.S. population and have increased in the last decade. In recent years, oral immunotherapy (OIT) has been tested in clinical trials for peanut, milk, and egg allergies in young children. OIT appears to be fairly well tolerated by most subjects and leads to desensitization with a greatly increased threshold of allergen required to induce reactions. Further approaches being investigated in preclinical studies in mouse models indicate the potential for using adjuvants, such as TLR9 agonists in combination with OIT; peptide OIT; and non-allergen specific applications such as herbal formulations. Further questions about OIT remain, including the optimal dosing and length of treatment; whether tolerance can be developed; and the exact cellular mechanisms resulting in protection following OIT. With many clinical trials underway across the United States and other countries, and a growing pipeline of preclinical research with translational potential, there is great hope for a widely applicable food allergy treatment. Copyright © 2012 Elsevier B.V. All rights reserved.

  3. New Perspectives for Use of Native and Engineered Recombinant Food Proteins in Treatment of Food Allergy

    PubMed Central

    Nowak-Wegrzyn, Anna

    2007-01-01

    Summary Food allergy is a serious medical problem without definitive treatment at this time. Intense research focuses on severe peanut allergy. Recombinant peanut major allergens engineered to lose IgE binding capacity mixed with E coli showed great promise in a murine model of peanut anaphylaxis. Rectal vaccine containing E.coli expressing engineered recombinant major peanut allergens Ara h 1, 2, 3 is in preparation for first human clinical trials. Oral desensitization and sublingual immunotherapy with food extracts represent another approach that is being actively explored. Novel therapies must be carefully evaluated in respect to safety and long-lasting effect on oral food tolerance before being applied in clinical practice. Diversity of approaches and promising preliminary results bring hope for patients with food allergy. PMID:17276882

  4. Skin manifestations and immunological parameters in childhood food allergy.

    PubMed

    Oehling, A; Fernández, M; Córdoba, H; Sanz, M L

    1997-01-01

    According to Hansen's contact rule, the digestive system should be considered as the main shock organ, yet in food allergy, this is not the case. Very often specific food triggers clinical manifestations not involving the digestive system; that is, reactions are manifested either in the respiratory system, as asthma or rhinitis, or in the skin. In these cases the BALT (broncho-alveolar lymphoid tissue) and GALT (gastrointestinal lymphoid tissue) units play a basic role in the sensitizations. The purpose of this study was to determine the most frequent skin manifestations of food allergy among children, and the most frequently involved foods. We also thought it interesting to evaluate the diagnostic reliability of the different standard immunological parameters utilized by the study team in food allergy. All patients underwent intracutaneous tests with 12 groups of the most frequent food allergens, as well as serum IgE, antigen-specific IgE against foods, and antigen-specific histamine release tests. Antigen-specific IgG4 determination was performed in some cases. The results obtained confirmed previous studies, the most common manifestations being: angioedema (48%), followed by urticaria (31%) and atopic dermatitis (21%). Regarding the frequency of sensitization to different food allergens, in mono- or polisensitization, fish and egg stand out in our environment. Certain food allergens are more frequently responsible for specific skin manifestations. Thus, for fish sensitization, the most frequent skin manifestation is atopic dermatitis (50%); for egg sensitization, angioedema is the most frequent skin manifestation (50%); and for milk, urticaria (50%). Finally, and in agreement with previous works regarding the diagnostic reliability of in vitro techniques, we found that the histamine release test offered the highest percentage of diagnostic reliability. Only for sensitization to milk proteins did antigen-specific IgE demonstrate higher reliability. Once again, we

  5. The role of epigenetic mediation and the future of food allergy research.

    PubMed

    Quake, Christine; Nadeau, Kari C

    2015-07-01

    IgE-mediated food allergy is a developing global health problem with prevalence rising at alarmingly fast rates. In this review, we discuss the interplay between genetics, epigenetics, and environmental exposures in the pathogenesis of food allergies. We aim to highlight the most recent evidence that suggests how epigenetic control may mediate genetic susceptibility of food allergies. We also examine how epigenetic modifications may be the key in explaining how environmental factors modulate and modify gene expression, leading to the dysregulation of immune tolerance and consequently, the development of food allergies. The emerging epigenetic paradigm in food allergies is likely to provide new mechanistic insight into food allergy risk and development as well as shape our therapeutic and preventive strategies. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Approach to evaluation and management of a patient with multiple food allergies.

    PubMed

    Bird, J Andrew

    2016-01-01

    Diagnosing food allergy is often challenging, and validated testing modalities are mostly limited to immunoglobulin E (IgE)-mediated reactions to foods. Use of food-specific IgE tests and skin prick tests in individuals without a history that supports an IgE-mediated reaction to the specific food being tested diminishes the predictive capabilities of the test. To review the literature regarding evaluation of patients with a concern for multiple food allergies and to demonstrate an evidence-based approach to diagnosis and management. A literature search was performed and articles identified as relevant based on the search terms "food allergy," "food allergy diagnosis," "skin prick test," "serum IgE test," "oral food challenge", and "food allergy management." Patients at risk of food allergy are often misdiagnosed and appropriate evaluation of patients with concern for food allergy includes taking a thorough diet history and reaction history, performing specific tests intentionally and when indicated, and conducting an oral food challenge in a safe environment by an experienced provider when test results are inconclusive. An evidence-based approach to diagnosing and managing a patient at risk of having a life-threatening food allergy is reviewed.

  7. Diet and food allergy development during infancy: birth cohort study findings using prospective food diary data.

    PubMed

    Grimshaw, Kate E C; Maskell, Joe; Oliver, Erin M; Morris, Ruth C G; Foote, Keith D; Mills, E N Clare; Margetts, Barrie M; Roberts, Graham

    2014-02-01

    After an era of only considering the allergenic properties of the infant diet and allergy outcomes, emerging data suggest that the overall composition of the infant diet might be a more important factor in the development of allergic disease. We sought to assess the relationship between infant dietary patterns in the first year of life and development of food allergy by age 2 years. We performed a nested, case-control, within-cohort study. Mothers kept prospective food diaries for the first year of life, with resultant diet data coded in a unique manner to produce new variables, which were then analyzed by using principal component analysis to identify infant feeding patterns within the study subjects. Principal component analysis of diet diary data from 41 infants given a diagnosis of food allergy based on results of double-blind, placebo-controlled food challenges in the first 2 years of life and their 82 age-matched control subjects provided an early infant diet pattern and an ongoing diet pattern. There was no difference between the study groups for the early infant diet pattern, but for the ongoing diet pattern, there was a significant difference between the groups (P = .001). This ongoing dietary pattern was characterized by higher intake of fruits, vegetables, and home-prepared foods, with control infants having a significantly higher healthy infant diet dietary pattern score than children who had a food allergy. An infant diet consisting of high levels of fruits, vegetables, and home-prepared foods is associated with less food allergy by the age of 2 years. Copyright © 2013 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

  8. Food allergy: is strict avoidance the only answer?

    PubMed

    Allen, C W; Campbell, D E; Kemp, A S

    2009-08-01

    It is an immunological paradigm that avoidance of food allergen may reduce the risk or prevent immunological reactions and conversely that a greater exposure increases the magnitude of the immune response. Consequently, food allergen avoidance has been recommended to reduce the risk of sensitization in infants and to prevent clinical reactions in children with positive skin prick tests (SPT). In the latter setting, it is hoped that avoidance may either promote or at least not retard the development of tolerance. Animal studies, however, have demonstrated that tolerance to food allergens may be induced by either large (high zone tolerance) or small (low zone tolerance) doses, whereas doses in between may actually stimulate immune responses. In this review, we discuss whether strict allergen avoidance is always the most appropriate strategy for preventing or managing IgE-mediated food allergy.

  9. Nannies' knowledge, attitude, and management of food allergies of children: an online survey.

    PubMed

    Greiwe, Justin C; Pazheri, Fouseena; Schroer, Brian

    2015-01-01

    Rates of food allergies in children as well as the rate of families who employ nannies have increased dramatically over the past decade. It is essential that nannies have the knowledge and tools necessary to recognize and treat food allergy reactions. To identify gaps in knowledge in the nanny population with regard to food allergy in children. A Web-based survey was sent by e-mail to 709 nannies. A total of 153 nannies (22%) completed the online survey: 26% of respondents had formal educational training at a nanny school; 99% recognized food allergy as a potentially fatal event; 37% reported caring for a child with food allergies. Of these, 71% had food allergy action plans, and 63% had epinephrine available. A total of 71% reported training on administering epinephrine. The nannies' major concerns included accidental ingestion and discomfort in administering epinephrine. A total of 36% were uncomfortable with recognizing a food allergy emergency, whereas 46% were uncomfortable administering epinephrine; 6% thought that a sensitized child could safely eat a small amount of allergenic food, whereas 14% believed that dilution with water might reduce an allergic reaction. A total of 66% desired additional information about recognizing food allergies, and 71% agreed that food allergy training should be required for all nannies. Nannies demonstrated gaps in knowledge with regard to food allergy in children, which reflects the need for more stringent training and education. Increased communication among parents, nannies, and physicians is needed to protect children with food allergy. Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  10. Food allergy--science and policy needs--The UK Food Standards Agency Research Programme.

    PubMed

    Buck, Joelle; Hattersley, Sue; Kimber, Ian

    2010-12-30

    Food allergy is a significant health issue in the UK, affecting between 1 and 2% of adults and 5 and 8% of children. The UK Food Standards Agency seeks to ensure the safety of food allergic consumers by providing them with information and guidance on food choices. Since 1995, with the aim of addressing important policy issues and improving the quality of the support and guidance available for food allergic consumers, the Agency (and before that the Ministry of Agriculture, Fisheries and Food), has had a programme of research dedicated to investigating the causes and mechanisms of food allergy and delivering benefits for UK consumers. In this paper, we outline some of the major scientific challenges that the programme has sought to address. We reflect on how the findings have been used as a basis for the development of sound, evidence-based policy and advice for UK consumers, and the current direction of research being supported by the programme.

  11. Socio-Cultural Matrix of Raising a Child with Food Allergies: Experiences of a Migrant Mother

    ERIC Educational Resources Information Center

    Sanagavarapu, Prathyusha

    2004-01-01

    Children with life-threatening food allergies are increasing in number in Australia. A variety of foods such as dairy milk, peanut and tree nuts, fish and egg can cause severe allergic reactions in some children. The foods that cause allergies could trigger severe breathing difficulties (anaphylaxis) for these children and, if not treated…

  12. Preparing School Personnel to Assist Students with Life-Threatening Food Allergies.

    ERIC Educational Resources Information Center

    Hay, Genevieve H.; And Others

    1994-01-01

    Knowledge of and preparation for life-threatening food allergies will enable school personnel to better respond to students who have severe allergic reactions. Given the high incidence of food-related anaphylaxis in public places, teachers and school personnel should be aware of and prepared to handle severe food allergy reactions. (SM)

  13. Preparing School Personnel to Assist Students with Life-Threatening Food Allergies.

    ERIC Educational Resources Information Center

    Hay, Genevieve H.; And Others

    1994-01-01

    Knowledge of and preparation for life-threatening food allergies will enable school personnel to better respond to students who have severe allergic reactions. Given the high incidence of food-related anaphylaxis in public places, teachers and school personnel should be aware of and prepared to handle severe food allergy reactions. (SM)

  14. Socio-Cultural Matrix of Raising a Child with Food Allergies: Experiences of a Migrant Mother

    ERIC Educational Resources Information Center

    Sanagavarapu, Prathyusha

    2004-01-01

    Children with life-threatening food allergies are increasing in number in Australia. A variety of foods such as dairy milk, peanut and tree nuts, fish and egg can cause severe allergic reactions in some children. The foods that cause allergies could trigger severe breathing difficulties (anaphylaxis) for these children and, if not treated…

  15. The ins and outs of managing avoidance diets for food allergies.

    PubMed

    Shaker, Marcus; Venter, Carina

    2016-08-01

    Food allergic reactions have become more prevalent and management of food allergies requires dietary avoidance of triggers that may place children at nutritional risk. Immunoglobulin E and non-immunoglobulin E-mediated food allergies lead to dietary avoidance. Although some children outgrow food allergies or become tolerant to cooked/baked versions of the allergen, many do not. Multiple food avoidance increases the risk for inadequate nutrient intake, including protein, calcium, vitamin D, and others. Multidisciplinary management of patients requires careful attention to growth, particularly height, and nutrition. Although attention to accurate diagnosis of food allergy is key, understanding nutritional risks of children with food allergies can lead to opportunities to address potential deficiencies resulting from food allergen avoidance.

  16. Beyond skin testing: state of the art and new horizons in food allergy diagnostic testing.

    PubMed

    Caubet, Jean-Christoph; Sampson, Hugh A

    2012-02-01

    Food allergy affects approximately 1% to 10.8% of the general population, and its prevalence seems to be increasing. An accurate diagnosis is particularly important because a misdiagnosis could lead to life-threatening reactions or to unnecessary restrictive diets. However, allergy tests currently used in clinical practice have limited accuracy, and an oral food challenge, considered as the gold standard, is often required to confirm or exclude a food allergy. This article reviews several promising novel approaches for the diagnosis of food allergy, such as new molecular diagnostic technologies and functional assays, along with their potential clinical applications.

  17. Impact of suspected food allergy on emotional distress and family life of parents prior to allergy diagnosis.

    PubMed

    Knibb, Rebecca C; Semper, Heather

    2013-12-01

    Food allergy is associated with psychological distress in both child and parent. It is unknown whether parental distress is present prior to clinical diagnosis or whether experiences at clinic can reduce any distress present. This study aimed to assess anxiety and depression in parents and the impact of suspected food allergy on the lives of families before and after a visit to an allergy clinic. One hundred and twenty-four parents visiting an allergy clinic for the first time to have their child assessed for food allergy completed a study-specific questionnaire and the Hospital Anxiety and Depression Scale; 50 parents completed these 4-6 wk later in their own home. Most parents (86.4%) reported suspected food allergy had an impact on their family life prior to clinic attendance; 76% had made changes to their child's diet. 32.5% of parents had mild-to-severe anxiety before their clinic visit; 17.5% had mild-to-moderate depression. Post-clinic, 40% had mild-to-severe anxiety; 13.1% had mild-to-moderate depression. There were no significant differences in anxiety (p = 0.34) or depression scores (p = 0.09) before and after the clinic visit. Anxiety and depression is present in a small proportion of parents prior to diagnosis of food allergy in their child and this does not reduce in the short term after the clinic visit. Identification of parents at risk of suffering from distress is needed and ways in which we communicate allergy information before and at clinic should be investigated to see if we can reduce distress. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. Phenotypes of IgE-mediated food allergy in Turkish children.

    PubMed

    Yavuz, S Tolga; Sahiner, Umit M; Buyuktiryaki, Betul; Soyer, Ozge U; Tuncer, Ayfer; Sekerel, Bulent E; Kalayci, Omer; Sackesen, Cansin

    2011-01-01

    Data on food allergy-related comorbid diseases and the knowledge on factors associating specific food types with specific allergic outcomes are limited. The aim of this study was to determine the clinical spectrum of IgE-dependent food allergy and the specific food-related phenotypes in a group of children with IgE-mediated food allergy. Children diagnosed with IgE-mediated food allergy were included in a cross-sectional study. IgE-mediated food allergy was diagnosed in the presence of specific IgE or skin-prick test and a consistent and clear-cut history of food-related symptoms or positive open provocation test. Egg (57.8%), cow's milk (55.9%), hazelnut (21.9%), peanut (11.7%), walnut (7.6%), lentil (7.0%), wheat (5.7%), and beef (5.7%) were the most common food allergies in children with food allergy. The respiratory symptoms and pollen sensitization were more frequent in children with isolated tree nuts-peanut allergy compared with those with egg or milk allergy (p < 0.001); whereas atopic dermatitis was more frequent in children with isolated egg allergy compared with those with isolated cow's milk and tree nuts-peanut allergy (p < 0.001). Children with food allergy were 3.1 (p = 0.003) and 2.3 (p = 0.003) times more likely to have asthma in the presence of allergic rhinitis and tree nuts-peanut allergy, respectively. Interestingly, children with atopic dermatitis were 0.5 (p = 0.005) times less likely to have asthma. Asthma (odds ratio [OR], 2.3; p = 0.002) and having multiple food allergies (OR, 5.4; p < 0.001) were significant risk factors for anaphylaxis. The phenotypes of IgE-mediated food allergy are highly heterogeneous and some clinical phenotypes may be associated with the specific type of food and the number of food allergies.

