Prevention of food allergy

2019 ◽  
Vol 40 (6) ◽  
pp. 450-452 ◽  
Author(s):  
Ashley L. Devonshire ◽  
Rachel Glick Robison
Keyword(s):  
Food Allergy ◽  
Peanut Allergy ◽  
Immunoglobulin E ◽  
Skin Prick Testing ◽  
Clinical Manifestations ◽  
Conclusive Evidence ◽  
Severe Atopic Dermatitis ◽  
Early Introduction ◽  
Infant Diet ◽  
Specific Immunoglobulin E

Primary prevention and secondary prevention in the context of food allergy refer to prevention of the development of sensitization (i.e., the presence of food-specific immunoglobulin E (IgE) as measured by skin-prick testing and/or laboratory testing) and sensitization plus the clinical manifestations of food allergy, respectively. Until recently, interventions that target the prevention of food allergy have been limited. Although exclusive breast-feeding for the first 6 months of life has been a long-standing recommendation due to associated health benefits, recommendations regarding complementary feeding in infancy have significantly changed over the past 20 years. There now is evidence to support early introduction of peanut into the diet of infants with egg allergy, severe atopic dermatitis, or both diagnoses, defined as high risk for peanut allergy, to try to prevent development of peanut allergy. Although guideline-based recommendations are not available for early introduction of additional allergenic foods, this topic is being actively studied. There is no evidence to support additional dietary modification of the maternal or infant diet for the prevention of food allergy. Similarly, there is no conclusive evidence to support maternal avoidance diets for the prevention of food allergy.

scholarly journals Dysregulated specific IgE production to bystander foods in children with peanut allergy but not egg allergy

2021 ◽  
Vol 3 (1) ◽  
pp. 24-31 ◽  
Author(s):  
Nurcicek Padem ◽  
Kristin Erickson ◽  
Meagan Yong ◽  
Melanie Makhija ◽  
Kathryn E. Hulse ◽  
...  
Keyword(s):  
Food Allergy ◽  
Peanut Allergy ◽  
Immunoglobulin E ◽  
Specific Ige ◽  
Egg White ◽  
Total Ige ◽  
Control Subjects ◽  
Specific Immunoglobulin E ◽  
Natural Tolerance ◽  
And Control

Background: Food specific immunoglobulin E (sIgE) levels are associated with the development of allergic responses and are used in the clinical evaluation of food allergy. Food sIgG4 levels have been associated with tolerance or clinical nonresponsiveness, particularly in interventional studies. Objective: We aimed to characterize food-specific antibody responses and compare responses with different foods in food allergy. Methods: Serum sIgA, sIgG4, and sIgE to whole peanut, egg white, and wheat, along with total IgE were measured in 57 children. Children with food allergy, children with natural tolerance, and controls were studied. The Mann-Whitney test or Kruskall Wallis test with the Dunn correction were used for statistical analysis. Results: As expected, total IgE levels were highest in the subjects with food allergy compared with the subjects who were nonallergic (p < 0.001) or the subjects who were naturally tolerant (p < 0.001). Peanut sIgE levels were higher in subjects with peanut allergy compared with the subjects who were naturally tolerant (p < 0.0001) and the control subjects (p < 0.03). Interestingly, peanut sIgG4 levels were also highest in children with peanut allergy compared with subjects who were naturally tolerant and control subjects (p = 0.28 and p < 0.001, respectively). Subjects with peanut allergy alone had comparable egg white sIgE levels to children with egg white allergy. In addition, the subjects with peanut allergy alone also had higher levels of egg white and wheat sIgE compared with the control subjects (p < 0.02 and p = 0.001, respectively). In contrast, the subjects with egg white allergy did not demonstrate elevated peanut or wheat sIgE levels. Conclusion: These novel findings suggested that IgE production is dysregulated in patients with peanut allergy, who are much less likely to outgrow their allergy, and suggest that the mechanisms that drive more persistent forms of food allergy may be distinct from more transient forms of food allergy.

Challenge-confirmed peanut allergy in older patients: Performance of skin tests, specific immunoglobulin E, and ara h 2

2018 ◽  
Vol 120 (3) ◽  
pp. 334-335
Author(s):  
Philip H. Li ◽  
Krzysztof Rutkowski ◽  
Lucinda Kennard ◽  
Priya Sellaturay ◽  
Timothy J. Watts ◽  
...  
Keyword(s):  
Older Patients ◽  
Peanut Allergy ◽  
Immunoglobulin E ◽  
Skin Tests ◽  
Ara H 2 ◽  
Specific Immunoglobulin E ◽  
Specific Immunoglobulin

In vitro testing for immunoglobulin E-mediated food allergies

1996 ◽  
Vol 115 (4) ◽  
pp. 312-318 ◽  
Author(s):  
Jacquelynne P. Corey ◽  
Anil Gungor
Keyword(s):  
Food Allergy ◽  
Immunoglobulin E ◽  
Diagnostic Methods ◽  
Food Allergies ◽  
Vitro Assay ◽  
Positive Screen ◽  
Specific Immunoglobulin E ◽  
Radioallergosorbent Test ◽  
Specific Immunoglobulin

