scholarly journals Non–IgE- or Mixed IgE/Non–IgE-Mediated Gastrointestinal Food Allergies in the First Years of Life: Old and New Tools for Diagnosis

Nutrients ◽  
2021 ◽  
Vol 13 (1) ◽  
pp. 226
Author(s):  
Mauro Calvani ◽  
Caterina Anania ◽  
Barbara Cuomo ◽  
Enza D’Auria ◽  
Fabio Decimo ◽  
...  
Keyword(s):  
Clinical Score ◽  
Food Allergies ◽  
Diagnostic Tools ◽  
Lymphocyte Stimulation Test ◽  
Food Protein ◽  
Patch Tests ◽  
Eosinophilic Colitis ◽  
Allergic Proctocolitis ◽  
Clinical Pictures ◽  
Fecal Biomarkers

non-IgE and mixed gastrointestinal food allergies present various specific, well-characterized clinical pictures such as food protein-induced allergic proctocolitis, food protein-induced enterocolitis and food protein-induced enteropathy syndrome as well as eosinophilic gastrointestinal disorders such as eosinophilic esophagitis, allergic eosinophilic gastroenteritis and eosinophilic colitis. The aim of this article is to provide an updated review of their different clinical presentations, to suggest a correct approach to their diagnosis and to discuss the usefulness of both old and new diagnostic tools, including fecal biomarkers, atopy patch tests, endoscopy, specific IgG and IgG4 testing, allergen-specific lymphocyte stimulation test (ALST) and clinical score (CoMiss).

Maternal mesalazine-induced neonatal gastrointestinal bleeding

2021 ◽  
Vol 14 (4) ◽  
pp. e238743
Author(s):  
Kohichiroh Nii ◽  
Kaoru Okazaki ◽  
Hitoshi Okada ◽  
Toru Kuboi
Keyword(s):  
Ulcerative Colitis ◽  
Preterm Neonate ◽  
Reproductive Age ◽  
Lymphocyte Stimulation Test ◽  
Food Protein ◽  
Aminosalicylic Acid ◽  
Drug Induced ◽  
Reproductive Age Women ◽  
Allergic Enterocolitis ◽  
Allergic Proctocolitis

Ulcerative colitis often develops in the reproductive age women and can cause exacerbation by pregnancy. Mesalazine (5-aminosalicylic acid) is recommended as a safe anti-inflammatory drug during pregnancy. However, maternal mesalazine is transferred to the fetus through the placenta and may cause allergic events. A pregnant woman with severe ulcerative colitis was treated with a dose of mesalazine 4,000 mg/day from early gestation to delivery. Immediately after birth, the preterm neonate vomited bloody contents and discharged massive gross haematochezia. Serum concentrations of mesalazine and its main metabolite were high in the mother and the umbilical cord. Faecal eosinophils and drug-induced lymphocyte stimulation test suggested possibility that sensitisation with mesalazine in utero caused allergic enterocolitis like food protein-induced allergic proctocolitis. Maternal mesalazine has a potential of fetal sensitisation and cause allergic disease.

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 Food protein‐induced proctocolitis and enteropathy

2020 ◽  
Vol 2 (1) ◽  
pp. 55-58
Author(s):  
Jonathan S. Tam
Keyword(s):  
Early Childhood ◽  
Gastrointestinal Tract ◽  
Immunoglobulin E ◽  
Chronic Diarrhea ◽  
Signs And Symptoms ◽  
Food Allergies ◽  
Food Protein ◽  
Healthy Infants ◽  
Allergic Proctocolitis ◽  
Bloody Stools

Non-IgE (immunoglobulin E) mediated gastrointestinal food allergies include several separate clinical entities, including food protein‐induced allergic proctocolitis (FPIAP) and food protein‐induced enteropathy (FPE). Although FPIAP and FPE both primarily affect the gastrointestinal tract, their presentations are vastly different. FPIAP presents with bloody stools in otherwise healthy infants, whereas FPE presents with chronic diarrhea, vomiting, malabsorption, and hypoproteinemia. These both typically present in infancy and resolve by early childhood. Although the presenting signs and symptoms may be different, management is similar in that both require avoidance of the suspected causal food.

