scholarly journals Classification and Coding of Data About IgE-mediated Food Allergic Reactions

2020 ◽  
Author(s):  
Chloe French ◽  
Benjamin Green ◽  
Saskia Lawson-Tovey ◽  
Bushra Javed ◽  
Martine Morisset ◽  
...  
Keyword(s):  
Food Allergy ◽  
Signs And Symptoms ◽  
Relevant Information ◽  
Food Allergies ◽  
Allergic Reactions ◽  
Snomed Ct ◽  
Clinical Coding ◽  
Classification Schemes ◽  
Coding Systems ◽  
Ige Mediated

Abstract Background: Collation of clinical data on IgE-mediated food allergies is essential to provide evidenced-based approaches to managing and treating food allergies and prevent accidental reactions. However, this can be a time consuming and difficult process due to the heterogeneous way in which studies collect such data. In order to facilitate data harmonisation a set of standardised terminologies have been identified and a consensus technique established to code food allergy data.Methods: Different terminologies to encode the most common signs, symptoms and problematic foods associated with IgE-mediated food allergies were identified. Their suitability for classifying and coding information about the signs and symptoms of food allergic reactions, causative foods and reaction severity of was assessed. The assessment included existing conceptual coverage and data descriptions, classification schemes and additional relevant information.Results: All of the terminologies reviewed included classification schemes, allowing broader concepts to be related to those that are more specialised. Additional information was often present such as equivalence. Of the clinical coding systems assessed, the Systemized Nomenclature of Medical Clinical Terms (SNOMED-CT) provided the most complete coverage with options to code symptom severity. Only food coding systems, such as FoodEx2, provided comprehensive conceptual coverage of the food terms.Conclusions: Utilising SNOMED-CT and FoodEx2 standards together will support the harmonisation of data regarding food allergy from diverse sources, providing a transparent and effective way to collate relevant data required for effective food allergen management in the future.

Food Allergies

2018 ◽  
Author(s):  
Edmond A. Hooker ◽  
Charles Kircher
Keyword(s):  
Food Allergy ◽  
Action Plan ◽  
The United States ◽  
Emergency Department Visits ◽  
Food Allergies ◽  
Cell Mediated Immunity ◽  
Clinical Criteria ◽  
Rome Iii ◽  
Ige Mediated ◽  
Irritable Bowel

Food allergies are responsible for a considerable number of emergency department visits. Food allergy can be divided into classic (i.e., IgE-mediated) reactions to specific allergens after exposure via skin or mucosal membrane and non–IgE-mediated food allergies, which include T cell–mediated immunity, enteropathies to specific proteins, and mixed disorders (e.g., eosinophilic esophagitis). Food-induced anaphylaxis can be life threatening and requires immediate treatment with epinephrine, even if the causative agent has not been identified. This review describes the pathophysiology, stabilization and assessment, diagnosis and treatment, and disposition and outcomes for patients with food allergies. Figures show IgE-mediated allergic reactions to food and other allergens, classification of adverse reactions to foods, commercially available epinephrine autoinjectors, a sample anaphylaxis action plan, and a map showing school access to epinephrine in the United States as of September 4, 2014. Tables list potential food allergies with estimated self-reported prevalence, National Institute of Allergy and Infectious Disease clinical criteria of anaphylaxis, non–IgE-mediated food intolerance disorders, Rome III diagnostic criteria for irritable bowel syndrome, food allergy mimickers, and potential criteria for prolonged observation. This review contains 5 highly rendered figures, 6 tables, and 54 references.

A Review on Identified Major Food Allergens: Characteristics and Role in Food Allergy

2017 ◽  
Vol 54 (3) ◽  
pp. 346
Author(s):  
Chhavi Arya ◽  
Chetna Jantwal
Keyword(s):  
Food Allergy ◽  
Food Allergies ◽  
Allergic Reactions ◽  
Food Allergens ◽  
Food Groups ◽  
Consumer Protection Act ◽  
Major Food ◽  
Life Threatening ◽  
Major Allergens ◽  
Allergen Labeling

Food allergens are the substances present in food that cause food allergy. Human body reactions to food allergens range from mild to severe life threatening anaphylactic shock. At least seventy different foods have been reported to cause allergic reactions and several other foods have been identified which have the potential to provoke allergic reactions. Majority of the identified food allergens are proteins. The Food Allergen Labeling and Consumer Protection Act (FALCPA) identifies eight major food groups i.e. milk, eggs, fish, crustacean shellfish, tree nuts, peanuts, wheat, and soybeans as major allergy causing foods. These eight foods are believed to account for 90 per cent of food allergies and are responsible for most serious reactions to foods. Several studies have been done which identify the major allergens in various foods. The present paper attempts to review the major allergens present in various food.

