Historical background, definitions and differential diagnosis.
Authors: Sampson HA
Abstract
Although awareness that food can cause adverse symptoms and even death in some individuals has been present since the times of Hippocrates, it was not until the seminal experiment of Prausnitz that the investigation of food allergy had a more scientific basis. In the first half of the 20th century, there were periodic reports in the medical literature describing various food allergic reactions. Until the studies of Charles May and colleagues in the mid- to late '70s, there was a great deal of skepticism in the medical world about the relevance of food allergy and how to diagnos...
Source: Chemical Immunology and Allergy - May 31, 2015 Category: Allergy & Immunology Tags: Chem Immunol Allergy Source Type: research
Immunological Basis of Food Allergy (IgE-Mediated, Non-IgE-Mediated, and Tolerance).
Authors: Kim EH, Burks W
Abstract
Food allergy includes a number of diseases that present with adverse immunological reactions to foods and can be IgE-mediated, non-IgE-mediated, or a combination of both mechanisms. IgE-mediated food allergy involves immediate hypersensitivity through the action of mast cells, whereas non-IgE-mediated food allergy is most commonly cell-mediated. These food allergies are thought to occur as a result of a breakdown in oral tolerance and, more specifically, from an aberrant regulatory T-cell response. Ongoing studies of experimental treatments for food allergy strive to induc...
Source: Chemical Immunology and Allergy - May 31, 2015 Category: Allergy & Immunology Tags: Chem Immunol Allergy Source Type: research
Food allergens: molecular and immunological aspects, allergen databases and cross-reactivity.
Authors: Lorenz AR, Scheurer S, Vieths S
Abstract
The currently known food allergens are assigned to a relatively small number of protein families. Food allergens grouped into protein families share common functional and structural features that can be attributed to the allergenic potency and potential cross-reactivity of certain proteins. Molecular data, in terms of structural information, biochemical characteristics and clinical relevance for each known allergen, including isoforms and variants, are mainly compiled into four open-access databases. Allergens are designated according to defined criteria by...
Source: Chemical Immunology and Allergy - May 31, 2015 Category: Allergy & Immunology Tags: Chem Immunol Allergy Source Type: research
Epidemiology: international point of view, from childhood to adults, food allergens.
Authors: Wong GW
Abstract
Recent studies have suggested that the prevalence of food allergy is increasing in many parts of the world. However, many epidemiology studies have been based only on questionnaires without objective testing. The data from these studies do show that the pattern of food allergies is different across the world. In general, studies using objective testing reported a lower prevalence than those without objective testing. The most common food allergens are cow's milk, hen's egg, wheat, fish, shellfish, peanuts, and tree nuts. Recent evidence also suggested that some of these allergies ...
Source: Chemical Immunology and Allergy - May 31, 2015 Category: Allergy & Immunology Tags: Chem Immunol Allergy Source Type: research
Food allergy in childhood (infancy to school age).
Authors: Bergmann MM, Eigenmann PA
Abstract
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, ar...
Source: Chemical Immunology and Allergy - May 31, 2015 Category: Allergy & Immunology Tags: Chem Immunol Allergy Source Type: research
Food allergy in adolescence and adulthood.
Authors: Ballmer-Weber BK
Abstract
In young children, food allergy is usually acquired via the gastrointestinal tract and directed toward egg and milk. Adolescent and adult patients, however, mainly acquire food allergy via primary sensitization to inhalant allergens on the basis of cross-reactivity between proteins in inhalant sources and in food. This type of food allergy is frequently mediated by sensitization to broadly represented allergens, or so-called panallergens. Food allergic reactions in adult patients - similar to those in children - range in severity from very mild and local symptoms, as in c...
Source: Chemical Immunology and Allergy - May 31, 2015 Category: Allergy & Immunology Tags: Chem Immunol Allergy Source Type: research
Hints for diagnosis.
Authors: Poulsen LK
Abstract
The diagnosis of food allergy requires responses to two important questions: Does the patient have a food allergy? If so, which foods will elicit allergic symptoms? The first question will most often have to be answered following a physical examination and an interview with the patient and/or caretakers. Based on this, a provisional decision to pursue a food allergy diagnosis may be made after carefully considering other possible reasons for an adverse reaction to a food: aversion, infection, intoxication, or an underlying metabolic disease. To respond to the next question, the...
Source: Chemical Immunology and Allergy - May 31, 2015 Category: Allergy & Immunology Tags: Chem Immunol Allergy Source Type: research
IgE-Related Examination in Food Allergy with Focus on Allergen Components.
Authors: Borres MP, Sato S, Ebisawa M
Abstract
Molecular allergology is a breakthrough science that enables the quantification of IgE antibodies against individual allergen protein components at the molecular level. The diagnosis of IgE-mediated allergic disorders is based on the clinical history and on sensitization demonstrated through an allergy test. Identifying whether the sensitization is primary (species specific) or due to cross-reactivity with proteins with similar protein structures helps the clinician to judge the risk of allergic reaction. This is possible today because allergen component tests...
Source: Chemical Immunology and Allergy - May 31, 2015 Category: Allergy & Immunology Tags: Chem Immunol Allergy Source Type: research
Non-IgE-Related Diagnostic Methods (LST, Patch Test).
