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Hippocrates is often credited with first recognizing that food could be responsible for adverse symptoms and even death in some individuals, but it was not until the seminal observations by Prausnitz that the investigation of food allergy was viewed on a more scientific basis. In the first half of the 20th century, there were periodic reports in th...
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... history and skin testing remain the cornerstone for diagnosing food allergy. However, the characteristics of food allergic disorders (Table 1) and food allergic symptoms (Table 2) have been more precisely defined, which has improved the diag- nostic accuracy of the medical history and its utility in guiding appropriate laboratory studies. 27 Until the mid-1990's, most aller- gists rarely utilized in vitro food-specific IgE measurements (RASTs) in their food allergy work-up because of poor sensitivity and specificity in identifying symptomatic food allergy. ...
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Citations
... A small difference was found on comparison with the NAP6 report, as the incidence of anaphylaxis (24 of 55,996, 0.043%) was higher than that in the NAP6 report (1 of 11,752, 0.0085%) [9]. This was due in part to anaphylaxis induced by new anesthesia-related agents [21,[24][25][26]. According to recent reports, the in vitro basophil activation test has high sensitivity and specificity to neuromuscular blocking agents and antibiotics, which are the major causative substances of perioperative anaphylaxis, and this test may be applied in practice in the future [27,28]. ...
Introduction: Hypotension is a cardiovascular symptom that appears at the onset of anaphylaxis. It is considered an important factor as it affects the severity of anaphylaxis; however, its details remain to be elucidated. In this study, we investigated the characteristics of hypotension at the onset of anaphylaxis during anesthesia, along with the relationship between hypotension, tryptase and histamine.
Materials and Methods: The minimum systolic blood pressures of patients diagnosed with anaphylaxis using the clinical diagnostic criteria of the World Allergy Organization guidelines were extracted from electronic anesthesia records. We analyzed changes in tryptase and histamine that were measured after the onset of anaphylaxis. We analyzed the relationship of tryptase and histamine with the minimum systolic blood pressure and the severity of anaphylaxis.
Results: Of 55,996 patients, 25 were diagnosed with anaphylaxis during anesthesia (0.045%). Among these patients, the minimum systolic blood pressure was less than 90 mmHg. Furthermore, the minimum systolic blood pressure was inversely correlated with tryptase levels immediately to 1 hour, and 2 to 4 hours after the onset of anaphylaxis. The minimum systolic blood pressure was inversely correlated with the severity of anaphylaxis. The severity of anaphylaxis was positively correlated with tryptase levels immediately to 1 hour, and 2 to 4 hours after the onset of anaphylaxis.
Conclusion: Hypotension tended to reflect the severity of anaphylaxis. Tryptase is an adjunct in the diagnosis of hypotension and may be a useful indicator of the severity of anaphylaxis. A larger-scale study is needed to validate these results.
... For the sake of space in this review, the evolution of the FA entity will be markedly summarized; details with abundance of references are available in previous publications. [1][2][3] ...
The food allergy (FA) entity went through a long difficult road which led to much delay in its recognition. After long periods of denial and misdiagnosis, it attained its current designation as food hypersensitivity or allergy. This review will briefly address the evolution of the FA entity from the early BC era until our 21st century and highlight the milestones in the main aspects of diagnosis, treatment, prevention, and research.
A great recognition of the allergy specialty was gained by the discovery of its main mediator –immunoglobulin E in 1967 – which also helped in classifying FA into IgE-mediated (immediate-type) and non-IgE-mediated. The cause of the increasing prevalence during the past few decades may be attributed to an increased food consumption and the consequences of modern lifestyle (the hygiene hypothesis).
In addition to a skillful medical history-taking, helpful tests have been developed involving the skin or blood. The scratch test was modified to the prick test and in certain instances prick-by-prick. The use of intradermal test has been markedly reduced. Blood testing began by measuring specific-IgE antibodies (sIgE) in the serum using the radioallergosorbent test which went through multiple modifications to avoid radioisotope material and increase the test's sensitivity. The test was advanced to measure sIgE to individual allergen components. Recently, cellular tests were developed in the form of basophil activation or mast cell activation. In most cases, FA needs verification by appropriately-designed challenge testing.
Regarding treatment, strict avoidance remains the basic approach. Certain food-labeling regulations led to some improvement in the problem of hidden food allergens but more is desired. Recently some protocols for oral immunotherapy (OIT) showed reasonable safety and efficacy in preventing reactions to accidental exposures. The protocol for peanut has been approved in the United States and other foods are expected to follow. Epicutaneous immunotherapy showed higher safety and promising efficacy. Sublingual immunotherapy might follow as well. Studies on the use of certain biologicals, alone or in combination of OIT, showed promising findings. Very recently, omalizumab was approved in the United States for patients with multiple FA. A major change in the strategy of prevention is the benefit of introducing allergenic foods at an early age (4–6 months). Research on FA markedly flourished in recent decades with increasing numbers of investigators, funding, publications, and education. Despite the major strides, still more awaits exploration with expected better understanding and practice of FA.