  19. Parental confidence in managing food allergy: development and validation of the Food Allergy Self-Efficacy Scale for Parents (FASE-P).

    PubMed

    Knibb, R C; Barnes, C; Stalker, C

    2015-11-01

    Food allergy is often a life-long condition that requires constant vigilance to prevent accidental exposure and avoid potentially life-threatening symptoms. Parents' confidence in managing their child's food allergy may relate to the poor quality of life anxiety and worry reported by parents of food-allergic children. The aim of this study was to develop and validate the first scale to measure parental confidence (self-efficacy) in managing food allergy in their child. The Food Allergy Self-Efficacy Scale for Parents (FASE-P) was developed through interviews with 53 parents, consultation of the literature and experts in the area. The FASE-P was then completed by 434 parents of food-allergic children from a general population sample in addition to the General Self-Efficacy Scale (GSES), the Food Allergy Quality of Life Parental Burden Scale (FAQL-PB), the General Health Questionnaire-12 (GHQ-12) and the Food Allergy Impact Measure (FAIM). A total of 250 parents completed the retest of the FASE-P. Factor and reliability analysis resulted in a 21-item scale with five subscales. The overall scale and subscales have good to excellent internal consistency (Cronbach's α of 0.63-0.89), and the scale is stable over time. There were low to moderate significant correlations with the GSES, FAIM and GHQ-12 and strong correlations with the FAQL-PB, with better parental confidence relating to better general self-efficacy, better quality of life and better mental health in the parent. Poorer self-efficacy was related to egg and milk allergy; self-efficacy was not related to severity of allergy. The FASE-P is a reliable and valid scale for use with parents from a general population. Its application within clinical settings could aid provision of advice and improve targeted interventions by identifying areas where parents have less confidence in managing their child's food allergy. © 2015 John Wiley & Sons Ltd.

  20. Management of food allergy in Japan "food allergy management guideline 2008 (revision from 2005)" and "guidelines for the treatment of allergic diseases in schools".

    PubMed

    Ebisawa, Motohiro

    2009-12-01

    In 2005, the "Food Allergy Management Guideline 2005" was published. In order to encompass food allergy from infancy to adulthood, the project committee included not only pediatricians, but also internists, dermatologists, and otolaryngologists. After the release of the guideline, oral food challenge tests were approved as a medical examination on hospital admission by the national health insurance system in 2006, and the tests at outpatient clinics were also approved in 2008. As clearly stated in the guideline, it is essential for general practitioners to refer food allergy patients to specialists to receive accurate diagnosis. A specialist is needed because the oral food challenge test, which is sometimes required for accurate diagnosis, carries the potential risk of developing an adverse reaction. In 2008, the "Food Allergy Management Guideline 2008" was revised to update recent advances, such as the appropriate conditions needed to perform oral food challenge tests and probability curves for hen's egg and cow's milk developed in Japan. In the same year, "The Guidelines for the Treatment of Allergic Diseases in Schools" was published by the Japanese Society of School Health. In addition to the guideline, "School Life Management Certificate (for Allergic Diseases) " was developed in order to allow the verification of the diagnosis and encourage the discussion of countermeasures by parents/guardians and school teachers for students requiring special care. It is hoped that this review article will be useful for doctors treating food allergy and that the quality of life of food allergy patients and their parents will be improved.

  1. Extracellular vesicle-derived protein from Bifidobacterium longum alleviates food allergy through mast cell suppression.

    PubMed

    Kim, Jung-Hwan; Jeun, Eun-Ji; Hong, Chun-Pyo; Kim, Seong-Hoon; Jang, Min Seong; Lee, Eun-Jung; Moon, Sook Jin; Yun, Chang Ho; Im, Sin-Hyeog; Jeong, Seok-Geun; Park, Beom-Young; Kim, Kyong-Tai; Seoh, Ju-Young; Kim, Yoon-Keun; Oh, Sung-Jong; Ham, Jun-Sang; Yang, Bo-Gie; Jang, Myoung Ho

    2016-02-01

    The incidence of food allergies has increased dramatically during the last decade. Recently, probiotics have been studied for the prevention and treatment of allergic disease. We examined whether Bifidobacterium longum KACC 91563 and Enterococcus faecalis KACC 91532 have the capacity to suppress food allergies. B longum KACC 91563 and E faecalis KACC 91532 were administered to BALB/c wild-type mice, in which food allergy was induced by using ovalbumin and alum. Food allergy symptoms and various immune responses were assessed. B longum KACC 91563, but not E faecalis KACC 91532, alleviated food allergy symptoms. Extracellular vesicles of B longum KACC 91563 bound specifically to mast cells and induced apoptosis without affecting T-cell immune responses. Furthermore, injection of family 5 extracellular solute-binding protein, a main component of extracellular vesicles, into mice markedly reduced the occurrence of diarrhea in a mouse food allergy model. B longum KACC 91563 induces apoptosis of mast cells specifically and alleviates food allergy symptoms. Accordingly, B longum KACC 91563 and family 5 extracellular solute-binding protein exhibit potential as therapeutic approaches for food allergies. Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  2. Temporal Regulation by Innate Type 2 Cytokines in Food Allergies.

    PubMed

    Graham, Michelle T; Andorf, Sandra; Spergel, Jonathan M; Chatila, Talal A; Nadeau, Kari C

    2016-10-01

    Food allergies (FAs) are a growing epidemic in western countries with poorly defined etiology. Defined as an adverse immune response to common food allergens, FAs present heterogeneously as a single- or multi-organ response that ranges in severity from localized hives and angioedema to systemic anaphylaxis. Current research focusing on epithelial-derived cytokines contends that temporal regulation by these factors impact initial sensitization and persistence of FA responses upon repeated food allergen exposure. Mechanistic understanding of FA draws insight from a myriad of atopic conditions studied in humans and modeled in mice. In this review, we will highlight how epithelial-derived cytokines initiate and then potentiate FAs. We will also review existing evidence of the contribution of other atopic diseases to FA pathogenesis and whether FA symptoms overlap with other atopic diseases.

  3. Food-Related Symptoms and Food Allergy in Swedish Children from Early Life to Adolescence.

    PubMed

    Protudjer, Jennifer L P; Vetander, Mirja; Kull, Inger; Hedlin, Gunilla; van Hage, Marianne; Wickman, Magnus; Bergström, Anna

    2016-01-01

    Risk factors for persistence of food-related symptoms (FRS) and food allergy (FA) from early life to adolescence are incompletely understood. The aim of this study was to identify risk factors for FRS and FA in adolescence amongst children with FRS or FA in the first four years of life (early life). In children enrolled in a Swedish birth cohort and followed to 16 years (n = 2572), we defined children with early life FRS in the absence of FA, and FA. Corresponding phenotypes were defined at 16 years. Associations between potential risk factors at 4 years and FRS and FA at 16 years were investigated using logistic regression. Early life FRS and FA prevalences were 12.2% and 6.8%, respectively. Amongst children with early life FRS, 35.7% had FRS or FA at 16 years, whereas 74.3% of the children with early life FA had FA at 16 years. For each of the early life phenotypes, parental allergy, early life allergic multimorbidity, early life reactions to peanuts/tree nuts and IgE reactivity at 4 years were statistically significantly associated with FRS or FA at 16 years. In contrast, male sex was associated with an increased risk of FA at 16 years among children with early life FA only. In early life, food-related symptoms are twice as common as food allergy. Unlike food allergy, food-related symptoms often remit by adolescence. Yet, these phenotypes have many common risk factors for persistence to adolescence.

  4. [Allergic transfusion reactions in a patient with multiple food allergies].

    PubMed

    Strobel, E; Schöniger, M; Münz, M; Hiefinger-Schindlbeck, R

    2012-07-01

    A 13-year-old girl with an osteosarcoma was treated by surgery and chemotherapy. During three transfusions of apheresis platelet concentrates allergic reactions occurred, partly in spite of premedication with an antihistamine and a corticoid. As the patient declared to be allergic to some foods, in-vitro tests for allergen-specific IgE antibodies were performed and showed markedly positive results for specific IgE to carrot and celery, less so to hazelnut, peanut and a lot of other food antigens. The donor of one of the unsuitable platelet concentrates remembered when questioned, that he had eaten carrots and chocolate with hazelnuts during the evening before platelet donation. Two washed platelet concentrates were transfused without any problem. Furthermore, transfusions of nine red blood cell concentrates and one unit of virus-inactivated frozen pooled plasma were well tolerated. Patients should be asked for allergies previous to transfusions to be alert to allergic reactions in patients with a positive history of food or drug allergies. If premedication with antihistamines does not prevent severe allergic transfusion reactions, transfusion of washed platelet concentrates and of virus-inactivated frozen pooled plasma can be considered. © Georg Thieme Verlag KG Stuttgart · New York.

  5. Use of a food allergy care management pathway in adolescents.

    PubMed

    Trower, Anna; Gettings, Sheryl

    2015-06-01

    The prevalence of allergic diseases is increasing, parents/carers. Healthcare staff also need training on with estimates suggesting that 3.9% of 0-19 year olds how best to deliver information to this age group and have a food allergy. Adolescents are seen as a high-risk to monitor them. More technically stylish adrenaline group for anaphylaxis because of their risk-taking auto-injectors, designed with the involvement of behaviours and challenges in using adrenaline adolescents, together with clearer food labelling, auto-injectors. The Royal College of Paediatrics would also help avoid episodes of anaphylaxis. and Child Health provides an allergy care pathway to assist health professionals with these issues. The pathway could be implemented more effectively with the adolescent age group if education on how to follow it was improved for young people and their parents/carers. Healthcare staff also need training on how best to deliver information to this age group and to monitor them. More technically stylish adrenaline auto-injectors, designed with the involvement of adolescents, together with clearer food labelling, would also help avoid episodes of anaphylaxis.

  6. Current Options for the Treatment of Food Allergy

    PubMed Central

    Lanser, Bruce J.; Wright, Benjamin L.; Orgel, Kelly A.; Vickery, Brian P.; Fleischer, David M.

    2016-01-01

    Food allergy is increasing in prevalence; as a result, there is intense focus on developing safe and effective therapies. Current methods of specific immunotherapy include oral, sublingual, and epicutaneous, while nonspecific methods that have been investigated include: Chinese herbal medicine, probiotics, and anti-IgE antibodies. Although some studies have demonstrated efficacy in inducing desensitization, questions regarding safety and the potential for achieving immune tolerance remain. Although some of these therapies demonstrate promise, further investigation is required before their incorporation into routine clinical practice. PMID:26456449

  7. Current Options for the Treatment of Food Allergy.

    PubMed

    Lanser, Bruce J; Wright, Benjamin L; Orgel, Kelly A; Vickery, Brian P; Fleischer, David M

    2015-12-01

    Food allergy is increasing in prevalence; as a result, there is intense focus on developing safe and effective therapies. Current methods of specific immunotherapy include oral, sublingual, and epicutaneous, while nonspecific methods that have been investigated include: Chinese herbal medicine, probiotics, and anti-IgE antibodies. Although some studies have demonstrated efficacy in inducing desensitization, questions regarding safety and the potential for achieving immune tolerance remain. Although some of these therapies demonstrate promise, further investigation is required before their incorporation into routine clinical practice. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Food allergies and eosinophilic esophagitis--two case studies.

    PubMed

    Martín-Muñoz, María F; Lucendo, Alfredo J; Navarro, Marta; Letrán, Antonio; Martín-Chávarri, Sonia; Burgos, Emilio; Martín-Esteban, M

    2006-01-01

    Eosinophilic esophagitis (EE) is a clinical-pathological disorder which is being increasingly diagnosed. It is etiologically associated with hypersensitivity to airborne allergens and/or dietary components. However, immediate hypersensitivity to foods has rarely been proven as the etiologic cause of the disorder. Two patients are presented with a history of rhinoconjunctivitis, allergic asthma, atopic dermatitis and food allergies which are currently under control and who show specific IgE to pulses and chicken respectively. These patients developed acute dysphagia and vomiting immediately after ingesting these foods and following appropriate examination were diagnosed as suffering from EE. The study also showed signs of blood hypereosinophilia while the esophageal manometry revealed a motor disorder characterized by aperistalsis and non-propulsive simultaneous waves affecting the lower two-thirds of the organ composed of smooth muscle. Topical treatment with fluticasone propionate was administered over a period of 3 months, in addition to a diet abstaining from the aforementioned foods and this led to remission of dysphagia and normalization of the endoscopic, histological and manometric studies of the esophagus. This situation remained stable for a considerable length of time after steroid treatment was discontinued, which showed that exposure to foods seemed to be the cause of the esophageal disorder. Similarly, allergies to inhalants and other digestive symptoms which appear upon immediate ingestion of the foods involved would not justify the sudden onset of dysphagia. We offer a pathophysiological explanation for the mechanisms of the disease based on the activation of eosinophils and mast cells by IgE and their ability to disturb the dynamic behavior of the neural and muscle components of the esophageal wall.

  9. Differences in empowerment and quality of life among parents of children with food allergy.

    PubMed

    Warren, Christopher M; Gupta, Ruchi S; Sohn, Min-Woong; Oh, Elissa H; Lal, Namit; Garfield, Craig F; Caruso, Deanna; Wang, Xiaobin; Pongracic, Jacqueline A

    2015-02-01

    Living with food allergy has been found to adversely affect quality of life. Previous studies of the psychosocial impact of food allergy on caregivers have focused on mothers. To describe differences in food allergy-related quality of life (FAQOL) and empowerment of mothers and fathers of a large cohort of children with food allergy. Eight hundred seventy-six families of children with food allergy were studied. Food allergy was defined by stringent criteria, including reaction history, skin prick testing, and specific IgE. Parental empowerment and FAQOL were assessed by the adapted Family Empowerment and FAQOL-Parental Burden scales. Parental scores were compared by Wilcoxon signed rank test. Multiple regression models examined the association of parental empowerment with FAQOL. Mothers reported greater empowerment (P < .001) and lower FAQOL (P < .001) compared with fathers, regardless of allergen severity, type, or comorbidities. However, parental empowerment was not significantly associated with FAQOL for mothers or fathers. Although parents of children with peanut, cow milk, egg, and tree nut allergies were similarly empowered, milk and egg allergies were associated with lower FAQOL (P < .01). Parental concern in the QOL assessment was greatest for items involving fear of allergen exposure outside the home. Parental empowerment and FAQOL vary significantly among mothers and fathers of children with food allergy. Greater effects on FAQOL were seen for milk and egg compared with other food allergies. Although parents of children with food allergy might be empowered to care for their child, they continue to experience impaired FAQOL owing to fears of allergen exposure beyond their control. Copyright © 2015 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  10. Food Allergies and the UK Catering Industry: A Study of the Training Needs for the Industry to Serve Those with Food Allergies

    ERIC Educational Resources Information Center

    Pratten, John; Towers, Neil

    2004-01-01

    This study looks at the ability of retail food outlets to provide suitable meals for those with special dietary needs. Thus, some food allergies are described briefly and the personnel involved in food preparation and service are examined. Groups of owners of catering outlets were interviewed to discover from them their knowledge of food allergies…

  11. Food Allergies and the UK Catering Industry: A Study of the Training Needs for the Industry to Serve Those with Food Allergies

    ERIC Educational Resources Information Center

    Pratten, John; Towers, Neil

    2004-01-01

    This study looks at the ability of retail food outlets to provide suitable meals for those with special dietary needs. Thus, some food allergies are described briefly and the personnel involved in food preparation and service are examined. Groups of owners of catering outlets were interviewed to discover from them their knowledge of food allergies…

  12. [Allergy to egg proteins in children].