The role of immunoglobulin E-mediated food allergy in subjects with allergic disorders, especially in patients with rhinitis and sinusitis, is underestimated by clinicians because of the initial attribution of these disorders to immediate-type hypersensitivity reactions. The difficulties of diagnosing food-related reactions have caused further delay in their recognition and incorporation into the daily practice of diagnosing food allergy. Two of the diagnostic methods for food allergy are the in vitro assay of total immunoglobulin E and the measurement of food-specific immunoglobulin E levels in serum with the radioallergosorbent test. Measurement of specific immunoglobulin E level is the most commonly used but also one of the most controversial techniques. We examined 123 patients with rhinitis who were referred to our otolaryngology/allergy clinic between January and April 1995. All patients received an initial radioallergosorbent test screen, which included milk. We determined the positive predictive value of this positive screen and, in particular, of a positive test for milk in the diagnosis of immunoglobulin E-mediated food allergies in these patients. Conclusions were based on comparison with the result of an additional radioallergosorbent test food panel consisting of eight common and two investigational food allergens. (Otolaryngol Head Neck Surg 1996;115:312-8.)

scholarly journals Additives and preservatives: Role in food allergy

2020 ◽  
Vol 2 (1) ◽  
pp. 119-123
Author(s):  
Amber N. Pepper ◽  
Panida Sriaroon ◽  
Mark C. Glaum
Keyword(s):  
Food Allergy ◽  
Immunoglobulin E ◽  
Skin Prick Testing ◽  
Food Additives ◽  
Specific Ige ◽  
Food Additive ◽  
Blood Testing ◽  
Commercial Products ◽  
Natural Substances ◽  
Ige Mediated

Food additives are natural or synthetic substances added to foods at any stage of production to enhance flavor, texture, appearance, preservation, safety, or other qualities. Common categories include preservatives and antimicrobials, colorings and dyes, flavorings, antioxidants, stabilizers, and emulsifiers. Natural substances rather than synthetics are more likely to cause hypersensitivity. Although rare, food additive hypersensitivity should be suspected in patients with immunoglobulin E (IgE)-mediated reactions to multiple, unrelated foods, especially if the foods are prepared outside of the home or when using commercial products. A complete and thorough history is vital. Skin prick testing and/or specific IgE blood testing to food additives, if available, additive avoidance diets, and blind oral challenges can help establish the diagnosis. Once an allergy to a food additive is confirmed, management involves avoidance and, if necessary, carrying self-injectable epinephrine.

scholarly journals Diagnostic Value of Antigen-Specific Immunoglobulin E Immunoassays against Ara h 2 and Ara h 8 Peanut Components in Child Food Allergy

2016 ◽  
Vol 169 (4) ◽  
pp. 216-222 ◽  
Author(s):  
Jérémie Martinet ◽  
Laure Couderc ◽  
Florian Renosi ◽  
Victor Bobée ◽  
Christophe Marguet ◽  
...  
Keyword(s):  
Food Allergy ◽  
Immunoglobulin E ◽  
Diagnostic Value ◽  
Ara H 2 ◽  
Specific Immunoglobulin E ◽  
Specific Immunoglobulin

scholarly journals Food allergy: Epicutaneous immunotherapy

2020 ◽  
Vol 2 (1) ◽  
pp. 81-85
Author(s):  
Timothy G. Chow ◽  
Christopher Parrish ◽  
J. Andrew Bird
Keyword(s):  
Food Allergy ◽  
Peanut Allergy ◽  
Immunoglobulin E ◽  
Treatment Options ◽  
Allergen Exposure ◽  
Application Site ◽  
Regional Lymph Nodes ◽  
Antigen Uptake ◽  
Allergen Specific Immunotherapy ◽  
Epicutaneous Immunotherapy

The goal of allergen-specific immunotherapy for treatment of immunoglobulin E (IgE) mediated food allergy is to safely and effectively modify the allergic response, providing protection against anaphylaxis via ongoing exposure to the triggering allergen. Targeted allergen exposure via application of allergen to the epidermis has emerged as a potentially promising approach to desensitization. Epicutaneous immunotherapy (EPIT) uses allergen embedded on an adhesive patch secured to the skin. This allows for long-lasting allergen exposure, with subsequent antigen uptake and trafficking by skin antigen‐presenting cells to regional lymph nodes, which produce immunomodulatory effects in a manner that is noninvasive and limits exposure of allergen to the systemic circulation when applied to intact skin. As such, EPIT is overall well tolerated; local application site reactions are common, but systemic adverse effects are infrequent compared with other forms of immunotherapy. For peanut allergy, EPIT may increase the dose-triggering threshold in some individuals with peanut-allergy, especially younger children, but induction of remission has not been closely studied, and reliable predictors of clinical response are lacking. With U.S. Food and Drug Administration approved treatment for peanut allergy now available, the precepts of shared decision-making will be crucial in discussions with patients and their families with regard to treatment options.

