scholarly journals GASTROINTESTINAL MANIFESTATIONS OF FOOD ALLERGY: PATHOGENESIS, CLINICAL FORMS AND CLUES TO THERAPY

2014 ◽  
Vol 11 (3) ◽  
pp. 11-20
Author(s):  
D S KOROSTOVTSEV ◽  
E A KORNIENKO ◽  
L A GALENKO ◽  
O V TRUSOVA ◽  
A V KAMAEV ◽  
...  

Food allergies (fa), defined as an adverse immune response to food proteins, effect up to 3-5% of the popula- tion in westernized countries, and their prevalence appears to be rising. a variety of mechanisms underlie the allergic reactions, not all of them run through the IgE sensitisation. the absence of sIgE in peripheral circulation characterize a group of non-Ig-Emediated disorders, such as food protein-induced enterocolitis, enteropathy and prococolitis. In case of eosinophilic esophagitis, gastritis and enterocolitis IgE sensitization arises in nearly 50%, therefore these disorders are classified as mixed-type. In some cases of gastrointestinal fa local IgE production, when switching to IgE synthesis occurs only in one organ, have been proved. although systemic investigation of this phenomenon is still lacking. Immune inflammation coursed by food allergens can involve nearly all organs and systems. this review focuses on gastroenterological manifestations of food allergy, except of broad field of gluten intolerance that demands a separate thorough reviewing.

2017 ◽  
Vol 54 (3) ◽  
pp. 346
Author(s):  
Chhavi Arya ◽  
Chetna Jantwal

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.


Cells ◽  
2019 ◽  
Vol 8 (9) ◽  
pp. 1073 ◽  
Author(s):  
Mariateresa Volpicella ◽  
Claudia Leoni ◽  
Maria C.G. Dileo ◽  
Luigi R. Ceci

Food allergies associated with class E immunoglobulins (IgE) are a serious health problem that affects between 1% and 10% of the population of developing countries, with a variability that depends on the geographical area and age range considered. These allergies are caused by a cross-link reaction between a specific food protein (the allergen) and the host IgE. Allergic reactions can range from mild itching to anaphylactic shock and there are no clues to predict the effects of an allergen. Strict avoidance of allergenic food is the only way to avoid possible serious allergic reactions. In the last 30 years a growing number of molecular studies have been conducted to obtain information on the diffusion of food allergens and to establish the structural basis of their allergenicity. At the same time, these studies have also allowed the development of molecular tools (mainly based on synthetic peptides and recombinant allergens) that can be of great help for diagnostic and therapeutic approaches of food allergies. Accordingly, this review focuses on advances in the study of food allergens made possible by molecular technologies and how results and technologies can be integrated for the development of a systematic food molecular allergology. The review may be of interest both to scientists approaching this field of investigation and to physicians who wish to have an update on the progress of research in diagnosis and therapy of food allergies.


Author(s):  
Vera P. Vavilova ◽  
Alexander M. Vavilov ◽  
Sofia A. Tsarkova ◽  
Irina A. Nechaeva ◽  
Ekaterina Iu. Burmistrova ◽  
...  