    PubMed

    Góngora-Meléndez, Marco Antonio; Magaña-Cobos, Armando; Montiel-Herrera, Juan Manuel; Pantoja-Minguela, Cinthya Lorena; Pineda-Maldonado, Mario Luis; Piñeyro-Beltrán, Eduardo Enrique

    2015-01-01

    Food allergy prevalence has increased during the last years, affecting 15-20% of children, in this case, egg allergy affects from 0.5-2.5%. Most of the egg allergic reactions are type I or IgE mediated antibodies against egg proteins. Five major proteins have been identified: ovomucoid (Gal d1), ovoalbumin (Gal d2), ovotransferrin (Gal d3), lysozyme (Gal d4) and albumin (Gal d5). Ovomucoid protein, which is found in the egg white, is heat resistant and enzyme resistant. This protein is the most allergenic and the most common in egg composition. Clinical diagnosis requires a detailed questionnaire. Skin prick test or Ige specific diagnosis are made as first choice. Skin prick tests are quick and useful to determine the presence of IgE specific antibodies to egg. Specific IgE for egg can be measured using standarized IgE studies in vitro, making a quantitative measure. Traditionally with the clinical history a diagnosis can be made. Standarized oral double blinded-placebo controlled challenge continues to be the gold standard for food allergy diagnosis. The identification and elimination of egg proteins from the diet is the primary treatment and the only one validated to this food, but there are more studies needed to stablish protocols for each specific egg allergen before the oral inmunotherapy becomes a routine practice.

  13. Food allergy in dogs and cats: a review.

    PubMed

    Verlinden, A; Hesta, M; Millet, S; Janssens, G P J

    2006-01-01

    Food allergy (FA) is defined as "all immune-mediated reactions following food intake," in contrast with food intolerance (FI), which is non-immune-mediated. Impairment of the mucosal barrier and loss of oral tolerance are risk factors for the development of FA. Type I, III, and IV hypersensitivity reactions are the most likely immunologic mechanisms. Food allergens are (glyco-)proteins with a molecular weight from 10-70 kDa and are resistant to treatment with heat, acid, and proteases. The exact prevalence of FA in dogs and cats remains unknown. There is no breed, sex or age predilection, although some breeds are commonly affected. Before the onset of clinical signs, the animals have been fed the offending food components for at least two years, although some animals are less than a year old. FA is a non-seasonal disease with skin and/or gastrointestinal disorders. Pruritus is the main complaint and is mostly corticoid-resistant. In 20-30% of the cases, dogs and cats have concurrent allergic diseases (atopy/flea-allergic dermatitis). A reliable diagnosis can only be made with dietary elimination-challenge trials. Provocation testing is necessary for the identification of the causative food component(s). Therapy of FA consists of avoiding the offending food component(s).

  14. Treatment of asthma and food allergy with herbal interventions from traditional chinese medicine.

    PubMed

    Li, Xiu-Min

    2011-01-01

    Prevalence of asthma and allergy has increased over the past 2-3 decades in Westernized countries. Despite increased understanding of the pathogenesis of asthma and allergic diseases, control of severe asthma is still difficult. Asthma is also associated with a high prevalence of anxiety, particularly in adolescents. There is no effective treatment for food allergy. Food allergy is often associated with severe and recalcitrant eczema. Novel approaches for treatment of asthma and food allergy and comorbid conditions are urgently needed. Traditional Chinese medicine, used in Asia for centuries, is beginning to play a role in Western healthcare. There is increasing scientific evidence supporting the use of traditional Chinese medicine for asthma treatment. Since 2005, several controlled clinical studies of "antiasthma" herbal remedies have been published. Among the herbal medicines, antiasthma herbal medicine intervention is the only antiasthma traditional Chinese medicine product that is a Food and Drug Administration investigational new drug that has entered clinical trials in the United States. Research into the effects and mechanisms of action of antiasthma herbal medicine intervention in animal models is actively being pursued. Research on traditional Chinese medicine herbal medicines for treating food allergy is rare. The herbal intervention Food Allergy Herbal Formula-2 is the only Food and Drug Administration botanical investigational new drug under investigation as a multiple food allergy therapy. This review article discusses promising traditional Chinese medicine interventions for asthma, food allergy, and comorbid conditions, and explores their possible mechanisms of action. © 2011 Mount Sinai School of Medicine.

  15. A retrospective chart review to identify perinatal factors associated with food allergies.

    PubMed

    Dowhower Karpa, Kelly; Paul, Ian M; Leckie, J Alexander; Shung, Sharon; Carkaci-Salli, Nurgul; Vrana, Kent E; Mauger, David; Fausnight, Tracy; Poger, Jennifer

    2012-10-19

    Gut flora are important immunomodulators that may be disrupted in individuals with atopic conditions. Probiotic bacteria have been suggested as therapeutic modalities to mitigate or prevent food allergic manifestations. We wished to investigate whether perinatal factors known to disrupt gut flora increase the risk of IgE-mediated food allergies. Birth records obtained from 192 healthy children and 99 children diagnosed with food allergies were reviewed retrospectively. Data pertaining to delivery method, perinatal antibiotic exposure, neonatal nursery environment, and maternal variables were recorded. Logistic regression analysis was used to assess the association between variables of interest and subsequent food allergy diagnosis. Retrospective investigation did not find perinatal antibiotics, NICU admission, or cesarean section to be associated with increased risk of food allergy diagnosis. However, associations between food allergy diagnosis and male gender (66 vs. 33; p=0.02) were apparent in this cohort. Additionally, increasing maternal age at delivery was significantly associated with food allergy diagnosis during childhood (OR, 1.05; 95% CI, 1.017 to 1.105; p=0.005). Gut flora are potent immunomodulators, but their overall contribution to immune maturation remains to be elucidated. Additional understanding of the interplay between immunologic, genetic, and environmental factors underlying food allergy development need to be clarified before probiotic therapeutic interventions can routinely be recommended for prevention or mitigation of food allergies. Such interventions may be well-suited in male infants and in infants born to older mothers.

  16. A retrospective chart review to identify perinatal factors associated with food allergies

    PubMed Central

    2012-01-01

    Background Gut flora are important immunomodulators that may be disrupted in individuals with atopic conditions. Probiotic bacteria have been suggested as therapeutic modalities to mitigate or prevent food allergic manifestations. We wished to investigate whether perinatal factors known to disrupt gut flora increase the risk of IgE-mediated food allergies. Methods Birth records obtained from 192 healthy children and 99 children diagnosed with food allergies were reviewed retrospectively. Data pertaining to delivery method, perinatal antibiotic exposure, neonatal nursery environment, and maternal variables were recorded. Logistic regression analysis was used to assess the association between variables of interest and subsequent food allergy diagnosis. Results Retrospective investigation did not find perinatal antibiotics, NICU admission, or cesarean section to be associated with increased risk of food allergy diagnosis. However, associations between food allergy diagnosis and male gender (66 vs. 33; p=0.02) were apparent in this cohort. Additionally, increasing maternal age at delivery was significantly associated with food allergy diagnosis during childhood (OR, 1.05; 95% CI, 1.017 to 1.105; p=0.005). Conclusions Gut flora are potent immunomodulators, but their overall contribution to immune maturation remains to be elucidated. Additional understanding of the interplay between immunologic, genetic, and environmental factors underlying food allergy development need to be clarified before probiotic therapeutic interventions can routinely be recommended for prevention or mitigation of food allergies. Such interventions may be well-suited in male infants and in infants born to older mothers. PMID:23078601

  17. What do asthmatics have to fear from food and additive allergy?

    PubMed

    Gillman, A; Douglass, Jo A

    2010-09-01

    International studies report marked increases in the prevalence of food allergy, along with increases in hospital admissions and emergency presentations for severe allergic reactions due to foods. The prevalence of self-reported food allergy is common, but generally exceeds that which can be verified from challenge studies, although nut allergies appear to be an important exception to this rule. Studies examining food allergy deaths suggest that those who die of food allergy usually have co-existent asthma. Adolescents and young adults are at most risk, and adrenaline auto-injectors are sub-optimally used. Food chemical sensitivity is very commonly reported but not usually verified by challenge testing. However, the exception to this is sulphite sensitivity, which can elicit reproducible reactions in some. The increasing prevalence of severe food allergies and awareness of its risk in those with asthma demands an especially rigorous approach to the diagnosis and management of co-existent food allergy and asthma, especially in young people who appear to be at most risk from death from severe food allergy.

  18. Food, risk and place: agency and negotiations of young people with food allergy.

    PubMed

    Stjerna, Marie-Louise

    2015-02-01

    Potentially life-threatening food allergies are increasing among children in the Western world. Informed by childhood studies, this article explores young people's management of food allergy risk and highlights their agency in relation to food, eating and place. Drawing on individual interviews with 10 young people who took part in a larger multi-method study of young people's experiences of food allergies, the findings demonstrate that the management of health risks means, to some extent, trying to control the uncontrollable. A reaction can occur at any time and to experience a severe reaction entails a temporarily loss of control. The strategies the young people develop to avoid allergic reactions can be understood both as responses to this uncertainty and as manifestations of their agency. Their risk experiences vary with place; at school and in other public places they face social as well as health risks. What we see is not agency as a voluntary choice but that young people with food allergies experience tensions between their own competence to manage different types of risks and their dependence on others to adjust to their needs. Thus, the relational aspects of young people's agency come to the fore. © 2015 The Author. Sociology of Health & Illness © 2015 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

  19. A developmental, community, and psychosocial approach to food allergies in children.

    PubMed

    Houle, Christy R; Leo, Harvey L; Clark, Noreen M

    2010-09-01

    Recent estimates show that food allergies affect a substantial proportion of children in the United States and appear to have increased in prevalence. At present, management of food allergies consists of strict avoidance of the responsible allergen and an appropriate response should a reaction occur. Creating safe environments for the growing number of children with food allergies requires a partnership between affected families and members of the caregiving and educational communities. This article reviews issues affecting children with food allergies at different stages of psychosocial development and discusses strategies that can be implemented to promote food safety within child care and school environments as well as in the community. It also presents an overview of policy developments at the state and national level that have implications for children with food allergies.

  20. Is there a role for probiotics in the prevention or treatment of food allergy?

    PubMed

    Nermes, Merja; Salminen, Seppo; Isolauri, Erika

    2013-12-01

    A balanced gut microbiota is crucial for the development of healthy immunoregulation and gut barrier function to allow brisk immune responses to pathogens and systemic hyporesponsiveness to harmless antigens such as food. Although the first allergic disease to manifest itself, atopic eczema, is not equivalent to food allergy, pre- and postnatal administration of specific probiotic strains has emerged as a promising tool for the prevention of this condition, with potential implications for food allergy development. For food allergy proper, however, we lack markers and risk factors and mechanisms, i.e., targets for preventive measures. The focus here is therefore on the treatment. Indeed, the potential of specific probiotic strains to alleviate food allergy resides in their ability to modify antigens, repair gut barrier functions, balance altered microbiota, and restore local and systemic immune regulation. In patients with multiple food allergies, induction of oral tolerance by specific probiotics continues to attract research interest.

  1. The prevalence and characteristics of food allergy in urban minority children.

    PubMed

    Taylor-Black, Sarah; Wang, Julie

    2012-12-01

    Urban minority children are known to have high rates of asthma and allergic rhinitis, but little is known about food allergy in this population. To examine the prevalence and characteristics of food allergy in an urban pediatric population. A retrospective review of electronic medical records from children seen in the hospital-based general pediatric clinic at Mount Sinai Hospital serving East Harlem, NY, between July 1, 2008 and July 1, 2010 was performed. Charts for review were selected based on diagnosis codes for food allergy, anaphylaxis, or epinephrine autoinjector prescriptions. Of 9,184 children seen in this low-income, minority clinic, 3.4% (313) had a physician-documented food allergy. The most common food allergies were peanut (1.6%), shellfish (1.1%), and tree nuts (0.8%). Significantly more black children (4.7%) were affected than children of other races (2.7%, P < .0001), which consisted primarily of Hispanic and multiracial children. Anaphylaxis was most frequently documented for peanut (15.1%), fish (12.5%), and milk (11.1%). Among food-allergic children, asthma (50%), atopic dermatitis (52%), and allergic rhinitis (49%) were common. Fewer than half had confirmatory testing or evaluation by an allergy specialist, and although most had epinephrine autoinjectors prescribed, most were not prescribed food allergy action plans. This is the largest study of food allergy prevalence in an urban minority pediatric population, and 3.4% had physician-documented food allergy. Significantly more blacks were affected than children of other races. Fewer than half of food-allergic children in this population had confirmatory testing or evaluation by an allergy specialist. Copyright © 2012 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  2. Epigenetics and development of food allergy (FA) in early childhood.

    PubMed

    Hong, Xiumei; Wang, Xiaobin

    2014-09-01

    This review aims to highlight the latest advance on epigenetics in the development of food allergy (FA) and to offer future perspectives. FA, a condition caused by an immunoglobulin (Ig) E-mediated hypersensitivity reaction to food, has emerged as a major clinical and public health problem worldwide in light of its increasing prevalence, potential fatality, and significant medical and economic impact. Current evidence supports that epigenetic mechanisms are involved in immune regulation and that the epigenome may represent a key "missing piece" of the etiological puzzle for FA. There are a growing number of population-based epigenetic studies on allergy-related phenotypes, mostly focused on DNA methylation. Previous studies mostly applied candidate-gene approaches and have demonstrated that epigenetic marks are associated with multiple allergic diseases and/or with early-life exposures relevant to allergy development (such as early-life smoking exposure, air pollution, farming environment, and dietary fat). Rapid technological advancements have made unbiased genome-wide DNA methylation studies highly feasible, although there are substantial challenge in study design, data analyses, and interpretation of findings. In conclusion, epigenetics represents both an important knowledge gap and a promising research area for FA. Due to the early onset of FA, epigenetic studies of FA in prospective birth cohorts have the potential to better understand gene-environment interactions and underlying biological mechanisms in FA during critical developmental windows (preconception, in utero, and early childhood) and may lead to new paradigms in the diagnosis, prevention, and management of FA and provide novel targets for future drug discovery and therapies for FA.

  3. Food Intolerance vs. Food Allergy: What's the Difference?

    MedlinePlus

    ... can cause cramping, constipation and diarrhea. Sensitivity to food additives. For example, sulfites used to preserve dried fruit, canned goods and wine can trigger asthma attacks in sensitive people. ... Sometimes the mere thought of a food may make you sick. The reason is not ...

