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Anyogu A, Somorin YM, Oladipo AO, Raheem S. Food safety issues associated with sesame seed value chains: Current status and future perspectives. Heliyon 2024; 10:e36347. [PMID: 39253262 PMCID: PMC11381738 DOI: 10.1016/j.heliyon.2024.e36347] [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] [Received: 08/25/2023] [Revised: 08/13/2024] [Accepted: 08/14/2024] [Indexed: 09/11/2024] Open
Abstract
Sesame (Sesamum indicum) is an oilseed crop which is increasingly recognised as a functional food by consumers due to its nutritional and nutraceutical components. Consequently, global demand for sesame has increased significantly over the last three decades. Sesame is an important export crop in producing countries, contributing to their socio-economic development. However, in recent years, major foodborne incidents have been associated with imported sesame seeds and products made with these seeds. Foodborne hazards are a potential risk to consumer health and hinder international trade due to border rejections and increased import controls. An insight into the routes of contamination of these hazards across the value chain and factors affecting persistence may lead to more focused intervention and prevention strategies. It was observed that Salmonella is a significant microbial hazard in imported sesame seeds and has been associated with several global outbreaks. Sesame is mainly cultivated in the tropical and subtropical regions of Africa and Asia by smallholder farmers. Agricultural and manufacturing practices during harvesting, storage, and processing before export may allow for the contamination of sesame seeds with Salmonella. However, only a few studies collect data on the microbiological quality of sesame across the value chain in producing countries. In addition, the presence of mycotoxins and pesticides above regulatory limits in sesame seeds is a growing concern. Eliminating foodborne hazards in the sesame value chain requires urgent attention from researchers, producers, processors, and regulators and suggestions for improving the safety of these foods are discussed.
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Affiliation(s)
- Amarachukwu Anyogu
- Food Safety and Security, School of Biomedical Sciences, University of West London, London, W5 5RF, United Kingdom
| | - Yinka M Somorin
- University of Glasgow, Glasgow, G12 8QQ, United Kingdom
- Department of Biological Science, Ajayi Crowther University, Oyo, Nigeria
| | - Abigail Oluseye Oladipo
- Food Safety and Security, School of Biomedical Sciences, University of West London, London, W5 5RF, United Kingdom
| | - Saki Raheem
- School of Life Sciences, University of Westminster, London, W1W 6UW, United Kingdom
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2
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Tusé D, McNulty M, McDonald KA, Buchman LW. A review and outlook on expression of animal proteins in plants. FRONTIERS IN PLANT SCIENCE 2024; 15:1426239. [PMID: 39239203 PMCID: PMC11374769 DOI: 10.3389/fpls.2024.1426239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Accepted: 06/25/2024] [Indexed: 09/07/2024]
Abstract
This review delves into the multifaceted technologies, benefits and considerations surrounding the expression of animal proteins in plants, emphasizing its potential role in advancing global nutrition, enhancing sustainability, while being mindful of the safety considerations. As the world's population continues to grow and is projected to reach 9 billion people by 2050, there is a growing need for alternative protein sources that can meet nutritional demands while minimizing environmental impact. Plant expression of animal proteins is a cutting-edge biotechnology approach that allows crops to produce proteins traditionally derived from animals, offering a sustainable and resource-efficient manner of producing these proteins that diversifies protein production and increases food security. In the United States, it will be important for there to be clear guidance in order for these technologies to reach consumers. As consumer demand for sustainable and alternative food sources rise, biotechnologies can offer economic opportunities, making this emerging technology a key player in the market landscape.