... Familia de las proteínas relacionadas con la patogénesis 10 (PR-10) Se consideran la causa más frecuente de SPA, son proteínas de defensa vegetal ante diferentes agresiones del medio ambiente, tienen propiedades hidrofílicas, son sensibles al calor y a la digestión, por lo que los síntomas que provocan generalmente son leves y limitados a la orofaringe. [4][5][6][7] Bet v 1, con un peso de 17.5 kDa, es el principal determinante antigénico en los granos de polen de esta familia, responsable de la sensibilización hasta en 74%. 6,7 Su homología molecular con otros tipos de polen, frutas, verduras, nueces y semillas genera la reactividad cruzada que a la ingesta conlleva la sintomatología 8 (Tabla 2). ...
... [4][5][6][7] Bet v 1, con un peso de 17.5 kDa, es el principal determinante antigénico en los granos de polen de esta familia, responsable de la sensibilización hasta en 74%. 6,7 Su homología molecular con otros tipos de polen, frutas, verduras, nueces y semillas genera la reactividad cruzada que a la ingesta conlleva la sintomatología 8 (Tabla 2). ...
... poseen un peso molecular 7-10 kDa, son proteínas de defensa que se activan a consecuencia de infecciones y estrés. 4,7 Se han reconocido en el polen de árboles, malezas, frutas, vegetales y látex; estos panalérgenos son estables a la digestión y al calor soportando temperaturas hasta de 90º C sin desnaturalizarse, por lo que a la ingesta llegan prácticamente intactas a nivel intestinal provocando con mayor frecuencia reacciones sistémicas y anafilaxia asociada al ejercicio. 5,6,8 Se encuentran en mayor cantidad en la piel más que en la pulpa de las frutas. ...
This book is a journey through the different aspects of food allergy, from the risk factors related to the development of the allergic response, its mechanisms, the different resulting pathologies, the approach and treatment of this complex group of diseases.
... It was only in the seventeenth century that medical literature began to recognize food allergy (FA) as a disease and described it as a hypersensitive reaction, having clinical symptoms like urticaria or anaphylaxis. 1 In the 1990s, the US National Institute of Allergy and Infectious Diseases (NIAID) and the European Academy of Allergy and Clinical Immunology (EAACI) defined FA as "an adverse health effect arising from an immune response that occurs reproducibly on exposure to a given food". 2,3 Currently, FA is considered as having a complex mechanism that encompasses many clinical entities resulting from complex interactions between food intake, metabolism, immune system, genetic background, and socioeconomic factors. ...
... The majority of comparable studies confirmed that skin reactions were the most common presentation of food allergies, and the less commonly reported were rhino-respiratory manifestations. 1,[37][38][39] In this study, 40% of adults and 30% of children have a family member who is also allergic. This member has the same allergy in 45.6% and 22.8% of the cases, respectively. ...
Background
Food allergy (FA) has become a major public health concern affecting millions of children and adults worldwide. In Tunisia, published data on FA are scarce.
Methods
This study, was intended to fill the gap and estimate the frequency of allergy to different foods in the Sfax region, Tunisia, within self-reported FA. One hundred twenty-five (125) children (56% males, 1–17 years old), and 306 adults (17% males, 18–70 years old) were interviewed using a bilingual questionnaire.
Results
The number of self-reported food allergens in this sample was 105; allergens were clustered in 8 foods: fruits, seafood, eggs, milk and dairy, cereals, nuts, vegetables, and peanuts. Cutaneous reactions were the most frequent symptoms, in both children and adults. About 40% of children and 30% of adults had a family history of FA. About 81% of adults and 38% of children are allergic to at least 1 non-food allergen. The most prevalent food allergen was the fruit group in both adults and children, followed by seafood. Most food allergies were mutually exclusive and 90% of individuals have a single FA. The relationship between self-declared FA was modeled using a Bayesian network graphical model in order to estimate conditional probabilities of each FA when other FA is present.
Conclusions
Our findings suggest that the prevalence of self-reported FA in Tunisia depends on dietary habits and food availability since the most frequent allergens are from foods that are highly consumed by the Tunisian population.