  4. Food allergy in Catalonia: Clinical manifestations and its association with airborne allergens.

    PubMed

    Sánchez-López, J; Gázquez, V; Rubira, N; Valdesoiro, L; Guilarte, M; Garcia-Moral, A; Depreux, N; Soto-Retes, L; De Molina, M; Luengo, O; Lleonart, R; Basagaña, M

    Food allergy affects around 6% of the European population and its prevalence worldwide has been increasing in the last decades, but studies focused on investigating food allergy epidemiology in Europe are lacking. The Cibus project was created to register the main culprit foods and their clinical manifestations in food allergic patients in Catalonia. A specific online database was designed. Allergists from eight different Catalan hospitals registered the new diagnoses of food allergy. 618 food allergic patients were included. Egg and milk were the main elicitors in the early ages, while fruits and nuts were the most frequent in patients >14 years old. Fish was more frequent in children, while seafood and Anisakis allergy were more frequent in the >14-year-old group. Overall, peach was the most prevalent food eliciting an allergic reaction (10%). Food allergy diagnosis was reached using compatible clinical history and positive skin prick test to the involved food in 98% of cases. Globally, urticaria was the most frequently reported manifestation in our population (48.2%), followed by oral allergy syndrome (25.6%) and anaphylaxis (24.8%). The Cibus project gives a full overview of the profile of food allergic patients in Catalonia and reinforces the predominance of plant food allergies in the Mediterranean area. Copyright © 2016 SEICAP. Published by Elsevier España, S.L.U. All rights reserved.

  5. Food allergy knowledge, attitudes, and beliefs of parents with food-allergic children in the United States.

    PubMed

    Gupta, Ruchi S; Springston, Elizabeth E; Smith, Bridget; Kim, Jennifer S; Pongracic, Jacqueline A; Wang, Xiaobin; Holl, Jane

    2010-09-01

    Parents of food-allergic children are responsible for risk assessment and management of their child's condition. Such practices are likely informed by parental knowledge, attitudes, and beliefs of food allergy. Our objective was to characterize food allergy knowledge and perceptions among parents with food-allergic children. Parents were recruited nationally between January 2008 and 2009 to complete the validated, web-based Chicago Food Allergy Research Survey for Parents of Children with Food Allergy. Findings were analyzed to provide composite/itemized knowledge scores, describe attitudes and beliefs, and examine the effects of participant characteristics on response. A sample of 2945 parents was obtained. Participants had an average knowledge score of 75% correct (range 19-100%). Strengths were observed in each content domain; e.g., 95% of participants accurately identified the signs of a milk-induced reaction. Weaknesses were limited to items assessing food allergy triggers/environmental risks and perceptions of susceptibility/prevalence; e.g., 52% of parents incorrectly believed young children are at higher risk for fatal anaphylaxis than adolescents. Parental attitudes/beliefs were diverse, although 85% agreed children should carry an EpiPen at school and 91% felt schools should have staff trained in food allergy. One in four parents reported food allergy caused a strain on their marriage/relationship, and 40% reported experiencing hostility from other parents when trying to accommodate their child's food allergy. In conclusion, parents in our study exhibited solid baseline knowledge although several important misconceptions were identified. While a broad spectrum of parental perceptions was observed, a large proportion of parents reported that their child's food allergy had an adverse impact on personal relationships and also agreed on certain policies to address food allergy in schools.

  6. Assessment of knowledge, attitude and practice of food allergies among food handlers in the state of Penang, Malaysia.

    PubMed

    Shafie, A A; Azman, A W

    2015-09-01

    Food handler's knowledge, attitude and practice regarding food allergies are important to prevent debilitating and sometimes fatal reactions. This study aimed to assess their food allergy knowledge, attitude and practice, which could help to maintain the safety and hygiene of food consumed by the public. Cross-sectional survey. A cross-sectional survey involving 121 conveniently sampled (81.76% response rate) respondents among the food handlers in the state of Penang, Malaysia, was conducted using a validated self-administered questionnaire. Their knowledge, attitude and work practice were captured using a 37-item questionnaire that elicited their responses using a mixture of closed-ended and Likert scale techniques. The mean knowledge score for respondents was 50.23 (SD = 14.03), attitude score was 54.26 (SD = 11.67) and practice score was 45.90 (SD = 24.78). Only 1.79% of the respondents were considered to have excellent knowledge, 21.37% had a low risk practice and 4.27% had positive attitudes towards food allergies. Most of the respondents (70%) knew about food allergies and their seriousness. There was a statistically significant correlation between the attitude and practice of respondents (r = 0.51). The type of establishment was the only characteristic significantly associated (P < 0.05) with food handler allergy knowledge, attitude and practice. More than half of food handlers in Penang have moderate levels of food allergy knowledge, practice and attitude. Only a small proportion of them have excellent food allergy knowledge, practice and attitude. Integration of food allergy training into compulsory food safety training programmes is needed to reduce food allergy risks and prevent fatal allergic reactions to food among their customers. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  7. Guidelines for Managing Life-Threatening Food Allergies in Massachusetts Schools

    ERIC Educational Resources Information Center

    Sheetz, Anne H.; Goldman, Patricia G.; Millett, Kathleen; Franks, Jane C.; McIntyre, C. Lynne; Carroll, Constance R.; Gorak, Diane; Harrison, Christanne Smith; Carrick, Michele Abu

    2004-01-01

    During the past decade, prevalence of food allergies among children increased. Caring for children with life-threatening food allergies has become a major challenge for school personnel Prior to 2002, Massachusetts did not provide clear guidelines to assist schools in providing a safe environment for these children and preparing for an emergency…

  8. Development of an Educational Packet for Persons with Life-Threatening Food Allergies

    ERIC Educational Resources Information Center

    Olson, Bradley F.; Teuber, Suzanne; Bruhn, Christine M.

    2009-01-01

    Previous studies have shown that those with severe food allergies have significant gaps in knowledge about their disease and how to prevent recurrences. The purpose of this study was to address these deficiencies by creating and testing an educational packet, "Coping with Food Allergies." Participants included 46 of 58 adults with documented…

  9. Is Low Vitamin D Status A Risk Factor For Food Allergy? Current Evidence And Future Directions.

    PubMed

    Molloy, John; Ponsonby, Anne-Louise; Allen, Katrina J; Tang, Mimi L K; Collier, Fiona M; Ward, Alister C; Koplin, Jennifer; Vuillermin, Peter

    2015-01-01

    Studies from several countries have reported an association between latitudes further from the equator and proxy markers of food allergy prevalence. As latitudes further from the equator are associated with lower sun exposure and vitamin D status (VDS), it has been proposed that low VDS may be a risk factor for food allergy. A range of basic science evidence supports the biological plausibility of this hypothesis; and recent work has identified a cross sectional association between low VDS and challenge proven food allergy in infants. Overall, however, the evidence regarding the relationship between VDS and food allergy remains controversial and the limited longitudinal data are discouraging. In this review we consider the evidence for and against low VDS as a risk factor for food allergy and discuss the possibility that other factors (including genetic variables) may contribute to the inconsistent nature of the available observational evidence. We then discuss whether genetic and/or environmental factors may modify the potential influence of VDS on food allergy risk. Finally, we argue that given the rising burden of food allergy, the balance of available evidence regarding the potential relevance of VDS to this phenomenon, and the inherent limitations of the existing observational data, there is a compelling case for conducting randomised clinical trials of vitamin D supplementation for the prevention of food allergy during early life.

  10. Guidelines for Managing Life-Threatening Food Allergies in Massachusetts Schools

    ERIC Educational Resources Information Center

    Sheetz, Anne H.; Goldman, Patricia G.; Millett, Kathleen; Franks, Jane C.; McIntyre, C. Lynne; Carroll, Constance R.; Gorak, Diane; Harrison, Christanne Smith; Carrick, Michele Abu

    2004-01-01

    During the past decade, prevalence of food allergies among children increased. Caring for children with life-threatening food allergies has become a major challenge for school personnel Prior to 2002, Massachusetts did not provide clear guidelines to assist schools in providing a safe environment for these children and preparing for an emergency…

  11. Development of an Educational Packet for Persons with Life-Threatening Food Allergies

    ERIC Educational Resources Information Center

    Olson, Bradley F.; Teuber, Suzanne; Bruhn, Christine M.

    2009-01-01

    Previous studies have shown that those with severe food allergies have significant gaps in knowledge about their disease and how to prevent recurrences. The purpose of this study was to address these deficiencies by creating and testing an educational packet, "Coping with Food Allergies." Participants included 46 of 58 adults with documented…

  12. Lettuce Allergy Is a Lipid Transfer Syndrome-Related Food Allergy With a High Risk of Severe Reactions.

    PubMed

    Muñoz-García, E; Luengo-Sánchez, O; Moreno-Pérez, N; Cuesta-Herranz, J; Pastor-Vargas, C; Cardona, V

    Lipid transfer protein (LTP) sensitization is the most common cause of food allergy in the Mediterranean area, with peach allergy acting as the primary sensitizer in most cases. Lettuce has been described as a common offending food in patients with LTP syndrome. The aim of the study was to investigate the frequency and clinical expression of LTP syndrome in a sample of lettuceallergic patients. We determined specific IgE to Pru p 3 and lettuce in a sample of 30 patients with a diagnosis of lettuce allergy. Symptoms elicited by other LTP-containing plant-derived foods and the presence of cofactors were assessed. The clinical symptoms of lettuce allergy were frequently severe, with 18 of the 30 patients experiencing anaphylaxis. All the patients had allergic reactions to other plant foods. Cofactors were involved in the clinical reactions of 13 of the 30 patients. Sensitization to pollens was found in 90% of patients. Lettuce allergy is found not as an isolated condition but in the context of LTP syndrome and it is characterized by severe reactions and frequent cofactor association.

  13. Improving the safety of oral immunotherapy for food allergy.

    PubMed

    Vazquez-Ortiz, Marta; Turner, Paul J

    2016-03-01

    Food allergy is a major public health problem in children, impacting upon the affected individual, their families and others charged with their care, for example educational establishments, and the food industry. In contrast to most other paediatric diseases, there is no established cure: current management is based upon dietary avoidance and the provision of rescue medication in the event of accidental reactions, which are common. This strategy has significant limitations and impacts adversely on health-related quality of life. In the last decade, research into disease-modifying treatments for food allergy has emerged, predominantly for peanut, egg and cow's milk. Most studies have used the oral route (oral immunotherapy, OIT), in which increasing amounts of allergen are given over weeks-months. OIT has proven effective to induce immune modulation and 'desensitization' - that is, an increase in the amount of food allergen that can be consumed, so long as regular (typically daily) doses are continued. However, its ability to induce permanent tolerance once ongoing exposure has stopped seems limited. Additionally, the short- and long-term safety of OIT is often poorly reported, raising concerns about its implementation in routine practice. Most patients experience allergic reactions and, although generally mild, severe reactions have occurred. Long-term adherence is unclear, which rises concerns given the low rates of long-term tolerance induction. Current research focuses on improving current limitations, especially safety. Strategies include alternative routes (sublingual, epicutaneous), modified hypoallergenic products and adjuvants (anti-IgE, pre-/probiotics). Biomarkers of safe/successful OIT are also under investigation.

  14. Latex Allergy

    MedlinePlus

    ... Allergic contact dermatitis. This reaction to the chemical additives used during manufacturing produces signs and symptoms — usually ... they're common in your family. Connection between food allergy and latex allergy Latex allergy also is ...

  15. Probiotics: a novel approach in the management of food allergy.

    PubMed

    Majamaa, H; Isolauri, E

    1997-02-01

    The gastrointestinal microflora is an important constituent of the gut mucosal defense barrier. We have previously shown that a human intestinal floral strain, Lactobacillus GG (ATCC 53103), promotes local antigen-specific immune responses (particularly in the IgA class), prevents permeability defects, and confers controlled antigen absorption. The aim of this study was to evaluate the clinical and immunologic effects of cow's milk elimination without (n = 14) and with (n = 13) the addition of Lactobacillus GG (5 x 10(8) colony-forming units/gm formula) in an extensively hydrolyzed whey formula in infants with atopic eczema and cow's milk allergy. The second part of the study involved 10 breast-fed infants who had atopic eczema and cow's milk allergy. In this group Lactobacillus GG was given to nursing mothers. The severity of atopic eczema was assessed by clinical scoring. The concentrations of fecal alpha 1- antitrypsin, tumor necrosis factor-alpha, and eosinophil cationic protein were determined as markers of intestinal inflammation before and after dietary intervention. The clinical score of atopic dermatitis improved significantly during the 1-month study period in infants treated with the extensively hydrolyzed whey formula fortified with Lactobacillus GG. The concentration of alpha 1-antitrypsin decreased significantly in this group (p = 0.03) but not in the group receiving the whey formula without Lactobacillus GG (p = 0.68). In parallel, the median (lower quartile to upper quartile) concentration of fecal tumor necrosis factor-alpha decreased significantly in this group, from 709 pg/gm (91 to 1131 pg/gm) to 34 pg/gm (19 to 103 pg/gm) (p = 0.003), but not in those receiving the extensively hydrolyzed whey formula only (p = 0.38). The concentration of fecal eosinophil cationic protein remained unaltered during therapy. These results suggest that probiotic bacteria may promote endogenous barrier mechanisms in patients with atopic dermatitis and food allergy

  16. The Development of a Clinical Decision Support System for the Management of Pediatric Food Allergy.

    PubMed

    Otto, Alana K; Dyer, Ashley A; Warren, Christopher M; Walkner, Madeline; Smith, Bridget M; Gupta, Ruchi S

    2017-06-01

    Pediatricians are often first-line providers for children with food allergy. Food allergy management guidelines have been developed but are cumbersome and confusing, and significant variation exists in pediatricians' management practices. We therefore consolidated the guidelines into 5 key steps for pediatricians caring for patients with food allergy and used rapid-cycle improvement methods to create a clinical decision support system to facilitate the management of food allergy in the primary care setting. This report details the development of the Food Allergy Support Tool (FAST), its pilot testing in 4 primary care pediatric practices, and our ongoing efforts to improve its utility and ease of use. Key themes identified during these processes include the importance of both initial and ongoing provider education as well as the limitations of a tool that must be actively initiated by providers.

  17. Potential links between the emerging risk factors for food allergy and vitamin D status.

    PubMed

    Vuillermin, P J; Ponsonby, A-L; Kemp, A S; Allen, K J

    2013-06-01

    A variety of hypotheses have been proposed to explain the recently described increase in food allergy among children living in developed countries. In this study, we summarize the emerging risk factors for IgE-mediated food allergy in early life, and then review the evidence for and against an association between low vitamin status (VDS) and food allergy. We consider whether each of the epidemiological variables that have been associated with food allergy may also be associated with VDS; and argue that future studies must adequately account for the potential relationships between risk factors for food allergy and VDS, and must also discriminate between vitamin D derived by sun exposure, diet and oral supplementation. © 2012 John Wiley & Sons Ltd.

  18. Creating a new community of support for students with food allergies.

    PubMed

    Pistiner, Michael; Lee, John J

    2012-09-01

    Managing food allergies in schools is a necessary but complex task. Breakdowns in implementation of school policies have resulted in devastating consequences and can create a divided school community. School nurses play the central role in the food allergy education of staff parents and students. An educated school community can then be united in supporting children with food allergies. A thoughtful approach that takes these different members of the school community into consideration is essential to put a successful food allergy policy into action. This article outlines issues to consider when educating each specific group as well as discussing the challenges that can hamper school community-wide education and their potential solutions. The ultimate goal of food allergy management education is to create a community of support and to create a self-sustaining environment of understanding and awareness that may save time, decrease divisiveness, and even save a life.