Background. At present, due to high prevalence of allergic diseases which start in early childhood, the search for new prevention and treatment methods is in great demand. Aim. To study the effectiveness of the Russian-produced enterosorbent colloidal silicon dioxide in the treatment of patients with food allergies combined with atopic dermatitis and gastrointestinal manifestations. Materials and methods. An open, randomized, comparative clinical study of the enterosorbent (colloidal silicon dioxide) effectiveness has been conducted in parallel groups of infants and preschool children with food allergy skin and gastrointestinal manifestations. The main groups (1 67 children with food allergies and atopic dermatitis skin manifestations, 3 60 children with food allergies and gastrointestinal manifestations) received, along with basic medication, colloidal silicon dioxide enterosorbent day at an age-specific dosage twice a for 1014 days. Control groups (2 60 children with food allergies and atopic dermatitis skin manifestations, 4 60 children with food allergies and gastrointestinal manifestations) did not receive enterosorbent. All children underwent a clinical, functional and laboratory status assessment, including medical records analysis, a pediatrician clinical examination, narrow specialists (allergist-immunologist) examination, laboratory and instrumental research. The treatment effectiveness was being evaluated on the 14th day after the initiation of therapy and after 30 days. The therapy effectiveness was assessed based on regression of skin syndrome clinical and gastrointestinal manifestations, intoxication syndrome and laboratory parameters (IgE, hemogram eosinophilia duration). The study was conducted from 2017 to 2019. On the basis of LLC Modern Medical Technologies Clinics (Kemerovo). Results. Therapy with colloidal silicon dioxide increases the significance of food allergy skin manifestations positive dynamics, which makes it possible to reduce the volume of medication and the duration of topical glucocorticosteroids use to 5.340.35 days, in the compared group 10.520.85 days (p=0.002). All patients with food allergy combined with atopic dermatitis in the main and control groups noted positive clinical dynamics, appearing as decrease in the skin inflammatory reaction area and intensity. However, the of colloidal silicon dioxide use accelerates skin syndrome condition normalization significantly (group 1 skin syndrome persisted in 2.92.0% after 14 days, in group 2 18.34.9%; p=0.003). Colloidal silicon dioxide use accelerates humoral immunity state normalization (IgE) and peripheral blood parameters (hemogram eosinophilia). Colloidal silicon dioxide therapy accelerates food allergy gastrointestinal manifestations positive dynamics in children. Two weeks after the sorbent therapy started, gastrointestinal tract lesions symptoms frequency is less than in patients in the compared group. Diarrhea frequency before treatment started was 48.36.5%, 45.06.4% in the compared groups. After two weeks it decreased to 6.73.2% with the Polisorb therapy and to 16.64.8% in the compared group (p=0.003). Abdominal pain was noted by patients of both groups equally often before the study began. After 2 weeks, abdominal pain was noted by ten percent 10.03.9% of patients taking colloidal silicon dioxide and 25.05.6% of the compared group (p=0.009). Conclusion. Taking into account the composition of the colloidal silicon dioxide, it makes sense to include this medication in childrens food allergies complex treatment starting from infancy, which contributes to a more rapid relief of gastrointestinal system damage symptoms, life quality improvement for children and their parents, and decrease in medication load. When using colloidal silicon dioxide in children with food allergies, a faster dynamics of disease symptoms relief (p=0.003) was noted, which allows us to conclude that it is highly effective in the treatment of allergic diseases associated with food sensitization.


Medicina ◽  
2019 ◽  
Vol 55 (8) ◽  
pp. 501 ◽  
Author(s):  
Caglayan-Sozmen ◽  
Santoro ◽  
Cipriani ◽  
Mastrorilli ◽  
Ricci ◽  
...  

Childhood food allergies are a growing public health problem. Once the offending food allergens have been identified, a strict elimination diet is necessary in treatment or prevention of most of the allergic reactions. Accidental food ingestion can lead to severe anaphylaxis. Food- derived substances can be used in medications at various stages of the manufacturing process. In this review, the possible roles of medications which may contain egg, red meat, gelatin, and fish allergens on allergic reactions in children with food allergy were evaluated.


2021 ◽  
Vol 42 (2) ◽  
pp. 118-123
Author(s):  
Aikaterini Anagnostou

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.


2018 ◽  
Author(s):  
Matthew Greenhawt

Food allergy represents a rapidly growing public health problem in the United States and other westernized nations. Adverse reactions to foods are categorized as either immunologic or nonimmunologic reactions. This distinction is highly important but often confusing to patients and physicians unfamiliar with allergy, who may simply describe any adverse reaction to a food as an “allergy.” A food allergy is an immune-mediated, adverse reaction to one or more protein allergens in a particular food item involving recognition of that protein by specifically targeted IgE or allergen-specific T cells. This chapter discusses the definition, pathophysiology, epidemiology, testing, management, prognosis, and natural history of food allergy. Clinical manifestations are systematically covered, including cutaneous, respiratory, cardiovascular, and gastrointestinal reactions, as well as eosinophilic esophagitis, food protein–induced enterocolitis syndrome, and oral allergy syndrome. Emerging treatments such as food oral immunotherapy are also reviewed. Tables outline signs and symptoms of immediate hypersensitivity reactions to food, the prevalence of major food allergens in the United States, common patterns of cross-reactivity among foods, clinical criteria for the diagnosis of anaphylaxis, and clinical studies involving treatment for food allergies. Figures illustrate the classification of adverse reactions to food, esophageal histology, visual and radiographic features of eosinophilic esophagitis, and a food allergy action plan. This review contains 4 figures, 8 tables, and 64 references. KeyWords: Food allergy, Hypersensitivity, IgE-mediated allergy, Eosinophilic esophagitis, Anaphylaxis


