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Biagioni B, Scala E, Cecchi L. What molecular allergy teaches us about genetics and epidemiology of allergies. Curr Opin Allergy Clin Immunol 2024; 24:280-290. [PMID: 38640142 DOI: 10.1097/aci.0000000000000990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2024]
Abstract
PURPOSE OF REVIEW To delineate pertinent information regarding the application of molecular allergology within the realm of both genetic and epidemiological facets of allergic diseases. RECENT FINDINGS The emergence of molecular allergy has facilitated the comprehension of the biochemical characteristics of allergens originating from diverse sources. It has allowed for the exploration of sensitization trajectories and provided novel insights into the influence of genetics and environmental exposure on the initiation and development of allergic diseases. This review delves into the primary discoveries related to the genetics and epidemiology of allergies, facilitated by the application of molecular allergy. It also scrutinizes the impact of environmental exposure across varied geoclimatic, socioeconomic, and lifestyle contexts. Additionally, the review introduces specific models of molecular allergy within the realms of plants and animals. SUMMARY The utilization of molecular allergy in clinical practice holds crucially acknowledged diagnostic and therapeutic implications. From a research standpoint, there is a growing need for the widespread adoption of molecular diagnostic tools to achieve a more profound understanding of the epidemiology and natural progression of allergic diseases.
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Affiliation(s)
- Benedetta Biagioni
- Allergy and Clinical Immunology Unit, San Giovanni di Dio Hospital, Florence
| | - Enrico Scala
- Clinical and Laboratory Molecular Allergy Unit, IDI-IRCCS, Rome
| | - Lorenzo Cecchi
- SOSD Allergology and Clinical Immunology, USL Toscana Centro, Prato, Italy
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Yazici D, Suer H, Bulbuloglu CN, Guzar E, Koçak E, Nemutlu E, Buyuktiryaki B, Sackesen C. Development of a low allergenic product for patients with milk allergy and assessment of its specific IgE reactivity. Pediatr Allergy Immunol 2024; 35:e14174. [PMID: 38899602 DOI: 10.1111/pai.14174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 05/10/2024] [Accepted: 05/29/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND Milk oral immunotherapy is the riskiest and most unpredictable form of oral immunotherapy. We aimed to produce a low allergenic product than conventional once baked-cake/muffin, to develop indirect in-house ELISA to check the tolerance status with milk products and evaluate IgE reactivity of patients' sera via western blotting (WB) and indirect in-house ELISA. METHOD A low allergenic product named biscotti-twice baked-cake was developed, and the total protein concentration was determined. The protein content was studied by SDS-PAGE and proteomics. Milk-specific IgE (sIgE) binding assays were performed by WB and indirect in-house ELISA by using patients' sera. RESULTS Casein band intensity was observed to be lower in the biscotti-twice baked-cake than in the once baked-cake (p = .014). Proteomics analysis and αS1-casein measurement showed that the lowest intensity of casein was found in biscotti. The low binding capacity of milk sIgE to biscotti compared with once baked-cake was shown by WB (p = .0012) and by indirect in-house ELISA (p = .0001). In the ROC analysis, the area under the curve (AUC) of the in-house ELISA IgE was comparable with Uni-CAP milk and casein sIgE. The AUC of the in-house ELISA IgE for cake (0.96) and biscotti (1) was slightly better than Uni-CAP milk sIgE (0.94; 0.97) and casein sIgE (0.96; 0.97), respectively. CONCLUSION The low allergenicity of the newly developed low allergenic product "biscotti-twice baked-cake" has been demonstrated by in vitro experiments. Biscotti could be a safe treatment option than once baked-cake/muffin in patients who are reactive to once baked-milk products.
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Affiliation(s)
- Duygu Yazici
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
- Research Center for Translational Medicine (KUTTAM), Koç University School of Medicine, Istanbul, Turkey
| | - Hande Suer
- Research Center for Translational Medicine (KUTTAM), Koç University School of Medicine, Istanbul, Turkey
- Graduate School of Health Sciences, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Cemre Naz Bulbuloglu
- Research Center for Translational Medicine (KUTTAM), Koç University School of Medicine, Istanbul, Turkey
| | - Elif Guzar
- Research Center for Translational Medicine (KUTTAM), Koç University School of Medicine, Istanbul, Turkey
| | - Engin Koçak
- Department of Analytical Chemistry, Faculty of Gulhane Pharmacy, Health Sciences University, Ankara, Turkey
| | - Emirhan Nemutlu
- Department of Analytical Chemistry, Faculty of Pharmacy, Hacettepe University, Ankara, Turkey
| | - Betul Buyuktiryaki
- Research Center for Translational Medicine (KUTTAM), Koç University School of Medicine, Istanbul, Turkey
- Division of Pediatric Allergy, School of Medicine, Koc University, Istanbul, Turkey
| | - Cansin Sackesen
- Research Center for Translational Medicine (KUTTAM), Koç University School of Medicine, Istanbul, Turkey
- Division of Pediatric Allergy, School of Medicine, Koc University, Istanbul, Turkey
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Dantzer JA, Kim EH. New Approaches to Food Allergy Immunotherapy. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024; 12:546-552. [PMID: 37852441 DOI: 10.1016/j.jaip.2023.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 10/04/2023] [Indexed: 10/20/2023]
Abstract
Food allergy is an increasing public health problem in children and adults. In addition to the risk of potentially severe reactions, food allergy can have a significant burden on quality of life, nutrition, cost of living, and social activities. Traditionally, treatment has primarily included strict food allergen avoidance and use of emergency medications to treat an allergic reaction. However, in recent years, there have been significant strides in the advancement of food allergy treatment, including the approval of the first and only approved therapy (peanut oral immunotherapy) for food allergy in 2020. Clinical trials have primarily focused on food allergen immunotherapy (oral, epicutaneous, sublingual). Building off of a foundation of promising data supporting the efficacy of food oral immunotherapy and our greater understanding of the underlying mechanism of immunotherapy, newer approaches, including alternative routes of delivery, adjuncts to therapy, modified allergens, and utilization in younger patients, aim to provide safer and more effective treatment approaches to the millions of patients burdened by food allergy.
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Affiliation(s)
- Jennifer A Dantzer
- Johns Hopkins University School of Medicine, Division of Pediatric Allergy, Immunology, and Rheumatology, Baltimore, Md.
| | - Edwin H Kim
- University of North Carolina School of Medicine, Division of Pediatric Allergy and Immunology, Chapel Hill, NC
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Hicks A, Fleischer D, Venter C. The future of cow's milk allergy - milk ladders in IgE-mediated food allergy. Front Nutr 2024; 11:1371772. [PMID: 38496796 PMCID: PMC10941844 DOI: 10.3389/fnut.2024.1371772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 02/14/2024] [Indexed: 03/19/2024] Open
Abstract
Cow's milk allergy (CMA) is one of the most common and complex presentations of allergy in early childhood. CMA can present as IgE and non-IgE mediated forms of food allergy. Non-IgE mediated CMA includes food protein-induced enterocolitis syndrome (FPIES), eosinophilic gastrointestinal disorders (EGIDs), and food protein-induced proctocolitis (FPIAP). There are recent guidelines addressing CMA diagnosis, management, and treatment. Each of these guidelines have their own strengths and limitations. To best manage CMA, individualized avoidance advice should be given. Cow's milk (CM) can be replaced in the diet by using hypoallergenic formulas or plant-based milk, depending on factors such as the child's age and their current food intake. Oral and epicutaneous immunotherapy is used to increase tolerance in children with CMA but is not without risk, and the long-term outcome of sustained unresponsiveness is still unclear. The allergenicity of CM proteins are affected differently by different forms of heating, leading to the use of baked milk or milk ladders in the management of CMA, most likely the most promising option for future management and treatment of CMA. Future management of children with CMA will also include discussion around the immunomodulatory potential of the child's dietary intake.
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Affiliation(s)
| | | | - Carina Venter
- Section of Pediatric Allergy and Immunology, Children’s Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, United States
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Radulovic S, Foong R, Bartha I, Marques‐Mejias A, Krawiec M, Kwok M, Jama Z, Harrison F, Ricci C, Lack G, Du Toit G, Santos AF. Basophil activation test as predictor of severity and threshold of allergic reactions to egg. Allergy 2024; 79:419-431. [PMID: 37680143 PMCID: PMC10952485 DOI: 10.1111/all.15875] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 06/15/2023] [Accepted: 07/07/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND Identifying patients at risk of severe allergic reactions and/or low threshold of reactivity is very important, particularly for staple foods like egg. METHODS One hundred and fifty children underwent double-blind placebo-controlled food challenge (DBPCFC) to baked egg (BE), skin prick testing and blood collection for serology and basophil activation test (BAT). Patients who passed BE DBPCFC underwent loosely cooked egg (LCE) DBPCFC. Severity of allergic reactions was classified following Practall guidelines and threshold dose was determined during DBPCFC. RESULTS Sixty out of 150 (40%) children reacted to BE and 16 out of 77 (21%) to LCE on DBPCFC. Considering DBPCFC to BE, 23 children (38%) had severe reactions and 33 (55%) reacted to 0.13 g or less of egg protein (low threshold group). Two children (2 out of 16 = 12%) had severe reactions to LCE. Demographic, clinical and most immunological features were not significantly different between severe/non-severe BE reactors or low/high threshold groups. Severe BE reactors had higher ovomucoid-sIgE (p = .009) and higher BAT to BE (p = .001). Patients with lower threshold to BE had higher IgE-specific activity (p = .027) and BAT to egg (p = .007) but lower severity score (p = .008). Optimal cut-offs for ovomucoid-sIgE had 100% sensitivity, 35% specificity and 60% accuracy and for BAT 76% sensitivity, 74% specificity and 75% accuracy to identify BE severe reactors. Optimal cut-offs for specific activity had 70% sensitivity, 68% specificity and 69% accuracy and for BAT 70% sensitivity, 72% specificity and 71% accuracy to identify low threshold patients. CONCLUSIONS BAT was the best biomarker to predict severity and threshold of allergic reactions to BE and can be useful when making decisions about management of egg allergy.
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Affiliation(s)
- Suzana Radulovic
- Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and MedicineKing's College LondonLondonUK
- Children's Allergy ServiceEvelina London Children's Hospital, Guy's and St Thomas' HospitalLondonUK
| | - Ru‐Xin Foong
- Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and MedicineKing's College LondonLondonUK
- Children's Allergy ServiceEvelina London Children's Hospital, Guy's and St Thomas' HospitalLondonUK
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial SciencesKing's College LondonLondonUK
| | - Irene Bartha
- Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and MedicineKing's College LondonLondonUK
- Children's Allergy ServiceEvelina London Children's Hospital, Guy's and St Thomas' HospitalLondonUK
| | - Andreina Marques‐Mejias
- Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and MedicineKing's College LondonLondonUK
- Children's Allergy ServiceEvelina London Children's Hospital, Guy's and St Thomas' HospitalLondonUK
| | - Marta Krawiec
- Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and MedicineKing's College LondonLondonUK
- Children's Allergy ServiceEvelina London Children's Hospital, Guy's and St Thomas' HospitalLondonUK
| | - Matthew Kwok
- Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and MedicineKing's College LondonLondonUK
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial SciencesKing's College LondonLondonUK
| | - Zainab Jama
- Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and MedicineKing's College LondonLondonUK
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial SciencesKing's College LondonLondonUK
| | - Faye Harrison
- Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and MedicineKing's College LondonLondonUK
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial SciencesKing's College LondonLondonUK
| | - Cristian Ricci
- Africa Unit for Transdisciplinary Health Research (AUTHeR)North‐West UniversityPotchefstroomSouth Africa
| | - Gideon Lack
- Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and MedicineKing's College LondonLondonUK
- Children's Allergy ServiceEvelina London Children's Hospital, Guy's and St Thomas' HospitalLondonUK
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial SciencesKing's College LondonLondonUK
| | - George Du Toit
- Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and MedicineKing's College LondonLondonUK
- Children's Allergy ServiceEvelina London Children's Hospital, Guy's and St Thomas' HospitalLondonUK
| | - Alexandra F. Santos
- Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and MedicineKing's College LondonLondonUK
- Children's Allergy ServiceEvelina London Children's Hospital, Guy's and St Thomas' HospitalLondonUK
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial SciencesKing's College LondonLondonUK
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Lee ASE, Suprun M, Sampson H. Epitope-Based IgE Assays and Their Role in Providing Diagnosis and Prognosis of Food Allergy. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:2983-2988. [PMID: 37394177 DOI: 10.1016/j.jaip.2023.06.043] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 06/19/2023] [Accepted: 06/19/2023] [Indexed: 07/04/2023]
Abstract
With advances in molecular and computational science, epitope-specific IgE antibody profiling has been developed and recently brought into clinical practice. Epitope-based testing detects IgE antibodies that directly bind to antigenic sites of an allergen, providing increased resolution specificity and fewer false-positive results for diagnosing food allergy. Epitope-binding profiles may also serve as prognostic markers of food allergy and help predict quantities of allergen that would provoke a reaction (ie, eliciting dose, possible severity of a reaction after allergen ingestion, and outcomes of treatment options such as oral immunotherapy [OIT]). Future studies are under way to discover additional applications of epitope-specific antibodies for multiple food allergens.