  19. Systematic review of nutrient intake and growth in children with multiple IgE-mediated food allergies.

    PubMed

    Sova, Cassandra; Feuling, Mary Beth; Baumler, Megan; Gleason, Linda; Tam, Jonathan S; Zafra, Heidi; Goday, Praveen S

    2013-12-01

    Food allergies affect up to 8% of American children. The current recommended treatment for food allergies is strict elimination of the allergens from the diet. Dietary elimination of nutrient-dense foods may result in inadequate nutrient intake and impaired growth. The purpose of this review was to critically analyze available research on the effect of an elimination diet on nutrient intake and growth in children with multiple food allergies. A systematic review of the literature was conducted and a workgroup was established to critically analyze each relevant article. The findings were summarized and a conclusion was generated. Six studies were analyzed. One study found that children with food allergies are more likely to be malnourished than children without food allergies. Three studies found that children with multiple food allergies were shorter than children with 1 food allergy. Four studies assessed nutrient intake of children with multiple food allergies, but the inclusion and comparison criteria were different in each of the studies and the findings were conflicting. One study found that children with food allergies who did not receive nutrition counseling were more likely to have inadequate intake of calcium and vitamin D. Children with multiple food allergies have a higher risk of impaired growth and may have a higher risk of inadequate nutrient intake than children without food allergies. Until more research is available, we recommend monitoring of nutrition and growth of children with multiple food allergies to prevent possible nutrient deficiencies and to optimize growth.

  20. Exploring quality of life in families of children living with and without a severe food allergy.

    PubMed

    Valentine, Althea Z; Knibb, Rebecca C

    2011-10-01

    This study aimed to explore the impact of food allergy on quality of life in children with food allergy and their primary caregivers, compared to a healthy non-food allergy comparison group. Food allergy children (n=34) and control children (n=15), aged 8-12, and their respective primary caregivers (n=30/n=13), completed generic quality of life scales (PedsQL™ and WHOQOLBREF) and were asked to take photographs and keep a diary about factors that they believed enhanced and/or limited their quality of life, over a one-week period. Questionnaire analysis showed that parents of children with food allergy had significantly lower quality of life in the social relationships domain and lower overall quality of life than the comparison parents. In contrast, children with food allergy had similar or higher quality of life scores compared to comparison children. Content analysis of photograph and diary data identified ten themes that influenced both child and parental quality of life. It was concluded that although food allergy influenced quality of life for some children, their parent's quality of life was hindered to a greater extent. The variability in findings highlights the importance of assessing quality of life in individual families, considering both children with allergies and their primary caregivers.

  1. Information and support from dietary consultation for mothers of children with food allergies.

    PubMed

    MacKenzie, Heather; Grundy, Jane; Glasbey, Gillian; Dean, Taraneh; Venter, Carina

    2015-01-01

    Professional dietetic input is essential to ensure that children with diagnosed food allergies have an individualized avoidance plan and nutritionally adequate diet. However, it is not clear what dietary information and support parents require. To explore what information and support parents of children with food allergies require from a dietary consultation. Focus groups were conducted with 17 mothers who attend an allergy center for dietary advice for their food allergic child. A number of issues around food allergy dietary advice needs were explored and analyzed using thematic analysis. Six themes were identified. The mothers described how they sought to protect their child from harm, to maintain normality for their child, and to promote child independence. They described needing to become an expert in their child's food allergy and fight their corner when needed. The dietitian supported their needs by ensuring their child's diet was safe and nutritionally adequate and giving information and support to help them provide a normal life for their child. Dietitians also taught mothers about food allergy and provided advocacy and emotional support. Mothers of children with food allergies want to understand how to provide a nutritionally adequate, allergen-safe diet while maintaining a normal life. Hence, mothers value a range of support from dietitians, including monitoring their child's health and providing information, practical advice and support, and emotional support. Copyright © 2015 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  2. Allergy Skin Tests

    MedlinePlus

    ... allergic rhinitis) Allergic asthma Dermatitis (eczema) Food allergies Penicillin allergy Bee venom allergy Latex allergy Skin tests are ... may recommend this test to check for an allergy to insect venom or penicillin. Patch test Patch testing is generally done to ...

  3. Extraintestinal manifestations in children with gastrointestinal food allergy.

    PubMed

    Domínguez-Ortega, G; Borrelli, O; Meyer, R; Dziubak, R; De Koker, C; Godwin, H; Fleming, C; Thapar, N; Elawad, M; Kiparissi, F; Fox, A T; Shah, N

    2014-08-01

    The presence of extraintestinal manifestations (EIM) in children with gastrointestinal (GI) food allergy (GIFA) is greatly debated. In the present study we assessed the prevalence of EIM in children with GIFA and investigated whether their presence is helpful in the allergy-focused history-taking process. The medical records of all children with a proven diagnosis of GIFA were reviewed along with those of children diagnosed as having inflammatory bowel disease (IBD) as controls. Data regarding age at onset, age at diagnosis, atopic family history, atopic comorbidities, GI symptoms, and EIM were recorded. Data from 436 children with GIFA and 74 children with IBD were included in the analysis. EIM were documented in 368 children with GIFA, including fatigue (53.0%), allergic shiners (49.1%), mouth ulcers (39.0%), joint pain/hypermobility (35.8%), poor sleep (34.4%), night sweats (34.4%), headache (22.7%), and bed-wetting (17.7%). The proportion of patients with EIM was higher in the GIFA group compared with that in the IBD group (368/436 [84.4%] vs 40/74 [54.1%]; P < 0.001). Segregating the GIFA group into children with and without atopic comorbidities, both atopic (276/30; 89.9%) and nonatopic (93/130; 71.5%) children showed higher proportion of EIM than children with IBD ([40/74; 54.1%], P < 0.01 and <0.05, respectively). GIFA are commonly associated with a wide range of EIM, which appear to represent important and specific clinical features of this group of conditions. Their recognition in taking an allergy-focused history may play an important role for both diagnosis and management.

  4. Relationship between respiratory and food allergy and evaluation of preventive measures.

    PubMed

    Vega, F; Panizo, C; Dordal, M T; González, M L; Velázquez, E; Valero, A; Sánchez, M C; Rondón, C; Montoro, J; Matheu, V; Lluch-Bernal, M; González, R; Fernández-Parra, B; Del Cuvillo, A; Dávila, I; Colás, C; Campo, P; Antón, E; Navarro, A M

    2016-01-01

    Food allergy and respiratory allergy are two frequently associated diseases and with an increasing prevalence. Several reports show the presence of respiratory symptoms in patients with food allergy, while certain foods may be related to the development or exacerbation of allergic rhinitis and asthma. The present update focuses on this relationship, revealing a pathogenic and clinical association between food and respiratory allergy. This association is even more intense when the food hypersensitivity is persistent or starts in the early years of life. Food allergy usually precedes respiratory allergy and may be a risk factor for allergic rhinitis and asthma, becoming a relevant clinical marker for severe atopic asthma. Furthermore, the presence of co-existing asthma may enhance life-threatening symptoms occurring during a food allergic reaction. Recommendations for dietary restrictions during pregnancy and breastfeeding to prevent the development of respiratory allergy are controversial and not supported by consistent scientific data. Current recommendations from medical societies propose exclusive breastfeeding during the first four months of life, with the introduction of solid food in the fourth to the seventh month period of life. A delayed introduction of solid food after this period may increase the risk of developing subsequent allergic conditions. Further studies are encouraged to avoid unjustified recommendations involving useless dietary restrictions.

  5. Eosinophilic airway inflammation is increased in children with asthma and food allergies.

    PubMed

    Kulkarni, Neeta; Ragazzo, Vincenzo; Costella, Silvia; Piacentini, Giorgio; Boner, Attilio; O'Callaghan, Christopher; Fiocchi, Alessandro; Kantar, Ahmad

    2012-02-01

    Asthma is associated with food allergies in a significant number of children, with evidence linking allergies to asthma severity and morbidity. In this study, we tested our hypothesis that the eosinophilic lower airway inflammation is higher in asthmatic children with food allergies. The aims of the study were to compare the eosinophilic inflammatory markers in asthmatic children with and without food allergies. Children with asthma, with (n = 22) and (n = 53) without food allergies were included. All subjects were classified according to the GINA guidelines (2009) and had received at least 3 months of anti-inflammatory therapy prior to testing. Fractional exhaled nitric oxide and sputum differential counts were performed using standard techniques.   Children with asthma and food allergies had significantly higher fractional exhaled nitric oxide median (range) [(22.4 (6.1-86.9) vs. 10.3 (2.7-38.7) (p = 0.01)] and sputum eosinophil percentage [15.5 (5.0-53.0) vs. 2.0 (0-20) (p < 0.001)] compared with asthmatic children without allergies. These results suggest that the children with asthma and food allergies have increased eosinophilic inflammation of the airways. © 2011 John Wiley & Sons A/S.

  6. Allergies

    MedlinePlus Videos and Cool Tools

    ... respond by producing antibodies. These antibodies attach to mast cells, which are white blood cells containing the chemical ... As more antibodies are produced, they cause the mast cells to release histamine. Histamine then produces allergy symptoms. ...

  7. Food Allergy Knowledge and Attitudes of Restaurant Managers and Staff: An EHS-Net Study

    PubMed Central

    Radke, Taylor J.; Brown, Laura G.; Hoover, E. Rickamer; Faw, Brenda V.; Reimann, David; Wong, Melissa R.; Nicholas, David; Barkley, Jonathan; Ripley, Danny

    2016-01-01

    Dining outside of the home can be difficult for persons with food allergies who must rely on restaurant staff to properly prepare allergen-free meals. The purpose of this study was to understand and identify factors associated with food allergy knowledge and attitudes among restaurant managers, food workers, and servers. This study was conducted by the Environmental Health Specialists Network (EHS-Net), a collaborative forum of federal, state, and local environmental health specialists working to understand the environmental factors associated with food safety issues. EHS-Net personnel collected data from 278 randomly selected restaurants through interviews with restaurant managers, food workers, and servers. Results indicated that managers, food workers, and servers were generally knowledgeable and had positive attitudes about accommodating customers’ food allergies. However, we identified important gaps, such as more than 10% of managers and staff believed that a person with a food allergy can safely consume a small amount of that allergen. Managers and staff also had lower confidence in their restaurant’s ability to properly respond to a food allergy emergency. The knowledge and attitudes of all groups were higher at restaurants that had a specific person to answer food allergy questions and requests or a plan for answering questions from food allergic customers. However, food allergy training was not associated with knowledge in any of the groups but was associated with manager and server attitudes. Based on these findings, we encourage restaurants to be proactive by training staff about food allergies and creating plans and procedures to reduce the risk of a customer having a food allergic reaction. PMID:28221943

  8. Food Allergy Knowledge and Attitudes of Restaurant Managers and Staff: An EHS-Net Study.

    PubMed

    Radke, Taylor J; Brown, Laura G; Hoover, E Rickamer; Faw, Brenda V; Reimann, David; Wong, Melissa R; Nicholas, David; Barkley, Jonathan; Ripley, Danny

    2016-09-01

    Dining outside of the home can be difficult for persons with food allergies who must rely on restaurant staff to properly prepare allergen-free meals. The purpose of this study was to understand and identify factors associated with food allergy knowledge and attitudes among restaurant managers, food workers, and servers. This study was conducted by the Environmental Health Specialists Network (EHS-Net), a collaborative forum of federal, state, and local environmental health specialists working to understand the environmental factors associated with food safety issues. EHS-Net personnel collected data from 278 randomly selected restaurants through interviews with restaurant managers, food workers, and servers. Results indicated that managers, food workers, and servers were generally knowledgeable and had positive attitudes about accommodating customers' food allergies. However, we identified important gaps, such as more than 10% of managers and staff believed that a person with a food allergy can safely consume a small amount of that allergen. Managers and staff also had lower confidence in their restaurant's ability to properly respond to a food allergy emergency. The knowledge and attitudes of all groups were higher at restaurants that had a specific person to answer food allergy questions and requests or a plan for answering questions from food allergic customers. However, food allergy training was not associated with knowledge in any of the groups but was associated with manager and server attitudes. Based on these findings, we encourage restaurants to be proactive by training staff about food allergies and creating plans and procedures to reduce the risk of a customer having a food allergic reaction.

  9. Are Children and Adolescents with Food Allergies at Increased Risk for Psychopathology?

    PubMed Central

    Shanahan, Lilly; Zucker, Nancy; Copeland, William E.; Costello, E. Jane; Angold, Adrian

    2014-01-01

    Objective Living with food allergy is a unique and potentially life-threatening stressor that requires constant vigilance to food-related stimuli, but little is known about whether adolescents with food allergies are at increased risk for psychopathology—concurrently and over time. Methods Data came from the prospective-longitudinal Great Smoky Mountains Study. Adolescents (N = 1,420) were recruited from the community, and interviewed up to six times between ages 10 to 16 for the purpose of the present analyses. At each assessment, adolescents and one parent were interviewed using the Child and Adolescent Psychiatric Assessment, resulting in N = 5,165 pairs of interviews. Results Cross-sectionally, food allergies were associated with more symptoms of separation and generalized anxiety, attention deficit and hyperactivity disorder, and anorexia nervosa. Longitudinally, adolescents with food allergy experienced increases in symptoms of generalized anxiety and depression from one assessment to the next. Food allergies were not, however, associated with a higher likelihood of meeting diagnostic criteria for a psychiatric disorder. Conclusion The unique constellation of adolescents’ increased symptoms of psychopathology in the context of food allergy likely reflects an adaptive increase in vigilance rather than cohesive syndromes of psychopathology. Support and guidance from health care providers is needed to help adolescents with food allergies and their caregivers achieve an optimal balance between necessary vigilance and hypervigilance and unnecessary restriction. PMID:25454290

  10. Are children and adolescents with food allergies at increased risk for psychopathology?

    PubMed

    Shanahan, Lilly; Zucker, Nancy; Copeland, William E; Costello, E Jane; Angold, Adrian

    2014-12-01

    Living with food allergy is a unique and potentially life-threatening stressor that requires constant vigilance to food-related stimuli, but little is known about whether adolescents with food allergies are at increased risk for psychopathology-concurrently and over time. Data came from the prospective-longitudinal Great Smoky Mountains Study. Adolescents (N=1420) were recruited from the community, and interviewed up to six times between ages 10 and 16 for the purpose of the present analyses. At each assessment, adolescents and one parent were interviewed using the Child and Adolescent Psychiatric Assessment, resulting in N=5165 pairs of interviews. Cross-sectionally, food allergies were associated with more symptoms of separation and generalized anxiety, disorder, attention deficit and hyperactivity disorder, and anorexia nervosa. Longitudinally, adolescents with food allergy experienced increases in symptoms of generalized anxiety disorder and depression from one assessment to the next. Food allergies were not, however, associated with a higher likelihood of meeting diagnostic criteria for a psychiatric disorder. The unique constellation of adolescents' increased symptoms of psychopathology in the context of food allergy likely reflects an adaptive increase in vigilance rather than cohesive syndromes of psychopathology. Support and guidance from health care providers is needed to help adolescents with food allergies and their caregivers achieve an optimal balance between necessary vigilance and hypervigilance and unnecessary restriction. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Traditional Chinese herbal remedies for Asthma and Food Allergy

    PubMed Central

    Li, Xiu-Min

    2009-01-01

    The increasing prevalence of allergic diseases in westernized countries is a significant health problem. Curative therapies for these diseases are not available. There are also significant concerns regarding the potential side effects from the chronic use of conventional drugs such as corticosteroids, especially in children. Many patients with chronic allergic conditions seek complementary and alternative medicine (CAM) therapies including traditional Chinese medicines (TCM). This trend has begun to attract interest from the mainstream healthcare providers and scientific investigators, and has stimulated government agencies in the US to provide support and guidance for the scientific investigation of CAM. This effort may lead to improved therapies and better healthcare/patient outcomes. This review presents an update on the most promising Chinese herbal remedies for asthma and food allergy. PMID:17560638

  12. Food allergy and autism spectrum disorders: is there a link?

    PubMed

    Jyonouchi, Harumi

    2009-05-01

    Gastrointestinal (GI) symptoms are common comorbidities in children with autism spectrum disorders (ASDs). Parents often attribute these GI symptoms to food allergy (FA), although an evaluation for IgE-mediated FA is often unrevealing. Our previous studies indicated a high prevalence of non-IgE-mediated FA in young children with ASDs. Therefore, non-IgE-mediated FA may account for some but not all GI symptoms observed in children with ASDs. This raises the question of what treatment measures are applicable to ASD children with GI symptoms. A wide variety of dietary supplements and dietary intervention measures for ASD children have been promoted by medical professionals practicing complementary and alternative medicine despite the lack of rigorous scientific validation in most instances. This review summarizes possible (or proposed) etiologies of GI symptoms in ASD children and discusses risks and possible benefits of intervention measures promoted by complementary and alternative practitioners, with emphasis on FA.