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Affiliation(s)
- Daniel Tusé
- DT/Consulting Group, Sacramento, CA, United States
| | - Matthew McNulty
- Center for Cellular Agriculture, Tufts University, Medford, MA, United States
| | - Karen A McDonald
- Department of Chemical Engineering and Global Healthshare Initiative, University of California, Davis, Davis, CA, United States
| | - Leah W Buchman
- Biotechniology Innovation Organization, Agriculture and Environment, Washington, DC, United States
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Zielinska J, Zagórska W, Krupa-Łaska A, Łyżwa K, Lewandowski Z, Kulus M, Grzela K. Efficacy and safety of low-dose sesame oral immunotherapy in paediatric patients: a protocol for a single-centre, randomised controlled trial. BMJ Open 2024; 14:e085811. [PMID: 39134434 PMCID: PMC11331968 DOI: 10.1136/bmjopen-2024-085811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 07/19/2024] [Indexed: 08/21/2024] Open
Abstract
INTRODUCTION Sesame allergy, though with low prevalence, can result in severe, potentially life-threatening reactions and poses challenges in allergen avoidance due to hidden sources. In the majority of patients, sesame allergy persists and there is currently no effective long-term treatment available. Therefore, oral immunotherapy (OIT) is a promising alternative approach to managing sesame allergy. In this study protocol, we present a randomised controlled trial evaluating the efficacy and safety of OIT with low-dose sesame protein in paediatric patients. The study's aim is to compare OIT with a 300 mg maintenance dose of sesame protein against controls. METHODS AND ANALYSIS 39 participants aged 3-17 with IgE-mediated sesame allergy confirmed by oral food challenge will be enrolled into the study. The trial will be conducted at the Paediatric Hospital of the Medical University of Warsaw, Poland. The study comprises two arms-sesame OIT and control. In the sesame OIT group, interventions will be administered once daily for up to 18 months. During the first phase, the dose will be escalated every 2-4 weeks, and in the second phase, the maintenance dose of 300 mg sesame protein will continue for 3 months. Members of the control group will receive standard treatment, which includes an elimination diet and will remain under observation for 1 year. The primary outcome is the proportion of participants tolerating a single dose of 4000 mg of sesame protein during the final oral food challenge in the experimental group versus the control group. Secondary outcomes assess adverse events, changes in immunological parameters and the maximum tolerated doses of sesame protein in each group. ETHICS AND DISSEMINATION This study has been approved by the Ethics Committee of the Medical University of Warsaw (approval number: KB/269/2023). Results will be published in peer-reviewed journals and disseminated via presentations at international conferences. TRIAL REGISTRATION NUMBER NCT06261554.
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Affiliation(s)
- Joanna Zielinska
- Department of Pediatric Pneumonology and Allergy, Medical University of Warsaw, Warsaw, Poland
| | | | - Anna Krupa-Łaska
- Department of Pediatric Pneumonology and Allergy, Medical University of Warsaw, Warsaw, Poland
| | | | - Zbigniew Lewandowski
- Institute of Hygiene and Epidemiology, Medical University of Warsaw, Warsaw, Poland
| | - Marek Kulus
- Medical University of Warsaw, Warsaw, Poland
| | - Katarzyna Grzela
- Department of Pediatric Pneumonology and Allergy, Medical University of Warsaw, Warsaw, Poland
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Zeng J, Ma F, Zhai L, Du C, Zhao J, Li Z, Wang J. Recent advance in sesame allergens: Influence of food processing and their detection methods. Food Chem 2024; 448:139058. [PMID: 38531299 DOI: 10.1016/j.foodchem.2024.139058] [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: 01/10/2024] [Revised: 03/14/2024] [Accepted: 03/15/2024] [Indexed: 03/28/2024]
Abstract
Sesame (Sesamum indicum L.) is a valuable oilseed crop with numerous nutritional benefits containing a diverse range of bioactive compounds. However, sesame is also considered an allergenic food that triggers various mild to severe adverse reactions (e.g., anaphylaxis). Strict dietary avoidance of sesame components is the best option to protect the sensitized consumers. Sesame or sesame-derived foods are always consumed after certain food processing operations, which would cause a considerable impact on the structure of sesame proteins, changing their sensitization capacity and detectability. In the review, the molecular structure properties, and immunological characteristics of the sesame allergens were described. Meanwhile, the influence of food processing techniques on sesame proteins and the relevant detection techniques used for the sesame allergens quantification are also emphasized critically. Hopefully, this review could provide valuable insight into the development and management for the new "Big Eight" sesame allergen in food industry.