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Affiliation(s)
- Ashley Sang Eun Lee
- Division of Allergy and Immunology, Icahn School of Medicine at Mount Sinai, New York, NY.
| | - Maria Suprun
- Division of Allergy and Immunology, Icahn School of Medicine at Mount Sinai, New York, NY; Janssen R&D, Spring House, Pa
| | - Hugh Sampson
- Division of Allergy and Immunology, Icahn School of Medicine at Mount Sinai, New York, NY
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Hosaagrahara Ramakrishna S, Shah N, Acharyya BC, Durairaj E, Verma L, Sankaranarayanan S, Wadhwa N, Venter C. The Need for Culturally Appropriate Food Allergy Management Strategies: The Indian Milk Ladder. Nutrients 2023; 15:3921. [PMID: 37764705 PMCID: PMC10535525 DOI: 10.3390/nu15183921] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 08/28/2023] [Accepted: 09/05/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Cow's milk allergy (CMA) is one of the most common and complex food allergies affecting children worldwide and, with a few exceptions, presents in the first few months of life. Baked-milk-containing diets are well tolerated in the majority of milk-allergic children and allow dietary restrictions to be relaxed. In addition, the early introduction of tolerated forms of allergenic foods to an infant's diet in small amounts may enhance the outgrowth of their milk allergy through oral tolerance induction. The methods of milk introduction vary widely across the globe. METHODS We convened an expert group to develop a comprehensive milk ladder based on the calculated milk protein content of Indian foods. To validate the milk ladder, the foods chosen for the ladder were analyzed and the ladder was re-evaluated based on the cooked milk protein content. RESULTS Combining expert consensus and validation of milk protein content, we created the world's first milk ladder containing Indian foods. This is the first ladder that provides information on the timing and temperature of cooking, with validated milk protein content. CONCLUSIONS This is the first milk ladder based on the unique features of Indian food habits built by the consensus of Indian experts along with international collaboration with laboratory quantification of milk protein in each step. We believe the "The Indian Milk Ladder" will be a very helpful tool for pediatricians helping manage CMA in children as well as their parents and caregivers, not only in India, but in countries world-wide where these foods are commonly consumed.
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Affiliation(s)
| | - Neil Shah
- The Portland Hospital, London W1W 5AH, UK
- Reckitt Nutrition, Slough SL1 3UH, UK
| | - Bhaswati C Acharyya
- Department of Paediatric Hepatology & Gastroenterology, AMRI Hospitals, Kolkata 700028, India
- Department of Paediatric Hepatology & Gastroenterology, Institute of Child Health, Kolkata 700017, India
| | - Emmany Durairaj
- Department of Clinical Nutrition, Mazumdar Shaw Medical Centre, Narayana Health City, Bengaluru 560099, India
| | - Lalit Verma
- Department of Paediatric Hepatology & Gastroenterology, Global Hospitals, Mumbai 400012, India
| | - Srinivas Sankaranarayanan
- Department of Paediatric Hepatology & Gastroenterology, Kanchi Kamakoti CHILDS Trust Hospital, Chennai 600024, India
- Department of Paediatric Hepatology & Gastroenterology, Apollo Children Hospital, Chennai 600006, India
| | - Nishant Wadhwa
- Institute of Child Health, Division of Paediatric Gastroenterology, Hepatology & Nutrition, Sir Gangaram Hospital, New Delhi 110060, India
| | - Carina Venter
- Paediatrics, Section of Allergy & Immunology, Denver School of Medicine, University of Colorado, Denver, CO 80204, USA
- Paediatrics, Section of Allergy & Immunology, Children's Hospital Colorado, Denver, CO 80218, USA
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Román‐Carrasco P, Klug C, Hemmer W, Focke‐Tejkl M, Raith M, Grosinger I, Stoll P, Quirce S, Sanchez‐Jareño M, Martínez‐Blanco M, Molina E, Somoza V, Lieder B, Marin Z, Nöbauer K, Hummel K, Razzazi‐Fazeli E, Swoboda I. Bos d 13, A Novel Heat-Stable Beef Allergen. Mol Nutr Food Res 2023; 67:e2200601. [PMID: 37173826 PMCID: PMC10909433 DOI: 10.1002/mnfr.202200601] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 03/24/2023] [Indexed: 05/15/2023]
Abstract
SCOPE Red meat, a staple food of Western diets, can also induce IgE-mediated allergic reactions. Yet, apart from the heat-labile protein serum albumin and the carbohydrate α-Gal, the molecules causing allergic reactions to red meat remain unknown. METHODS AND RESULTS IgE reactivity profiles of beef-sensitized individuals are analyzed by IgE-immunoblotting with protein extracts from raw and cooked beef. Two IgE-reactive proteins are identified by peptide mass fingerprinting as myosinlight chain 1 (MYL1) and myosin light chain 3 (MYL3) in cooked beef extract and are designated Bos d 13 isoallergens. MYL1 and MYL3 are produced recombinantly in Escherichia coli. ELISAs proved their IgE reactivity and circular dichroism analysis showed that they represent folded molecules with remarkable thermal stability. In vitro gastrointestinal digestion experiments showed the higher stability of rMYL1 as compared to rMYL3. Exposure of a monolayer of Caco-2 cells to rMYL1 indicated that the molecule is able to cross intestinal epithelial cells without disturbing the integrity of the tight junctions, suggesting the sensitizing capacity of MYL1. CONCLUSION MYLs are identified as novel heat-stable bovine meat allergens.
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Affiliation(s)
- Patricia Román‐Carrasco
- Biotechnology SectionFH Campus WienCampus Vienna BiocenterUniversity of Applied SciencesVienna1100Austria
| | - Christoph Klug
- Biotechnology SectionFH Campus WienCampus Vienna BiocenterUniversity of Applied SciencesVienna1100Austria
- Present address: MacroArray Diagnostics GmbHVienna1230Austria
| | | | - Margarete Focke‐Tejkl
- Division of ImmunopathologyDepartment of Pathophysiology and Allergy ResearchCenter for PathophysiologyInfectiology and ImmunologyMedical University of ViennaVienna1090Austria
| | - Marianne Raith
- Biotechnology SectionFH Campus WienCampus Vienna BiocenterUniversity of Applied SciencesVienna1100Austria
| | - Isabella Grosinger
- Biotechnology SectionFH Campus WienCampus Vienna BiocenterUniversity of Applied SciencesVienna1100Austria
| | - Peter Stoll
- Biotechnology SectionFH Campus WienCampus Vienna BiocenterUniversity of Applied SciencesVienna1100Austria
| | - Santiago Quirce
- Department of AllergyLa Paz University Hospital, IdiPAZMadrid28046Spain
| | | | - Mónica Martínez‐Blanco
- Instituto de Investigación en Ciencias de la Alimentación (CIAL, CSIC‐UAM)Madrid28049Spain
| | - Elena Molina
- Instituto de Investigación en Ciencias de la Alimentación (CIAL, CSIC‐UAM)Madrid28049Spain
| | - Veronika Somoza
- Department of Physiological ChemistryFaculty of ChemistryUniversity of ViennaVienna1090Austria
- Leibniz Institute for Food Systems BiologyTechnical University Munich85354MunichGermany
| | - Barbara Lieder
- Department of Physiological ChemistryFaculty of ChemistryUniversity of ViennaVienna1090Austria
| | - Zana Marin
- Biotechnology SectionFH Campus WienCampus Vienna BiocenterUniversity of Applied SciencesVienna1100Austria
| | - Katharina Nöbauer
- VetCore Facility for ResearchUniversity of Veterinary MedicineVienna1210Austria
| | - Karin Hummel
- VetCore Facility for ResearchUniversity of Veterinary MedicineVienna1210Austria
| | | | - Ines Swoboda
- Biotechnology SectionFH Campus WienCampus Vienna BiocenterUniversity of Applied SciencesVienna1100Austria
- Division of ImmunopathologyDepartment of Pathophysiology and Allergy ResearchCenter for PathophysiologyInfectiology and ImmunologyMedical University of ViennaVienna1090Austria
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Kang W, Zhang J, Yu N, He L, Chen Y. Effect of ultrahigh-pressure treatment on the structure and allergenicity of peach allergenic proteins. Food Chem 2023; 423:136227. [PMID: 37201255 DOI: 10.1016/j.foodchem.2023.136227] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 03/24/2023] [Accepted: 04/20/2023] [Indexed: 05/20/2023]
Abstract
Peach is a common plant-derived allergenic food and ultrahigh-pressure treatment is often used in peach products. In our study, an in-depth analysis of the structural and allergenicity changes of peach allergenic proteins after UHP treatment was performed by spectroscopy, mass spectrometry combined with serology and cytology. The results indicated that UHP treatment could reduce the content of peach soluble proteins and cause changes in secondary and tertiary structures. In addition, more hydrophobic residues were exposed and proteins tended to polymerize after UHP-treatment. The results of immunological assays showed that UHP treatment could reduce the IgE binding capacity of peach proteins and affect the ability of basophil degranulation, the upregulation of some cytokines may contribute to the reduction of peach protein allergenicity. Notably, UHP treatment may lead to the masking of some digestion sites in Pru p 3 epitopes, thus impeding human digestion and increasing the potential risk of allergenicity.
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Affiliation(s)
- Wenhan Kang
- Chinese Academy of Inspection and Quarantine, Beijing 100176, PR China
| | - Jiukai Zhang
- Chinese Academy of Inspection and Quarantine, Beijing 100176, PR China
| | - Ning Yu
- Chinese Academy of Inspection and Quarantine, Beijing 100176, PR China
| | - Lei He
- Chinese Academy of Inspection and Quarantine, Beijing 100176, PR China
| | - Ying Chen
- Chinese Academy of Inspection and Quarantine, Beijing 100176, PR China.
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Liu K, Lin S, Liu Y, Wang S, Liu Q, Sun K, Sun N. Mechanism of the reduced allergenicity of shrimp (Macrobrachium nipponense) by combined thermal/pressure processing: insight into variations in protein structure, gastrointestinal digestion and immunodominant linear epitopes. Food Chem 2022; 405:134829. [DOI: 10.1016/j.foodchem.2022.134829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 10/24/2022] [Accepted: 10/30/2022] [Indexed: 11/06/2022]
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11
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Comparative digestion of thermally treated vertebrates and invertebrates allergen pairs in real food matrix. Food Chem 2022; 405:134981. [DOI: 10.1016/j.foodchem.2022.134981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 10/28/2022] [Accepted: 11/14/2022] [Indexed: 11/22/2022]
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Zhao J, Timira V, Ahmed I, Chen Y, Wang H, Zhang Z, Lin H, Li Z. Crustacean shellfish allergens: influence of food processing and their detection strategies. Crit Rev Food Sci Nutr 2022; 64:3794-3822. [PMID: 36263970 DOI: 10.1080/10408398.2022.2135485] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Despite the increasing popularity of crustacean shellfish among consumers due to their rich nutrients, they can induce a serious allergic response, sometimes even life-threatening. In the past decades, a variety of crustacean allergens have been identified to facilitate the diagnosis and management of crustacean allergies. Although food processing techniques can ease the risk of crustacean shellfish allergy, no available processing methods to tackle crustacean allergies thoroughly. Strict dietary avoidance of crustacean shellfish and its component is the best option for the protection of sensitized individuals, which should rely on the compliance of food labeling and, as such, on their verification by sensitive, reliable, and accurate detection techniques. In this present review, the physiochemical properties, structure aspects, and immunological characteristics of the major crustacean allergens have been described and discussed. Subsequently, the current research progresses on how various processing techniques cause the alterations and modifications in crustacean allergens to produce hypoallergenic crustacean food products were summarized and discussed. Particularly, various analytical methodologies employed in crustacean shellfish allergen detection, and the effect of food processing and matrix on these techniques, are also herein emphasized for the appropriate selection of analytical detection tools to safeguard consumers safety.
