MILESTONES MARKING THE KNOWLEDGE OF ADVERSE REACTIONS TO FOOD IN THE DECADE OF THE 1980s

PEDIATRICS ◽  
1995 ◽  
Vol 96 (2) ◽  
pp. 380-381
Author(s):  
Betty Miller
Keyword(s):  
Food Allergy ◽  
Adverse Reactions ◽  
Food Additives ◽  
Food Challenge ◽  
Cross Reactivity ◽  
Allergic Reactions ◽  
Double Blind ◽  
Specific Patient ◽  
Clinical Sensitivity ◽  
A Prospective Study

Purpose of the Study. This study outlines the significant advances made to our understanding of adverse reactions to foods and food additives in the last decade. The milestones are listed in order of overall importance and are discussed in depth in the review. 1. Establishing double-blind, placebo-controlled food challenge (DBPCFC) as the "gold-standard" for defining specific patient population to be used in scientific studies. (VanMetre, May, Bock) 2. Recognition of the key role food allergy plays in the pathogenesis of atopic dermatitis. (Sampson, May) 3. Identifying the group of foods most likely to be associated with true allergic reactions. Analysis of DBPCFC in children has shown that 93% of allergic reactions occurred to eight foods (in order of frequency): egg, peanut, milk, soy, tree nuts, crustacean-type shellfish, fish, and wheat. Corn and chocolate allergy was rarely found. (Bock, Sampson, Atkins) 4. Food allergy has a natural history. In a prospective study of 501 children, Bock found that, of 15 cases of allergy proven by DBPCFC in the first year of life, none of the 15 cases was reactive beyond 24 months of age. In contrast, long-term follow-up of patients who have experienced peanut anaphylaxis revealed that clinical sensitivity lasts for at least 14 years. (Bock, Atkins) 5. Food allergy cross-sensitivity (clinical reactivity) does not extend equally to all members of a biologic food family. Although immunologic cross-reactivity between peanut, soy, and other peas/beans could be regularly found in allergic patients, clinically important cross-reactions demonstrated by DBPCFC were rare. (Bernhisel -Broadbent, Sampson)

scholarly journals Oral food challenges

2020 ◽  
Vol 2 (1) ◽  
pp. 31-34
Author(s):  
Amal H. Assa’ad
Keyword(s):  
Food Allergy ◽  
Peanut Allergy ◽  
Food Challenge ◽  
Oral Food Challenge ◽  
Allergic Reactions ◽  
Double Blind ◽  
Trained Personnel ◽  
Open Food Challenge ◽  
Food Challenges ◽  
Shed Light

Oral food challenge (OFC) is a procedure that is conducted most commonly by allergist/immunologists in their office or in food allergy centers to confirm a food allergy or to confirm tolerance to the food. The procedure as conducted in clinical practice is mostly open food challenge and, in research, a double-blind, placebo controlled food challenge. OFC has associated risks that can be minimized by having the challenges conducted by trained personnel who are prepared to treat allergic reactions and who have rescue medications available. However, OFCs have tremendous benefits to the patients and their families, including the potential to determine that a food is no longer an allergen and can be introduced into the diet. Even OFCs that result in clinical reactions have the benefit of confirming the food allergy and demonstrating the therapeutic effect of the rescue medications. The study of the outcomes of OFC has shed light on food allergy reactions and characteristics of the patients with food allergy as well as on the value of other diagnostic tests compared with OFC. OFCs have helped establish food allergy thresholds, confirm that subjects enrolled in research studies have the allergy, and demonstrate the response to the therapies tested in terms of ameliorating the allergic response or raising the reaction threshold. OFCs have also been used to promote the recent guidelines for the prevention of peanut allergy by identifying the infants at risk for peanut allergy but who are not allergic yet.

scholarly journals Iodine allergy: Common misperceptions

2021 ◽  
Author(s):  
Nicole R Wulf ◽  
John Schmitz ◽  
Amy Choi
Keyword(s):  
Literature Review ◽  
Adverse Reactions ◽  
Povidone Iodine ◽  
Cross Reactivity ◽  
Current Evidence ◽  
Allergic Reactions ◽  
Iodinated Contrast Media ◽  
Inclusion Criteria ◽  
Iodinated Contrast ◽  
Final Article