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Affiliation(s)
- Jianhua Zeng
- School of Food Engineering, Anhui Provincial Key Laboratory of Functional Agriculture and Functional Foods, Associated Discipline Key Laboratory of Whole Grain Nutrition and High-Value Utilization, Anhui Science and Technology University, No.9, Donghua Road, Fengyang, Anhui Province 233100, China; College of Food Science and Engineering, Ocean University of China, No.5, Yushan Road, Qingdao, Shandong Province 266003, China
| | - Feifei Ma
- School of Food Engineering, Anhui Provincial Key Laboratory of Functional Agriculture and Functional Foods, Associated Discipline Key Laboratory of Whole Grain Nutrition and High-Value Utilization, Anhui Science and Technology University, No.9, Donghua Road, Fengyang, Anhui Province 233100, China; Nutrition and Bromatology Group, Department of Analytical and Food Chemistry, Faculty of Sciences, University of Vigo, Ourense 32004, Spain
| | - Ligong Zhai
- School of Food Engineering, Anhui Provincial Key Laboratory of Functional Agriculture and Functional Foods, Associated Discipline Key Laboratory of Whole Grain Nutrition and High-Value Utilization, Anhui Science and Technology University, No.9, Donghua Road, Fengyang, Anhui Province 233100, China
| | - Chuanlai Du
- School of Food Engineering, Anhui Provincial Key Laboratory of Functional Agriculture and Functional Foods, Associated Discipline Key Laboratory of Whole Grain Nutrition and High-Value Utilization, Anhui Science and Technology University, No.9, Donghua Road, Fengyang, Anhui Province 233100, China
| | - Jinlong Zhao
- School of Food Engineering, Anhui Provincial Key Laboratory of Functional Agriculture and Functional Foods, Associated Discipline Key Laboratory of Whole Grain Nutrition and High-Value Utilization, Anhui Science and Technology University, No.9, Donghua Road, Fengyang, Anhui Province 233100, China.
| | - Zhenxing Li
- College of Food Science and Engineering, Ocean University of China, No.5, Yushan Road, Qingdao, Shandong Province 266003, China
| | - Jin Wang
- Key Laboratory of Environmental Medicine and Engineering, Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, No. 87 Dingjiaqiao Rd., Nanjing, Jiangsu Province 210009, China
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5
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Tomiki M, Sakai M, Tanaka D, Hosoya M, Uchida K, Shibata H, Morita M, Ito R, Iwasaki Y, Akiyama H. A reliable enzyme-linked immunosorbent assay for the determining of sesame proteins in raw food ingredients and in processed foods. Food Chem X 2024; 21:101231. [PMID: 38420508 PMCID: PMC10900753 DOI: 10.1016/j.fochx.2024.101231] [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: 11/18/2023] [Revised: 02/09/2024] [Accepted: 02/14/2024] [Indexed: 03/02/2024] Open
Abstract
Sesame is a frequent cause of adverse food reactions in allergic patients. We developed a novel sandwich enzyme-linked immunosorbent assay (ELISA) using two monoclonal antibodies and a unique extraction buffer for the detection and quantification of sesame proteins in processed foods and in raw food ingredients to clarify the validity of sesame labeling and for precautionary allergen labeling. The developed sandwich ELISA method is highly specific for sesame proteins. The limit of detection (LOD) and limit of quantification (LOQ) are 0.013 µg/g and 0.025 µg/g, respectively. The recoveries for incurred food samples, such as dressing, breads, sauce and pudding, ranged from 67 % to 81 %, while the repeatability and reproducibility coefficients of variation were less than 4.7 % and 4.5 %, respectively. The developed method has applicability for food products and is a reliable tool for the detection of hidden sesame proteins in raw food ingredients and in processed foods.
