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.

Food Allergies

2015 ◽  
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.

Food Allergies

2018 ◽  
Author(s):  
Matthew Greenhawt
Keyword(s):  
United States ◽  
Adverse Reaction ◽  
Food Allergy ◽  
Eosinophilic Esophagitis ◽  
Adverse Reactions ◽  
Action Plan ◽  
The United States ◽  
Oral Allergy Syndrome ◽  
Food Allergies ◽  
Food Protein

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

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 Food allergy epidemiology and racial and/or ethnic differences

2020 ◽  
Vol 2 (1) ◽  
pp. 11-16
Author(s):  
Jialing Jiang ◽  
Christopher M. Warren ◽  
Rebekah L. Browning ◽  
Christina E. Ciaccio ◽  
Ruchi S. Gupta
Keyword(s):  
Health Care ◽  
Food Allergy ◽  
Health Care Utilization ◽  
Immunoglobulin E ◽  
Allergic Sensitization ◽  
The United States ◽  
Health Concern ◽  
Food Allergies ◽  
Care Utilization ◽  
Ige Mediated

In recent decades, immunoglobulin E (IgE) mediated food allergy has become a growing public health concern. Converging evidence from cross-sectional prevalence studies, health care utilization records, and cohort studies indicate that food allergies are increasingly prevalent and often severe. Although IgE-mediated food allergy has long been considered a predominantly pediatric concern, analysis of recent self-reported data suggests that food allergies may be more prevalent among adult populations than previously acknowledged, with many reported cases of adult-onset allergies as well as persistent childhood-onset allergies. Results of studies also suggest that food allergy‐related health care utilization is increasing as more individuals seek emergency treatment for food-induced anaphylaxis. Analysis of epidemiologic data also indicates that the burden of food allergies is unequally distributed. Published prevalence rates are highest in Western countries, e.g., the United States, United Kingdom, and Australia. Within these countries, there also is heterogeneity across racial and/or ethnic groups, with non-White and second-generation immigrant populations disproportionately affected. Importantly, such observations can shed light on the etiology of food allergy and inform improved clinical management, treatment, and prevention efforts. For example, there is a growing consensus that earlier introduction of allergenic foods, e.g., peanut, promotes oral tolerance and can dramatically reduce food allergy risk. In addition, much attention has been paid to the potentially deleterious effects of cutaneous allergen exposure, e.g., through eczematous skin, which can skew the immune response away from tolerance and toward allergic sensitization, thereby increasing food allergy risk. Furthermore, there is a growing appreciation for the potential protective effects of diverse microbial exposures, given mounting evidence for the immunomodulatory effects of the human microbiome. Also, when considering the geographic variability in the prevalence of certain food and environmental allergies as well as their structural similarities at the molecular level, it is believed that co-sensitization between food and environmental allergens may be a key driver of rising food allergy prevalence.

Food Allergies

2018 ◽  
Author(s):  
Matthew Greenhawt
Keyword(s):  
United States ◽  
Adverse Reaction ◽  
Food Allergy ◽  
Eosinophilic Esophagitis ◽  
Adverse Reactions ◽  
Action Plan ◽  
The United States ◽  
Oral Allergy Syndrome ◽  
Food Allergies ◽  
Food Protein

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

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 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 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.

Mo1642 Population Prevalence of Rome IV and Rome III Irritable Bowel Syndrome (IBS) in the United States (US), Canada and the United Kingdom (UK)

2016 ◽  
Vol 150 (4) ◽  
pp. S739-S740 ◽  
Author(s):  
Olafur S. Palsson ◽  
Miranda A. van Tilburg ◽  
Magnus Simren ◽  
Ami D. Sperber ◽  
William E. Whitehead
Keyword(s):  
United States ◽  
Irritable Bowel Syndrome ◽  
United Kingdom ◽  
The United States ◽  
The United Kingdom ◽  
Population Prevalence ◽  
Rome Iii ◽  
Irritable Bowel ◽  
Rome Iv

scholarly journals Glycation end products and technological aspects of reducing immunogenicity of specialized food products for nutrition of athletes

Food systems ◽  
2022 ◽  
Vol 4 (4) ◽  
pp. 278-285
Author(s):  
I. V. Kobelkova ◽  
M. M. Korosteleva ◽  
D. B. Nikityuk ◽  
M. S. Kobelkova
Keyword(s):  
Food Allergy ◽  
Maillard Reaction ◽  
The United States ◽  
The Body ◽  
Food Allergies ◽  
Consumer Protection Act ◽  
Heat Treated ◽  
Glycation End Products ◽  
End Products ◽  
Allergen Labeling

Food allergy, which affects about 8% of children and 5% of adults in the world, is one of the major global health problems, and allergen control is an important aspect of food safety. According to the FALCPA (Food Allergen Labeling and Consumer Protection Act of 2004 FDA), more than 160 foods can cause allergic reactions, with eight of them responsible for 90% of all food allergies in the United States, including milk, eggs, wheat, peanuts, soybeans, tree nuts, crustaceans and fish, also known as the Big 8. Most foods that are sources of obligate allergens are heat treated before consumption, which can trigger the Maillard reaction, which produces glycation end products. Symptoms of food sensitization are known to significantly affect the quality of life, gut microbial diversity and adaptation potential. In particular, in athletes, this can be expressed in a decrease in the effectiveness of the training process, which leads to poor endurance and athletic performance. In this regard, it seems relevant to study the effect of the Maillard reaction and AGEs on the immunogenicity of proteins and the possible relationship between these compounds and food allergy, as well as to develop measures to prevent the adverse effect of allergens on the body of a professional athlete and any other consumer.

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