scholarly journals Addressing Common Misconceptions in Food Allergy: A Review

Children ◽  
2021 ◽  
Vol 8 (6) ◽  
pp. 497
Author(s):  
Aikaterini Anagnostou
Keyword(s):  
Food Allergy ◽  
The United States ◽  
Specific Ige ◽  
Oral Immunotherapy ◽  
Food Allergies ◽  
Allergy Prevention ◽  
Diagnosis And Management ◽  
Skin Prick Tests ◽  
Food Specific Ige ◽  
Common Misconceptions

Background: Food allergies are common, affecting 1 in 13 school children in the United States and their prevalence is increasing. Many misconceptions exist with regards to food allergy prevention, diagnosis and management. Objective: The main objective of this review is to address misconceptions with regards to food allergies and discuss the optimal, evidence-based approach for patients who carry this diagnosis. Observations: Common misconceptions in terms of food allergy prevention include beliefs that breastfeeding and delayed introduction of allergenic foods prevent the development of food allergies. In terms of diagnosis, statements such as ‘larger skin prick tests or/and higher levels of food-specific IgE can predict the severity of food-induced allergic reactions’, or ‘Tryptase is always elevated in food-induced anaphylaxis’ are inaccurate. Additionally, egg allergy is not a contraindication for receiving the influenza vaccine, food-allergy related fatalities are rare and peanut oral immunotherapy, despite reported benefits, is not a cure for food allergies. Finally, not all infants with eczema will develop food allergies and epinephrine auto-injectors may unfortunately be both unavailable and underused in food-triggered anaphylaxis. Conclusions and relevance: Healthcare professionals must be familiar with recent evidence in the food allergy field and avoid common misunderstandings that may negatively affect prevention, diagnosis and management of this chronic disease.

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.

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.

scholarly journals Two Cases of Occupational Contact Urticaria Caused by Percutaneous Sensitization to Parvalbumin

2015 ◽  
Vol 7 (2) ◽  
pp. 227-232 ◽  
Author(s):  
Akiyo Sano ◽  
Akiko Yagami ◽  
Kayoko Suzuki ◽  
Yohei Iwata ◽  
Tsukane Kobayashi ◽  
...  
Keyword(s):  
Food Allergy ◽  
Specific Ige ◽  
Hand Eczema ◽  
Physical Contact ◽  
Food Allergies ◽  
Ige Antibodies ◽  
Contact Urticaria ◽  
Microarray Immunoassay ◽  
Specific Ige Antibodies ◽  
Skin Prick Tests

Background: In recent years, it has been proposed that the primary mechanism for the development of food allergies is percutaneous sensitization. Since 2010, in Japan, the number of immediate-type wheat allergy due to hydrolyzed wheat protein has dramatically increased among those who have been using soap containing hydrolyzed wheat. This incidence supports the hypothesis that food allergens arise through percutaneous sensitization. Clinical Summary: A 25-year-old man (case 1) and an 18-year-old girl (case 2) with atopic dermatitis visited our Department because of food allergy and hand eczema. After starting their work with fish, severe itchy eczema appeared on their hands. They subsequently started to experience oral allergic symptoms, intraoral itchiness and dyspnea after eating fish. Specific IgE antibodies were detected for many fishes, and skin prick tests showed positive reactions for a variety of fishes in both cases. Furthermore, the fluorescence intensities of specific IgE antibodies against parvalbumin from various types of fish in microarray immunoassay analysis showed positive reactions. We diagnosed them as contact urticaria caused by percutaneous sensitization to parvalbumin through job-related physical contact with fish. Conclusion: The patients' histories and findings indicate the possibility of percutaneous sensitization through occupational exposure to parvalbumin, leading to food allergy.

scholarly journals Oral Food Challenge

Medicina ◽  
2019 ◽  
Vol 55 (10) ◽  
pp. 651
Author(s):  
Calvani ◽  
Bianchi ◽  
Reginelli ◽  
Peresso ◽  
Testa
Keyword(s):  
Food Allergy ◽  
Food Challenge ◽  
Clinical History ◽  
Specific Ige ◽  
Oral Food Challenge ◽  
Food Allergies ◽  
Pediatric Allergy ◽  
Expert Review ◽  
Ige Mediated ◽  
Food Specific Ige

: Oral food challenge (OFC) is the gold standard for diagnosis of IgE-mediated and non-IgE mediated food allergy. It is usually conducted to make diagnosis, to monitor for resolution of a food allergy, or to identify the threshold of responsiveness. Clinical history and lab tests have poor diagnostic accuracy and they are not sufficient to make a strict diagnosis of food allergy. Higher concentrations of food-specific IgE or larger allergy prick skin test wheal sizes correlate with an increased likelihood of a reaction upon ingestion. Several cut-off values, to make a diagnosis of some food allergies (e.g., milk, egg, peanut, etc.) without performing an OFC, have been suggested, but their use is still debated. The oral food challenge should be carried out by experienced physicians in a proper environment equipped for emergency, in order to carefully assess symptoms and signs and correctly manage any possible allergic reaction. This review does not intend to analyse comprehensively all the issues related to the diagnosis of food allergies, but to summarize some practical information on the OFC procedure, as reported in a recent issue by The Expert Review of Food Allergy Committee of Italian Society of Pediatric Allergy and Immunology (SIAIP)

scholarly journals Food allergens–food safety hazard

2021 ◽  
Vol 854 (1) ◽  
pp. 012038
Author(s):  
V V Jankovic ◽  
B M Velebit ◽  
B Z Lakicevic ◽  
R R Mitrovic ◽  
L Z Milojevic
Keyword(s):  
Food Allergy ◽  
Health Effect ◽  
Public Health Problem ◽  
Specific Ige ◽  
Food Allergies ◽  
Oral Exposure ◽  
Medical Systems ◽  
Cellular Mechanisms ◽  
Significant Public Health ◽  
Food Specific Ige