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Affiliation(s)
- Jinlong Zhao
- College of Food Science and Engineering, Ocean University of China, Qingdao, Shandong, P.R. China
| | - Vaileth Timira
- College of Food Science and Engineering, Ocean University of China, Qingdao, Shandong, P.R. China
| | - Ishfaq Ahmed
- College of Food Science and Engineering, Ocean University of China, Qingdao, Shandong, P.R. China
| | - Yan Chen
- China National Center for Food Safety Risk Assessment, Chaoyang District, Beijing, P.R. China
| | - Hao Wang
- College of Food Science and Engineering, Ocean University of China, Qingdao, Shandong, P.R. China
| | - Ziye Zhang
- College of Food Science and Engineering, Ocean University of China, Qingdao, Shandong, P.R. China
| | - Hong Lin
- College of Food Science and Engineering, Ocean University of China, Qingdao, Shandong, P.R. China
| | - Zhenxing Li
- College of Food Science and Engineering, Ocean University of China, Qingdao, Shandong, P.R. China
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Zhao J, Li Y, Xu L, Zeng J, Liu Y, Timira V, Zhang Z, Lin H, Li Z. Thermal induced the structural alterations, increased IgG/IgE binding capacity and reduced immunodetection recovery of tropomyosin from shrimp (Litopenaeus vannamei). Food Chem 2022; 391:133215. [DOI: 10.1016/j.foodchem.2022.133215] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 04/22/2022] [Accepted: 05/11/2022] [Indexed: 12/24/2022]
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14
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Scala E, Abeni D, Aruanno A, Boni E, Brusca I, Cappiello F, Caprini E, Buzzulini F, Deleonardi G, Demonte A, Farioli L, Lodi Rizzini F, Michelina Losappio L, Macchia D, Manzotti G, Meneguzzi G, Montagni M, Nucera E, Onida R, Pastorello EA, Peveri S, Radice A, Rivolta F, Rizzi A, Giani M, Cecchi L, Pinter E, Miglionico M, Vantaggio L, Pravettoni V, Villalta D, Asero R. Mollusk allergy in shrimp-allergic patients: Still a complex diagnosis. An Italian real-life cross-sectional multicenter study. World Allergy Organ J 2022; 15:100685. [PMID: 36119659 PMCID: PMC9468587 DOI: 10.1016/j.waojou.2022.100685] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 06/16/2022] [Accepted: 07/29/2022] [Indexed: 11/22/2022] Open
Abstract
Introduction Shellfish allergy is an important cause of food allergies worldwide. Both in vivo and in vitro diagnostics failure nowadays is caused by the poor quality of the extracts associated with the scarce availability of allergenic molecules in the market. It is known that not all patients with shellfish allergies experience adverse reactions to mollusks. It is still unclear how to detect and diagnose these patients correctly. Aim To investigate the features of shrimp-allergic patients either reactive or tolerant to mollusks, with the currently available diagnostic methods. Methods Nineteen centers, scattered throughout Italy, participated in the real-life study, enrolling patients allergic to shrimp with or without associated reactions to mollusks. Patients underwent skin tests using commercial extracts or fresh raw and cooked shrimp and mollusks, and IgE reactivity to currently available allergenic extracts and molecules was measured in vitro. Results Two hundred and forty-seven individuals with a self reported adverse reactions to shrimp participated in the study; of these 47.8% reported an adverse reaction to mollusks ingestion (cephalopod and/or bivalve). Neither of the tests used, in vivo nor in vitro, was able to detect all selected patients. Accordingly, a great heterogeneity of results was observed: in vivo and in vitro tests agreed in 52% and 62% of cases. Skin tests were able to identify the mollusk reactors (p < 0.001), also using fresh cooked or raw food (p < 0.001). The reactivity profile of mollusk reactors was dominated by Pen m 1, over Pen m 2 and Pen m 4 compared to tolerant subjects, but 33% of patients were not detected by any of the available molecules. Overall, a higher frequency of IgE rectivity to shrimp was recorded in northern Italy, while mollusk reactivity was more frequent in the center-south. Conclusion The current diagnostic methods are inadequate to predict the cross-reactivity between crustaceans and mollusks. The detection of mollusks hypersensitivity should still rely on skin tests with fresh material. The exclusion of mollusks from shrimp allergic patients’ diets should occur when clinical history, available diagnostic instruments, and/or tolerance tests support such a decision. Current diagnostic methods are inadequate to predict cross-reactivity between crustaceans and mollusks; The detection of mollusks hypersensitivity must still rely on skin tests with fresh material (and oral challenges where possible); Clinically, there is no need to exclude a priori mollusks from shrimp allergic patients' diets;
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Affiliation(s)
- Enrico Scala
- Clinical and Laboratory Molecular Allergy Unit - IDI-IRCCS
- FLMM, Roma, Italy
| | - Damiano Abeni
- Clinical and Laboratory Molecular Allergy Unit - IDI-IRCCS
- FLMM, Roma, Italy
| | - Arianna Aruanno
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Elisa Boni
- Allergologia e autoimmunità LUM AUSL, Bologna, Italy
| | - Ignazio Brusca
- Clinical Pathology U.O.C., Buccheri La Ferla F.B.F. Hospital, Palermo, Italy
| | | | - Elisabetta Caprini
- Clinical and Laboratory Molecular Allergy Unit - IDI-IRCCS
- FLMM, Roma, Italy
| | - Francesca Buzzulini
- SSD di immunologia e Allergologia, PO S. Maria Degli Angeli, Pordenone, Italy
| | | | | | - Laura Farioli
- Dipartimento di Allergologia, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Fabio Lodi Rizzini
- SSVD Allergologia Spedali Civili - Università Studi Brescia, Brescia, Italy
| | | | - Donatella Macchia
- SOS Allergologia e Immunologia Clinica, Ospedale San Giovanni di Dio, Firenze, Italy
| | | | - Giorgia Meneguzzi
- Clinical and Laboratory Molecular Allergy Unit - IDI-IRCCS
- FLMM, Roma, Italy
| | | | - Eleonora Nucera
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Rosa Onida
- Clinical Pathology U.O.C., Buccheri La Ferla F.B.F. Hospital, Palermo, Italy
| | - Elide Anna Pastorello
- Dipartimento di Allergologia, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Silvia Peveri
- UOsD Allergologia, ospedale G. Da Saliceto, Piacenza, Italy
| | - Anna Radice
- SOS Allergologia e Immunologia Clinica, Ospedale San Giovanni di Dio, Firenze, Italy
| | - Federica Rivolta
- Immunology and Allergy Department, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Angela Rizzi
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Mauro Giani
- Clinical and Laboratory Molecular Allergy Unit - IDI-IRCCS
- FLMM, Roma, Italy
| | - Lorenzo Cecchi
- SOS Allergology and Clinical Immunology, USL Toscana Centro, Prato, Italy
| | - Elena Pinter
- UOC Medicina interna e Immunologia Clinica, Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Marzia Miglionico
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Lorenzo Vantaggio
- Department of Translational and Precision Medicine, Sapienza University of Rome, Italy
| | - Valerio Pravettoni
- Immunology and Allergy Department, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Danilo Villalta
- SSD di immunologia e Allergologia, PO S. Maria Degli Angeli, Pordenone, Italy
| | - Riccardo Asero
- Ambulatorio di allergologia, Clinica San Carlo, Paderno Dugnano (MI), Italy
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15
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Berni Canani R, Caffarelli C, Calvani M, Martelli A, Carucci L, Cozzolino T, Alvisi P, Agostoni C, Lionetti P, Marseglia GL. Diagnostic therapeutic care pathway for pediatric food allergies and intolerances in Italy: a joint position paper by the Italian Society for Pediatric Gastroenterology Hepatology and Nutrition (SIGENP) and the Italian Society for Pediatric Allergy and Immunology (SIAIP). Ital J Pediatr 2022; 48:87. [PMID: 35689252 PMCID: PMC9188074 DOI: 10.1186/s13052-022-01277-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 05/10/2022] [Indexed: 11/10/2022] Open
Abstract
Epidemiologic data suggest an increased prevalence of pediatric food allergies and intolerances (FAIs) during the last decades. This changing scenario has led to an increase in the overall healthcare costs, due to a growing demand for diagnostic and treatment services. There is the need to establish Evidence-based practices for diagnostic and therapeutic intervention that could be adopted in the context of public health policies for FAIs are needed. This joint position paper has been prepared by a group of experts in pediatric gastroenterology, allergy and nutrition from the Italian Society for Pediatric Gastroenterology Hepatology and Nutrition (SIGENP) and the Italian Society for Pediatric Allergy and Immunology (SIAIP). The paper is focused on the Diagnostic Therapeutic Care Pathway (DTCP) for pediatric FAIs in Italy.
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Affiliation(s)
- Roberto Berni Canani
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy. .,CEINGE-Biotecnologie Avanzate s.c.ar.l. University of Naples Federico II, Naples, Italy. .,European Laboratory for the Investigation of Food-Induced Diseases, University of Naples, Federico II, Naples, Italy. .,Task Force for Microbiome Studies, University of Naples Federico II, Naples, Italy.
| | - Carlo Caffarelli
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Mauro Calvani
- Pediatric Unit, S. Camillo Forlanini Hospital, Rome, Italy
| | - Alberto Martelli
- Department of Pediatrics, G. Salvini Hospital, Garbagnate Milanese, Milan, Italy
| | - Laura Carucci
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.,CEINGE-Biotecnologie Avanzate s.c.ar.l. University of Naples Federico II, Naples, Italy
| | - Tommaso Cozzolino
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.,CEINGE-Biotecnologie Avanzate s.c.ar.l. University of Naples Federico II, Naples, Italy
| | - Patrizia Alvisi
- Pediatric Gastroenterology Unit, Maggiore Hospital, Bologna, Italy
| | - Carlo Agostoni
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Pediatric Intermediate Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Lionetti
- Pediatric Gastroenterology and Nutrition Unit, Meyer Children's Hospital, Florence, Italy
| | - Gian Luigi Marseglia
- Pediatric Clinic, IRCCS "S. Matteo" Foundation, University of Pavia, Pavia, Italy
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16
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De Vlieger L, Nuyttens L, Matton C, Diels M, Verelst S, Leus J, Coppens K, Sauer K, Dilissen E, Coorevits L, Matthys C, Schrijvers R, Raes M, Bullens DMA. Guided Gradual Egg-Tolerance Induction in Hen's Egg Allergic Children Tolerating Baked Egg: A Prospective Randomized Trial. FRONTIERS IN ALLERGY 2022; 3:886094. [PMID: 35769568 PMCID: PMC9234941 DOI: 10.3389/falgy.2022.886094] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 03/29/2022] [Indexed: 12/02/2022] Open
Abstract
Background Over the last few years, studies have shown that the majority of egg allergic children tolerate baked egg (e.g., cake), and that consuming baked egg accelerates the resolution of egg allergy. However, few prospective studies demonstrate the step-wise reintroduction of egg at home after developing baked egg tolerance. Although this could have a positive impact on the children's quality of life and nutrition. Additionally, research supporting the theoretical concept that heating in the presence or absence of wheat causes reduced allergenicity of egg proteins is limited. Objective To investigate the clinically most favorable duration of gradual egg-tolerance induction in baked egg tolerant children at home, with regard to complete raw egg tolerance. Methods Baked egg tolerant children above 12 months of age were randomly assigned to a short- or long arm protocol. In the short arm, egg-tolerance induction was studied over 18 months compared to 30 months in the long arm. Children were guided through this protocol involving the step-wise introduction of increasingly allergenic forms of egg starting with baked egg offered as cake, followed by hard-boiled egg, omelet/waffle/pancake, soft-boiled egg, and finally raw egg. We hereby designed this protocol based on the influence of thermal processing in the presence or absence of wheat on egg proteins, as investigated by ELISA, SDS-PAGE, and immunoblotting. At inclusion, children either passed an in-hospital cake challenge or had ovomucoid sIgE ≤1.2 kUA/L, which was considered safe for introduction at home. Results Gel electrophoresis revealed that the ovalbumin band became weaker with heating, while the ovomucoid band remained stable. In accordance, the IgE-binding to ovalbumin decreased with extensive heating, as opposed to ovomucoid. However, heating in the presence of wheat led to a decreased IgE reactivity to ovomucoid. Of the 78 children in the intention-to-treat group, 39 were randomized to each arm. Fifty-eight children reached the raw egg tolerance endpoint, of which 80% were in the short arm and 69% in the long arm. Within the short arm, the median time to raw egg tolerance was 24 months (95% CI, 21–27 months) compared to 30 months (95% CI, 28–32 months) in the long arm (p = 0.005). No grade IV reactions or cases of eosinophilic esophagitis were observed. The short arm was considered to be non-inferior to the long arm. Conclusion Our gradual short arm protocol appears to be safe and allows clinicians to guide baked egg tolerant children toward raw egg tolerance at home. The allergenicity of the egg proteins was affected by heating temperature and duration, as well as the presence of wheat.
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Affiliation(s)
- Liselot De Vlieger
- Department of Microbiology, Immunology and Transplantation, Allergy and Immunology Research Group, KU Leuven, Leuven, Belgium
- *Correspondence: Liselot De Vlieger
| | - Lisa Nuyttens
- Department of Microbiology, Immunology and Transplantation, Allergy and Immunology Research Group, KU Leuven, Leuven, Belgium
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
| | | | - Marianne Diels
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
| | - Sophie Verelst
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
- Department of Pediatrics, Jessa Hospital, Hasselt, Belgium
| | - Jasmine Leus
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
- Department of Pediatrics, AZ Maria Middelares, Ghent, Belgium
| | - Katrien Coppens
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
- Department of Pediatrics, Imelda Hospital, Bonheiden, Belgium
| | - Kate Sauer
- Department of Pediatrics, AZ Sint-Jan Hospital, Bruges, Belgium
| | - Ellen Dilissen
- Department of Microbiology, Immunology and Transplantation, Allergy and Immunology Research Group, KU Leuven, Leuven, Belgium
| | - Lieve Coorevits
- Department of Microbiology, Immunology and Transplantation, Allergy and Immunology Research Group, KU Leuven, Leuven, Belgium
| | - Christophe Matthys
- Department of Chronic Diseases and Metabolism, Clinical and Experimental Endocrinology, KU Leuven, Leuven, Belgium
- Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium
| | - Rik Schrijvers
- Department of Microbiology, Immunology and Transplantation, Allergy and Immunology Research Group, KU Leuven, Leuven, Belgium
- Department of General Internal Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Marc Raes
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
- Department of Pediatrics, Jessa Hospital, Hasselt, Belgium
| | - Dominique M. A. Bullens
- Department of Microbiology, Immunology and Transplantation, Allergy and Immunology Research Group, KU Leuven, Leuven, Belgium
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
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17
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The US population-level burden of cow's milk allergy. World Allergy Organ J 2022; 15:100644. [PMID: 35539895 PMCID: PMC9046619 DOI: 10.1016/j.waojou.2022.100644] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 02/28/2022] [Accepted: 03/10/2022] [Indexed: 11/21/2022] Open
Abstract
Background Cow's milk is a food allergen of public health importance both in the United States and globally. Its natural history and epidemiology have been most studied among infants and young children, but the public health burden it places on adults and older pediatric populations remains unclear. This study comprehensively characterizes the US population-level burden of cow's milk allergy (CMA), including its prevalence, severity, health care utilization, psychosocial impact, natural history, and other associated factors-including ability to tolerate extensively heated milk products-within a large, nationally-representative survey sample of US households. Methods A cross-sectional survey was administered via web and telephone. Population level inference was based on data collected from participants recruited from National Opinion Research Center (NORC) at the University of Chicago's probability-based AmeriSpeak panel. Established dual-sample complex survey calibration methods were used to augment this sample with additional participants recruited through Survey Sampling International to increase the precision of the resulting estimates. In total, surveys were administered to a nationally representative sample of 51 819 US households from October 1, 2015, through September 31, 2016. Self-report responses from 40 453 adults and parent-proxy report for 38 408 children were analyzed. Results Analyzing survey responses from 78 851 individuals, an estimated 4.7% (95% CI, 4.4%-4.9%) of the US population reported current CMA, whereas 1.9% (95% CI, 1.8%-2.1%) met symptom-report criteria for convincing IgE-mediated allergy. An estimated 0.9% (95% CI, 0.8%-1.0%) had CMA that met convincing symptom-report criteria and was physician diagnosed. Female and White respondents were more likely to report outgrowing CMA relative to males and those reporting other races and ethnicities. Individuals with CMA who reported tolerance to baked milk products were less likely to report severe reaction histories (33.5% vs 42.7%; p = .03), a lifetime history of food allergy-related emergency department visits (43.4% vs. 55.8%; p = .005), and treating a milk-allergic reaction with epinephrine (10.6 vs. 18.9%; p = .003). These individuals also exhibited less psychosocial burden on the validated Food Allergy Independent Measure (FAIM) than their counterparts with CMA who were allergic to baked forms of milk. Conclusion These data indicate a discrepancy in reported rates of allergy to cow's milk among the US general population ranging from approximately 1 in 20 with reported CMA to fewer than 1 in 50 with physician-confirmed CMA. However, they suggest a substantial population-level burden of CMA, including substantial healthcare utilization, psychosocial burden and nutritional impacts-particularly among the approximately 30% of individuals with CMA who cannot tolerate baked forms of milk.