scholarly journals Clinical manifestations of immunoglobulin E‐mediated food allergy, including pollen‐food allergy syndrome

2020 ◽  
Vol 2 (1) ◽  
pp. 22-25
Author(s):  
Pooja Varshney ◽  
Jacqueline A. Pongracic
Keyword(s):  
Food Allergy ◽  
Immunoglobulin E ◽  
Acute Infection ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Physical Exertion ◽  
Allergic Reactions ◽  
Cutaneous Manifestations ◽  
Ige Mediated ◽  
Inflammatory Drugs

Immunoglobulin E-(IgE) mediated food allergy affects people of all ages but does not have a consistent presentation and may result in various manifestations, even for an individual. The onset of symptoms is usually quite rapid, minutes to a few hours after consumption of the allergen, although exceptions exist. Cutaneous and gastrointestinal symptoms are the most common clinical manifestations; however, they are not present in all allergic reactions. Clinicians, particularly those in emergency care settings, need to be aware that the lack of cutaneous manifestations does not exclude the possibility of anaphylaxis. It is extremely unusual for food allergy reactions to present with isolated upper or lower respiratory symptoms, nor is chronic urticaria a manifestation of food allergy. Clinical manifestations of IgE-mediated food allergy range from mild to severe and, in rare cases, can be fatal. Mild, localized reactions, such as those that occur in pollen‐food allergy syndrome, occur in individuals with sensitization to pollens. A small proportion of patients with this syndrome develop anaphylaxis. Alcohol, medications (nonsteroidal anti-inflammatory drugs, antacids), physical exertion, increased body temperature, acute infection, and menstruation are factors that are known to augment the severity of food-induced allergic reactions.

scholarly journals The Epidemiology of Food Allergy in the Global Context

2018 ◽  
Vol 15 (9) ◽  
pp. 2043 ◽  
Author(s):  
Wenyin Loh ◽  
Mimi Tang
Keyword(s):  
Developing Countries ◽  
Food Allergy ◽  
Immunoglobulin E ◽  
Clinical History ◽  
Food Allergies ◽  
Western Countries ◽  
Specific Immunoglobulin E ◽  
Food Challenges ◽  
Surrogate Measures ◽  
Allergy Prevalence

There is a lack of high-quality evidence based on the gold standard of oral food challenges to determine food allergy prevalence. Nevertheless, studies using surrogate measures of food allergy, such as health service utilization and clinical history, together with allergen-specific immunoglobulin E (sIgE), provide compelling data that the prevalence of food allergy is increasing in both Western and developing countries. In Western countries, challenge-diagnosed food allergy has been reported to be as high as 10%, with the greatest prevalence noted among younger children. There is also growing evidence of increasing prevalence in developing countries, with rates of challenge-diagnosed food allergy in China and Africa reported to be similar to that in Western countries. An interesting observation is that children of East Asian or African descent born in a Western environment are at higher risk of food allergy compared to Caucasian children; this intriguing finding emphasizes the importance of genome-environment interactions and forecasts future increases in food allergy in Asia and Africa as economic growth continues in these regions. While cow’s milk and egg allergy are two of the most common food allergies in most countries, diverse patterns of food allergy can be observed in individual geographic regions determined by each country’s feeding patterns. More robust studies investigating food allergy prevalence, particularly in Asia and the developing world, are necessary to understand the extent of the food allergy problem and identify preventive strategies to cope with the potential increase in these regions.

Respiratory Manifestations of Food Allergy

PEDIATRICS ◽  
2003 ◽  
Vol 111 (Supplement_3) ◽  
pp. 1625-1630
Author(s):  
John M. James
Keyword(s):  
Food Allergy ◽  
Respiratory Tract ◽  
Immunoglobulin E ◽  
Food Additives ◽  
Airway Hyperreactivity ◽  
Severe Atopic Dermatitis ◽  
Increased Risk ◽  
Food Particles ◽  
Food Challenges

Food allergy may present with a variety of respiratory tract symptoms that generally involve immunoglobulin E antibody-mediated responses. Exposure is typically through ingestion, but in some cases, inhalation of airborne food particles may trigger these reactions. Upper and lower respiratory tract reactions are often a significant component of multisystem, anaphylactic reactions. However, chronic or isolated asthma or rhinitis induced by food is unusual. It is important to recognize that food allergy in early childhood is a marker indicating an increased risk to develop respiratory allergy. The role of food allergy in otitis media is controversial and probably is extremely rare. Likewise, asthmatic responses to food additives can occur but are uncommon. Studies using blinded oral food challenges have demonstrated that foods can elicit airway hyperreactivity and asthmatic responses. Therefore, an evaluation for food allergy should be considered in patients who are at risk, including those with recalcitrant or otherwise unexplained acute, severe asthma exacerbations, asthma triggered after ingestion of particular foods, and asthma that is accompanied by other manifestations of food allergy (eg, anaphylaxis, moderate to severe atopic dermatitis).

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