Food Allergens
Richard F. Lockey, Dennis K. Ledford in Allergens and Allergen Immunotherapy, 2014
Allen et al. [27] reviewed and identified key points of egg allergy. It primarily affects pre-school children. Life-threatening reactions are less common with egg than with peanut or tree nut allergy, and heat and digestion alter the allergenicity of egg proteins. Heating reduces the allergenicity of ovomucoid and ovalbumin, but does not affect lysozyme. Ovomucoid allergenicity may also be reduced by gastric pH. It is possible that the age and/or use of inhibitors of gastric acid secretion in young children promotes egg protein food sensitization. As with baked milk products, baked egg products are tolerated by a majority of egg allergic patients. Sixty-four of 117 subjects with confirmed egg allergy tolerated baked egg products (muffins or waffles) according to the results of one trial [28]. These clinical findings are consistent with the reduction of egg allergenicity by heating and may reassure select patients of the safety in consuming foods with baked egg.
Food allergens
Richard F. Lockey, Dennis K. Ledford in Allergens and Allergen Immunotherapy, 2020
Allen et al. [31] reviewed and identified key points of egg allergy. It primarily affects preschool children. Life-threatening reactions are less common with egg than with peanut or tree nut allergy, and heat and digestion alter the allergenicity of egg proteins. Heating reduces the allergenicity of ovomucoid and ovalbumin but does not affect lysozyme. Ovomucoid allergenicity may also be reduced by gastric pH. It is possible that the age and/or the use of inhibitors of gastric acid secretion in young children promotes egg protein food sensitization. As with baked milk products, baked egg products are tolerated by a majority of egg-allergic patients. Sixty-four of 117 subjects with confirmed egg allergy tolerated baked egg products (muffins or waffles) according to the results of one trial [32]. These clinical findings are consistent with the reduction of egg allergenicity by heating and may reassure select patients of the safety in consuming foods with baked egg.
Egg Allergy
Andreas L. Lopata in Food Allergy, 2017
There is much interest in the possible allergy prevention effects of a range of macro- and micro-nutrient supplements including vitamin D, vitamin A, pre- and pro-biotics and fish oils, both as maternal and infant supplements (reviewed in (Rueter et al. 2015)). To date, egg allergy as an outcome has only been examined in terms of allergen sensitization, not clinical or challenge proven allergy. Current meta- analyses of these nutritional strategies have not supported their use to date, however higher quality randomised controlled trials with clinically relevant food allergy outcomes are required to fully answer this question.
Food allergy severity predictions based on cellular in vitro tests
Published in Expert Review of Molecular Diagnostics, 2020
Betul Buyuktiryaki, Alexandra F. Santos
Egg allergy is seen mostly in childhood and may cause mild to severe allergic reactions. In Turkey, 203 children with IgE-mediated egg allergy were followed up until 6 years of age and underwent open or DBPCFC tests; logistic regression analysis yielded that the natural algorithm for egg white sIgE and gastrointestinal symptoms at onset were major factors for high risk of anaphylaxis [48]. Similarly, in a retrospective cohort study, Benhamou et al. [49] analyzed the data of 51 oral challenge tests to egg in a pediatric population. Children under 3 years old with IgE-mediated food allergy underwent open food challenges, the ones with atopic dermatitis or with equivocal symptoms (e.g. pruritus) had double-blind placebo-controlled food challenge (DBPCFC) tests. Median levels of egg-white sIgE were 1.17 kU/L (0.35–6.41), 2.47 (0.35–14.90), and 3.70 (1.18–11.0) kU/L for negative, mild to moderate, and severe reactions, respectively (p = 0.006). In line with this study, some other studies also supported the association between SPT and/or sIgE and severity of reactions to egg [23,30,35,50]. Nevertheless, other studies did not show any association [43–45].
Important risk factors for the development of food allergy and potential options for prevention
Published in Expert Review of Clinical Immunology, 2019
Jennifer J. Koplin, Katrina J. Allen, Mimi L. K. Tang
This changed in 2015 with the publication of the Learning Early about Peanut Allergy (LEAP) study, which has been appropriately hailed as a landmark development in peanut allergy prevention [11]. This study provided the first evidence from a randomized trial that introduction of peanut into an infant’s diet from 4–11 months of age is protective against the development of peanut allergy compared to peanut avoidance until the age of 5 years. The study randomized 640 infants with severe eczema or egg allergy, a population considered to be at increased risk for developing peanut allergy, to either peanut avoidance for 5 years or regular peanut consumption commencing from 4–11 months of age, and then evaluated infants for peanut allergy at age 5 years. Egg allergy was defined as either a skin prick test wheal size of 6mm or greater with no history of previous egg tolerance or a history of reaction to egg plus a skin prick test wheal of 3 mm or greater. Severe eczema was defined as either SCORAD grade ≥40, or parental description of very bad rash, or frequent need for topical corticosteroids or calcineurin inhibitors. The trial reported ~80% reduction in peanut allergy in the infants who commenced regular consumption of peanut from 4–11 months of age. There is also emerging evidence of a potential benefit on food allergy prevention with earlier introduction of other allergenic foods such as egg, wheat and cow’s milk. This evidence has been comprehensively examined in a recent systematic review [15].
The importance of early peanut ingestion in the prevention of peanut allergy
Published in Expert Review of Clinical Immunology, 2019
Amanda Agyemang, Scott Sicherer
The compelling outcomes of early peanut introduction and the observed persistence of peanut tolerance prompted the reconvening of the NIAID-sponsored coordinating committee to create new guidelines for peanut introduction for infants [10,41]. The guidelines were structured with different advice for three distinct populations of infants who are stratified by risk for peanut allergy (Table 1). The first guideline closely mirrors the approaches taken in the LEAP trial and applies the label of high risk to patients with egg allergy and/or severe eczema [41]. Egg allergy requires a history of egg allergic reaction and an egg white skin prick test ≥3 mm or positive oral food challenge to egg [10]. Severe eczema is classified by a physician and characterized by recurrent flares requiring topical prescription treatment such as steroids or calcineurin inhibitors despite appropriate use of moisturizers [10,41]. Contrary to previous guideline iterations, risk does not include having a first degree relative with a history of atopy (food allergy, allergic dermatitis, allergic rhinitis, or asthma) [40,45].
Related Knowledge Centers
- Atopic Dermatitis
- Milk
- Protein
- Anaphylaxis
- Hypersensitivity
- Eosinophilic Esophagitis
- Epinephrine
- Egg
- Eggs as Food
- Wheat