... Introduction: Modern era milestones in the immunology of food allergy "What is food to one, to another is rank poison" said a line from a poem of Titus Lucretius Cato (98e55 BC), intimating that there was some understanding of the potential harmful effects of foods 2000 years ago (Cohen, 2008). However, it was not until 1912 that, as recounted by Sampson (2016), American pediatrician Oscar Menderson Schloss first diagnosed a case of egg allergy when he performed a skin scratch test with hen's egg white and observed a positive skin reaction. An experimental milestone was achieved in 1921 when O. Prausnitz injected serum from his colleague H. Kustner, who had a fish allergy, and a non-allergic control subject into his own skin. ...
Adverse reactions to foods have been reported for over 2000 years. Our knowledge of the immune mechanisms that govern this disease are much younger, starting primarily with the discovery of IgE a little over 60 years ago. In this overview article of the sections to come, we highlight the history of immunology research that has led us to our current understanding of the disease. We broadly discuss the mechanisms that govern oral tolerance to food antigens, the adaptive and innate immune mechanisms of allergic sensitization, the mechanisms of anaphylactic reactions to foods, and the mechanisms that maintain persistent allergic reactions. This article serves as a primer for the future articles in the section, which expand upon these ideas significantly in scope and depth.
... An appreciation for the role of gut microbiota to modulate immune responses (1,2) has led to intense interest in the relationship between gut microbiota and food allergy (3)(4)(5), which continues to be a major health problem worldwide. Food allergy treatments have been elusive and the development of lasting cures for food allergy remains an active area of research (6)(7)(8)(9). Several studies in human and animal models of food allergy have demonstrated an association with distinct gut microbiota profiles (3,(10)(11)(12). ...
Background
Gut microbiota influence food allergy. We showed that the natural compound berberine reduces IgE and others reported that BBR alters gut microbiota implying a potential role for microbiota changes in BBR function.
Objective
We sought to evaluate an oral Berberine-containing natural medicine with a boiled peanut oral immunotherapy (BNP) regimen as a treatment for food allergy using a murine model and to explore the correlation of treatment-induced changes in gut microbiota with therapeutic outcomes.
Methods
Peanut-allergic (PA) mice, orally sensitized with roasted peanut and cholera toxin, received oral BNP or control treatments. PA mice received periodic post-therapy roasted peanut exposures. Anaphylaxis was assessed by visualization of symptoms and measurement of body temperature. Histamine and serum peanut-specific IgE levels were measured by ELISA. Splenic IgE⁺B cells were assessed by flow cytometry. Fecal pellets were used for sequencing of bacterial 16S rDNA by Illumina MiSeq. Sequencing data were analyzed using built-in analysis platforms.
Results
BNP treatment regimen induced long-term tolerance to peanut accompanied by profound and sustained reduction of IgE, symptom scores, plasma histamine, body temperature, and number of IgE⁺ B cells (p <0.001 vs Sham for all). Significant differences were observed for Firmicutes/Bacteroidetes ratio across treatment groups. Bacterial genera positively correlated with post-challenge histamine and PN-IgE included Lachnospiraceae, Ruminococcaceae, and Hydrogenanaerobacterium (all Firmicutes) while Verrucromicrobiacea. Caproiciproducens, Enterobacteriaceae, and Bacteroidales were negatively correlated.
Conclusions
BNP is a promising regimen for food allergy treatment and its benefits in a murine model are associated with a distinct microbiota signature.
... Several studies have shown that the prevalence of FA in children and related emergency hospital visits is increasing in developed countries, especially in the last decade [16][17][18][19]. The prevalence of FA in all age groups is estimated to be approximately 8% [20]. ...
Background and objective:
The worldwide prevalence of food allergies has been increasing recently. Due to limited data on food allergy (FA) in Saudi Arabia, this study was conducted to estimate the prevalence and risk factors of parent-reported food allergies and clinical manifestations in children in Taif, Saudi Arabia.
Methodology:
A cross-sectional questionnaire-based observational study was conducted from July 2019 to December 2020. A total of 508 parents of school children (aged five to eight years) responded to the questions based on the child's health and food allergies.
Results:
FA (16.1%) was observed as the most common type of allergy among children. The prevalence of other atopic diseases was estimated at 30.5%. The most common allergy-causing foods were eggs (4.9%), peanuts (2.7%), and sesame (2.5%). Rash, itching without rash, and vomiting were the most common FA symptoms. The presence of childhood eczema (p< 0.0001), allergic rhinitis (p= 0.005), and the father's history of allergy (p= 0.005) were all significant and independent predictors/risk factors for FA among the studied children.
Conclusion:
We noted substantial parents' concern with food allergies among children in Saudi Arabia, which necessitates the establishment of effective diagnosis and treatment strategies and primary prevention initiatives.
... As one of the major public health problems worldwide, food allergy (FA) is thought to be the second-wave allergy epidemic after asthma, with evidence of increasing prevalence [1]. It is reported that food allergy affects 2% of adults and 8% of school-age children [2]. ...