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Khan MU, Lin H, Hang T, Zhao J, Dasanayaka BP, Zhang J, Ahmed I, Zhang Z, Jiang Y, Qazi IM, Abbas M, Li Z. Development of a sandwich enzyme-linked immunosorbent kit for reliable detection of milk allergens in processed food. Anal Biochem 2022; 648:114667. [PMID: 35331695 DOI: 10.1016/j.ab.2022.114667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 03/10/2022] [Accepted: 03/14/2022] [Indexed: 11/01/2022]
Abstract
The inclusion of undeclared cow's milk proteins may cause health complications to milk-allergic consumers and is one of the leading cause of food recall in many countries all over the world. Therefore, to keep control on such incidences in processed products, we established a milk sandwich ELISA test kit by incorporating two polyclonal antibodies against milk proteins obtained from different species. Its analytical effectiveness in terms of sensitivity, specificity, accuracy, trueness, and precision were all analyzed. The limit of detection (LOD) of the test kit was 0.011 ppm, with high specificity for milk protein residues. The test kit was highly specific, apart from considerable cross-reactivity with goat milk and minor cross-reactivity with donkey and horse milk. The coefficient of variation of the test kit for intra-assay ranged from 4.02% to 14.62% and inter-assay ranged from 6.05% to 15.08% respectively. The sandwich ELISA was highly specific in detecting commercial food products. In a limited retail survey, 5/6 of the milk proteins declared on the ingredient labels tested positive for milk proteins. The study offers effective technical support for the sensitive detection of milk products both for food manufacturers and regulatory authorities.
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Affiliation(s)
- Mati Ullah Khan
- College of Food Science and Engineering, Ocean University of China, No.5, Yushan Road, Qingdao, Shandong Province, 266003, PR China
| | - Hong Lin
- College of Food Science and Engineering, Ocean University of China, No.5, Yushan Road, Qingdao, Shandong Province, 266003, PR China
| | - Tian Hang
- College of Food Science and Engineering, Ocean University of China, No.5, Yushan Road, Qingdao, Shandong Province, 266003, PR China
| | - Jinlong Zhao
- College of Food Science and Engineering, Ocean University of China, No.5, Yushan Road, Qingdao, Shandong Province, 266003, PR China
| | - Binaka Prabashini Dasanayaka
- College of Food Science and Engineering, Ocean University of China, No.5, Yushan Road, Qingdao, Shandong Province, 266003, PR China
| | - Jiukai Zhang
- Agro-Product Safety Research Center Chinese Academy of Inspection and Quarantine, CAIQ, 11 Ronghua Nanlu, Yi Zhuang, Beijing, 100176, PR China
| | - Ishfaq Ahmed
- College of Food Science and Engineering, Ocean University of China, No.5, Yushan Road, Qingdao, Shandong Province, 266003, PR China
| | - Ziye Zhang
- College of Food Science and Engineering, Ocean University of China, No.5, Yushan Road, Qingdao, Shandong Province, 266003, PR China
| | - YunGuo Jiang
- Penglai Hospital of Traditional Chinese Medicine in Yantai City, 132 Nanhuan Road, Yantai, Shandong Province, 265600, PR China.
| | - Ihsan Mabood Qazi
- Department of Food Science and Technology, The University of Agriculture, Peshawar, Pakistan
| | - Muhammad Abbas
- Department of Human Nutrition, The University of Agriculture, Peshawar, Pakistan
| | - Zhenxing Li
- College of Food Science and Engineering, Ocean University of China, No.5, Yushan Road, Qingdao, Shandong Province, 266003, PR China.
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19
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Zhao J, Khan MU, Chen J, Li S, Dasanayaka BP, Timira V, Li Y, Zhang J, Lin H, Li Z. A sensitive sandwich enzyme‐linked immunosorbent assay (sELISA) targeted multiple wheat protein fractions for the detection of several cereal grains in processed foods. J Food Sci 2022; 87:1514-1526. [DOI: 10.1111/1750-3841.16119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 02/19/2022] [Accepted: 02/21/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Jinlong Zhao
- College of Food Science and Engineering Ocean University of China Qingdao P. R. China
| | - Mati Ullah Khan
- College of Food Science and Engineering Ocean University of China Qingdao P. R. China
| | - Jin Chen
- College of Food Science and Engineering Ocean University of China Qingdao P. R. China
| | - Siyue Li
- College of Food Science and Engineering Ocean University of China Qingdao P. R. China
| | | | - Vaileth Timira
- College of Food Science and Engineering Ocean University of China Qingdao P. R. China
| | - Yonghong Li
- College of Food Science and Engineering Ocean University of China Qingdao P. R. China
- HOB Biotech Group Corp., Ltd Suzhou City P. R. China
| | - Jiukai Zhang
- Agro‐Product Safety Research Center Chinese Academy of Inspection and Quarantine Beijing P. R. China
| | - Hong Lin
- College of Food Science and Engineering Ocean University of China Qingdao P. R. China
| | - Zhenxing Li
- College of Food Science and Engineering Ocean University of China Qingdao P. R. China
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20
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Tuppo L, Giangrieco I, Tamburrini M, Alessandri C, Mari A, Ciardiello MA. Detection of Allergenic Proteins in Foodstuffs: Advantages of the Innovative Multiplex Allergen Microarray-Based Immunoassay Compared to Conventional Methods. Foods 2022; 11:foods11060878. [PMID: 35327300 PMCID: PMC8949930 DOI: 10.3390/foods11060878] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 03/12/2022] [Accepted: 03/17/2022] [Indexed: 02/04/2023] Open
Abstract
Several factors can affect the allergen content and profile of a specific food, including processing procedures often leading to a decrease in allergenicity, although no change, or even an increase, have also been reported. Evaluation of the effectiveness of a processing procedure requires the availability of reliable methodologies to assess the variation in molecules able to induce allergic reactions in the analyzed food. Conventional and innovative strategies and methodologies can be exploited to identify allergenic proteins in foodstuffs. However, depending on the specific purposes, different methods can be used. In this review, we have critically reviewed the advantages of an innovative method, the multiplex allergen microarray-based immunoassay, in the detection of allergens in foodstuffs. In particular, we have analyzed some studies reporting the exploitation of an IgE-binding inhibition assay on multiplex allergen biochips, which has not yet been reviewed in the available literature. Unlike the others, this methodology enables the identification of many allergenic proteins, some of which are still unknown, which are recognized by IgE from allergic patients, with a single test. The examined literature suggests that the inhibition test associated with the multiplex allergen immunoassay is a promising methodology exploitable for the detection of IgE-binding proteins in food samples.
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Affiliation(s)
- Lisa Tuppo
- Institute of Biosciences and BioResources (IBBR), CNR, 80131 Naples, Italy; (L.T.); (I.G.); (M.T.)
| | - Ivana Giangrieco
- Institute of Biosciences and BioResources (IBBR), CNR, 80131 Naples, Italy; (L.T.); (I.G.); (M.T.)
| | - Maurizio Tamburrini
- Institute of Biosciences and BioResources (IBBR), CNR, 80131 Naples, Italy; (L.T.); (I.G.); (M.T.)
| | - Claudia Alessandri
- Associated Centers for Molecular Allergology (CAAM), 00100 Rome, Italy; (C.A.); (A.M.)
- Allergy Data Laboratories (ADL), 04100 Latina, Italy
| | - Adriano Mari
- Associated Centers for Molecular Allergology (CAAM), 00100 Rome, Italy; (C.A.); (A.M.)
- Allergy Data Laboratories (ADL), 04100 Latina, Italy
| | - Maria Antonietta Ciardiello
- Institute of Biosciences and BioResources (IBBR), CNR, 80131 Naples, Italy; (L.T.); (I.G.); (M.T.)
- Correspondence:
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21
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Maillard Reaction Induced Changes in Allergenicity of Food. Foods 2022; 11:foods11040530. [PMID: 35206007 PMCID: PMC8870895 DOI: 10.3390/foods11040530] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 02/09/2022] [Accepted: 02/11/2022] [Indexed: 01/27/2023] Open
Abstract
Food allergy is increasing in prevalence, posing aheavier social and financial burden. At present, there is still no widely accepted treatment for it. Methods to reduce or eliminate the allergenicity of trigger foods are urgently needed. Technological processing contributes to producing some hypoallergenic foods. Among the processing methods, the Maillard reaction (MR) is popular because neither special chemical materials nor sophisticated equipment is needed. MR may affect the allergenicity of proteins by disrupting the conformational epitope, disclosing the hidden epitope, masking the linear epitope, and/or forming a new epitope. Changes in the allergenicity of foods after processing are affected by various factors, such as the characteristics of the allergen, the processing parameters, and the processing matrix, and they are therefore variable and difficult to predict. This paper reviews the effects of MR on the allergenicity of each allergen group from common allergenic foods.
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22
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Zhao J, Li Y, Xu L, Ji Y, Zeng J, Timira V, Zhang Z, Chen G, Lin H, Li Z. Insight into IgG/IgE binding ability, in vitro digestibility and structural changes of shrimp (Litopenaeus vannamei) soluble extracts with thermal processing. Food Chem 2022; 381:132177. [PMID: 35121318 DOI: 10.1016/j.foodchem.2022.132177] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 12/27/2021] [Accepted: 01/14/2022] [Indexed: 11/20/2022]
Abstract
The effects of six kinds of thermal processing on soluble protein recovery, potential allergenicity, in vitro digestibility and structural characteristics of shrimp soluble proteins were evaluated. Obtained results confirmed soluble protein recovery and IgG/IgE reactivity of shrimp soluble extracts were markedly suppressed by various thermal treatments with enhanced digestibility depended on the extent and type of heating applied, which correlated well with the structural alterations and modification. The maximum reduction of IgG/IgE-binding capacity and digestive stability were observed in the autoclaved shrimps because of unfolding of protein and hydrophobic residues exposed. Notably, tropomyosin (TM) and sarcoplasmic calcium-binding protein (SCP) were still IgG/IgE-reactive in various heat-processed shrimps, even higher IgG reactivity were found in heat-treated shrimps TM according to TM antiserum western-blotting and indirect ELISA results. Shrimp TM and SCP maintains its IgE/IgG-binding capacity after various cooking methods, thus most probably initiating allergic sensitization to both raw and cooked shrimps.
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Affiliation(s)
- Jinlong Zhao
- College of Food Science and Engineering, Ocean University of China, No.5, Yushan Road, Qingdao, Shandong Province 266003, PR China
| | - Yonghong Li
- College of Food Science and Engineering, Ocean University of China, No.5, Yushan Road, Qingdao, Shandong Province 266003, PR China; HOB Biotech Group Corp., Ltd., No. 218, Xinghu Road, Suzhou City, Jiangsu Province 215000, PR China
| | - Lili Xu
- College of Food Science and Engineering, Ocean University of China, No.5, Yushan Road, Qingdao, Shandong Province 266003, PR China
| | - Yu Ji
- College of Food Science and Engineering, Ocean University of China, No.5, Yushan Road, Qingdao, Shandong Province 266003, PR China
| | - Jianhua Zeng
- College of Food Science and Engineering, Ocean University of China, No.5, Yushan Road, Qingdao, Shandong Province 266003, PR China
| | - Vaileth Timira
- College of Food Science and Engineering, Ocean University of China, No.5, Yushan Road, Qingdao, Shandong Province 266003, PR China
| | - Ziye Zhang
- College of Food Science and Engineering, Ocean University of China, No.5, Yushan Road, Qingdao, Shandong Province 266003, PR China
| | - Guanzhi Chen
- Department of Dermatology, The Affiliated Hospital of Qingdao University, Qingdao University, No.16, Jiangsu Road, Qingdao City, Shandong Province 266071, PR China
| | - Hong Lin
- College of Food Science and Engineering, Ocean University of China, No.5, Yushan Road, Qingdao, Shandong Province 266003, PR China
| | - Zhenxing Li
- College of Food Science and Engineering, Ocean University of China, No.5, Yushan Road, Qingdao, Shandong Province 266003, PR China.