scholarly journals Microbial signature in IgE-mediated food allergies

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Michael R. Goldberg ◽  
Hadar Mor ◽  
Dafna Magid Neriya ◽  
Faiga Magzal ◽  
Efrat Muller ◽  
...  
Keyword(s):  
Food Allergy ◽  
Gut Microbiota ◽  
Learning Algorithm ◽  
Area Under The Curve ◽  
Food Allergies ◽  
Rrna Gene ◽  
Microbiota Composition ◽  
Α Diversity ◽  
Ige Mediated ◽  
Gut Microbiota Composition

Abstract Background Multiple studies suggest a key role for gut microbiota in IgE-mediated food allergy (FA) development, but to date, none has studied it in the persistent state. Methods To characterize the gut microbiota composition and short-chain fatty acid (SCFAs) profiles associated with major food allergy groups, we recruited 233 patients with FA including milk (N = 66), sesame (N = 38), peanut (N = 71), and tree nuts (N = 58), and non-allergic controls (N = 58). DNA was isolated from fecal samples, and 16S rRNA gene sequences were analyzed. SCFAs in stool were analyzed from patients with a single allergy (N = 84) and controls (N = 31). Results The gut microbiota composition of allergic patients was significantly different compared to age-matched controls both in α-diversity and β-diversity. Distinct microbial signatures were noted for FA to different foods. Prevotella copri (P. copri) was the most overrepresented species in non-allergic controls. SCFAs levels were significantly higher in the non-allergic compared to the FA groups, whereas P. copri significantly correlated with all three SCFAs. We used these microbial differences to distinguish between FA patients and non-allergic healthy controls with an area under the curve of 0.90, and for the classification of FA patients according to their FA types using a supervised learning algorithm. Bacteroides and P. copri were identified as taxa potentially contributing to KEGG acetate-related pathways enriched in non-allergic compared to FA. In addition, overall pathway dissimilarities were found among different FAs. Conclusions Our results demonstrate a link between IgE-mediated FA and the composition and metabolic activity of the gut microbiota.

scholarly journals Weighing the benefits and risks of oral immunotherapy in clinical practice

2021 ◽  
Vol 42 (2) ◽  
pp. 118-123
Author(s):  
Aikaterini Anagnostou
Keyword(s):  
Quality Of Life ◽  
Food Allergy ◽  
The United States ◽  
Oral Immunotherapy ◽  
Food Allergies ◽  
Allergic Reactions ◽  
Immune Modulators ◽  
Significant Burden ◽  
Working Together

Food allergies are common and affect 6‐8% of children in the United States; they pose a significant burden on the quality of life of children with allergy and their caregivers due to multiple daily restrictions. Despite the recommended dietary avoidance, reactions tend to occur due to unintentional exposure to the allergenic food trigger. Fear of accidental ingestions with potentially severe reactions, including anaphylaxis and death, creates anxiety in individuals with food allergy. Oral immunotherapy has emerged as a form of active and potentially disease-modifying treatment for common food allergies encountered in childhood. The efficacy of oral immunotherapy is high, with the majority of participants achieving desensitization and, as a result, protection from trace exposures and improved quality of life. The main risk of oral immunotherapy consists of allergic reactions to treatment. In general, rates of allergic reactions and anaphylaxis are reported to be higher in individuals pursuing therapy options, but most subjects who undergo oral immunotherapy will likely experience mild or moderate reactions during treatment. Adverse events tend to reduce in both frequency and number in the maintenance period. The use of immune modulators alongside oral immunotherapy has been suggested, with the aim to improve efficacy and safety, and to facilitate the overall process. It is evident that the landscape of food allergy management is changing and that the future looks brighter, with different options emerging over time. The process of how to choose the appropriate option becomes a discussion between the clinician and the patient, which involves a joint review of the current medical evidence but also the patient's preference for balancing particular attributes of the treatment. By working together, providers and patients will ensure achievement of the best possible outcome for children with food allergies.

Non-IgE Mediated Food Allergy

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.

scholarly journals Industrial dimensions of food allergy

2005 ◽  
Vol 64 (4) ◽  
pp. 470-474 ◽  
Author(s):  
René Crevel
Keyword(s):  
Food Allergy ◽  
Food Industry ◽  
Food Allergies ◽  
Allergic Reactions ◽  
Atopic Diseases ◽  
Novel Proteins ◽  
Safety Assurance ◽  
The One ◽  
A Minor ◽  
The Impact

Serious attempts to estimate the impact of allergic reactions to foods on public health did not begin until the 1980s. Until about 15 years ago food allergy was considered a minor aspect of food safety. Two developments probably prompted a radical re-appraisal of that situation. The first was the apparently inexorable rise in the prevalence of atopic diseases, of which food allergy forms a part, with its possible consequences highlighted by some well-publicised severe reactions. The second was the growth of genetic modification technology, manifested by the commercialisation of transgenic crops. Each of these developments impacted on the food industry in distinct ways. On the one hand, consumers with food allergies had to be enabled to avoid specific allergens in products formulated with existing ingredients. Food manufacturers therefore had to identify those specific allergens down to trace amounts in all the ingredients forming the product and label or remove them. On the other hand, the introduction of products using ingredients from novel sources required an assessment of the allergenicity of these ingredients as an integral part of safety assurance. The approaches used by the food industry to protect existing consumers who have food allergies and those at potential risk of sensitisation from novel proteins will be illustrated, emphasising how they need to be built into every stage of the life cycle of a product.