Authors: Matsumoto K
Abstract
Although most food allergy patients have immediate-type reactions, some have delayed-type reactions. Unlike for the detection of food-specific IgE antibody in immediate-type (IgE-mediated) food allergies, only a few tests are currently available to aid in the diagnosis of delayed-type (non-IgE-mediated) food allergies. This chapter summarizes our current understanding of one in vitro test and one in vivo test for non-IgE-mediated food allergies: the lymphocyte stimulation test (LST) and the atopy patch test (APT). Although the LST is not yet standardized, a food protein-specif...
Source: Chemical Immunology and Allergy - May 31, 2015 Category: Allergy & Immunology Tags: Chem Immunol Allergy Source Type: research
Diagnostic elimination diets and oral food provocation.
Authors: Wood RA
Abstract
Accurately diagnosing patients with suspected food allergy is obviously critically important. The patient's health may be compromised if problem foods are left in the diet, while nutrition and quality of life may be negatively affected if foods are unnecessarily removed from the diet. In some patients, the diagnosis is very straightforward, such as with anaphylaxis with the first known exposure to peanut, but in many cases, the diagnosis will not be clear based on the history, skin tests, and serologic tests, especially because these tests often yield falsely positive results. In ...
Source: Chemical Immunology and Allergy - May 31, 2015 Category: Allergy & Immunology Tags: Chem Immunol Allergy Source Type: research
Pharmacological management of acute food-allergic reactions.
Authors: Richards S, Tang M
Abstract
There is currently no well-established disease-modifying treatment for food allergy, so management relies upon strict avoidance of food allergen(s), implementation of risk minimisation strategies to avoid inadvertent exposure and allergic reactions, and prompt management of acute allergic reactions, should they occur. The pharmacological management of acute food-induced allergic reactions is dependent on the underlying pathophysiology of the allergic reaction and the severity of clinical symptoms and signs. Mild to moderate symptoms of an immunoglobulin E-mediated acute...
Source: Chemical Immunology and Allergy - May 31, 2015 Category: Allergy & Immunology Tags: Chem Immunol Allergy Source Type: research
Oral immunotherapy and potential treatment.
Authors: Sato S, Yanagida N, Ebisawa M
Abstract
The standardized therapeutic approach for food allergy is based on avoidance of allergens in foods. Oral immunotherapy (OIT) is a significant focus of food allergy research and appears to be effective in inducing desensitization. However, most patients receiving OIT have mild to moderate symptoms during the therapy, and it has not been clearly established whether OIT is effective in inducing permanent tolerance. Recently, novel therapeutic approaches for food allergy, or sublingual immunotherapy and epicutaneous immunotherapy using an anti-IgE monoclonal anti...
Source: Chemical Immunology and Allergy - May 31, 2015 Category: Allergy & Immunology Tags: Chem Immunol Allergy Source Type: research
Cow's Milk Allergy in Children and Adults.
Authors: Fiocchi A, Dahdah L, Albarini M, Martelli A
Abstract
Cow's milk allergy is among the more frequent food allergies in infants and children. Because its suspicion stems from a plethora of symptoms, it is frequently reported. However, the development of a rigorous diagnostic pathway will reduce the diagnosed children to less than 50% of those reported. Cow's milk allergy is the only specific food allergy for which an EBM guideline exists. According to the guidelines (Diagnosis and Rationale for Action against Cow's Milk Allergy), a diagnostic process based on the pre-test probability of this conditio...
Source: Chemical Immunology and Allergy - May 31, 2015 Category: Allergy & Immunology Tags: Chem Immunol Allergy Source Type: research
Hen's Egg Allergy.
Authors: Urisu A, Kondo Y, Tsuge I
Abstract
Egg allergy is one of the most frequent food allergies in infants and young children. The prevalence of egg allergy is estimated to be between 1.8 and 2% in children younger than 5 years of age. The reactions are mainly mediated by IgE and partially by non-IgE or are a mix of both types. Egg white contains more than 20 different proteins and glycoproteins. Ovomucoid (Gal d 1), ovalbumin (Gal d 2), conalbumin (ovotransferrin) (Gal d 3) and lysozyme (Gal d 4) have been identified as major allergens in hen's egg. Alpha-livetin (Gal d 5) is thought to be a main egg y...
Source: Chemical Immunology and Allergy - May 31, 2015 Category: Allergy & Immunology Tags: Chem Immunol Allergy Source Type: research
Peanut and tree nut allergy.
Authors: Cox A, Sicherer SH
Abstract
Allergy to peanut and tree nuts is a major worldwide health concern. The prevalence of these allergies may be increasing, but the reasons for these increases remain unclear. This group of foods accounts for a large proportion of severe and fatal food-allergic reactions. These allergies present most often during childhood but can occur at any age. Resolution is possible but uncommon, and frequent lifetime reactions caused by accidental ingestion are a serious problem. The major allergens of peanut and most tree nuts have been identified, allowing for insights into patien...
Source: Chemical Immunology and Allergy - May 31, 2015 Category: Allergy & Immunology Tags: Chem Immunol Allergy Source Type: research