  13. Food-Related Symptoms and Food Allergy in Swedish Children from Early Life to Adolescence

    PubMed Central

    Protudjer, Jennifer L. P.; Vetander, Mirja; Kull, Inger; Hedlin, Gunilla; van Hage, Marianne; Wickman, Magnus; Bergström, Anna

    2016-01-01

    Background Risk factors for persistence of food-related symptoms (FRS) and food allergy (FA) from early life to adolescence are incompletely understood. The aim of this study was to identify risk factors for FRS and FA in adolescence amongst children with FRS or FA in the first four years of life (early life). Methods In children enrolled in a Swedish birth cohort and followed to 16 years (n = 2572), we defined children with early life FRS in the absence of FA, and FA. Corresponding phenotypes were defined at 16 years. Associations between potential risk factors at 4 years and FRS and FA at 16 years were investigated using logistic regression. Results Early life FRS and FA prevalences were 12.2% and 6.8%, respectively. Amongst children with early life FRS, 35.7% had FRS or FA at 16 years, whereas 74.3% of the children with early life FA had FA at 16 years. For each of the early life phenotypes, parental allergy, early life allergic multimorbidity, early life reactions to peanuts/tree nuts and IgE reactivity at 4 years were statistically significantly associated with FRS or FA at 16 years. In contrast, male sex was associated with an increased risk of FA at 16 years among children with early life FA only. Conclusions In early life, food-related symptoms are twice as common as food allergy. Unlike food allergy, food-related symptoms often remit by adolescence. Yet, these phenotypes have many common risk factors for persistence to adolescence. PMID:27846286

  14. The EuroPrevall outpatient clinic study on food allergy: background and methodology.

    PubMed

    Fernández-Rivas, M; Barreales, L; Mackie, A R; Fritsche, P; Vázquez-Cortés, S; Jedrzejczak-Czechowicz, M; Kowalski, M L; Clausen, M; Gislason, D; Sinaniotis, A; Kompoti, E; Le, T-M; Knulst, A C; Purohit, A; de Blay, F; Kralimarkova, T; Popov, T; Asero, R; Belohlavkova, S; Seneviratne, S L; Dubakiene, R; Lidholm, J; Hoffmann-Sommergruber, K; Burney, P; Crevel, R; Brill, M; Fernández-Pérez, C; Vieths, S; Clare Mills, E N; van Ree, R; Ballmer-Weber, B K

    2015-05-01

    The EuroPrevall project aimed to develop effective management strategies in food allergy through a suite of interconnected studies and a multidisciplinary integrated approach. To address some of the gaps in food allergy diagnosis, allergen risk management and socio-economic impact and to complement the EuroPrevall population-based surveys, a cross-sectional study in 12 outpatient clinics across Europe was conducted. We describe the study protocol. Patients referred for immediate food adverse reactions underwent a consistent and standardized allergy work-up that comprised collection of medical history; assessment of sensitization to 24 foods, 14 inhalant allergens and 55 allergenic molecules; and confirmation of clinical reactivity and food thresholds by standardized double-blind placebo-controlled food challenges (DBPCFCs) to milk, egg, fish, shrimp, peanut, hazelnut, celeriac, apple and peach. A standardized methodology for a comprehensive evaluation of food allergy was developed and implemented in 12 outpatient clinics across Europe. A total of 2121 patients (22.6% <14 years) reporting 8257 reactions to foods were studied, and 516 DBPCFCs were performed. This is the largest multicentre European case series in food allergy, in which subjects underwent a comprehensive, uniform and standardized evaluation including DBPCFC, by a methodology which is made available for further studies in food allergy. The analysis of this population will provide information on the different phenotypes of food allergy across Europe, will allow to validate novel in vitro diagnostic tests, to establish threshold values for major allergenic foods and to analyse the socio-economic impact of food allergy. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Relationship between treatment with antacid medication and the prevalence of food allergy in children.

    PubMed

    DeMuth, Karen; Stecenko, Arlene; Sullivan, Kevin; Fitzpatrick, Anne

    2013-01-01

    Food allergy affects 8% of preschool children, but factors responsible for food allergy in children are poorly understood. Use of antacid medication may be a contributing factor. The purpose of this study was to determine if parent-reported antacid medication use was associated with higher prevalence of food allergy in atopic children. In this cross-sectional study, parents of children with atopic diseases completed a questionnaire relating to a history of treatment with antacid medication and food allergy. Charts were independently reviewed for food-specific IgE and/or skin-prick test results. Food allergy was defined as a reaction to a food consistent with the anaphylaxis consensus statement and either an elevated food-specific IgE or a positive food skin-prick test. One hundred four questionnaires were completed. Mean age of the participating children was 7.0 ± 4.3 years (range, 5 months to 18 years of age). Forty-seven (45%) individuals were reported to have taken an antacid medication in the past. History of taking antacid medication was associated with an increased prevalence (57% (27)/47 versus 32% (18)/57) and higher prevalence of food allergy of having food allergy (aPR, 1.7 [1.1-2.5]). Mean peanut food-specific IgE was higher in those with a history of taking antacid medication (11.0 ± 5.0 versus 2.0 ± 5.5.; p = 0.01). History of treatment with antacid medication is associated with an increased prevalence of having food allergy.

  16. Non-IgE-mediated gastrointestinal food allergy.

    PubMed

    Nowak-Węgrzyn, Anna; Katz, Yitzhak; Mehr, Sam Soheil; Koletzko, Sibylle

    2015-05-01

    Non-IgE-mediated gastrointestinal food-induced allergic disorders (non-IgE-GI-FAs) account for an unknown proportion of food allergies and include food protein-induced enterocolitis syndrome (FPIES), food protein-induced allergic proctocolitis (FPIAP), and food protein-induced enteropathy (FPE). Non-IgE-GI-FAs are separate clinical entities but have many overlapping clinical and histologic features among themselves and with eosinophilic gastroenteropathies. Over the past decade, FPIES has emerged as the most actively studied non-IgE-GI-FA, potentially because of acute and distinct clinical features. FPIAP remains among the common causes of rectal bleeding in infants, while classic infantile FPE is rarely diagnosed. The overall most common allergens are cow's milk and soy; in patients with FPIES, rice and oat are also common. The most prominent clinical features of FPIES are repetitive emesis, pallor, and lethargy; chronic FPIES can lead to failure to thrive. FPIAP manifests with bloody stools in well-appearing young breast-fed or formula-fed infants. Features of FPE are nonbloody diarrhea, malabsorption, protein-losing enteropathy, hypoalbuminemia, and failure to thrive. Non-IgE-GI-FAs have a favorable prognosis; the majority resolve by 1 year in patients with FPIAP, 1 to 3 years in patients with FPE, and 1 to 5 years in patients with FPIES, with significant differences regarding specific foods. There is an urgent need to better define the natural history of FPIES and the pathophysiology of non-IgE-GI-FAs to develop biomarkers and novel therapies.

  17. Turmeric (Curcuma longa) attenuates food allergy symptoms by regulating type 1/type 2 helper T cells (Th1/Th2) balance in a mouse model of food allergy.

    PubMed

    Shin, Hee Soon; See, Hye-Jeong; Jung, Sun Young; Choi, Dae Woon; Kwon, Da-Ae; Bae, Min-Jung; Sung, Ki-Seung; Shon, Dong-Hwa

    2015-12-04

    Turmeric (Curcuma longa) has traditionally been used to treat pain, fever, allergic and inflammatory diseases such as bronchitis, arthritis, and dermatitis. In particular, turmeric and its active component, curcumin, were effective in ameliorating immune disorders including allergies. However, the effects of turmeric and curcumin have not yet been tested on food allergies. Mice were immunized with intraperitoneal ovalbumin (OVA) and alum. The mice were orally challenged with 50mg OVA, and treated with turmeric extract (100mg/kg), curcumin (3mg/kg or 30 mg/kg) for 16 days. Food allergy symptoms including decreased rectal temperature, diarrhea, and anaphylaxis were evaluated. In addition, cytokines, immunoglobulins, and mouse mast cell protease-1 (mMCP-1) were evaluated using ELISA. Turmeric significantly attenuated food allergy symptoms (decreased rectal temperature and anaphylactic response) induced by OVA, but curcumin showed weak improvement. Turmeric also inhibited IgE, IgG1, and mMCP-1 levels increased by OVA. Turmeric reduced type 2 helper cell (Th2)-related cytokines and enhanced a Th1-related cytokine. Turmeric ameliorated OVA-induced food allergy by maintaining Th1/Th2 balance. Furthermore, turmeric was confirmed anti-allergic effect through promoting Th1 responses on Th2-dominant immune responses in immunized mice. Turmeric significantly ameliorated food allergic symptoms in a mouse model of food allergy. The turmeric as an anti-allergic agent showed immune regulatory effects through maintaining Th1/Th2 immune balance, whereas curcumin appeared immune suppressive effects. Therefore, we suggest that administration of turmeric including various components may be useful to ameliorate Th2-mediated allergic disorders such as food allergy, atopic dermatitis, and asthma. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  18. Asthma and Food Allergy in Children: Is There a Connection or Interaction?

    PubMed

    Caffarelli, Carlo; Garrubba, Marilena; Greco, Chiara; Mastrorilli, Carla; Povesi Dascola, Carlotta

    2016-01-01

    This review explores the relationship between food allergy and asthma. They can share the same risk factors, such as parental allergy, atopic eczema, and allergen sensitization, and they often coincide in the same child. Coexistence may negatively influence the severity of both conditions. However, it remains to be determined whether food allergy may directly affect asthma control. An early food sensitization in the first year of life can predict the onset of asthma. Furthermore, asthmatic symptoms could rarely be caused by ingestion or inhalation of the offending food. Asthma caused by food allergy is severe and may be associated with anaphylactic symptoms. Therefore, an accurate identification of the offending foods is necessary in order to avoid exposure. Patients should be instructed to treat asthmatic symptoms quickly and to use self-injectable epinephrine.

  19. Asthma and Food Allergy in Children: Is There a Connection or Interaction?

    PubMed Central

    Caffarelli, Carlo; Garrubba, Marilena; Greco, Chiara; Mastrorilli, Carla; Povesi Dascola, Carlotta

    2016-01-01

    This review explores the relationship between food allergy and asthma. They can share the same risk factors, such as parental allergy, atopic eczema, and allergen sensitization, and they often coincide in the same child. Coexistence may negatively influence the severity of both conditions. However, it remains to be determined whether food allergy may directly affect asthma control. An early food sensitization in the first year of life can predict the onset of asthma. Furthermore, asthmatic symptoms could rarely be caused by ingestion or inhalation of the offending food. Asthma caused by food allergy is severe and may be associated with anaphylactic symptoms. Therefore, an accurate identification of the offending foods is necessary in order to avoid exposure. Patients should be instructed to treat asthmatic symptoms quickly and to use self-injectable epinephrine. PMID:27092299

  20. Is oral immunotherapy the cure for food allergies?

    PubMed

    Nowak-Wegrzyn, Anna; Fiocchi, Alessandro

    2010-06-01

    To review current evidence on food oral immunotherapy (OIT). Desensitized state, defined as the ingestion of a substantial amount of food in the home diet that protects from severe reactions to accidental exposures, can be achieved by approximately 50-75% of the children treated with OIT. The rate of permanent tolerance is unknown; the longer duration of OIT may result in permanent tolerance. Side effects are common both during the initial dose escalation and during home dosing. Most reactions are mild (oral pruritus, abdominal discomfort, and rashes) and decrease in frequency with the longer duration of OIT. Severe reactions treated with epinephrine have been reported during home dosing. Factors associated with increased risk of reactions to previously tolerated doses during home dosing include exercise, viral infection, dosing on empty stomach, menses, and asthma exacerbation. These preliminary data on OIT are encouraging. Additional studies must answer multiple questions including optimal dose, ideal duration of oral/sublingual immunotherapy, degree of protection, efficacy for different ages, severity and type of food allergy responsive to treatment and need for patient protection during home administration. Until these questions are answered in rigorous multicenter randomized and placebo-controlled trials, OIT remains an experimental approach with not sufficiently well established risk-to-benefit ratio.

  1. Hand eczema as a risk factor for food allergy among occupational kitchen workers.

    PubMed

    Minami, Takafumi; Fukutomi, Yuma; Sekiya, Kiyoshi; Akasawa, Akira; Taniguchi, Masami

    2017-09-02

    An increasing number of studies in children is highlighting the importance of transdermal routes of exposure to food allergens through damaged skin in the pathogenesis of food allergies. However, data on this in adults are limited. A few case-series studies has documented development of food allergy among kitchen workers with hand eczema after direct contact exposure to foods. To explore the significance of hand eczema as a risk factor for food allergies in adults at the epidemiological level, we performed a cross-sectional web-based questionnaire survey on kitchen workers whose exposures were classed as occupational (cooks and food handlers, n = 1592) or non-occupational (housewives, n = 1915). Logistic regression was used to explore the association between the presence/severity of hand eczema and the risk of food allergy after adjustment for potential confounders. Current hand eczema and current diagnosed food allergy were more common among occupational kitchen workers (OKW) than among non-occupational kitchen workers (NOKW) (32.3%-vs-29.9% and 9.9%-vs-3.8%, respectively). Current hand eczema was significantly associated with increased risk of current diagnosed food allergy in OKW (adjusted odds ratio 2.4, 95% CI 1.6-3.7). Those with more severe hand eczema were more likely to suffer from allergic symptoms for foods, and diagnosed food allergy. This study illustrates a significant public health problem in the adult population, documenting a major impact of hand eczema on the ongoing adult food allergy epidemic. Copyright © 2017 Japanese Society of Allergology. Production and hosting by Elsevier B.V. All rights reserved.

  2. Copy Number Variations in CTNNA3 and RBFOX1 Associate with Pediatric Food Allergy.

    PubMed

    Li, Jin; Fung, Irene; Glessner, Joseph T; Pandey, Rahul; Wei, Zhi; Bakay, Marina; Mentch, Frank D; Pellegrino, Renata; Wang, Tiancheng; Kim, Cecilia; Hou, Cuiping; Wang, Fengxiang; Chiavacci, Rosetta M; Thomas, Kelly A; Spergel, Jonathan M; Hakonarson, Hakon; Sleiman, Patrick M A

    2015-08-15

    Food allergy is a significant public health concern, especially among children. Previous candidate gene studies suggested a few susceptibility loci for food allergy, but no study investigated the contribution of copy number variations (CNVs) to food allergy on a genome-wide scale. To investigate the genetics of food allergy, we performed CNV assessment using high-resolution genome-wide single nucleotide polymorphism arrays. CNV calls from a total of 357 cases with confirmed food allergy and 3980 controls were analyzed within a discovery cohort, followed by a replication analysis composed of 167 cases and 1573 controls. We identified that CNVs in CTNNA3 were significantly associated with food allergy in both the discovery cohort and the replication cohort. Of particular interest, CTNNA3 CNVs hit exons or intron regions rich in histone marker H3K4Me1. CNVs in a second gene (RBFOX1) showed a significant association (p = 7.35 × 10(-5)) with food allergy at the genome-wide level in our meta-analysis of the European ancestry cohorts. The presence of these CNVs was confirmed by quantitative PCR. Furthermore, knockdown of CTNNA3 resulted in upregulation of CD63 and CD203c in mononuclear cells upon PMA stimulation, suggesting a role in sensitization to allergen. We uncovered at least two plausible genes harboring CNV loci that are enriched in pediatric patients with food allergies. The novel gene candidates discovered in this study by genome-wide CNV analysis are compelling drug and diagnostic targets for food allergy. Copyright © 2015 by The American Association of Immunologists, Inc.