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Affiliation(s)
- Masayoshi Tomiki
- Morinaga Institute of Biological Science, Inc., 2-1-1 Shimosueyoshi, Tsurumi-Ku, Yokohama 230 -8504, Japan
- Department of Analytical Chemistry, School of Pharmacy and Pharmaceutical Sciences, Hoshi University, 2-4-41 Ebara, Shinagawa-Ku, Tokyo 142-8501, Japan
| | - Masatoshi Sakai
- Morinaga Institute of Biological Science, Inc., 2-1-1 Shimosueyoshi, Tsurumi-Ku, Yokohama 230 -8504, Japan
| | - Daichi Tanaka
- Morinaga Institute of Biological Science, Inc., 2-1-1 Shimosueyoshi, Tsurumi-Ku, Yokohama 230 -8504, Japan
| | - Mai Hosoya
- Department of Analytical Chemistry, School of Pharmacy and Pharmaceutical Sciences, Hoshi University, 2-4-41 Ebara, Shinagawa-Ku, Tokyo 142-8501, Japan
| | - Kana Uchida
- Department of Analytical Chemistry, School of Pharmacy and Pharmaceutical Sciences, Hoshi University, 2-4-41 Ebara, Shinagawa-Ku, Tokyo 142-8501, Japan
| | - Haruki Shibata
- Morinaga Institute of Biological Science, Inc., 2-1-1 Shimosueyoshi, Tsurumi-Ku, Yokohama 230 -8504, Japan
| | - Minoru Morita
- Morinaga Institute of Biological Science, Inc., 2-1-1 Shimosueyoshi, Tsurumi-Ku, Yokohama 230 -8504, Japan
| | - Rie Ito
- Department of Analytical Chemistry, School of Pharmacy and Pharmaceutical Sciences, Hoshi University, 2-4-41 Ebara, Shinagawa-Ku, Tokyo 142-8501, Japan
| | - Yusuke Iwasaki
- Department of Analytical Chemistry, School of Pharmacy and Pharmaceutical Sciences, Hoshi University, 2-4-41 Ebara, Shinagawa-Ku, Tokyo 142-8501, Japan
| | - Hiroshi Akiyama
- Department of Analytical Chemistry, School of Pharmacy and Pharmaceutical Sciences, Hoshi University, 2-4-41 Ebara, Shinagawa-Ku, Tokyo 142-8501, Japan
- Division of Foods, National Institute of Health Sciences, 3-25-26 Tonomachi, Kawasaki-ku, Kawasaki 210-9501, Japan
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Treudler R. Emerging and Novel Elicitors of Anaphylaxis: Collegium Internationale Allergologicum Update 2024. Int Arch Allergy Immunol 2024; 185:794-802. [PMID: 38527454 DOI: 10.1159/000537958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 02/19/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND Anaphylaxis represents the most severe end of the spectrum of allergic reactions. Frequent elicitors of anaphylaxis are insects, foods, and drugs. This paper summarizes recent development with regard to emerging and novel elicitors of anaphylaxis. SUMMARY Food allergens on the rise include pulses (like pea, chickpea), seeds (hemp, chia), nuts (cashew), pseudograins (buckwheat, quinoa), fruits, and microalgae. Novel foods are foods that were not consumed to any significant extent in the European Union before May 1997, which includes four edible insects (mealworm, migratory locust, house cricket, and buffalo worm). Recent investigations have pointed out the risk of anaphylaxis associated with the consumption of yellow mealworm for people allergic to shellfish and house dust mites. In Europe, fire ants (mostly Solenopsis invicta) and Vespa velutina nigrithorax represent invasive species, which account for increasing numbers of anaphylactic reactions. Also, several new drugs, especially biologicals, have been associated with anaphylaxis. KEY MESSAGES Elicitors of anaphylaxis are changing as a result of (i) increase in demand for plant-based food, (ii) introduction of novel foods, (iii) spreading of allergens by climate changes and globalization, or (iv) due to exposure to newly developed drugs.