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23
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Gazme B, Rezaei K, Udenigwe CC. Epitope mapping and the effects of various factors on the immunoreactivity of main allergens in egg white. Food Funct 2022; 13:38-51. [PMID: 34908097 DOI: 10.1039/d1fo01867a] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Egg white has high protein content and numerous biological/functional properties. However, reported allergenicity for some of the proteins in egg white is an issue that needs to be paid exclusive attention. A consideration of the structure of IgE epitopes and their sequences, as well as a comprehensive understanding of the effects of various processes on epitopes and the impact of the gastrointestinal tract on them, can help target such issues. The current study focuses on the identified IgE epitopes in egg white proteins and evaluation of the effects of the gastrointestinal digestion, carbohydrate moiety, food matrix, microbial fermentation, recombinant allergen, heat treatment, Maillard reaction and combination of various processes and gastrointestinal digestion on egg white allergenicity. Although the gastrointestinal tract reduces the immunoreactivity of native egg white proteins, some of the IgE epitope-containing fragments remain intact during the digestion process. It has been found that the gastrointestinal tract can have both positive and negative impacts on the IgE binding activities of egg white proteins. Elimination of the carbohydrate moiety leads to a reduction in the immunoreactivity of ovalbumin. But, such effects from the carbohydrate parts in the IgE binding activity need to be explored further. In addition, the interaction between the egg white proteins and the food matrix leads to various effects from the gastrointestinal tract on the digestion of egg white proteins and their subsequent immunoreactivity. Further on this matter, studies have shown that both microbial fermentation and Maillard reaction can reduce the IgE binding activities of egg white proteins. Also, as an alternate approach, the thermal process can be used to treat the egg white proteins, which may result in the reduction or increase in their IgE binding activities depending on the conditions used in the process. Overall, based on the reported data, the allergenicity levels of egg white proteins can be mitigated or escalated depending on the conditions applied in the processing of the food products containing egg white. So far, no practical solutions have been reported to eliminate such allergenicity.
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Affiliation(s)
- Behzad Gazme
- Department of Food Science, Engineering, and Technology, University of Tehran, 31587-77871 Karaj, Iran.
| | - Karamatollah Rezaei
- Department of Food Science, Engineering, and Technology, University of Tehran, 31587-77871 Karaj, Iran.
| | - Chibuike C Udenigwe
- School of Nutrition Sciences, Faculty of Health Sciences, 415 Smyth Road, University of Ottawa, Ottawa, Ontario, K1H 8L1, Canada. .,Department of Chemistry and Biomolecular Sciences, University of Ottawa, Ottawa, Ontario K1N 6N5, Canada
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24
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Kaplan M, Arslan A, Duman H, Karyelioğlu M, Baydemir B, Günar BB, Alkan M, Bayraktar A, Tosun Hİ, Ertürk M, Eskici G, Duar RM, Henrick BM, Frese SA, Karav S. Production of Bovine Colostrum for Human Consumption to Improve Health. Front Pharmacol 2022; 12:796824. [PMID: 35046820 PMCID: PMC8762312 DOI: 10.3389/fphar.2021.796824] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 11/30/2021] [Indexed: 12/12/2022] Open
Abstract
Colostrum contains all essential nutrients for the neonate during the first days of life, with impacts that continue far beyond these first days. Bovine colostrum has been used for human consumption due to the high concentrations of bioactive proteins, vitamins, minerals, growth factors, as well as free and conjugated oligosaccharides. Processes involved in the preparation of bovine colostrum for human consumption play a pivotal role in preserving and maintaining the activity of the bioactive molecules. As bovine colostrum is a multifunctional food that offers a myriad of benefits for human health, assessing the main processes used in preparing it with both advantages and disadvantages is a crucial point to discuss. We discuss major processes effects for colostrum production on the nutritional value, some advanced technologies to preserve processed bovine colostrum and the end-product forms consumed by humans whether as dairy products or dietary supplements.
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Affiliation(s)
- Merve Kaplan
- Department of Molecular Biology and Genetics, Canakkale Onsekiz Mart University, Canakkale, Turkey
| | - Ayşenur Arslan
- Department of Molecular Biology and Genetics, Canakkale Onsekiz Mart University, Canakkale, Turkey
| | - Hatice Duman
- Department of Molecular Biology and Genetics, Canakkale Onsekiz Mart University, Canakkale, Turkey
| | - Melda Karyelioğlu
- Department of Molecular Biology and Genetics, Canakkale Onsekiz Mart University, Canakkale, Turkey
| | - Barış Baydemir
- Department of Coaching Education, Canakkale Onsekiz Mart University, Canakkale, Turkey
| | - Bilgetekin Burak Günar
- Department of Physical Education and Sports Teaching, Canakkale Onsekiz Mart University, Canakkale, Turkey
| | - Merve Alkan
- Department of Molecular Biology and Genetics, Canakkale Onsekiz Mart University, Canakkale, Turkey
- Uluova Dairy, Canakkale, Turkey
| | - Ayşe Bayraktar
- Department of Molecular Biology and Genetics, Canakkale Onsekiz Mart University, Canakkale, Turkey
- Uluova Dairy, Canakkale, Turkey
| | | | | | - Günay Eskici
- Department of Coaching Education, Canakkale Onsekiz Mart University, Canakkale, Turkey
| | | | - Bethany M. Henrick
- Evolve Biosystems, Inc., Davis, CA, United States
- Department of Food Science and Technology, University of Nebraska Lincoln, Lincoln, NE, United States
| | - Steven A. Frese
- Department of Nutrition, University of Nevada Reno, Reno, NV, United States
| | - Sercan Karav
- Department of Molecular Biology and Genetics, Canakkale Onsekiz Mart University, Canakkale, Turkey
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25
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Mullins E, Bresson J, Dalmay T, Dewhurst IC, Epstein MM, George Firbank L, Guerche P, Hejatko J, Naegeli H, Nogué F, Rostoks N, Sánchez Serrano JJ, Savoini G, Veromann E, Veronesi F, Fernandez Dumont A, Moreno FJ. Scientific Opinion on development needs for the allergenicity and protein safety assessment of food and feed products derived from biotechnology. EFSA J 2022; 20:e07044. [PMID: 35106091 PMCID: PMC8787593 DOI: 10.2903/j.efsa.2022.7044] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
This Scientific Opinion addresses the formulation of specific development needs, including research requirements for allergenicity assessment and protein safety, in general, which is urgently needed in a world that demands more sustainable food systems. Current allergenicity risk assessment strategies are based on the principles and guidelines of the Codex Alimentarius for the safety assessment of foods derived from 'modern' biotechnology initially published in 2003. The core approach for the safety assessment is based on a 'weight-of-evidence' approach because no single piece of information or experimental method provides sufficient evidence to predict allergenicity. Although the Codex Alimentarius and EFSA guidance documents successfully addressed allergenicity assessments of single/stacked event GM applications, experience gained and new developments in the field call for a modernisation of some key elements of the risk assessment. These should include the consideration of clinical relevance, route of exposure and potential threshold values of food allergens, the update of in silico tools used with more targeted databases and better integration and standardisation of test materials and in vitro/in vivo protocols. Furthermore, more complex future products will likely challenge the overall practical implementation of current guidelines, which were mainly targeted to assess a few newly expressed proteins. Therefore, it is timely to review and clarify the main purpose of the allergenicity risk assessment and the vital role it plays in protecting consumers' health. A roadmap to (re)define the allergenicity safety objectives and risk assessment needs will be required to inform a series of key questions for risk assessors and risk managers such as 'what is the purpose of the allergenicity risk assessment?' or 'what level of confidence is necessary for the predictions?'.
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26
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Venter C, Meyer R, Ebisawa M, Athanasopoulou P, Mack DP. Food allergen ladders: A need for standardization. Pediatr Allergy Immunol 2022; 33:e13714. [PMID: 34882843 DOI: 10.1111/pai.13714] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 11/29/2021] [Accepted: 12/02/2021] [Indexed: 01/22/2023]
Abstract
INTRODUCTION The process of gradually reintroducing food allergens into an individual's diet is referred to as food allergen "ladders". There remain many questions regarding the foods chosen, structure and composition of the ladder, and medical and safety considerations. The COVID-19 pandemic has propelled us into an era where medicine is increasingly practiced via online platforms, highlighting the need for standardized food allergen ladder approaches for successful and safe introduction of food allergens. METHODS We performed a search of currently published food allergen ladders and obtained published information and clinical expertise to summarize current knowledge and suggest future standardized approaches for using food allergen ladders. RESULTS There are currently a limited number of published milk, egg, wheat, and soy ladders. We suggest the following points should be considered when developing food ladders: (1) Food allergen: dose, time, and temperature of heating of the food allergen, simplicity of the ladder and recipes, the possible role of the wheat matrix, and testing for allergenic protein levels to standardize doses; (2) Nutritional factors: health and nutritional value of the foods in the ladder, taste, texture, and cultural appropriateness of foods should be considered; and (3) Medical aspects: consideration of which patients are safe to undergo ladders outside of the clinical setting, other safety aspects and risk factors for severe reactions, number of days suggested per steps, and availability and provision of rescue medication. Written instructions and recipes should be provided to families who wish to use food allergen ladders. DISCUSSION Food allergen ladders used for gradual reintroduction of food allergens into a food allergic individual's diet are increasingly being used internationally. Standardization regarding the foods included in the ladder and medical considerations are required to practice patient-centered care, best assist patients and families, and ensure safety.
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Affiliation(s)
- Carina Venter
- Children's Hospital Colorado, University of Colorado, AuRoRa, Colorado, USA
| | - Rosan Meyer
- Department of Paediatrics, Imperial College, London, UK
| | - Motohiro Ebisawa
- Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Sagamihara, Japan
| | | | - Douglas Paul Mack
- Department of Paediatrics, Paediatric Allergy, Asthma, and Immunology, McMaster University, Hamilton, Ontario, Canada
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27
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Román-Carrasco P, Hemmer W, Cabezas-Cruz A, Hodžić A, de la Fuente J, Swoboda I. The α-Gal Syndrome and Potential Mechanisms. FRONTIERS IN ALLERGY 2021; 2:783279. [PMID: 35386980 PMCID: PMC8974695 DOI: 10.3389/falgy.2021.783279] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 11/08/2021] [Indexed: 12/17/2022] Open
Abstract
The α-Gal syndrome is a complex allergic disease characterized by the development of specific IgE antibodies against the carbohydrate galactose-α-1,3-galactose (α-Gal), an oligosaccharide present in cells and tissues of non-primate mammals. Individuals with IgE antibodies to α-Gal suffer from a delayed form of anaphylaxis following red meat consumption. There are several features that make the α-Gal syndrome such a unique allergic disease and distinguish it from other food allergies: (1) symptoms causing IgE antibodies are directed against a carbohydrate moiety, (2) the unusual delay between the consumption of the food and the onset of the symptoms, and (3) the fact that primary sensitization to α-Gal occurs via tick bites. This review takes a closer look at the immune response against α-Gal, in healthy and in α-Gal allergic individuals. Furthermore, the similarities and differences between immune response against α-Gal and against the other important glycan moieties associated with allergies, namely cross-reactive carbohydrate determinants (CCDs), are discussed. Then different mechanisms are discussed that could contribute to the delayed onset of symptoms after consumption of mammalian meat. Moreover, our current knowledge on the role of tick bites in the sensitization process is summarized. The tick saliva has been shown to contain proteins carrying α-Gal, but also bioactive molecules, such as prostaglandin E2, which is capable of stimulating an increased expression of anti-inflammatory cytokines while promoting a decrease in the production of proinflammatory mediators. Together these components might promote Th2-related immunity and trigger a class switch to IgE antibodies directed against the oligosaccharide α-Gal. The review also points to open research questions that remain to be answered and proposes future research directions, which will help to get a better understanding and lead to a better management of the disease.