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 Non-IgE-Mediated Gastrointestinal Food Protein-Induced Allergic Disorders. Clinical Perspectives and Analytical Approaches

Foods ◽  
2021 ◽  
Vol 10 (11) ◽  
pp. 2662
Author(s):  
Elisa Zubeldia-Varela ◽  
Tomás Clive Barker-Tejeda ◽  
Frank Blanco-Pérez ◽  
Sonsoles Infante ◽  
José M. Zubeldia ◽  
...  
Keyword(s):  
Treatment Options ◽  
Clinical History ◽  
Food Allergies ◽  
Clinical Aspects ◽  
Food Protein ◽  
Ige Mediated ◽  
Gastrointestinal Food Allergy ◽  
Allergic Proctocolitis ◽  
Analytical Approaches ◽  
Allergic Disorders

Non-IgE-mediated gastrointestinal food allergy (non-IgE-GI-FA) is the name given to a series of pathologies whose main entities are food protein-induced allergic proctocolitis (FPIAP), food protein-induced enteropathy (FPE), and food protein-induced enterocolitis syndrome (FPIES). These are more uncommon than IgE-mediated food allergies, their mechanisms remain largely unknown, and their diagnosis is mainly done by clinical history, due to the lack of specific biomarkers. In this review, we present the latest advances found in the literature about clinical aspects, the current diagnosis, and treatment options of non-IgE-GI-FAs. We discuss the use of animal models, the analysis of gut microbiota, omics techniques, and fecal proteins with a focus on understanding the pathophysiological mechanisms of these pathologies and obtaining possible diagnostic and/or prognostic biomarkers. Finally, we discuss the unmet needs that researchers should tackle to advance in the knowledge of these barely explored pathologies.

scholarly journals Non-IgE-Mediated Gastrointestinal Food Allergies in Children: An Update

Nutrients ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 2086 ◽  
Author(s):  
Roxane Labrosse ◽  
François Graham ◽  
Jean-Christoph Caubet
Keyword(s):  
Immunoglobulin E ◽  
Food Allergies ◽  
Nutritional Deficiencies ◽  
Food Protein ◽  
Dietary Antigens ◽  
Ige Mediated ◽  
Before School ◽  
Allergic Proctocolitis ◽  
Conclusive Diagnosis

Non-immunoglobulin E-mediated gastrointestinal food allergic disorders (non-IgE-GI-FA) include food protein-induced enterocolitis syndrome (FPIES), food protein-induced enteropathy (FPE) and food protein-induced allergic proctocolitis (FPIAP), which present with symptoms of variable severity, affecting the gastrointestinal tract in response to specific dietary antigens. The diagnosis of non-IgE-GI-FA is made clinically, and relies on a constellation of typical symptoms that improve upon removal of the culprit food. When possible, food reintroduction should be attempted, with the documentation of symptoms relapse to establish a conclusive diagnosis. Management includes dietary avoidance, nutritional counselling, and supportive measures in the case of accidental exposure. The prognosis is generally favorable, with the majority of cases resolved before school age. Serial follow-up to establish whether the acquisition of tolerance has occurred is therefore essential in order to avoid unnecessary food restriction and potential consequent nutritional deficiencies. The purpose of this review is to delineate the distinctive clinical features of non-IgE-mediated food allergies presenting with gastrointestinal symptomatology, to summarize our current understanding of the pathogenesis driving these diseases, to discuss recent findings, and to address currents gaps in the knowledge, to guide future management opportunities.

Increased IgE-Mediated Food Allergy With Food Protein-Induced Allergic Proctocolitis

PEDIATRICS ◽  
2021 ◽  
Vol 148 (Supplement 3) ◽  
pp. S35-S36
Author(s):  
Monica T. Kraft ◽  
David Stukus
Keyword(s):  
Food Allergy ◽  
Food Protein ◽  
Ige Mediated ◽  
Allergic Proctocolitis

Risk Factors Influencing Tolerance and Clinical Features of Food Protein-Induced Allergic Proctocolitis

PEDIATRICS ◽  
2021 ◽  
Vol 148 (Supplement 3) ◽  
pp. S37-S37
Author(s):  
Price Edwards ◽  
Anthony Olive ◽  
Carla M. Davis
Keyword(s):  
Risk Factors ◽  
Clinical Features ◽  
Food Protein ◽  
Factors Influencing ◽  
Allergic Proctocolitis

scholarly journals Maternal Prenatal Use of Reflux Medication and the Development of Food Protein-Induced Allergic Proctocolitis in Offspring

2020 ◽  
Vol 145 (2) ◽  
pp. AB51
Author(s):  
Michael Marget ◽  
Victoria Martin ◽  
Yamini Virkud ◽  
Hannah Seay ◽  
Rachael Rosow ◽  
...  
Keyword(s):  
Food Protein ◽  
Allergic Proctocolitis
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