  3. Food allergies in developing and emerging economies: need for comprehensive data on prevalence rates

    PubMed Central

    2012-01-01

    Although much is known today about the prevalence of food allergy in the developed world, there are serious knowledge gaps about the prevalence rates of food allergy in developing countries. Food allergy affects up to 6% of children and 4% of adults. Symptoms include urticaria, gastrointestinal distress, failure to thrive, anaphylaxis and even death. There are over 170 foods known to provoke allergic reactions. Of these, the most common foods responsible for inducing 90% of reported allergic reactions are peanuts, milk, eggs, wheat, nuts (e.g., hazelnuts, walnuts, almonds, cashews, pecans, etc.), soybeans, fish, crustaceans and shellfish. Current assumptions are that prevalence rates are lower in developing countries and emerging economies such as China, Brazil and India which raises questions about potential health impacts should the assumptions not be supported by evidence. As the health and social burden of food allergy can be significant, national and international efforts focusing on food security, food safety, food quality and dietary diversity need to pay special attention to the role of food allergy in order to avoid marginalization of sub-populations in the community. More importantly, as the major food sources used in international food aid programs are frequently priority allergens (e.g., peanut, milk, eggs, soybean, fish, wheat), and due to the similarities between food allergy and some malnutrition symptoms, it will be increasingly important to understand and assess the interplay between food allergy and nutrition in order to protect and identify appropriate sources of foods for sensitized sub-populations especially in economically disadvantaged countries and communities. PMID:23256652

  4. BSACI guideline for the diagnosis and management of peanut and tree nut allergy.

    PubMed

    Stiefel, G; Anagnostou, K; Boyle, R J; Brathwaite, N; Ewan, P; Fox, A T; Huber, P; Luyt, D; Till, S J; Venter, C; Clark, A T

    2017-06-01

    Peanut nut and tree nut allergy are characterised by IgE mediated reactions to nut proteins. Nut allergy is a global disease. Limited epidemiological data suggest varying prevalence in different geographical areas. Primary nut allergy affects over 2% of children and 0.5% of adults in the UK. Infants with severe eczema and/or egg allergy have a higher risk of peanut allergy. Primary nut allergy presents most commonly in the first five years of life, often after the first known ingestion with typical rapid onset IgE-mediated symptoms. The clinical diagnosis of primary nut allergy can be made by the combination of a typical clinical presentation and evidence of nut specifc IgE shown by a positive skin prick test (SPT) or specific IgE (sIgE) test. Pollen food syndrome is a distinct disorder, usually mild, with oral/pharyngeal symptoms, in the context of hay fever or pollen sensitisation, which can be triggered by nuts. It can usually be distinguish clinically from primary nut allergy. The magnitude of a SPT or sIgE relates to the probability of clinical allergy, but does not relate to clinical severity. SPT of ≥ 8 mm or sIgE ≥ 15 KU/L to peanut is highly predictive of clinical allergy. Cut off values are not available for tree nuts. Test results must be interpreted in the context of the clinical history. Diagnostic food challenges are usually not necessary but may be used to confirm or refute a conflicting history and test result. As nut allergy is likely to be a long-lived disease, nut avoidance advice is the cornerstone of management. Patients should be provided with a comprehensive management plan including avoidance advice, patient specific emergency medication and an emergency treatment plan and training in administration of emergency medication. Regular re-training is required. © 2017 John Wiley & Sons Ltd.

  5. Mental health and quality-of-life concerns related to the burden of food allergy.

    PubMed

    Ravid, N L; Annunziato, R A; Ambrose, M A; Chuang, K; Mullarkey, C; Sicherer, S H; Shemesh, E; Cox, A L

    2012-02-01

    As food allergy increases, more research is devoted to its influence on patient and family mental health and quality of life (QoL). This article discusses the effects on parent and child QoL, as well as distress, while appraising the limitations of knowledge given the methods used. Topics include whether QoL and distress are affected compared with other illnesses, assessment of distress and QoL in parents compared with children, concerns about food allergy-related bullying, and the necessity for evidence-based interventions. Suggestions are offered for how to improve QoL and reduce distress on the way to better coping with food allergy.

  6. Aberrant interaction of the gut immune system with environmental factors in the development of food allergies.

    PubMed

    Kunisawa, Jun; Kiyono, Hiroshi

    2010-05-01

    The gastrointestinal immune system is a major component of the mucosal barrier, which maintains an immunologic homeostasis between the host and the harsh environment of the gut. This homeostasis is achieved by immunologic quiescence, and its dysregulation is thought to result from the development of immune diseases such as food allergies. Recent findings have revealed versatile pathways in the development of intestinal allergies to certain food antigens. In this review, we summarize the regulatory and quiescence mechanisms in the gut immune system and describe aberrant interactions between the host immune system and the gut environment in the development of food allergies.

  7. Precision medicine in allergic disease-food allergy, drug allergy, and anaphylaxis-PRACTALL document of the European Academy of Allergy and Clinical Immunology and the American Academy of Allergy, Asthma and Immunology.

    PubMed

    Muraro, A; Lemanske, R F; Castells, M; Torres, M J; Khan, D; Simon, H-U; Bindslev-Jensen, C; Burks, W; Poulsen, L K; Sampson, H A; Worm, M; Nadeau, K C

    2017-07-01

    This consensus document summarizes the current knowledge on the potential for precision medicine in food allergy, drug allergy, and anaphylaxis under the auspices of the PRACTALL collaboration platform. PRACTALL is a joint effort of the European Academy of Allergy and Clinical Immunology and the American Academy of Allergy, Asthma and Immunology, which aims to synchronize the European and American approaches to allergy care. Precision medicine is an emerging approach for disease treatment based on disease endotypes, which are phenotypic subclasses associated with specific mechanisms underlying the disease. Although significant progress has been made in defining endotypes for asthma, definitions of endotypes for food and drug allergy or for anaphylaxis lag behind. Progress has been made in discovery of biomarkers to guide a precision medicine approach to treatment of food and drug allergy, but further validation and quantification of these biomarkers are needed to allow their translation into practice in the clinical management of allergic disease. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Formula and breast feeding in infant food allergy: A population-based study.

    PubMed

    Goldsmith, Alice J; Koplin, Jennifer J; Lowe, Adrian J; Tang, Mimi Lk; Matheson, Melanie C; Robinson, Marnie; Peters, Rachel; Dharmage, Shyamali C; Allen, Katrina J

    2016-04-01

    To determine whether infant-feeding practices, including duration of exclusive breastfeeding and use of partially hydrolysed formula, modify the risk of developing infant food allergy. In an observational population-based study, 1 year olds were recruited from community immunisation clinics in Melbourne, Australia. Parent-reported data on infant-feeding practices and potential confounders were collected prior to infant skin prick testing for four food allergens. Sensitised infants attended hospital-based oral food challenges to establish food allergy status. Multiple logistic regression was used to investigate associations between breastfeeding and formula-feeding and infant food allergy adjusting for possible confounding variables. A total of 5276 (74% response) infants participated. Of the 4537 for whom food allergy status was determined, 515 (11.3%) were food allergic (challenge-proven in the context of skin prick testing positive (≥2 mm)). After adjusting for confounding variables, there was no association between duration of exclusive breastfeeding and food allergy. Use of partially hydrolysed formula did not reduce the risk of food allergy compared with cow's milk formula in the general population (adjusted odds ratios 1.03 (confidence interval 0.67-1.50)). Duration of exclusive breastfeeding and use of partially hydrolysed formula were not associated with food allergy at 1 year of age in this large population-based study. These findings have implications for population-based infant-feeding guidelines and do not support the use of partially hydrolysed formula for food allergy prevention. © 2016 The Authors Journal of Paediatrics and Child Health © 2016 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  9. Epidemiological survey of pediatric food allergy in Mashhad in Northeast Iran

    PubMed Central

    Ahanchian, Hamid; Jafari, Seyedali; Behmanesh, Fatemeh; Haghi, Nasrinsadat Motevalli; Nakhaei, Alireza Ataei; Kiani, Mohammad Ali; Radbin, Mohammad Hossein; Kianifar, Hamidreza

    2016-01-01

    Introduction Food allergy is an increasing problem worldwide, but the foods responsible for food allergy are not the same in different countries, probably because of the role of genetic, cultural, and nutritional factors. The aim of this study was to determine the common food allergens in pediatric patients with different presentation of food allergy. Methods In this cross-sectional study, all of the patients were referred to pediatric allergy clinics affiliated with Mashhad University of Medical Sciences from September 2012 to August 2014. For patients with IgE-mediated food allergy that was diagnosed with clinical manifestations, the skin prick test was done. The results were analyzed by SPSS version 17 and statistical analysis was done with the chi-squared test and the t-test. P values < 0.05 were considered statistically significant. Results Three hundred seventy-one patients (53.9% male, 46.1% female) with ages in the range of three months to 18 years were studied. The most frequent food allergen in all patients with decreasing prevalence were egg white (17.8%), pepper (15.8%), curry (14.3%), egg yolk (14%), cow’s milk (10%), and tomato (7.8%). The most common presenting symptoms were respiratory (allergic rhinitis 45%, asthma 32%), dermatologic (atopic dermatitis 30%, urticaria 8.3%), colitis (17.5%), and gasteroesophagial reflux disease (GERD) (2%). According to the prevalence of food allergens in different age groups, we realized that, after the age of three years, the frequency of sensitization to egg white, egg yolk, cow’s milk, wheat and cereals was decreased and allergy to pepper and curry was increased. Conclusion The prevalence of culprit foods that produce food allergies depends on several factors, including age, presenting manifestation, and where the patient lives. As many food allergies are outgrown, patients should be reevaluated regularly to determine whether they have lost their reactivity or not. PMID:26955442

  10. [Association of dietary patterns and food allergy in infants during the first year of life].

    PubMed

    Bascuñán Gamboa, Karla Amada; Weisstaub Nuta, Sergio Gerardo; Chamorro Melo, Rodrigo Andrés; Guzmán, María Antonieta; Araya Quezada, Magdalena

    2012-10-01

    There is controversy about the effect of dietary patterns during the first year of life and the occurrence of food allergy. The objective of this study was to evaluate the association between family history of allergy, allergic manifestations and dietary patterns during the first year of life in infants with and without food allergy. We performed a descriptive cross-sectional study in children under 2 years of age (n= 99), sorted in two groups: allergic group (n= 50) and control group (n= 49), matched by socioeconomic status, age and gender. Food allergy was deifned by internationally approved clinical criteria, prick and patch tests, and response to diet. Information on diet, clinical data and history of allergy in the parents were collected. The sample size was estimated for logistic regression (Freeman), and Student X² and Mann-Withney tests were used. The study and consent forms were approved by the Ethics Committee of the Institute of Nutrition and Food Technology (Instituto de Nutrición y Tecnología de los Alimentos, INTA) and the Universidad de Chile. The allergic group showed a significantly higher prevalence (p <0.0001) of family history of allergy (84%) than the control group (16%). Diarrhea was the symptom most frequently reported by the mothers of allergic infants during the first year of life. Bottle feeding was introduced earlier in the allergic group than in the control group (3 versus 6 months [p < 0.03]); no differences regarding the start age for supplementary feeding was found. When performing logistic regression, only the family history of allergy was associated with a higher risk of food allergy (OR: 48.2; CI= 14.2-164; p < 0.001). The early introduction of milk formula could promote the occurrence of food allergy in infants frequently presenting family history of allergy.

  11. Automated identification of drug and food allergies entered using non-standard terminology.

    PubMed

    Epstein, Richard H; St Jacques, Paul; Stockin, Michael; Rothman, Brian; Ehrenfeld, Jesse M; Denny, Joshua C

    2013-01-01

    An accurate computable representation of food and drug allergy is essential for safe healthcare. Our goal was to develop a high-performance, easily maintained algorithm to identify medication and food allergies and sensitivities from unstructured allergy entries in electronic health record (EHR) systems. An algorithm was developed in Transact-SQL to identify ingredients to which patients had allergies in a perioperative information management system. The algorithm used RxNorm and natural language processing techniques developed on a training set of 24 599 entries from 9445 records. Accuracy, specificity, precision, recall, and F-measure were determined for the training dataset and repeated for the testing dataset (24 857 entries from 9430 records). Accuracy, precision, recall, and F-measure for medication allergy matches were all above 98% in the training dataset and above 97% in the testing dataset for all allergy entries. Corresponding values for food allergy matches were above 97% and above 93%, respectively. Specificities of the algorithm were 90.3% and 85.0% for drug matches and 100% and 88.9% for food matches in the training and testing datasets, respectively. The algorithm had high performance for identification of medication and food allergies. Maintenance is practical, as updates are managed through upload of new RxNorm versions and additions to companion database tables. However, direct entry of codified allergy information by providers (through autocompleters or drop lists) is still preferred to post-hoc encoding of the data. Data tables used in the algorithm are available for download. A high performing, easily maintained algorithm can successfully identify medication and food allergies from free text entries in EHR systems.

  12. The epidemiology of IgE-mediated food allergy and anaphylaxis.

    PubMed

    Allen, Katrina J; Koplin, Jennifer J

    2012-02-01

    The rise in food allergy prevalence in developed countries is evident from anecdotal reports but has been difficult to document and until recently good quality prevalence data were lacking. Although most emerging risk factors seem related to the "modern lifestyle" the reasons for the rise in food allergy prevalence remain poorly understood. The incidence of food allergy-related anaphylaxis is rising particularly in children younger than 5 years of age. Emerging studies are better designed to assess the true prevalence of IgE-mediated food allergy using formal population sampling frames, standardized and objective outcome data including use of the gold standard oral food challenge, and the capacity to adjust for potential selection bias.