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Affiliation(s)
- Patricia Román-Carrasco
- Molecular Biotechnology Section, FH Campus Wien, University of Applied Sciences, Vienna, Austria
| | | | - Alejandro Cabezas-Cruz
- Anses, INRAE, Ecole Nationale Vétérinaire d'Alfort, UMR BIPAR, Laboratoire de Santé Animale, Maisons-Alfort, France
| | - Adnan Hodžić
- Department of Pathobiology, Institute of Parasitology, University of Veterinary Medicine Vienna, Vienna, Austria
| | - José de la Fuente
- SaBio, Instituto de Investigación de Recursos Cinegéticos, IREC-CSIC-UCLM-JCCM, Ciudad Real, Spain
- Department of Veterinary Pathobiology, Center for Veterinary Health Sciences, Oklahoma State University, Stillwater, OK, United States
| | - Ines Swoboda
- Molecular Biotechnology Section, FH Campus Wien, University of Applied Sciences, Vienna, Austria
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28
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Dantzer J, Dunlop J, Psoter KJ, Keet C, Wood R. Efficacy and Safety of Baked Milk Oral Immunotherapy in Children with Severe Milk Allergy: A Randomized, Double-blind, Placebo-controlled Phase 2 Trial. J Allergy Clin Immunol 2021; 149:1383-1391.e17. [PMID: 34740607 DOI: 10.1016/j.jaci.2021.10.023] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 10/25/2021] [Accepted: 10/27/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Cow's milk allergy is the most common food allergy in young children and has no current treatment. Oral immunotherapy studies to date have shown efficacy but high rates of adverse reactions. OBJECTIVE We sought to evaluate the safety and efficacy of baked milk oral immunotherapy (BMOIT) in baked milk allergic children. METHODS Participants (3-18 years) were randomized to receive BMOIT or placebo for 12 months. Efficacy was assessed by double-blind placebo-controlled food challenge after 12 months of treatment. Safety, quality of life, and mechanistic parameters were also evaluated. RESULTS 11/15 (73%) of the BMOIT participants reached the primary endpoint, tolerating 4044 mg of baked milk protein after 12 months of OIT, compared to 0/15 (0%) on placebo. The median maximal tolerated dose (MTD) and median change from baseline was significantly higher in the BMOIT group compared to placebo (median MTD 4044mg vs 144mg; p=0.001; median change in MTD of 3900mg vs 0mg, p=0.0001). Dose-related reactions were common but >95% in both groups were mild. There was no significant change in CM- or beta lactoglobulin-IgE from baseline for either group. CM-sIgG4 did significantly increase and casein IgE decreased in the BMOIT group. For proxy-reported food allergy quality of life, there was a significant difference in the emotional impact domain only with more improving while on placebo compared BMOIT. The majority of children and adolescents in the BMOIT group directly reported improvement in at least one domain. CONCLUSION BMOIT was well tolerated and induced a substantial level of desensitization after 12 months of treatment.
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Affiliation(s)
- Jennifer Dantzer
- Division of Pediatric Allergy and Immunology, Department of Pediatrics, John Hopkins University School of Medicine, Baltimore, MD.
| | - Joan Dunlop
- Division of Pediatric Allergy and Immunology, Department of Pediatrics, John Hopkins University School of Medicine, Baltimore, MD
| | - Kevin J Psoter
- Division of General Pediatrics, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Corinne Keet
- Division of Pediatric Allergy and Immunology, Department of Pediatrics, John Hopkins University School of Medicine, Baltimore, MD
| | - Robert Wood
- Division of Pediatric Allergy and Immunology, Department of Pediatrics, John Hopkins University School of Medicine, Baltimore, MD
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29
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Chomyn A, Chan ES, Yeung J, Vander Leek TK, Williams BA, Soller L, Abrams EM, Mak R, Wong T. Canadian food ladders for dietary advancement in children with IgE-mediated allergy to milk and/or egg. Allergy Asthma Clin Immunol 2021; 17:83. [PMID: 34353372 PMCID: PMC8340453 DOI: 10.1186/s13223-021-00583-w] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 07/15/2021] [Indexed: 12/16/2022] Open
Abstract
Food ladders are clinical tools already widely used in Europe for food reintroduction in milk- and egg-allergic children. Previously developed milk and egg ladders have limited applicability to Canadian children due to dietary differences and product availability. Herein we propose a Canadian version of cow’s milk and egg food ladders and discuss the potential role that food ladders may have in the care of children with IgE-mediated allergies to cow’s milk and/or egg, as either a method of accelerating the acquisition of tolerance in those who would outgrow on their own, or as a form of modified oral immunotherapy in those with otherwise persistent allergy.
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Affiliation(s)
- Alanna Chomyn
- Department of Pediatrics, Division of Clinical Immunology & Allergy, University of British Columbia, BC Children's Hospital, Room 1C31B, 4480 Oak Street, Vancouver, BC, V5Z 4H4, Canada.
| | - Edmond S Chan
- Department of Pediatrics, Division of Clinical Immunology & Allergy, University of British Columbia, BC Children's Hospital, Room 1C31B, 4480 Oak Street, Vancouver, BC, V5Z 4H4, Canada
| | - Joanne Yeung
- Department of Pediatrics, Division of Clinical Immunology & Allergy, University of British Columbia, BC Children's Hospital, Room 1C31B, 4480 Oak Street, Vancouver, BC, V5Z 4H4, Canada
| | - Timothy K Vander Leek
- Pediatric Allergy & Asthma, Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Brock A Williams
- Department of Pediatrics, Division of Clinical Immunology & Allergy, University of British Columbia, BC Children's Hospital, Room 1C31B, 4480 Oak Street, Vancouver, BC, V5Z 4H4, Canada.,Food, Nutrition, and Health, Faculty of Land and Food Systems, University of British Columbia, Vancouver, BC, Canada
| | - Lianne Soller
- Department of Pediatrics, Division of Clinical Immunology & Allergy, University of British Columbia, BC Children's Hospital, Room 1C31B, 4480 Oak Street, Vancouver, BC, V5Z 4H4, Canada
| | - Elissa M Abrams
- Department of Pediatrics, Division of Clinical Immunology & Allergy, University of British Columbia, BC Children's Hospital, Room 1C31B, 4480 Oak Street, Vancouver, BC, V5Z 4H4, Canada.,Department of Pediatrics and Child Health, Section of Allergy and Immunology, University of Manitoba, Winnipeg, Canada
| | - Raymond Mak
- Department of Pediatrics, Division of Clinical Immunology & Allergy, University of British Columbia, BC Children's Hospital, Room 1C31B, 4480 Oak Street, Vancouver, BC, V5Z 4H4, Canada
| | - Tiffany Wong
- Department of Pediatrics, Division of Clinical Immunology & Allergy, University of British Columbia, BC Children's Hospital, Room 1C31B, 4480 Oak Street, Vancouver, BC, V5Z 4H4, Canada.
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30
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Khan MU, Lin H, Ahmed I, Chen Y, Zhao J, Hang T, Dasanayaka BP, Li Z. Whey allergens: Influence of nonthermal processing treatments and their detection methods. Compr Rev Food Sci Food Saf 2021; 20:4480-4510. [PMID: 34288394 DOI: 10.1111/1541-4337.12793] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 06/02/2021] [Accepted: 06/06/2021] [Indexed: 12/16/2022]
Abstract
Whey and its components are recognized as value-added ingredients in infant formulas, beverages, sports nutritious foods, and other food products. Whey offers opportunities for the food industrial sector to develop functional foods with potential health benefits due to its unique physiological and functional attributes. Despite all the above importance, the consumption of whey protein (WP) can trigger hypersensitive reactions and is a constant threat for sensitive individuals. Although avoiding such food products is the most successful approach, there is still a chance of incorrect labeling and cross-contamination during food processing. As whey allergens in food products are cross-reactive, the phenomenon of homologous milk proteins of various species may escalate to a more serious problem. In this review, nonthermal processing technologies used to prevent and eliminate WP allergies are presented and discussed in detail. These processing technologies can either enhance or mitigate the impact of potential allergenicity. Therefore, the development of highly precise analytical technologies to detect and quantify the existence of whey allergens is of considerable importance. The present review is an attempt to cover all the updated approaches used for the detection of whey allergens in processed food products. Immunological and DNA-based assays are generally used for detecting allergenic proteins in processed food products. In addition, mass spectrometry is also employed as a preliminary technique for detection. We also highlighted the latest improvements in allergen detection toward biosensing strategies particularly immunosensors and aptasensors.
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Affiliation(s)
- Mati Ullah Khan
- College of Food Science and Engineering, Ocean University of China, 5# Yushan Road, Qingdao, 266003, China
| | - Hong Lin
- College of Food Science and Engineering, Ocean University of China, 5# Yushan Road, Qingdao, 266003, China
| | - Ishfaq Ahmed
- College of Food Science and Engineering, Ocean University of China, 5# Yushan Road, Qingdao, 266003, China
| | - Yan Chen
- NHC Key Laboratory of Food Safety Risk Assessment, Chinese Academy of Medical Science Research Unit (No. 2019RU014), China National Center for Food Safety Risk Assessment, No. 7 Panjiayuan Nanli, Beijing, Chaoyang, 100021, China
| | - Jinlong Zhao
- College of Food Science and Engineering, Ocean University of China, 5# Yushan Road, Qingdao, 266003, China
| | - Tian Hang
- College of Food Science and Engineering, Ocean University of China, 5# Yushan Road, Qingdao, 266003, China
| | | | - Zhenxing Li
- College of Food Science and Engineering, Ocean University of China, 5# Yushan Road, Qingdao, 266003, China
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31
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Anagnostou A. Optimizing Patient Care in Egg Allergy Diagnosis and Treatment. J Asthma Allergy 2021; 14:621-628. [PMID: 34135601 PMCID: PMC8197590 DOI: 10.2147/jaa.s283307] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 05/21/2021] [Indexed: 01/01/2023] Open
Abstract
Egg allergy occurs frequently in childhood with a reported prevalence of 1.3–1.6%. Providing optimal care to egg-allergic patients requires knowledge of the most up-to-date developments in both diagnosis and management, as well as effective communication skills, which will engage the patient in the shared decision-making process. This review aims to provide up-to-date information on egg allergy and also serve as a concise guide on optimal patient diagnosis and management. The field of food allergy has seen multiple advances in recent years, including use of component resolved diagnostics, early egg introduction into the infant diet as a way of preventing egg allergy, baked egg introduction and oral immunotherapy as a form of active therapy. Faced with a variety of options and treatment paths, it is important to ensure that patients and families taking part in the decision-making process have fully understood the potential outcomes and trade-offs and can undertake a detailed discussion of all options that are available to them. Shared decision-making remains the cornerstone of optimal patient care.
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Affiliation(s)
- Aikaterini Anagnostou
- Baylor College of Medicine, Section of Pediatric Immunology, Allergy and Retrovirology, Houston, TX, USA.,Texas Children's Hospital, Department of Pediatrics, Section of Immunology, Allergy and Retrovirology, Houston, TX, USA
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32
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Bird JA, Leonard S, Groetch M, Assa'ad A, Cianferoni A, Clark A, Crain M, Fausnight T, Fleischer D, Green T, Greenhawt M, Herbert L, Lanser BJ, Mikhail I, Mustafa S, Noone S, Parrish C, Varshney P, Vlieg-Boerstra B, Young MC, Sicherer S, Nowak-Wegrzyn A. Conducting an Oral Food Challenge: An Update to the 2009 Adverse Reactions to Foods Committee Work Group Report. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 8:75-90.e17. [PMID: 31950914 DOI: 10.1016/j.jaip.2019.09.029] [Citation(s) in RCA: 95] [Impact Index Per Article: 31.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 09/27/2019] [Indexed: 11/17/2022]
Abstract
Oral food challenges are an integral part of an allergist's practice and are used to evaluate the presence or absence of allergic reactivity to foods. A work group within the Adverse Reactions to Foods Committee of the American Academy of Allergy, Asthma & Immunology was formed to update a previously published oral food challenge report. The intention of this document was to supplement the previous publication with additional focus on safety, treatment of IgE-mediated allergic reactions, guidance for challenges in infants and adults, psychosocial considerations for children and families participating in an oral food challenge, specific guidance for baked milk or baked egg challenges, masking agents and validated blinding recipes for common food allergens, and recommendations for conducting and interpreting challenges in patients with suspected food protein-induced enterocolitis syndrome. Tables and figures within the report and an extensive online appendix detail age-specific portion sizes, appropriate timing for antihistamine discontinuation, serum and skin test result interpretation, written consents, and instructional handouts that may be used in clinical practice.
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Affiliation(s)
- J Andrew Bird
- University of Texas Southwestern Medical Center, Dallas, Texas.
| | - Stephanie Leonard
- University of California, San Diego, Calif; Rady Children's Hospital, San Diego, Calif
| | - Marion Groetch
- Jaffe Food Allergy Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Amal Assa'ad
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | | | | | | | | | - David Fleischer
- Children's Hospital Colorado, Denver, Colo; University of Colorado School of Medicine, Aurora, Colo
| | - Todd Green
- UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pa
| | - Matthew Greenhawt
- Children's Hospital Colorado, Denver, Colo; University of Colorado School of Medicine, Aurora, Colo
| | - Linda Herbert
- Children's National Hospital, Washington, DC; GW School of Medicine and Health Sciences, George Washington University, Washington, DC
| | | | - Irene Mikhail
- Division of Allergy and Immunology, Nationwide Children's Hospital, Columbus, Ohio
| | - Shahzad Mustafa
- Rochester Regional Health, Rochester, NY; University of Rochester School of Medicine and Dentistry, Rochester, NY
| | - Sally Noone
- Jaffe Food Allergy Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | | | - Pooja Varshney
- Dell Children's Medical Center, Austin, Texas; Dell Medical School at University of Texas Austin, Austin, Texas
| | - Berber Vlieg-Boerstra
- OLVG, Department of Pediatrics, Amsterdam, The Netherlands; Department of Nutrition & Dietetics, Hanze University of Applied Sciences, Groningen, The Netherlands
| | | | - Scott Sicherer
- Jaffe Food Allergy Institute, Icahn School of Medicine at Mount Sinai, New York, NY
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Milk Ingredients in Meat Products: Can Autoclaving and In Vitro Gastroduodenal Digestion Mitigate Their IgE-Binding Capacity? Nutrients 2021; 13:nu13030931. [PMID: 33805703 PMCID: PMC8000631 DOI: 10.3390/nu13030931] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 02/23/2021] [Accepted: 03/06/2021] [Indexed: 12/03/2022] Open
Abstract
The food industry commonly uses milk ingredients as technological aids in an uncounted number of products. On the other hand, milk contains allergenic proteins causing adverse allergic reactions in sensitized/allergic individuals. This work intends to evaluate the effect of autoclaving and in vitro digestion on the allergenicity of milk proteins incurred in meat products. Protein profiles of raw and autoclaved sausages without and with the addition of 10% of milk protein concentrates were analyzed by gel electrophoresis and liquid chromatography–mass spectrometry. Additionally, residual IgE-reactivity was evaluated by immunoblot analysis using pooled sera of cow’s-milk-allergic individuals followed by bioinformatic analysis. Results showed that autoclaving led to an increase in protein fragmentation (higher number of short peptides) and consequently to a higher digestion rate, that was found to be more pronounced in β-casein. The IgE-binding capacity of milk proteins seems to be reduced after autoclaving prior to digestion, with a residual reactivity in caseins, but was eliminated following digestion. This study highlights the importance of autoclaving as a processing strategy to produce hypoallergenic formulas.
