A053 SCREENING CHILDREN WITH IGE-MEDIATED FOOD ALLERGY FOR EOSINOPHILIC ESOPHAGITIS

Food allergies, defined as an immune response to food proteins, affect as many as 8% of young children and 2% of adults in western countries, and their prevalence appears to be rising like all allergic diseases. In addition to well-recognized urticaria and anaphylaxis triggered by IgE antibody– mediated immune responses, there is an increasing recognition of cell-mediated disorders, such as eosinophilic esophagitis and food protein–induced enterocolitis. Non-IgE-Mediated gastrointestinal food allergies are a heterogeneous group of food allergies in which there is an immune reaction against food but the primary pathogenesis is not a production of IgE and activation of mast cells and basophils. Those diseases tend to affect mainly the gastrointestinal tract and can present as acute (FPIES) or chronic reaction, such as Eosinophilic Esophagitis (EoE), Food Protein-Induced Allergic Proctocolitis (FPIAP). The role of food allergy in Non-EoE gastrointestinal Eosinophilic disorders (Non- EoE EGID) is poorly understood. In some diseases like EoE, T cell seems to play a major role in initiating the immunological reaction against food, however, in FPIES and FPIAP, the mechanism of sensitization is not clear. Diagnosis requires food challenges and/or endoscopies in most of the patients, as there are no validated biomarkers that can be used for monitoring or diagnosis of Non-IgE mediated food allergies. The treatment of Non-IgE food allergy is dependent on diet (FPIES, and EoE) and/or use of drugs (i.e. steroids, PPI) in EoE and Non-EoE EGID. Non-IgE mediated food allergies are being being investigated.

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Updates on Food Allergy, Increasingly Prevalent Challenge

JURNAL BIOMEDIK (JBM) ◽

10.35790/jbm.10.3.2018.21980 ◽

2018 ◽

Vol 10 (3) ◽

pp. 152

Author(s):

Tonny Tanus ◽

Sunny Wangko

Keyword(s):

Atopic Dermatitis ◽

Food Allergy ◽

Eosinophilic Esophagitis ◽

Immunoglobulin E ◽

Pediatric Population ◽

Food Allergies ◽

Food Protein ◽

Safety Issues ◽

Ige Mediated ◽

Allergic Disorders

Abstrak: Prevalensi alergi makanan makin meningkat di seluruh dunia dan mengenai semua usia. Keparahan dan kompleksitas penyakit juga meningkat terlebih pada populasi anak. Terdapat beberapa jenis reaksi alergi yang dibahas: immunoglobulin E (IgE) mediated allergies and anaphylaxis, food triggered atopic dermatitis, eosinophilic esophagitis, dan non IgE mediated gastrointestinal food allergic disorders seperti food protein induced enterocolitis syndrome (FPIEs). Tes alergi, baik melalui kulit maupun IgE yang telah dikerjakan sekian lama masih dibebani dengan hasil positif palsu dan negatif palsu yang bermakna dengan manfaat terbatas pada beberapa alergi makanan. Selain menghindari, tidak terdapat terapi yang ampuh untuk alergi makanan. Berbagai imunoterapi telah dipelajari melalui jalur, subkutan, epikutan, oral dan sublingual yang hanya menghasilkan desensitisasi sementara dan dibebani dengan berbagai isu mengenai keamanannya. Agen biologik yang menghambat sitokin/interleukin (IL) dan molekul pada reaksi alergi makanan tampaknya merupakan pilihan yang menjanjikan. Anti IgE telah dipergunakan pada asma dan urtikaria kronis. Anti IL-4 dan IL-13 yang menghambat produksi IgE diindikasikan untuk dermatitis atopik. Anti eosinofil anti IL-5 berhasil menurunkan eksaserbasi asma. Berbagai agen biologik telah dipelajari untuk berbagai kondisi alergik dan imunologik, tetapi efektivitas dan kepraktisan terapi yang mahal ini untuk alergi makanan masih menjadi tanda tanya.Kata kunci: alergi makanan, reaksi alergi, terapi alergi makananAbstract: Food allergies have been increasing in prevalence for years affecting all ages. Disease severity and complexity have also increased, especially in the pediatric population. There are several types of reactions including: immunoglobulin-E (IgE) mediated allergies and anaphylaxis, food-triggered atopic dermatitis, eosinophilic esophagitis, and non IgE mediated gastrointestinal food allergic disorders such as FPIEs. Though allergy testing has been around for years, both skin and IgE testing are burdened by significant false positives and negatives, and are only useful in some food allergies. Avoidance is the sole therapy for food allergy. A variety of immunotherapies have been studied; subcutaneous, epicutaneous, oral, and sublingual. At best they only produce a temporary state of desensitization and have many safety issues. Examples of biologicals which block critical cytokines/interleukins (IL) in allergic conditions are Anti IgE, anti IL-4 and IL-13, and Anti eosinophils, Anti IL-5. Other biologicals are being studied for allergic conditions, but whether these expensive future treatments will be proven effective and practical in food allergy is unknown.Keywords: food allergy, allergic reaction, food allergy therapy

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Non-IgE Mediated Food Allergy

Current Pediatric Reviews ◽

10.2174/1573396315666191031103714 ◽

2020 ◽

Vol 16 (2) ◽

pp. 95-105

Author(s):

Antonella Cianferoni

Keyword(s):

Food Allergy ◽

Eosinophilic Esophagitis ◽

Allergic Diseases ◽

Food Allergies ◽

Food Protein ◽

Ige Mediated ◽

Food Challenges ◽

Allergic Proctocolitis ◽

Eosinophilic Disorders

: Food allergies, defined as an immune response to food proteins, affect as many as 8% of young children and 2% of adults in western countries, and their prevalence appears to be rising like all allergic diseases. In addition to well-recognized urticaria and anaphylaxis triggered by IgE antibody– mediated immune responses, there is an increasing recognition of cell-mediated disorders, such as eosinophilic esophagitis and food protein–induced enterocolitis. Non-IgE-Mediated gastrointestinal food allergies are a heterogeneous group of food allergies in which there is an immune reaction against food but the primary pathogenesis is not a production of IgE and activation of mast cells and basophils. : Those diseases tend to affect mainly the gastrointestinal tract and can present as acute (FPIES) or chronic reaction, such as Eosinophilic Esophagitis (EoE), Food Protein-Induced Allergic Proctocolitis (FPIAP). The role of food allergy in Non-EoE gastrointestinal Eosinophilic disorders (Non- EoE EGID) is poorly understood. : In some diseases like EoE, T cell seems to play a major role in initiating the immunological reaction against food, however, in FPIES and FPIAP, the mechanism of sensitization is not clear. : Diagnosis requires food challenges and/or endoscopies in most of the patients, as there are no validated biomarkers that can be used for monitoring or diagnosis of Non-IgE mediated food allergies. : The treatment of Non-IgE food allergy is dependent on diet (FPIES, and EoE) and/or use of drugs (i.e. steroids, PPI) in EoE and Non-EoE EGID. : Non-IgE mediated food allergies are being being investigated.

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