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Affiliation(s)
- Regina Treudler
- Charité - Universitätsmedizin Berlin, Institute of Allergology IFA, Berlin, Germany
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7
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Saf S, Borres MP, Södergren E. Sesame allergy in children: New insights into diagnosis and management. Pediatr Allergy Immunol 2023; 34:e14001. [PMID: 37622261 DOI: 10.1111/pai.14001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 06/30/2023] [Accepted: 07/07/2023] [Indexed: 08/26/2023]
Abstract
Sesame is a potentially potent allergen that can trigger skin, gastrointestinal, and respiratory tract symptoms, and anaphylaxis. Only 20% to 30% of sesame-allergic children develop tolerance. The prevalence of sesame allergy depends on local diets and ranges from 0.1% to 0.9%. A high risk of accidental exposure to sesame has resulted in mandatory food labeling in many countries. More than half of patients with sesame allergy are also allergic to peanut/tree nuts. Serum-specific IgE testing with a quantitative Ses i 1 component can be performed safely and has higher clinical specificity and better positive predictive value for oral food challenge (OFC) than whole sesame extract or skin prick testing (SPT). Compared with SPT or OFC, in vitro Ses i 1 testing requires no special techniques and carries no risk of reactions. Diagnosis of suspected sesame allergy begins with a thorough history and physical examination. A positive sesame extract test (≥0.1 kUA /L) should prompt further testing. In patients with a high probability of reacting, results of component testing may facilitate a decision about performing an OFC. In a Japanese study of OFC and Ses i 1, there was a 5% probability of a positive OFC with Ses i 1 sIgE levels <0.13 kUA /L, and a 50% probability of a positive OFC with levels >32.0 kUA /L. Most patients could safely consume sesame if sIgE levels were <0.13 kUA /L. Ses i 1 testing can be used to guide appropriate management (avoidance, emergency medication, and oral immunotherapy).
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Affiliation(s)
- Sarah Saf
- Allergology Department, Hopital A. Trousseau, Sorbonne Universite, Paris, France
| | - Magnus P Borres
- Thermo Fisher Scientific, Phadia AB, Uppsala, Sweden
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Eva Södergren
- Thermo Fisher Scientific, Phadia AB, Uppsala, Sweden
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Jiang S, Wang T, Chen K, Wang H, Meng X. Assessment of the effect of glycation on the allergenicity of sesame proteins. Food Res Int 2023; 168:112771. [PMID: 37120220 DOI: 10.1016/j.foodres.2023.112771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 03/21/2023] [Accepted: 03/23/2023] [Indexed: 03/28/2023]
Abstract
Sesame allergy is a growing concern worldwide. In this study, sesame proteins was glycated with glucose, galactose, lactose and sucrose respectively, and the allergenicity of different glycated sesame proteins were assessed by a comprehensive strategy, including simulated gastrointestinal digestion in vitro, a BALB/c mice model, a rat basophilic leukemia (RBL)-2H3 cell degranulation model and a serological experiment. Firstly, simulated gastrointestinal digestion in vitro showed that glycated sesame proteins were more easily to digest than raw sesame. Subsequently, the allergenicity of sesame proteins was assessed in vivo by detecting the allergic indexes of mice, and results showed that the levels of total immunoglobulin E (IgE) and histamine were reduced in glycated sesame proteins treated mice. Meanwhile, the Th2 cytokines (IL-4, IL-5, and IL-13) were downregulated significantly, demonstrating that sesame allergy was relieved in glycated sesame treated mice. Thirdly, the RBL-2H3 cell degranulation model results showed that the release of β-hexosaminidase and histamine were decreased to different degrees in glycated sesame proteins treated groups. Notably, the monosaccharide glycated sesame proteins exhibited lower allergenicity both in vivo and in vitro. Furthermore, the study also analyzed the structure alteration of sesame proteins, and the results showed that the secondary structure of glycated sesame proteins were changed (the content of α-helix and β-sheet were reduced), and the tertiary structure of sesame proteins after glycation modification was also changed (microenvironment around aromatic amino acids was altered). Besides, the surface hydrophobicity of glycated sesame proteins was also reduced except sucrose glycated sesame proteins. In conclusion, this study demonstrated that glycation reduced the allergenicity of sesame proteins effectively, especially glycation with monosaccharides, and the allergenicity reduction might be related to structural changes. The results will provide a new reference for developing hypoallergenic sesame products.
