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Bosi I, Ford LS. Erythritol allergy. J Paediatr Child Health 2024; 60:248-249. [PMID: 38738732 DOI: 10.1111/jpc.16565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 04/02/2024] [Accepted: 05/04/2024] [Indexed: 05/14/2024]
Affiliation(s)
- Isabelle Bosi
- Department of Clinical Immunology and Allergy, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
- Department of Allergy and Immunology, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
- Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Lara S Ford
- Department of Allergy and Immunology, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
- Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
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Younes M, Aquilina G, Castle L, Degen G, Engel K, Fowler PJ, Frutos Fernandez MJ, Fürst P, Gundert‐Remy U, Gürtler R, Husøy T, Manco M, Mennes W, Moldeus P, Passamonti S, Shah R, Waalkens‐Berendsen I, Wright M, Batke M, Boon P, Bruzell E, Chipman J, Crebelli R, FitzGerald R, Fortes C, Halldorsson T, LeBlanc J, Lindtner O, Mortensen A, Ntzani E, Wallace H, Barmaz S, Civitella C, D'Angelo L, Lodi F, Laganaro M, Rincon AM, Smeraldi C, Tard A. Re-evaluation of erythritol (E 968) as a food additive. EFSA J 2023; 21:e8430. [PMID: 38125972 PMCID: PMC10731997 DOI: 10.2903/j.efsa.2023.8430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Abstract
This opinion addresses the re-evaluation of erythritol (E 968) as food additive and an application for its exemption from the laxative warning label requirement as established under Regulation (EU) No 1169/2011. Erythritol is a polyol obtained by fermentation with Moniliella pollinis BC or Moniliella megachiliensis KW3-6, followed by purifications and drying. Erythritol is readily and dose-dependently absorbed in humans and can be metabolised to erythronate to a small extent. Erythritol is then excreted unchanged in the urine. It does not raise concerns regarding genotoxicity. The dataset evaluated consisted of human interventional studies. The Panel considered that erythritol has the potential to cause diarrhoea in humans, which was considered adverse because its potential association with electrolyte and water imbalance. The lower bound of the range of no observed adverse effect levels (NOAELs) for diarrhoea of 0.5 g/kg body weight (bw) was identified as reference point. The Panel considered appropriate to set a numerical acceptable daily intake (ADI) at the level of the reference point. An ADI of 0.5 g/kg bw per day was considered by the Panel to be protective for the immediate laxative effect as well as potential chronic effects, secondary to diarrhoea. The highest mean and 95th percentile chronic exposure was in children (742 mg/kg bw per day) and adolescents (1532 mg/kg bw per day). Acute exposure was maximally 3531 mg/kg bw per meal for children at the 99th percentile. Overall, the Panel considered both dietary exposure assessments an overestimation. The Panel concluded that the exposure estimates for both acute and chronic dietary exposure to erythritol (E 968) were above the ADI, indicating that individuals with high intake may be at risk of experiencing adverse effects after single and repeated exposure. Concerning the new application, the Panel concluded that the available data do not support the proposal for exemption.
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Mori S, Kurihara K, Inuo C. Case of a 6-year-old boy with anaphylaxis induced by erythritol with positive skin prick test and negative basophil activation test. ALLERGY, ASTHMA, AND CLINICAL IMMUNOLOGY : OFFICIAL JOURNAL OF THE CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY 2022; 18:28. [PMID: 35331324 PMCID: PMC8951716 DOI: 10.1186/s13223-022-00670-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 03/13/2022] [Indexed: 11/10/2022]
Abstract
Erythritol is widely used as an additive in foods and pharmaceuticals. We present the case of a 6-year-old boy who developed an allergy to erythritol. He showed a positive skin prick test result and a negative basophil activation test result. In cases involving allergens with low molecular weights, the test results should be carefully interpreted.
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Affiliation(s)
- Satomi Mori
- Department of General Medicine, Kanagawa Children's Medical Center, 2-138-4, Mutsukawa, Minami-ku, Yokohama, Kanagawa, 232-8555, Japan.
| | - Kazuyuki Kurihara
- Department of Allergy, Kanagawa Children's Medical Center, Yokohama, Kanagawa, Japan
| | - Chisato Inuo
- Department of Allergy, Kanagawa Children's Medical Center, Yokohama, Kanagawa, Japan
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Okamoto K, Kagami M, Kawai M, Mori Y, Yamawaki K, Nakajima Y, Kondo Y, Tsuge I. Anaphylaxis to xylitol diagnosed by skin prick test and basophil activation test. Allergol Int 2019; 68:130-131. [PMID: 30190098 DOI: 10.1016/j.alit.2018.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 07/25/2018] [Accepted: 08/01/2018] [Indexed: 11/28/2022] Open
Affiliation(s)
- Kaoru Okamoto
- Department of Pediatrics, Fujita Health University Hospital, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, Japan.
| | - Michiko Kagami
- Department of Pediatrics, Fujita Health University Hospital, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, Japan
| | - Manabu Kawai
- Department of Pediatrics, Fujita Health University Hospital, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, Japan
| | - Yuji Mori
- Department of Pediatrics, Fujita Health University Hospital, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, Japan
| | - Kazuo Yamawaki
- Department of Pediatrics, Fujita Health University Hospital, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, Japan
| | - Yoichi Nakajima
- Department of Pediatrics, Fujita Health University Hospital, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, Japan
| | - Yasuto Kondo
- Department of Pediatrics, Fujita Health University Hospital, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, Japan
| | - Ikuya Tsuge
- Department of Pediatrics, Fujita Health University Hospital, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, Japan
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