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Cow's Milk Processing-Friend or Foe in Food Allergy? Foods 2021; 10:foods10030572. [PMID: 33803451 PMCID: PMC8000412 DOI: 10.3390/foods10030572] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 03/01/2021] [Accepted: 03/02/2021] [Indexed: 12/12/2022] Open
Abstract
Cow’s milk (CM) is an integral part of our daily diet starting in infancy and continuing throughout our lifetime. Its composition is rich in proteins with a high nutritional value, bioactive components, milk minerals including calcium, and a range of immunoactive substances. However, cow’s milk can also induce a range of immune-mediated diseases including non-IgE-mediated food allergies and IgE-mediated food allergies. Cow’s milk allergens have been identified and characterized and the most relevant ones can be assigned to both, the whey and casein fraction. For preservation a range of processing methods are applied to make cow’s milk and dairy products safe for consumers. However, these methods affect milk components and thus alter the overall immunogenic activity of cow’s milk. This review summarizes the current knowledge on cow’s milk allergens and immunoactive substances and the impact of the different processes up- or downregulating the immunogenicity of the respective proteins. It highlights the gaps of knowledge of the related disease mechanisms and the still unidentified beneficial immunomodulating compounds of cow’s milk.
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Akharume FU, Aluko RE, Adedeji AA. Modification of plant proteins for improved functionality: A review. Compr Rev Food Sci Food Saf 2021; 20:198-224. [DOI: 10.1111/1541-4337.12688] [Citation(s) in RCA: 92] [Impact Index Per Article: 30.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 11/14/2020] [Accepted: 11/16/2020] [Indexed: 01/08/2023]
Affiliation(s)
- Felix U. Akharume
- Department of Biosystems and Agricultural Engineering University of Kentucky Lexington Kentucky USA
| | - Rotimi E. Aluko
- Department of Food and Human Nutritional Sciences and The Richardson Centre for Functional Foods and Nutraceuticals University of Manitoba Winnipeg Manitoba Canada
| | - Akinbode A. Adedeji
- Department of Biosystems and Agricultural Engineering University of Kentucky Lexington Kentucky USA
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Nagakura KI, Sato S, Miura Y, Nishino M, Takahashi K, Asaumi T, Ogura K, Ebisawa M, Yanagida N. A randomized trial of oral immunotherapy for pediatric cow's milk-induced anaphylaxis: Heated vs unheated milk. Pediatr Allergy Immunol 2021; 32:161-169. [PMID: 32869399 PMCID: PMC7821001 DOI: 10.1111/pai.13352] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 07/25/2020] [Accepted: 08/14/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND Severe reactions may develop during cow's milk (CM) oral immunotherapy (OIT). We investigated the safety and efficacy of low-dose OIT with heated milk (HM) or unheated milk (UM) in children with anaphylaxis. METHODS Children with symptom onset after ingestion of 3-mL HM on a double-blind, placebo-controlled food challenge were randomly assigned to the HM (n = 17) or UM (n = 16) group. HM group ingested milk powder heated at 125°C for 30 seconds, whereas the UM group used UM. Patients were hospitalized for 5 days; the HM or UM was gradually increased to 3 mL/day; 3-mL/day ingestion was continued at home. One year later, the patients underwent 2-day consecutive 3- and 25-mL HM-oral food challenges (OFCs) after 2-week avoidance. RESULTS At baseline, milk- and casein-specific immunoglobulin E (IgE) levels were 56.0 and 51.4 kUA/L in the HM group, and 55.2 and 65.6 kUA/L in the UM group, respectively. One year later, 35% and 18% in the HM group and 50% and 31% in UM group passed the 3 and 25 mL OFCs, respectively. Rates of moderate or severe symptoms and respiratory symptoms per home dose were significantly lower in the HM than in the UM group (0.7% and 1.2% vs 1.4% and 2.6%, respectively, P < .001). β-lactoglobulin-specific IgG4 levels significantly increased from baseline only in the UM group, whereas casein-specific IgG4 levels significantly increased from baseline in both groups. CONCLUSIONS HM-OIT induced immunological changes more safely than the UM-OIT. The possibility of lower treatment efficacy with HM-OIT needs to be evaluated in larger studies.
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Affiliation(s)
- Ken-Ichi Nagakura
- Department of Pediatrics, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan.,Department of Pediatrics, Jikei University School of Medicine, Tokyo, Japan
| | - Sakura Sato
- Department of Allergy, Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan.,Course of Allergy and Clinical Immunology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yoko Miura
- Department of Pediatrics, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan
| | - Makoto Nishino
- Department of Pediatrics, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan.,Course of Allergy and Clinical Immunology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kyohei Takahashi
- Department of Pediatrics, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan.,Course of Allergy and Clinical Immunology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Tomoyuki Asaumi
- Department of Pediatrics, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan
| | - Kiyotake Ogura
- Department of Pediatrics, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan.,Course of Allergy and Clinical Immunology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Motohiro Ebisawa
- Department of Pediatrics, Jikei University School of Medicine, Tokyo, Japan.,Department of Allergy, Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan
| | - Noriyuki Yanagida
- Department of Pediatrics, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan
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Liu M, Han TJ, Huan F, Li MS, Xia F, Yang Y, Wu YH, Chen GX, Cao MJ, Liu GM. Effects of thermal processing on the allergenicity, structure, and critical epitope amino acids of crab tropomyosin. Food Funct 2021; 12:2032-2043. [DOI: 10.1039/d0fo02869j] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Food processing can change the structure and immunoreactivity of purified allergens, but the effect of food processing on the immunoreactivity of the processed and purified allergen is still poorly understood.
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Suther C, Moore MD, Beigelman A, Zhou Y. The Gut Microbiome and the Big Eight. Nutrients 2020; 12:nu12123728. [PMID: 33287179 PMCID: PMC7761723 DOI: 10.3390/nu12123728] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 11/28/2020] [Accepted: 12/01/2020] [Indexed: 12/11/2022] Open
Abstract
Food allergies are increasing at an alarming rate, with 6.5% of the general population affected. It has been hypothesized that the increase in allergies stems from the “hygiene hypothesis”. The gut microbiome, a collection of microbiota and their genetic contents from the gastrointestinal tract, has been shown to play a part in the development of food allergies. The Food and Drug Administration requires all regulated food companies to clearly state an inclusion of the major, or “big eight” food allergens on packaging. This review is to provide information on the significant advancements related to the gut microbiome and each of the eight major food allergies individually. Establishment of causal connection between the microbiome and food allergies has uncovered novel mechanisms. New strategies are discussed to prevent future sensitization and reaction through novel treatments involving functional additives and dietary changes that target the microbiome.
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Affiliation(s)
- Cassandra Suther
- Department of Food Science, University of Massachusetts, Amherst, MA 01003, USA; (C.S.); (M.D.M.)
- Department of Medicine, University of Connecticut Health Center, Farmington, CT 06030, USA
| | - Matthew D. Moore
- Department of Food Science, University of Massachusetts, Amherst, MA 01003, USA; (C.S.); (M.D.M.)
| | - Avraham Beigelman
- Kipper Institute of Allergy and Immunology, Schneider Children’s Medical Center, Tel Aviv University, Tel Aviv 5891000, Israel;
| | - Yanjiao Zhou
- Department of Medicine, University of Connecticut Health Center, Farmington, CT 06030, USA
- Correspondence: ; Tel.: +1-860-679-6379
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Zenker HE, Raupbach J, Boeren S, Wichers HJ, Hettinga KA. The effect of low vs. high temperature dry heating on solubility and digestibility of cow's milk protein. Food Hydrocoll 2020. [DOI: 10.1016/j.foodhyd.2020.106098] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Yonkof JR, Mikhail IJ, Prince BT, Stukus D. Delayed and Severe Reactions to Baked Egg and Baked Milk Challenges. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2020; 9:283-289.e2. [PMID: 33049390 DOI: 10.1016/j.jaip.2020.09.059] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 09/21/2020] [Accepted: 09/26/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Although many egg- and milk-allergic children tolerate baked egg (BE) and baked milk (BM), reactions elicited by these oral food challenges (OFCs) can be severe. Previous studies comparing BE and BM reactions to other OFC reactions are limited. OBJECTIVE To compare the clinical features of reactions to BE and BM with other OFCs to promote challenge safety. METHODS A retrospective review of OFCs eliciting objective reactions to BE, BM, lightly cooked egg (CE), fresh cow's milk (CM), peanut (PN), and tree nuts (TN) which were performed at a tertiary referral center from June 1, 2017, to June 1, 2019. RESULTS We identified 174 OFCs conducted in 158 subjects, age 6 to 187 months (34 BE, 19 BM, 14 CE, 25 CM, 52 PN, and 30 TN). TN reactors were older than BE (P = .049) and PN (P < .01) reactors and had a higher frequency of persistent asthma than PN-reactive subjects (P = .02). Mucocutaneous symptoms occurred less frequently during BE (56%) and BM (42%) OFCs compared with other OFCs (P < .05). Lower respiratory tract reactions were increased during BM (37%) versus BE (12%), CM (8%), and PN (12%) OFCs (P < .05). Epinephrine was administered to more BE (44%) and TN (50%) than PN (17%) OFCs (P < .01). New reaction manifestations developed 60 minutes or later after OFC termination during 29% BE and 21% BM versus 0% PN OFCs (P < .05). One-third of anaphylactic reactions to BE began more than 60 minutes after OFC termination. CONCLUSIONS BE and BM challenge reactions differed phenotypically from other OFC reactions, including significantly increased frequencies of new symptoms beginning 60 minutes or later after challenge termination. Consider amended dose-escalation and prolonged observation after BE and BM OFCs.
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Affiliation(s)
- Jennifer R Yonkof
- Division of Allergy and Immunology, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio; Division of Allergy and Immunology, Department of Otolaryngology, The Ohio State University Wexner Medical Center, Columbus, Ohio.
| | - Irene J Mikhail
- Division of Allergy and Immunology, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio
| | - Benjamin T Prince
- Division of Allergy and Immunology, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio
| | - David Stukus
- Division of Allergy and Immunology, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio
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Kim EH, Perry TT, Wood RA, Leung DYM, Berin MC, Burks AW, Cho CB, Jones SM, Scurlock A, Sicherer SH, Henning AK, Dawson P, Lindblad RW, Plaut M, Sampson HA. Induction of sustained unresponsiveness after egg oral immunotherapy compared to baked egg therapy in children with egg allergy. J Allergy Clin Immunol 2020; 146:851-862.e10. [PMID: 32535135 PMCID: PMC7554054 DOI: 10.1016/j.jaci.2020.05.040] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 05/17/2020] [Accepted: 05/19/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND While desensitization and sustained unresponsiveness (SU) have been shown with egg oral immunotherapy (OIT), the benefits of baked egg (BE) therapy for egg allergy have not been well studied. OBJECTIVES This study sought to evaluate the safety and efficacy of BE ingestion compared with egg OIT in participants allergic to unbaked egg but tolerant to BE. METHODS Children who are BE-tolerant but unbaked egg reactive ages 3 to 16 years were randomized to 2 years of treatment with either BE or egg OIT. Double-blind, placebo-controlled food challenges were conducted after 1 and 2 years of treatment to assess for desensitization, and after 2 years of treatment followed by 8 to 10 weeks off of treatment to assess for SU. Mechanistic studies were conducted to assess for immune modulation. A cohort of participants who are BE-reactive underwent egg OIT and identical double-blind, placebo-controlled food challenges as a comparator group. RESULTS Fifty participants (median age 7.3 years) were randomized and initiated treatment. SU was achieved in 3 of 27 participants assigned to BE (11.1%) versus 10 of 23 participants assigned to egg OIT (43.5%) (P = .009). In the BE-reactive comparator group, 7 of 39 participants (17.9%) achieved SU. More participants who are BE-tolerant withdrew from BE versus from egg OIT (29.6% vs 13%). Dosing symptom frequency in participants who are BE-tolerant was similar with BE and egg OIT, but more frequent in participants who are BE-reactive. Egg white-specific IgE, skin testing, and basophil activation decreased similarly after BE and egg OIT. CONCLUSIONS Among children allergic to unbaked egg but tolerant to BE, those treated with egg OIT were significantly more likely to achieve SU than were children ingesting BE.