  13. Preventive effects of skullcap (Scutellaria baicalensis) extract in a mouse model of food allergy.

    PubMed

    Shin, Hee Soon; Bae, Min-Jung; Jung, Sun Young; Shon, Dong-Hwa

    2014-05-14

    Food allergy, which accompanies acute symptoms such as pruritus, vomiting, diarrhea, and lethal anaphylactic shock is an increasing clinical problem. Skullcap (Scutellaria baicalensis Georgi) has been widely used as a traditional herbal medicine to treat inflammation, cancer, and allergy, but its effects in treating food allergy are not yet known. To examine the effect of skullcap on food allergy, female BALB/c mice were sensitized with 20 μg OVA and 2mg alum by intraperitoneal injection on day 0. From day 17, mice were orally challenged with OVA (50 mg) in saline every 3 days, for a total of six times. To investigate the preventive effect, skullcap (25 mg/kg) was orally administered every day from day 17 to 34. Food allergy symptoms were evaluated by the criteria for diarrhea, anaphylactic response, and rectal temperature. Severe symptoms of food allergy were observed in the sham group (diarrhea, 3 points; anaphylactic response, 2.6 points; rectal temperature, -8.36 °C. In contrast, the skullcap treatment group had a significantly suppressed OVA-induced anaphylactic response (1.3 points) and rectal temperature (-4.76°C). Moreover, both OVA-specific IgE, Th17 cytokine (IL-17), and Th2-related cytokines (IL-4, IL-5, IL-10, and IL-13), which increased with food allergy, were significantly inhibited by skullcap treatment. We demonstrate that the administration of skullcap attenuates OVA-induced food allergy symptoms through regulating systemic immune responses of Th cells. These results indicate that skullcap may be a potential candidate as a preventive agent for food allergy. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  14. TREATMENT OF ASTHMA AND FOOD ALLERGY WITH HERBAL INTERVENTIONS FROM TRADITIONAL CHINESE MEDICINE

    PubMed Central

    Li, Xiu-Min

    2014-01-01

    Prevalence of asthma and allergy has increased over the past 2–3 decades in Westernized countries. Despite increased understanding of the pathogenesis of asthma and allergic diseases, control of severe asthma is still difficult. Asthma is also associated with high prevalence of anxiety in particular adolescents. There is no effective treatment for food allergy. Food allergy is often associated with severe and recalcitrant eczema. Novel approaches for treatment of asthma and food allergy and comorbid conditions are urgently needed. Traditional Chinese medicine (TCM), used in Asia for centuries, is beginning to play a role in Western health care. There is increasing scientific evidence supporting the use of TCM for asthma treatment. This review article discusses promising TCM interventions for asthma, food allergy and comorbid conditions and explores their possible mechanisms of action. Since 2005, several controlled clinical studies of “anti-asthma” herbal remedies have been published. Among the herbal medicines, anti-asthma herbal medicine intervention (ASHMI) is the only anti-asthma TCM product that is a US FDA investigational new drug (IND) that has entered clinical trials. Research into ASHMI’s effects and mechanisms of actions in animal models is actively being pursued. Research on TCM herbal medicines for treating food allergy is rare. The herbal intervention, Food Allergy Herbal Formula-2 (FAHF-2) is the only US FDA botanical IND under investigation as a multiple food allergy therapy. Published articles and abstracts, as well as new data generated in preclinical and clinical studies of ASHMI and FAHF-2 are the bases for this review. The effect of TCM therapy on food allergy associated recalcitrant eczema, based on case review, is also included. Laboratory and clinical studies demonstrate a beneficial effect of ASHMI treatment on asthma. The possible mechanisms underlying the efficacy are multiple. Preclinical studies demonstrated the efficacy and

  15. Characterization of plasma cytokines in an infant population cohort of challenge-proven food allergy.

    PubMed

    Dang, T D; Tang, M L K; Koplin, J J; Licciardi, P V; Eckert, J K; Tan, T; Gurrin, L C; Ponsonby, A-L; Dharmage, S C; Allen, K J

    2013-10-01

    Sensitization to food allergens indicates the production of food-specific IgE; however, sensitization is not a definite indicator of allergic reaction upon ingestion (N Engl J Med, 344, 2001, 30: J Allergy Clin Immunol, 120, 2007, 491). Currently, food challenge is the best approach to identify the presence or absence of allergy. While 95% positive predictive values (PPVs) thresholds for sIgE can assist with identifying increased likelihood of allergy among those who are sensitized, there are no specific biological markers that differentiate between allergic and sensitized individuals. To determine whether plasma serum cytokine profiles predict (i) sensitization to peanut and egg and (ii) food allergy among sensitized infants. Peanut-sensitized (PT) and egg-sensitized 14-month-old infants and nonsensitized controls enrolled in HealthNuts, a population-based study of food allergy, underwent an oral food challenge (OFC). Blood was collected within 1 h after OFC. Serum levels of Th1, Th2 and regulatory cytokines were determined in allergic (n = 79), sensitized (n = 40) and nonsensitized, nonallergic (n = 37) infants by multiplex assay. Food-sensitized infants had significantly higher plasma IL-4, IL-13, IL-12p70 and lower IL-10 levels compared to nonsensitized infants. IL-10 and IL-6 levels were significantly higher in sensitized compared with allergic infants. Egg-allergic infants had significantly higher IL-13 and IL-12p70 levels compared to peanut-allergic (PA) infants. Levels of Th2-related cytokines in plasma are higher in food-sensitized infants, irrespective of clinical food allergy status. In contrast, IL-10 levels appear to predict food allergy among sensitized infants. Differences in IL-13 and IL-12p70 between egg- and peanut-allergic infants could help explain the different resolution rates of the allergies. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Overview of Evidence in Prevention and Aetiology of Food Allergy: A Review of Systematic Reviews

    PubMed Central

    Lodge, Caroline J.; Allen, Katrina J.; Lowe, Adrian J.; Dharmage, Shyamali C.

    2013-01-01

    The worldwide prevalence of food allergy appears to be increasing. Early life environmental factors are implicated in the aetiology of this global epidemic. The largest burden of disease is in early childhood, where research efforts aimed at prevention have been focused. Evidence synthesis from good quality systematic reviews is needed. We performed an overview of systematic reviews concerning the prevention and aetiology of food allergy, retrieving 14 systematic reviews, which covered three broad topics: formula (hydrolysed or soy) for the prevention of food allergy or food sensitization; maternal and infant diet and dietary supplements for the prevention of food allergy or food sensitization and hygiene hypothesis-related interventions. Using the AMSTAR criteria for assessment of methodological quality, we found five reviews to be of high quality, seven of medium quality and two of low quality. Overall we found no compelling evidence that any of the interventions that had been systematically reviewed were related to the risk of food allergy. Updating of existing reviews, and production of new systematic reviews, are needed in areas where evidence is emerging for interventions and environmental associations. Furthermore, additional primary studies, with greater numbers of participants and objective food allergy definitions are urgently required. PMID:24192789

  17. Food diversity in infancy and the risk of childhood asthma and allergies.

    PubMed

    Nwaru, Bright I; Takkinen, Hanna-Mari; Kaila, Minna; Erkkola, Maijaliisa; Ahonen, Suvi; Pekkanen, Juha; Simell, Olli; Veijola, Riitta; Ilonen, Jorma; Hyöty, Heikki; Knip, Mikael; Virtanen, Suvi M

    2014-04-01

    Recently, the bacterial diversity of the intestinal flora and the diversity of various environmental factors during infancy have been linked to the development of allergies in childhood. Food is an important environmental exposure, but the role of food diversity in the development of asthma and allergies in childhood is poorly defined. We studied the associations between food diversity during the first year of life and the development of asthma and allergies by age 5 years. In a Finnish birth cohort we analyzed data on 3142 consecutively born children. We studied food diversity at 3, 4, 6, and 12 months of age. Asthma, wheeze, atopic eczema, and allergic rhinitis were measured by using the International Study of Asthma and Allergies in Childhood questionnaire at age 5 years. By 3 and 4 months of age, food diversity was not associated with any of the allergic end points. By 6 months of age, less food diversity was associated with increased risk of allergic rhinitis but not with the other end points. By 12 months of age, less food diversity was associated with increased risk of any asthma, atopic asthma, wheeze, and allergic rhinitis. Less food diversity during the first year of life might increase the risk of asthma and allergies in childhood. The mechanisms for this association are unclear, but increased dietary antigen exposure might contribute to this link. Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

  18. A review of oral food challenges in children presenting to a single tertiary centre with perceived or true food allergies.

    PubMed

    Thalayasingam, Meera; Loo, Evelyn Xiu Ling; Tan, Michelle Meiling; Bever, Hugo Van; Shek, Lynette Pei-Chi

    2015-11-01

    The prevalence of perceived food allergies exceeds that of true food allergies. Unnecessary food avoidance may increase parental and patient anxiety, reduce quality of life and increase the risk of nutritional deficiency. An oral food challenge (OFC) can provide an objective measure regarding the presence or absence of food allergies in a child. This study reviews the indications for and outcomes of OFCs performed on children. A retrospective review was performed on all children who underwent OFCs at the Allergy Unit of the National University Hospital, Singapore, over a three-year period. A total of 197 OFCs were performed among 58 patients (34 male, 24 female). Most of the tests were for allergies to tree nuts (n = 107). Among the OFCs, 43.1% were for foods that were avoided and never eaten due to perceived food allergies, 25.9% were for foods that had previously resulted in positive skin prick tests (SPTs) and/or immunoassay results, 16.2% were for foods thought to worsen eczema and 14.7% were for foods thought to have caused a previous reaction. Of all the OFCs, 5% were positive, although adverse reactions were mostly cutaneous. Challenge-positive patients had either positive SPTs (wheal > 3 mm) or raised serum immunoglobulin E levels to specific foods that they reacted to during the challenges. No episodes of anaphylaxis were reported after the challenge. Most of the patients were able to safely introduce the avoided foods into their diets. OFCs provide an objective assessment for suspected food allergies.

  19. Seal and whale meat: two newly recognized food allergies.

    PubMed

    Moore, Laura M; Rathkopf, Melinda McNeal; Sanner, Carol J; Whisman, Bonnie A; Demain, Jeffrey G

    2007-01-01

    Alaska's marine mammals compose a large portion of the diet of indigenous coastal Alaskan people. Bowhead whales (Balaena mysticetus) and bearded seals (Erignathus barbatus), inhabitants of the Bering and Beaufort seas along Alaska's western and northern coasts, are 2 of the most important subsistence species, serving as major food sources to the native population. To describe an Inupiaq boy with symptoms consistent with an IgE-mediated food allergy after ingestion of bowhead whale and bearded seal meat. Extracts of cooked bowhead whale and bearded seal were prepared, lyophilized, and evaluated for protein content. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis was performed for each extract, followed by transfer to nitrocellulose and IgE immunoblots. Skin prick testing was conducted using reconstituted extracts of 1:10 wt/vol dilution. Immunoblots revealed serum specific IgE binding with the extracts of bowhead whale and bearded seal meat. Protein bands of approximately 25, 40, 50, and 90 kDa were found in the seal meat. Protein bands of 55 and 90 kDa were found in the whale meat. Skin prick test results were positive to whale and seal extracts with appropriate positive and negative controls. Ten control subjects had negative reactions to both extracts. A patient with moderate anaphylaxis to bowhead whale and bearded seal meat demonstrated serum specific IgE by means of immunoblot and positive skin prick test results. This is the first known reported case of specific IgE to these species.

  20. Effectiveness of Cognitive Behaviour Therapy for Mothers of Children with Food Allergy: A Case Series

    PubMed Central

    Knibb, Rebecca C.

    2015-01-01

    Background: Food allergy affects quality of life in patients and parents and mothers report high levels of anxiety and stress. Cognitive Behaviour Therapy (CBT) may be helpful in reducing the psychological impact of food allergy. The aim of this study was to examine the appropriateness and effectiveness of CBT to improve psychological outcomes in parents of children with food allergy. Methods: Five parents (all mothers) from a local allergy clinic requested to have CBT; six mothers acted as controls and completed questionnaires only. CBT was individual and face-to face and lasted 12 weeks. All participants completed measures of anxiety and depression, worry, stress, general mental health, generic and food allergy specific quality of life at baseline and at 12 weeks. Results: Anxiety, depression and worry in the CBT group significantly reduced and overall mental health and QoL significantly improved from baseline to 12 weeks (all p < 0.05) in mothers in the CBT group; control group scores remained stable. Conclusions: CBT appears to be appropriate and effective in mothers of children with food allergy and a larger randomised control trial now needs to be conducted. Ways in which aspects of CBT can be incorporated into allergy clinic visits need investigation. PMID:27417820

  1. Mold Allergy

    MedlinePlus

    ... Albuterol in Schools Access to Medications Clean Air Climate and Health Epinephrine in Schools Healthy Settings Food ... Allergy Capitals Anaphylaxis in America Extreme Allergies and Climate Change Access to Pseudoephedrine Consensus Study on Food ...

  2. Risk-taking and coping strategies of adolescents and young adults with food allergy.

    PubMed

    Sampson, Margaret A; Muñoz-Furlong, Anne; Sicherer, Scott H

    2006-06-01

    Fatal food-allergic reactions are most common among adolescents and young adults. To gain insight toward devising interventions, we queried risk-taking behaviors and coping strategies of persons age 13 to 21 years with food allergy. We used an Internet-based anonymous questionnaire devised on the basis of data from focus groups. Participants (174 subjects; 49% male; mean age, 16 years) reported the following: 75% had peanut allergy, 75% had 2 or more food allergies, and 87% had been prescribed self-injectable epinephrine. Regarding risk taking, 61% reported that they "always" carry self-injectable epinephrine, but frequencies varied according to activities: traveling (94%), restaurants (81%), friends' homes (67%), school dance (61%), wearing tight clothes (53%), and sports (43%). Fifty-four percent indicated purposefully ingesting a potentially unsafe food. Willingness to eat a food labeled "may contain" an allergen was reported by 42%. Twenty-nine participants were designated at high risk because they did not always carry epinephrine and ate foods that "may contain" allergens. The high-risk group, compared with the rest of the participants (P < .05), felt less "concern" about and "different" because of their allergy and had more recent reactions. The high-risk group was not distinguishable (P = not significant) by age, sex, or number or severity of reactions. Participants variably (60%) tell their friends about their allergy, but 68% believe education of their friends would make living with food allergy easier. A significant number of teens with food allergy admit to risk taking that varies by social circumstances and perceived risks. The results imply that education of teenagers and, importantly, those around them during social activities might reduce risk taking and its consequences. Our survey of adolescents and young adults with food allergy revealed risk-taking behaviors that vary by social circumstances and perceived risks, indicating that education of

  3. Oral Immunotherapy for Treatment of Immunoglobulin E-Mediated Food Allergy: The Transition to Clinical Practice

    PubMed Central

    Cox, Linda; Caminiti, Lucia; Ramistella, Vincenzo; Crisafulli, Giuseppe

    2014-01-01

    Today, there is neither an effective nor an active treatment for food allergy. Allergy immunotherapy has been proposed as an attractive strategy to actively treat food allergy. Oral immunotherapy (OIT), also known as oral desensitization, is a method of inducing the body's immune system to tolerate a food that causes an allergic overreaction. It has been studied for the use in treatment of immunoglobulin E-mediated food allergy to the most common foods, including milk, egg, and peanut. OIT has been able to desensitize subjects to varying degrees. However, many questions remain unanswered, including efficient formulation, optimal dosing, and induction protocol to achieve full tolerance, transition of OIT to clinical practice, and maximal safety profile. This review focuses on the use of OIT as a new and active treatment for food allergy. The possibility of transition of OIT to clinical practice represents, in this field, the next pivotal step with the goal of improving the quality of life of patients with food allergy and their families. PMID:24963452

  4. Oral Immunotherapy for Treatment of Immunoglobulin E-Mediated Food Allergy: The Transition to Clinical Practice.

    PubMed

    Pajno, Giovanni B; Cox, Linda; Caminiti, Lucia; Ramistella, Vincenzo; Crisafulli, Giuseppe

    2014-06-01

    Today, there is neither an effective nor an active treatment for food allergy. Allergy immunotherapy has been proposed as an attractive strategy to actively treat food allergy. Oral immunotherapy (OIT), also known as oral desensitization, is a method of inducing the body's immune system to tolerate a food that causes an allergic overreaction. It has been studied for the use in treatment of immunoglobulin E-mediated food allergy to the most common foods, including milk, egg, and peanut. OIT has been able to desensitize subjects to varying degrees. However, many questions remain unanswered, including efficient formulation, optimal dosing, and induction protocol to achieve full tolerance, transition of OIT to clinical practice, and maximal safety profile. This review focuses on the use of OIT as a new and active treatment for food allergy. The possibility of transition of OIT to clinical practice represents, in this field, the next pivotal step with the goal of improving the quality of life of patients with food allergy and their families.

  5. Food allerg