Abstract Disclaimer In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose The current evidence regarding iodine-containing compounds and iodine allergy cross-reactivity is reviewed. Summary Iodine is an essential human nutrient found in the thyroid gland. It is used in the synthesis of the thyroid hormones thyroxine and triiodothyroxine. Patients who report having adverse reactions to iodine-containing substances are often labelled as having an “iodine allergy,” which can result in delays in care or patients being denied essential ICM or other iodine-containing drugs. A literature review was conducted to evaluate the evidence regarding iodine allergy and iodine-containing drugs. Of 435 articles considered potentially appropriate for full review (plus 12 additional articles included on the basis of references from the eligible articles), 113 could not be obtained. After exclusion of 353 articles that did not meet all inclusion criteria, the remaining 81 articles were included in the review. The results of the literature review indicated that iodine has not been shown to be the allergen responsible for allergic reactions to iodinated contrast media, amiodarone, povidone-iodine, and other iodine-containing compounds. Conclusion There is a lack of evidence to support cross-reactivity between iodine-containing compounds in so called iodine-allergic individuals.

scholarly journals Oral immunotherapy for treatment of peanut allergy

2020 ◽  
Vol 68 (6) ◽  
pp. 1152-1155
Author(s):  
Joan H Dunlop
Keyword(s):  
Food Allergy ◽  
Peanut Allergy ◽  
Food Challenge ◽  
Oral Immunotherapy ◽  
Peanut Protein ◽  
Subcutaneous Immunotherapy ◽  
Double Blind ◽  
The Us ◽  
Allergy Prevalence

The US Food and Drug Administration’s approval of a peanut oral immunotherapy product in January 2020 is a landmark development in the field of food allergy therapy. While food allergy prevalence has been increasing, this product is the first approved therapy for food allergy. Oral immunotherapy has many similarities to subcutaneous immunotherapy and drug desensitization protocols, but does not lead to sustained unresponsiveness. The studies leading to approval of the Palforzia product demonstrated increase in the amount of peanut protein able to be consumed, with 67% of subjects randomized to the treatment arm able to consume 600 mg of peanut protein in double-blind placebo-controlled food challenge at study exit. However, side effects are an important consideration, and dropout rates in studies of Palforzia ranged from 11% to 21%. Postmarketing surveillance of this product will be critical in assessing its long-term risks and benefits.

scholarly journals Safety of barley starch syrup in patients with allergy to cereals

2008 ◽  
Vol 101 (2) ◽  
pp. 165-168
Author(s):  
Merja Nermes ◽  
Henna Karvonen ◽  
Essi Sarkkinen ◽  
Erika Isolauri
Keyword(s):  
Atopic Dermatitis ◽  
Food Processing ◽  
Food Challenge ◽  
Allergic Reactions ◽  
Double Blind ◽  
Food Ingredients ◽  
Double Blind Placebo ◽  
Allergic Symptoms ◽  
Skin Prick Tests

It is not known whether trace amounts of proteins that may remain in cereal-starch-derived food ingredients even after food processing can trigger allergic symptoms in cereal-allergic individuals. The aim of this study was to find out if barley starch syrup causes allergic reactions in patients with allergy to wheat, barley, rye or oats. Fifteen children with allergy to these cereals, confirmed by double-blind placebo-controlled food challenge (DBPCFC), were selected for the study. When exposed to cereals, seven of the children (47 %) showed immediate type reactions, such as urticaria, rash or anaphylaxis. Eight of the children (53 %) showed delayed type reactions, such as deterioration of atopic dermatitis or diarrhoea. The fifteen children with allergy to cereals were exposed to barley starch syrup in DBPCFC and none of them showed any objective signs of allergy. On skin-prick tests (SPT), five of the children (33·3 %) showed a positive ( ≥ 3 mm) reaction to at least one of the cereals but none of them to barley starch syrup. This study confirmed with 98 % confidence that at least 90 % of the patients with verified allergy to cereals will not react with allergic symptoms to barley starch syrup.

scholarly journals Prevalence and Clinical Impact of IgE-Mediated Food Allergy in School Children With Asthma: A Double-Blind Placebo-Controlled Food Challenge Study

