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Food hypersensitivity – food allergies and intolerances
Published in Judy More, Infant, Child and Adolescent Nutrition, 2021
Although most people use the term ‘food allergy’ loosely to cover all unpleasant reactions to food, the current clinical classification is based on the type of adverse response to food (Johansson et al. 2004). ‘Food hypersensitivity’ is the umbrella term used to cover all the different types of physiological reactions to foods (Figure 17.1).
Food Allergy
Published in Pudupakkam K Vedanthan, Harold S Nelson, Shripad N Agashe, PA Mahesh, Rohit Katial, Textbook of Allergy for the Clinician, 2021
PA Mahesh, Hugo Van Bever, Pudupakkam K Vedanthan
Any aberrant reaction after consumption of a food or food additive is classified as an adverse food reaction, which may be immune mediated or non-immune mediated (Fig. 27.1). Immune mediated adverse food reactions are called food allergy or food hypersensitivity and non-immune mediated adverse food reactions are called food intolerance such as lactose intolerance. Immune mediated reactions can be IgE mediated, the classical food allergy or non-IgE mediated is now gaining in importance especially, gastrointestinal (GI) reactions.
Food Allergy and Atopic Disease
Published in Fima Lifshitz, Childhood Nutrition, 2020
The terms food allergy and food hypersensitivity are used synonymously, and these should be distinguished from the all-inclusive term “food intolerance” which includes all adverse reactions to foods and food additives; the underlying process may be pharmacologic, microbiologic, toxic, idiosyncratic, psychologic, or immunologic. It is only when we can show the existence of any immunologic mechanism underlying symptoms and signs related to foods and food additives that the term food allergy can be accepted.
Oral Immunotherapy in Patients with IgE Mediated Reactions to Egg White: A Clinical Trial Study
Published in Immunological Investigations, 2022
Vahid Ghobadi Dana, Morteza fallahpour, Raheleh Shokouhi Shoormasti, Mohammad Nabavi, Mohammad Hassan Bemanian, Mohsen Fateh, Zeinab Zaker, Mehdi Torabizadeh, Seyed Ali Aghapour, Saba Arshi
As mentioned in the literature review, oral immunotherapy could assist in restitution of immunologic tolerance or sustained unresponsiveness in patients with food hypersensitivity, even after discontinuing treatment (Burks et al. 2012; Pecora et al. 2018). Although little has been understood about the underlying mechanisms of desensitization and tolerance, it appears that the desensitization and immunologic tolerance could be developed through some processes such as reducing the activity of effector cells of allergic processes, rising the production of IgA and IgG4 immunoglobulins, T regulatory cells, CD103 dendritic cells inducing Treg cells, and producing immunosuppressive cytokines such as IL-10 and TGF-b (Cabrera and Urra 2015; Nowak-Węgrzyn and Albin 2015; Yoneyama et al. 2020). In this study, the effectiveness of oral immunotherapy to egg white was determined in patients with IgE-mediated hypersensitivity to egg white after 6 months. To examine the impact of OIT, we evaluated the changes in the wheal size of skin prick test (SPT), specific IgE, and IgG4 concentrations to egg white and ovomucoid.
Hypersensitivity and adverse reactions to biologics for asthma and allergic diseases
Published in Expert Review of Clinical Immunology, 2020
Eosinophilic esophagitis (EoE) is a chronic, allergic inflammatory disease of the esophagus. The pathogenesis is not completely understood but seems to involve multiple mechanisms. In some patients, food hypersensitivity seems to play a role. The basic treatment is swallowed corticosteroid (budesonide slur) and elimination of identified causative food(s) [64,65] showed inconsistent results (Table 4) [66]. Trials of anti-IgE [67] and anti-IL5 agents [68–71] showed inconsistent efficacy. Biologics targeting IL13 and IL4 have demonstrated promising results [66]. Anti-IL13 agents demonstrated a significant reduction in endoscopic findings and mucosal eosinophil severity but insignificant improvement in GI symptom [72,73]. Dupilumab showed significant improvement in both symptoms and endoscopic features in 47 patients followed for 12 weeks after receiving dupilumab 600 mg first loading dose followed with 300 mg weekly [74]. Additional trials are being conducted to validate these results and to clarify the role of blocking IL13 and IL4 in the management of EoE. To date, none of the biologic agents have received FDA approval for EoE.
The Southern Sweden Adolescent Allergy-Cohort: Prevalence of allergic diseases and cross-sectional associations with individual and social factors
Published in Journal of Asthma, 2019
Therese Sterner, Ada Uldahl, Åke Svensson, Jonas Björk, Cecilia Svedman, Christel Nielsen, Alf Tunsäter, Magnus Bruze, Hampus Kiotseridis
Of all children 32.5% (433 out of 1333) reported at least one allergic disease including asthma. In this group 67.2% (291) had one allergic disease and 32.8% (142) had more than one allergic diseases, Figure 2. Self-reported current asthma was reported for 9.8% of the children (131 out of 1333) and current rhino-conjunctivitis was reported for 12.7% (170 out of 1333). The prevalence of current food hypersensitivity was 12.2% (163 out of 1333) and the prevalence of eczema was 10.8% (144 out of 1333). The proportions of girls in each disease group were 47% (asthma), 50% (rhinoconjunctivitis), 70% (food hypersensitivity) and 58% (eczema). Among those with self-reported disease, doctor diagnosis were reported from; asthma 51%, rhinoconjunctivitis 69%, food hypersensitivity 36% and eczema 51%. No allergy-related disease was reported from 67.5% (900 out of 1333). Figure 2 illustrates the overlapping of allergic diseases and also that 44–51% of the children in each disease are mono-symptomatic with no allergic comorbidity.