Spice allergies in children

Do Foods Cause Rhinitis?

Rhinitis is a frequent inflammatory disease, that implies various etiopathogenetic mechanisms. The most relevant are IgE- and non-IgE-mediated cellular infiltration, and different causal substances. Foods may cause of rhinitis in some patients. Rhinitis by foods, or food rhinitis (FR) as a isolate condition, is infrequent and usually associated with other allergic or nonallergic disorders. Food Rhinitis may depend on different pathogenetic mechanisms, including IgE-mediated, type 2 non-allergic inflammation, and hyperreactivity reactions. FR also may dependent on professional exposure, which is a type of occupational rhinitis (OR).

Allergy to food additives

PURPOSE OF REVIEW

To provide an update of the studies concerning the diagnosis and management of food additives allergy.

RECENT FINDINGS

Additives improve specific characteristics of food products, but they may induce allergic even life-threatening reactions. Physical examination and medical history are basic to assess specific in-vivo and in-vitro tests. The only treatment for allergic patients consists in avoiding the food containing culprit additives. High-risk patients should be able to recognize severe reactions and self-manage them.

SUMMARY

The prevalence of adverse reactions to food additives is low, and it may depend on comorbidities, like asthma or chronic idiopathic urticaria. Food labels may help the correct identification of ingredients. Natural additives like spices should cause immediate reactions because of a pollen-sensitization or panallargen proteins presence. Additive-free diets may help the patient care, but the authors suggest assessing an oral food challenge with the culprit substance if there are no contraindications.

Assessment of Occupational Health Hazards Due to Particulate Matter Originated from Spices

Spices have been known for their various health activities; however, they also possess the allergic potential for the respiratory system and the skin as they are fine particulate matter. Persons involved in spice agriculture and food industries are at greater risk since they are exposed to a considerable amount of combustible dust, which may be the cause of fire and explosion and adversely affect the health. These workers may experience allergy, long-term and short-term respiratory issues including occupational asthma, dermatitis, etc. Some spices induce T cell-based inflammatory reaction upon contact recognition of the antigen. Antigen Presenting Cells (APC) on binding to the causative metabolite results in activation of macrophages by allergen cytokine interleukin (IL)-12 and tumor necrosis factor-beta (TNF). Cross-reactivity for protein allergens is another factor which seems to be a significant trigger for the stimulation of allergic reactions. Thus, it was imperative to perform a systematic review along with bioinformatics based representation of some evident allergens has been done to identify the overall conservation of epitopes. In the present manuscript, we have covered a multifold approach, i.e., to categorize the spice particles based on a clear understanding about nature, origin, mechanisms; to assess metabolic reactions of the particles after exposure as well as knowledge on the conditions of exposure along with associated potential health effects. Another aim of this study is to provide some suggestions to prevent and to control the exposure up to some extent.

Hypersensitivity reactions to food and drug additives: problem or myth?

BACKGROUND AND AIM OF THE WORK

The possibility of an allergic reaction or an intolerance to additives is frequently suspected by parents, especially for chronic illness with frequent exacerbations such as atopic dermatitis or chronic urticaria. For more than 50 years, potential adverse reactions to additives have been suggested, but to date data are conflicting. The purpose of this article is to provide the clinicians with general information about additives and adverse reactions to them and to suggest a practical approach to children suspected to have reactions to food additives.

METHODS

We performed an extensive research on all English-language Medline articles, case reports and reviews published online until December 2018. Used search terms were: food additives, food dye, adverse reactions, food allergy, food hypersensitivity, intolerance, drugs, children.

RESULTS

There are only few case reports of adverse reactions in childhood with a clear involvement of additives. In this review article we reported the associations between additives and adverse reactions described in literature, in order to inform the pediatrician about the potential clinical manifestations.

CONCLUSIONS

Prior to suspect an adverse reaction to additives, it is important to rule out other possible causes: the diagnostic process is complicated and rarely conclusive. The gold standard is the double-blind placebo controlled oral challenge after an exclusion diet.

Mimotopes for Api g 5, a Relevant Cross-reactive Allergen, in the Celery-Mugwort-Birch-Spice Syndrome

PURPOSE

In the celery-mugwort-birch-spice syndrome, a significant proportion of IgE is directed against high molecular weight (HMW) glycoproteins, including the celery allergen Api g 5. BIP3, a monoclonal antibody originally raised against birch pollen, recognizes HMW allergens in birch and mugwort pollens, celery, and Apiaceae spices. Our aim was to generate mimotopes using BIP3 for immunization against the HMW allergens relevant in the celery-mugwort-birch-spice cross reactivity syndrome.

METHODS

Mimotopes were selected from a random-peptide display library by BIP3 and applied in IgE inhibition assays. The 3 phage clones with the highest inhibitory capacity were chosen for immunization of BALB/c mice. Mouse immune sera were tested for IgG binding to blotted birch pollen extract and used for inhibiting patients' IgE binding. Furthermore, sera were tested for binding to Api g 5, to horseradish peroxidase (HRP) as a second glycoprotein, or to non-glycosylated control allergen Phl p 5 in ELISA, and the specific Api g 5-specific IgG titers were determined.

RESULTS

Three rounds of biopanning resulted in phage clones exhibiting 7 different sequences including 1 dominant, 1-6-cyclo-CHKLRCDKAIA. Three phage clones had the capacity to inhibit human IgE binding and induced IgG to the HMW antigen when used for immunizing BALB/c mice. The induced BIP3-mimotope IgG reached titers of 1:500 specifically to Api g 5, but hardly reacted to glycoprotein HRP, revealing a minor role of carbohydrates in their epitope.

CONCLUSIONS

The mimotopes characterized in this study mimic the epitope of BIP3 relevant for Api g 5, one of the cross-reactive HMW allergens relevant in the celery-mugwort-birch-spice syndrome. BIP3 mimotopes may be used in the future for hyposensitization in this clinical syndrome by virtue of good and specific immunogenicity.

Specific immunotherapy for allergic rhinitis in children

PURPOSE OF REVIEW

Allergic rhinitis is a highly prevalent inflammatory disease affecting 20-40% of the children worldwide. Allergen-specific immunotherapy (SIT) is an effective treatment for allergic rhinitis. This article reviews the recent advances in SIT for children.

RECENT FINDINGS

In current clinical practice, immunotherapy is delivered as either subcutaneous immunotherapy or sublingual immunotherapy (SLIT). Most meta-analyses and reviews concluded a trend that subcutaneous immunotherapy was better than SLIT in reducing symptoms of allergic rhinitis and rescue medication use, however, SLIT has a better safety profile than subcutaneous immunotherapy. Additionally, the absence of pain on administration of therapy is a character of SLIT, which is well suited for children. T regulatory cells, especially Tr1 cells that secrete interleukin-10 and induce production of immunoglobulin G4, play a role during SIT.

SUMMARY

Although there is substantial evidence for effectiveness of both subcutaneous immunotherapy and SLIT, safer and more effective SIT approaches are needed. New approaches to improve SIT include omalizumab pretreatment, use of recombinant allergens, and alternate routes of administration.