2015 ◽  
Vol 7 (6) ◽  
pp. 547 ◽  
Author(s):  
Aneta Krogulska ◽  
Jarosław Dynowski ◽  
Marzena Funkowicz ◽  
Beata Małachowska ◽  
Krystyna Wąsowska-Królikowska
Keyword(s):  
Food Allergy ◽  
School Children ◽  
Food Challenge ◽  
Clinical Impact ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Challenge Study ◽  
Children With Asthma ◽  
Ige Mediated

scholarly journals Late Type of Bronchial Response to Milk Ingestion Challenge: A Comparison of Open and Double-Blind Challenge

2012 ◽  
Vol 2012 ◽  
pp. 1-11
Author(s):  
Zdenek Pelikan
Keyword(s):  
Food Allergy ◽  
Food Challenge ◽  
Diagnostic Value ◽  
Skin Tests ◽  
Natural Food ◽  
Double Blind ◽  
Positive Skin ◽  
Asthma Patients ◽  
Natural Foods ◽  
Milk Ingestion

Background. In some asthmatics the food allergy, for example, to milk, can participate in their bronchial complaints. The role of food allergy should be confirmed definitively by food ingestion challenge performed by an open challenge with natural foods (OFICH) or by a double-blind placebo-controlled food challenge (DBPCFC). Objectives. To investigate the diagnostic value of these techniques for confirmation of a suspected milk allergy in bronchial asthma patients. Methods. In 54 asthmatics with a positive history and/or positive skin tests for milk the 54 OFICH, and DBPCFC, were performed in combination with spirometry. Results. The 54 patients developed 39 positive late asthmatic responses (LAR) and 15 negative asthmatic responses to OFICH and 40 positive LARs and 14 negative responses to DBPCFC. The overall correlation between the OFICH and DBPCFC was statistically significant (). Conclusions. This study has confirmed the existence of LAR to milk ingestion performed by OFICH and DBPCFC in combination with spirometry. The results obtained by both the techniques did not differ significantly. The OFICH with natural food combined with monitoring of objective parameter(s), such as spirometry, seems to be a suitable method for detection of the food allergy in asthmatics. The DBPCFC can be performed as an additional check, if necessary.

scholarly journals Alergia Alimentaria, puntos clave para la práctica clínica

2021 ◽  
Vol 67 (3) ◽  
Author(s):  
BLANCA E DEL RIO NAVARRO ◽  
Omar Josúe Saucedo Ramírez ◽  
Joaquín A. Pimentel Hayashi
Keyword(s):  
Food Allergy ◽  
Food Challenge ◽  
Elimination Diet ◽  
Oral Immunotherapy ◽  
Industrialized Countries ◽  
Double Blind ◽  
Immunological Mechanisms ◽  
Hen’S Egg ◽  
Ige Mediated

Food allergy is an immune reaction that occurs frequently in pediatric age, its prevalence is higher in industrialized countries, affecting 8% of the population, the most frequently involved foods are milk, hen’s egg, soybeans, peanuts, fish, wheat, seafood and tree nuts. Food allergy can be divided into three groups: IgE-mediated, non-IgE-mediated, and mixed food allergy. The symptoms will depend on the immunological mechanisms and can be divided into immediate or no immediate, the immediate symptoms appear in the first two hours of intake and the no immediate symptoms after the second hour and up to 72 hours. Diagnosis of food allergy requires a medical history, physical examination and laboratory tests; misdiagnosis can lead to unnecessary elimination diets. The gold standard is the double-blind placebo controlled oral food challenge. The main treatment is food restriction, the nutritional and psychological implications that this entails must be taken into account; Another treatment option is oral immunotherapy, it is recommended in patients who cannot carry out an elimination diet and it has a significant impact on quality of life.

scholarly journals Cross-reactivity in fish allergy: A double-blind, placebo-controlled food-challenge trial

2017 ◽  
Vol 140 (4) ◽  
pp. 1170-1172 ◽  
Author(s):  
Martin Sørensen ◽  
Annette Kuehn ◽  
E.N. Clare Mills ◽  
Carol Ann Costello ◽  
Markus Ollert ◽  
...  
Keyword(s):  
Food Challenge ◽  
Cross Reactivity ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Fish Allergy
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