2020 ◽  
Vol 16 (2) ◽  
pp. 95-105
Author(s):  
Antonella Cianferoni

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.


2005 ◽  
Vol 64 (4) ◽  
pp. 470-474 ◽  
Author(s):  
René Crevel

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.


2018 ◽  
Vol 101 (1) ◽  
pp. 91-95 ◽  
Author(s):  
René R W Crevel ◽  
Stefan Ronsmans ◽  
Cyril F M Marsaux ◽  
Diána Bánáti

Abstract The International Life Sciences Institute (ILSI) Europe Food Allergy Task Force was founded in response to early public concerns about the growing impact of food allergies almost coincidentally with the publication of the 1995 Food and Agriculture Organization-World Health Organization Technical Consultation on Food Allergies. In line with ILSI principles aimed to foster collaboration between stakeholders to promote consensus on science-based approaches to food safety and nutrition, the task force has played a central role since then in the development of risk assessment for food allergens. This ranged from consideration of the criteria to be applied to identifying allergens of public health concern through methodologies to determine the relationship between dose and the proportion of allergic individuals reacting, as well as the nature of the observed responses. The task force also promoted the application of novel, probabilistic risk assessment methods to better delineate the impact of benchmarks, such as reference doses, and actively participated in major European food allergy projects, such as EUROPREVALL, the European Union (EU)-funded project “The prevalence, cost and basis of food allergy across Europe;” and iFAAM, “Integrated approaches to food allergen and allergy risk management,” also an EU-funded project. Over the years, the task force’s work has evolved as answers to initial questions raised further issues: Its current work program includes a review of analytical methods and how different ones can best be deployed given their strengths and limitations. Another activity, which has just commenced, aims to develop a framework for stakeholders to achieve consensus on acceptable risk.


Medicina ◽  
2019 ◽  
Vol 55 (7) ◽  
pp. 323 ◽  
Author(s):  
Pasquale Comberiati ◽  
Giorgio Costagliola ◽  
Sofia D’Elios ◽  
Diego Peroni

Over the last two decades, the prevalence of food allergies has registered a significant increase in Westernized societies, potentially due to changes in environmental exposure and lifestyle. The pathogenesis of food allergies is complex and includes genetic, epigenetic and environmental factors. New evidence has highlighted the role of the intestinal microbiome in the maintenance of the immune tolerance to foods and the potential pathogenic role of early percutaneous exposure to allergens. The recent increase in food allergy rates has led to a reconsideration of prevention strategies for atopic diseases, mainly targeting the timing of the introduction of solid foods into infants’ diet. Early recommendation for high atopy risk infants to delay the introduction of potential food allergens, such as cow’s milk, egg, and peanut, until after the first year of life, has been rescinded, as emerging evidence has shown that these approaches are not effective in preventing food allergies. More recently, high-quality clinical trials have suggested an opposite approach, which promotes early introduction of potential food allergens into infants’ diet as a means to prevent food allergies. This evidence has led to the production of new guidelines recommending early introduction of peanut as a preventive strategy for peanut allergy. However, clinical trials investigating whether this preventive dietary approach could also apply to other types of food allergens have reported ambiguous results. This review focuses on the latest high-quality evidence from randomized controlled clinical trials examining the timing of solid food introduction as a strategy to prevent food allergies and also discusses the possible implications of early complementary feeding on both the benefits and the total duration of breastfeeding.


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