Background:
Peanut allergy (PA) has become a clinical and public health problem, which is mainly regulated by genetics, immune responses, and environmental factors. Diagnosis and treatment for PA have always remained huge challenges due to its multiple triggers. Studies have shown that long non-coding RNAs (lncRNAs) play a critical role in the development of allergic diseases.
Method and results:
In the current study, we examined the plasma lncRNA expression profiles of peanut allergy Brown Norway rats and healthy controls and 496 differently expressed lncRNAs were identified, including 411 up-regulated genes and 85 down-regulated genes. We screened 8 lncRNAs based on the candidate principle and the candidates were verified in individual samples by quantitative real-time PCR. Then, the four lncRNA-based diagnostic model was established by least absolute shrinkage and selection operator (LASSO) and logistic regression, which was proved by area under the receiver operating characteristic curve (AUC).
Conclusions:
In summary, we assessed the correlation between lncRNA expression levels and the diagnosis of peanut allergy, which may perform a vital role in guiding the management of peanut allergy.
... Somos seres únicos, e precisamos ter uma visão ampla de todo o processo que envolve nossa saúde, uma vez que "somos os resultados da interação de nosso exclusivo genótipo com o meio ambiente em que vivemos, e não poderia ser diferente quanto às reações aos alimentos" (Sampson, 2016). ...
Introdução: As Reações Adversas aos Alimentos (RAA) são qualquer reação anormal à ingestão de alimentos ou aditivos alimentares, independentemente de sua causa. Sabe-se que o trato gastrointestinal (TGI) é a porta de entrada para os nutrientes oriundos da nossa alimentação, e quando este tem sua permeabilidade alterada pode ter como uma das consequências uma hipersensibilidade alimentar, muitas vezes não diagnosticada, que causa inúmeros impactos, entre estes, alterações no Sistema Nervoso Central, dando origem, influenciando ou piorando a transtornos do neurodesenvolvimento Objetivo: Analisar de que forma a hipersensibilidade alimentar pode influenciar nos transtornos principalmente de cunho comportamentais. Metodologia: Trata-se de uma revisão bibliográfica com abordagem dedutiva. Resultados: A partir do estudo de literatura foi possível observar a importância da alimentação adequada para a homeostase do Sistema Nervoso Central, e na prevenção, tratamento e promoção de patologias neste Sistema. Discussão dos resultados: Apresentou-se a importância do entendimento dos mecanismos da hipersensibilidade para uma melhor elucidação do seu papel nas patologias do SNC. Para assim determinar melhor o papel da nutrição nestes tipos de patologias. Conclusão: O desenvolvimento do presente estudo permitiu elucidar que patologias de cunho neuronal tem causa multifatoriais, sendo a hipersensibilidade um fator que pode fazer parte dessa cadeia causídica. Uma má alimentação pode dá origem a ambas fisiopatologias, logo deve ser vista como uma ferramenta essencial para quebra dessa cadeia patológica, além de que a alimentação adequada é essencial para atender as necessidades fisiológicas e individuas para alcançar homeostase.
... Although most reactions (e.g., urticaria) are mild, severe and life-threatening reactions, such as anaphylaxis, may occur. 2 The effects of food allergies on the quality of life and mental health of patients and their families have been investigated in recent years. 3 The early onset of food allergies, the delay in the development of tolerance until school age or even adolescence, and the presence of accompanying allergies, such as atopic dermatitis, allergic rhinitis, and asthma, enhance the negative impact. ...
Background
Our study aimed to investigate emotional, behavioral, and social characteristics assessed with internationally validated psychometric scales and their relationship with demographic, clinical, and laboratory data in children with a history of food-related anaphylaxis.
Method
The study included patients aged 1–5 who were followed up in the pediatric allergy outpatient clinic with a diagnosis of food-related anaphylaxis. All participants were evaluated during admission to the clinic using a study questionnaire, which was prepared by the authors, consisting of three parts: a sociodemographic information form, a clinical evaluation form, and the Aberrant Behavior Checklist (ABC) for psychiatric evaluation. Parents answered the questionnaires regarding the patients’ emotional and behavioral health.
Results
Thirty patients aged between 12 and 62 months were included in the study. The data were compared with 30 healthy controls with similar age and gender distribution. The total ABC score (p = 0.015), and the stereotypic behavior (p = 0.003) and hyperactivity (p = 0.002) subscale scores were significantly higher in patients with anaphylaxis history compared to the controls.
Conclusion
Emotional and behavioral status assessments and the clinical follow-up of food allergies of patients who experienced anaphylaxis in early childhood are useful for the holistic management and early recognition of possible pathologies.