Active management of food allergy: an emerging concept

2014 ◽  
Vol 100 (4) ◽  
pp. 386-390 ◽  
Author(s):  
Katherine Anagnostou ◽  
Gary Stiefel ◽  
Helen Brough ◽  
George du Toit ◽  
Gideon Lack ◽  
...  
Keyword(s):  
Food Allergy ◽  
Management Strategies ◽  
Active Management ◽  
Food Allergies ◽  
Active Monitoring ◽  
Early Introduction ◽  
Active Approach ◽  
Medication Plan ◽  
Emergency Medication ◽  
Ige Mediated

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.

scholarly journals Allergic reactions to emerging food allergens in Canadian children

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Lianne Soller ◽  
Sebastien La Vieille ◽  
Scott B. Cameron ◽  
Raymond Mak ◽  
Victoria E. Cook ◽  
...  
Keyword(s):  
Food Allergy ◽  
Allergic Reactions ◽  
Food Allergens ◽  
The Past ◽  
Ige Mediated ◽  
Packaged Foods ◽  
Reaction Severity ◽  
Seeds And Fruits

AbstractMost Canadian food allergy data has focused on Health Canada’s priority food allergens. This study describes which non-priority (emerging) food allergens were most commonly reported by Canadian parents and categorized/confirmed by allergists. A secondary aim was to describe severity of allergic reactions to emerging allergens. Parents reported allergic reactions to emerging food allergens experienced by their child (< 18 years) which occurred in the past 12 months, and allergists categorized/confirmed them according to likelihood of IgE-mediated food allergy. Of 68 eligible patients completing the survey, the most commonly reported emerging allergens were fruits/vegetables (58.8%), seeds (22.1%), legumes (19.1%) and other (11.8%). Median allergist ranking for legumes was ‘probable’ IgE-mediated food allergy, ‘possible’ for seeds and fruits/vegetables, and ‘unlikely’ for other. Median reaction severity was mild for legumes, and moderate for seeds, fruits/vegetables, and other. Our study highlights that non-priority food allergens, namely legumes and seeds, can lead to probable/likely allergic reactions in Canadian children. These food allergens are increasing in popularity in the Canadian diet, which could lead to increasing reports of allergic reactions. More research is needed to confirm reports of reactions to emerging allergens, and to document their inclusion as ingredients in packaged foods.

scholarly journals Using oral food challenges to provide clarity and confidence when diagnosing food allergies

2021 ◽  
Vol 3 (1) ◽  
pp. 3-7 ◽  
Author(s):  
Justin Greiwe
Keyword(s):  
Food Allergy ◽  
Immunoglobulin E ◽  
Food Challenge ◽  
Clinical History ◽  
The United States ◽  
Oral Immunotherapy ◽  
Food Allergies ◽  
Ige Mediated ◽  
Challenge Education ◽  
Food Challenges

A verified food allergy can be an impactful life event that leads to increased anxiety and measurable effects on quality of life. Allergists play a key role in framing this discussion and can help alleviate underlying fears by promoting confidence and clarifying safety concerns. Correctly diagnosing a patient with an immunoglobulin E (IgE) mediated food allergy remains a nuanced process fraught with the potential for error and confusion. This is especially true in situations in which the clinical history is not classic, and allergists rely too heavily on food allergy testing to provide a confirmatory diagnosis. A comprehensive medical history is critical in the diagnosis of food allergy and should be used to determine subsequent testing and interpretation of the results. Oral food challenge (OFC) is a critical procedure to identify patients with an IgE-mediated food allergy when the history and testing are not specific enough to confirm the diagnosis and can be a powerful teaching tool regardless of outcome. Although the safety and feasibility of performing OFC in a busy allergy office have always been a concern, in the hands of an experienced and trained provider, OFC is a safe and reliable procedure for patients of any age. With food allergy rates increasing and analysis of recent data that suggests that allergists across the United States are not providing this resource consistently to their patients, more emphasis needs to be placed on food challenge education and hands-on experience. The demand for OFCs will only continue to increase, especially with the growing popularity of oral immunotherapy programs; therefore, it is essential that allergists become familiar with the merits and limitations of current testing modalities and open their doors to using OFCs in the office.

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