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Affiliation(s)
- Edwin H Kim
- Department of Medicine and Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC.
| | - Tamara T Perry
- Department of Pediatrics, University of Arkansas for Medical Sciences and Arkansas Children's Hospital, Little Rock, Ark
| | - Robert A Wood
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Rockville
| | | | - M Cecilia Berin
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York
| | - A Wesley Burks
- Department of Medicine and Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Christine B Cho
- Department of Pediatrics, National Jewish Health, Denver, Colo
| | - Stacie M Jones
- Department of Pediatrics, University of Arkansas for Medical Sciences and Arkansas Children's Hospital, Little Rock, Ark
| | - Amy Scurlock
- Department of Pediatrics, University of Arkansas for Medical Sciences and Arkansas Children's Hospital, Little Rock, Ark
| | - Scott H Sicherer
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York
| | | | | | | | - Marshall Plaut
- National Institutes of Health/National Institutes of Allergy and Infectious Diseases, Bethesda, Md
| | - Hugh A Sampson
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York
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Ogura T, Wakayama M, Ashino Y, Kadowaki R, Sato M, Soga T, Tomita M. Effects of feed crops and boiling on chicken egg yolk and white determined by a metabolome analysis. Food Chem 2020; 327:127077. [DOI: 10.1016/j.foodchem.2020.127077] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 05/14/2020] [Accepted: 05/14/2020] [Indexed: 12/11/2022]
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Zenker HE, Wichers HJ, Tomassen MMM, Boeren S, De Jong NW, Hettinga KA. Peptide Release after Simulated Infant In Vitro Digestion of Dry Heated Cow's Milk Protein and Transport of Potentially Immunoreactive Peptides across the Caco-2 Cell Monolayer. Nutrients 2020; 12:nu12082483. [PMID: 32824739 PMCID: PMC7468992 DOI: 10.3390/nu12082483] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 07/30/2020] [Accepted: 08/13/2020] [Indexed: 02/07/2023] Open
Abstract
Dry heating of cow’s milk protein, as applied in the production of “baked milk”, facilitates the resolution of cow’s milk allergy symptoms upon digestion. The heating and glycation-induced changes of the protein structure can affect both digestibility and immunoreactivity. The immunological consequences may be due to changes in the peptide profile of the digested dry heated milk protein. Therefore, cow’s milk protein powder was heated at low temperature (60 °C) and high temperature (130 °C) and applied to simulated infant in vitro digestion. Digestion-derived peptides after 10 min and 60 min in the intestinal phase were measured using LC-MS/MS. Moreover, digests after 10 min intestinal digestion were applied to a Caco-2 cell monolayer. T-cell epitopes were analysed using prediction software, while specific immunoglobin E (sIgE) binding epitopes were identified based on the existing literature. The largest number of sIgE binding epitopes was found in unheated samples, while T-cell epitopes were equally represented in all samples. Transport of glycated peptide indicated a preference for glucosyl lysine and lactosyl-lysine-modified peptides, while transport of peptides containing epitope structures was limited. This showed that the release of immunoreactive peptides can be affected by the applied heating conditions; however, availability of peptides containing epitopes might be limited.
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Affiliation(s)
- Hannah E. Zenker
- Food Quality & Design Group, Wageningen University & Research Centre, 6708 WG Wageningen, The Netherlands;
| | - Harry J. Wichers
- Wageningen Food & Biobased Research, Wageningen University & Research Centre, 6708 WG Wageningen, The Netherlands; (H.J.W.); (M.M.M.T.)
- Laboratory of Food chemistry, Wageningen University & Research Centre, 6708 WG Wageningen, The Netherlands
| | - Monic M. M. Tomassen
- Wageningen Food & Biobased Research, Wageningen University & Research Centre, 6708 WG Wageningen, The Netherlands; (H.J.W.); (M.M.M.T.)
| | - Sjef Boeren
- Laboratory of Biochemistry, Wageningen University & Research Centre, 6708 WE Wageningen, The Netherlands;
| | - Nicolette W. De Jong
- Internal Medicine, Department of Allergology & Clinical Immunology, Erasmus Medical Centre, 3000 CA Rotterdam, The Netherlands;
| | - Kasper A. Hettinga
- Food Quality & Design Group, Wageningen University & Research Centre, 6708 WG Wageningen, The Netherlands;
- Correspondence:
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Pérez-Quintero O, Martinez-Azcona O, Balboa V, Vila L. Daily baked egg intake may accelerate the development of tolerance to raw egg in egg-allergic children. Eur J Pediatr 2020; 179:679-682. [PMID: 31758309 DOI: 10.1007/s00431-019-03488-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 08/12/2019] [Accepted: 09/26/2019] [Indexed: 11/26/2022]
Abstract
Recent studies suggest that egg-allergic children who tolerate baked egg (BE) are more likely to outgrow egg allergy than children that do not tolerate it. The question to be answered is whether regular ingestion of BE accelerates tolerance to other forms of egg (cooked and raw). Our aim was to determine if daily ingestion of BE would accelerate tolerance to raw egg in BE-tolerant patients compared to patients who tolerate BE at diagnosis but eliminated it from their diet and to patients who didn't tolerate it. We performed a retrospective analysis of all children diagnosed of IgE-mediated egg allergy at the Pediatric Allergy Unit of the Complejo Hospitalario Universitario A Coruña, from 2008 to 2014. Seventy children were included. At diagnosis, 33 patients tolerated BE and kept its daily ingestion, 16 patients tolerated BE and were recommended to avoid it, and 21 patients didn't tolerate it. Patients tolerating BE who kept daily ingestion achieved tolerance to raw egg significantly earlier (p < 0.05) than the other two groups.Conclusion: Our data suggest that daily intake of BE in BE-tolerant children accelerates tolerance to raw egg.What is Known:• It has been suggested that egg-allergic children who consume baked egg (BE) products on a regular bases are more likely to outgrow egg allergy than children that do not tolerate themWhat is New:• Patients who tolerated BE on diagnosis and followed an exclusion diet show a similar evolution than patients who initially did not tolerate BE. Daily ingestion of BE seems to accelerates tolerance to raw egg.
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Affiliation(s)
- Olinda Pérez-Quintero
- Pediatric Allergy Unit, Department of Pediatrics, Complejo Hospitalario Universitario A Coruña, Xubias s/n, 15005, A Coruña, Spain
| | - Oihana Martinez-Azcona
- Pediatric Allergy Unit, Department of Pediatrics, Complejo Hospitalario Universitario A Coruña, Xubias s/n, 15005, A Coruña, Spain
| | - Vanesa Balboa
- Epidemiology Department, Complejo Hospitalario Universitario A Coruña, Xubias s/n, 15005, A Coruña, Spain
| | - Leticia Vila
- Pediatric Allergy Unit, Department of Pediatrics, Complejo Hospitalario Universitario A Coruña, Xubias s/n, 15005, A Coruña, Spain.
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Oral food challenges: Special considerations. Ann Allergy Asthma Immunol 2020; 124:451-458. [PMID: 32088320 DOI: 10.1016/j.anai.2020.02.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 02/08/2020] [Accepted: 02/11/2020] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To reinforce special considerations when offering and conducting oral food challenges (OFCs). DATA SOURCES Published studies and reviews. STUDY SELECTIONS Studies concerning OFCs and their conduct. RESULTS Multiple OFC protocols for various clinical situations and foods were reviewed. CONCLUSION OFCs are used for the definitive diagnosis of food allergy. Risk and benefit assessment guide the OFC procedure. The conduct of OFCs is influenced by multiple factors, including age, food, and goal of the challenge.
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Wang HT, Warren CM, Gupta RS, Davis CM. Prevalence and Characteristics of Shellfish Allergy in the Pediatric Population of the United States. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2020; 8:1359-1370.e2. [PMID: 31917365 DOI: 10.1016/j.jaip.2019.12.027] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 11/16/2019] [Accepted: 12/09/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Shellfish allergy (SA) is one of the most common food allergies causing anaphylaxis in adults and children. There are limited data showing the prevalence of SA in US children. OBJECTIVE To determine the prevalence and reaction characteristics of SA in the US pediatric population. METHODS A cross-sectional food allergy prevalence survey was administered via phone and the Web by the National Opinion Research Center at the University of Chicago from 2015 to 2016. Point prevalence SA estimates, complex survey weighted proportions, and 95% CIs were determined. Relative proportions of demographic characteristics were compared using weighted Pearson χ2 statistics. RESULTS The prevalence of SA was 1.3% (95% CI, 1.1-1.5), with more children allergic to crustaceans (1.2%; 95% CI, 1.0-1.3) than to mollusks (0.5%; 95% CI, 0.4-0.6). Mean ages of shellfish, crustacean, and mollusk allergy diagnoses were 5.0 (95% CI, 4.4-5.6), 5.1 (95% CI, 4.6-5.6), and 7.7 (95% CI, 5.7-9.7) years, respectively. More than half (54.9%; 95% CI, 48.1-61.4) of pediatric patients with SA had more than 1 lifetime food allergy-related emergency room visit, but only 45.7% (95% CI, 39.2-52.4) carried an epinephrine autoinjector. Children with SA were more likely to be black/Hispanic/Latino and have comorbid asthma, allergic rhinitis, or a parental history of asthma, environmental, or other food allergies (P < .001). CONCLUSIONS The epidemiology of SA in the US pediatric population shows that crustacean allergy is more common than mollusk allergy. A disparity in SA children and epinephrine autoinjector carriage exists. Results from this study will lead to increased awareness of the need for detailed histories, specific diagnostic tests, and rescue epinephrine for anaphylaxis in US children with SA.
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Affiliation(s)
- Helen T Wang
- Department of Pediatrics, Section of Immunology, Allergy, and Retrovirology, Texas Children's Hospital, Houston, Texas; Department of Medicine, Section of Immunology, Allergy, and Rheumatology, Baylor College of Medicine, Houston, Texas
| | - Christopher M Warren
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, Calif
| | - Ruchi S Gupta
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Carla M Davis
- Department of Pediatrics, Section of Immunology, Allergy, and Retrovirology, Texas Children's Hospital, Houston, Texas; Department of Medicine, Section of Immunology, Allergy, and Rheumatology, Baylor College of Medicine, Houston, Texas.
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Di Stasio L, Tranquet O, Picariello G, Ferranti P, Morisset M, Denery-Papini S, Mamone G. Comparative analysis of eliciting capacity of raw and roasted peanuts: the role of gastrointestinal digestion. Food Res Int 2020; 127:108758. [DOI: 10.1016/j.foodres.2019.108758] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 10/09/2019] [Accepted: 10/14/2019] [Indexed: 01/06/2023]
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Lv L, Tian S, Ahmed I, Ramesh Pavase T, Lin H, Xu L, Li Z, Liu F. Effect of laccase-catalyzed cross-linking on the structure and allergenicity of Paralichthys olivaceus parvalbumin mediated by propyl gallate. Food Chem 2019; 297:124972. [DOI: 10.1016/j.foodchem.2019.124972] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Revised: 06/01/2019] [Accepted: 06/09/2019] [Indexed: 10/26/2022]
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50
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Sirin Kose S, Asilsoy S, Uzuner N, Karaman O, Anal O. Outcomes of Baked Milk and Egg Challenge in Cow's Milk and Hen's Egg Allergy: Can Tolerance Be Predicted with Allergen-Specific IgE and Prick-to-Prick Test? Int Arch Allergy Immunol 2019; 180:264-273. [PMID: 31597156 DOI: 10.1159/000502957] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 08/23/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Adding baked food into the diets of patients with cow's milk allergy (MA) and hen's egg allergy (EA) has several benefits. OBJECTIVE We aimed to determine baked and unbaked food tolerance and evaluate the effectiveness of laboratory findings on the prediction of baked and unbaked food tolerance in patients with MA and EA. METHODS Clinical outcomes of the patients with MA and EA who had been exposed to oral food challenge with baked food were retrospectively analyzed. RESULTS Ninety-one patients were evaluated. The median age of the study group was 22 months. Forty-nine and 42 patients had IgE-mediated MA and EA, respectively. While all patients with EA tolerated baked egg, 24.5% patients with MA could not tolerate baked cow's milk (BM). In patients with MA, BM tolerance showed negative association with milk-specific IgE, skin prick test (SPT), and prick-to-prick test (PTP), and the PTP was the most significant parameter (sensitivity 83.8%, specificity 91.7% for PTP ≤7 mm). Negative association was seen between milk-specific IgE, SPT, PTP, and unbaked milk (UBM) tolerance, and PTP was the most significant parameter (sensitivity 100%, specificity 55% for PTP ≤4 mm). In patients with EA, at the end of 6 months of baked hen's egg (BE) consumption, scrambled egg tolerance showed negative association with egg white-specific IgE level, egg white SPT and PTP. Egg white PTP was the most significant parameter (sensitivity 82.4%, specificity 96.0% for PTP ≤5 mm). CONCLUSION Specific-IgE, SPT, and PTP should be kept in mind as parameters that can be used to predict tolerance to BM and BE for patients with MA and EA.
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Affiliation(s)
- Seda Sirin Kose
- Department of Pediatric Immunology and Allergy, Dokuz Eylul University, Izmir, Turkey,
| | - Suna Asilsoy
- Department of Pediatric Immunology and Allergy, Dokuz Eylul University, Izmir, Turkey
| | - Nevin Uzuner
- Department of Pediatric Immunology and Allergy, Dokuz Eylul University, Izmir, Turkey
| | - Ozkan Karaman
- Department of Pediatric Immunology and Allergy, Dokuz Eylul University, Izmir, Turkey
| | - Ozden Anal
- Department of Pediatric Immunology and Allergy, Dokuz Eylul University, Izmir, Turkey
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