Abstract Food allergy is a life-threatening chronic condition that substantially impairs quality of life. It constitutes a significant public health problem that affects children and adults and is a considerable burden on health, medical systems and emerging economies. Food allergy is defined as an adverse health effect arising from a specific immune-mediated response that occurs reproducibly on oral exposure to a given food and which can be mediated by food-specific IgE antibodies, by cellular mechanisms or by both. Appropriately managing food allergies has become an issue for the food industry because of the rising number of individuals with food allergies. Current initiatives to support consumers at risk include a recognised standard for manufacturers seeking to eliminate an allergen from their production, and the integration of food allergy into training for food business operators.

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.

scholarly journals Guidelines for the Diagnosis and Management of Food Allergy in the United States: Summary of the NIAID-Sponsored Expert Panel Report

2011 ◽  
Vol 31 (1) ◽  
pp. 61-75 ◽  
Author(s):  
Joshua A. Boyce ◽  
Amal Assa'ad ◽  
A. Wesley Burks ◽  
Stacie M. Jones ◽  
Hugh A. Sampson ◽  
...  
Keyword(s):  
United States ◽  
Food Allergy ◽  
Expert Panel ◽  
The United States ◽  
Panel Report ◽  
Diagnosis And Management

scholarly journals Food Allergy Prevention and Treatment by Targeted Nutrition

2018 ◽  
Vol 72 (Suppl. 3) ◽  
pp. 33-45 ◽  
Author(s):  
Ralf G. Heine
Keyword(s):  
Vitamin D ◽  
Food Allergy ◽  
Food Allergen ◽  
Population Level ◽  
Food Allergies ◽  
Allergy Prevention ◽  
Prevention Strategies ◽  
Allergen Avoidance ◽  
Effective Prevention ◽  
Young Infants

In view of the dramatic rise in the prevalence of food allergy globally, effective prevention strategies have become a public health priority. Several models have emerged around the etiology of food allergy, including the hygiene hypothesis, dual allergen exposure hypothesis, and vitamin D hypothesis. These form the basis for current and potential prevention strategies. Breastfeeding remains a key pillar of primary allergy prevention. Other nutritional interventions, including the use of whey-based, partially hydrolyzed formula in non-breastfed infants, also play an important role. In recent years, there has been a shift away from prolonged food allergen avoidance to the proactive allergen introduction from 4 months of age. This approach is supported by 2 pivotal randomized clinical trials showing that the early introduction of peanut and other food allergens significantly reduces the risk of food allergy. However, the implementation of this strategy at the population level still raises significant logistic problems, including patient selection and development of suitable food formats for young infants. Other prevention strategies, including vitamin D supplementation, are currently under evaluation. Maternal elimination diets during pregnancy and lactation are not recommended for allergy prevention. The treatment of food allergies has also seen major transformations. While strict allergen avoidance is still the key treatment principle, there is a greater focus on desensitization and tolerance induction by oral and epicutaneous immunotherapy. In addition, specialized hypoallergenic infant formulas for the treatment of infants with cow’s milk allergy have undergone reformulation, including the addition of lactose and probiotics in order to modulate the gut microbiome and early immune responses. Further research is needed to inform the most effective food allergy prevention strategies at the population level. In addition, the wider application of food allergen immunotherapy may provide better health outcomes and improved quality of life for families affected by food allergies.

scholarly journals Trick or treat? – when children with childhood food allergies lead parents into unhealthy food choices

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ali B. Mahmoud ◽  
Dieu Hack-Polay ◽  
Leonora Fuxman ◽  
Dina Naquiallah ◽  
Nicholas Grigoriou
Keyword(s):  
Food Allergy ◽  
Structural Equation ◽  
Food Choices ◽  
The United States ◽  
Path Model ◽  
Food Allergies ◽  
Unhealthy Food ◽  
Parental Gender ◽  
Fresh Perspective ◽  
Complex Relationships

Abstract Background This study examines the relationships between childhood food allergy and parental unhealthy food choices for their children across attitudes towards childhood obesity as mediators and parental gender, income and education as potential moderators. Methods We surveyed parents with at least one child between the ages of 6 and 12 living in Canada and the United States. We received 483 valid responses that were analysed using structural equation modelling approach with bootstrapping to test the hypothetical path model and its invariance across the moderators. Results The analysis revealed that pressure to eat fully mediated the effects of childhood food allergy and restriction on parental unhealthy food choices for their children. Finally, we found that parental gender moderated the relationship between childhood food allergy and the pressure to eat. Conclusions The paper contributes to the literature on food allergies among children and the marginalisation of families with allergies. Our explorative model is a first of its kind and offers a fresh perspective on complex relationships between variables under consideration. Although our data collection took place prior to Covid-19 outbreak, this paper bears yet particular significance as it casts light on how families with allergies should be part of the priority groups to have access to food supply during crisis periods.

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