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Jares EJ, Cardona V, Gómez RM, Bernstein JA, Rosario Filho NA, Cherrez-Ojeda I, Ensina LF, De Falco A, Díaz MC, Chávez Vereau PA, Rocha Felix MM, Lavrut J, Moreno Laflor OI, Latour Staffeld P, Piraino P, Alacaraz Duarte P, Ivancevich JC, Dabove F, Giavina-Bianchi P, Tinoco Moran IO, Nunes Oliviera FA, Monsell S, Souza MV, Cepeda AM, Slullitel PD, Morfin-Maciel BM. Latin American anaphylaxis registry. World Allergy Organ J 2023; 16:100748. [PMID: 36816598 PMCID: PMC9936519 DOI: 10.1016/j.waojou.2023.100748] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 01/03/2023] [Accepted: 01/11/2023] [Indexed: 02/07/2023] Open
Abstract
Background Recent data about clinical features, triggers and management of anaphylaxis in Latin America is lacking. Objective To provide updated and extended data on anaphylaxis in this region. Method An online questionnaire was used, with 67 allergy units involved from 12 Latin-American countries and Spain. Among data recorded, demographic information, clinical features, severity, triggering agents, and treatment were received. Results Eight hundred and seventeen anaphylactic reactions were recorded. No difference in severity, regardless of pre-existing allergy or asthma history was found. Drug induced anaphylaxis (DIA) was most frequent (40.6%), followed by food induced anaphylaxis (FIA) (32.9%) and venom induced anaphylaxis (VIA) (12%). FIA and VIA were more common in children-adolescents. Non-steroidal anti-inflammatory drugs (NSAIDs) and beta-lactam antibiotics (BLA) were the most frequent drugs involved. Milk (61.1% of FIA) and egg (15.4% of FIA) in children, and shellfish (25.5% of FIA), fresh fruits (14.2% of FIA), and fish (11.3% of FIA) in adults were the most common FIA triggers. Fire ants were the most frequent insect triggers, and they induced more severe reactions than triggers of FIA and DIA (p < 0.0001). Epinephrine was used in 43.8% of anaphylaxis episodes. After Emergency Department treatment, epinephrine was prescribed to 13% of patients. Conclusions Drugs (NSAIDs and BLA), foods (milk and egg in children and shellfish, fruits and fish in adults) and fire ants were the most common inducers of anaphylaxis. Epinephrine was used in less than half of the episodes emphasizing the urgent need to improve dissemination and implementation of anaphylaxis guidelines.
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Affiliation(s)
- Edgardo J. Jares
- Allergy Section, CMP S.A. LIBRA Foundation. Buenos Aires, Argentina,Corresponding author. Sucre 2496 2 D, Caba, Cp 1426, Argentina,
| | - Victoria Cardona
- Allergy Section, Hospital Universitari Vall D'hebron, Barcelona, Spain
| | | | - Jonathan A. Bernstein
- Professor of Medicine University of Cincinnati, Department of Internal Medicine, Division of Rheumatology, Allergy and Immunology. Cincinnati, USA
| | | | - Ivan Cherrez-Ojeda
- Respiralab Research Center, Universidad Espiritu Santo, Samborondon, Ecuador
| | - Luis Felipe Ensina
- Faaaai Affiliate Preceptor and Research Associate Division of Allergy, Immunology and Rheumatology, Department of Pediatrics, Federal University of São Paulo, São Paulo, Brazil
| | - Alicia De Falco
- Facultad De Cs Médicas Dto Posgrado Universidad Nacional De La Plata Jefe Area Alergia E Inmunología Clínica, Hospital Español De La Plata, Argentina
| | | | | | - Mara M. Rocha Felix
- Professor of Allergy and Immunology, Universidade Federal Do Estado Do Rio De Janeiro, Brazil
| | - Jorge Lavrut
- Hospital Pedro De Elizalde, Buenos Aires, Argentina
| | - Oscar I. Moreno Laflor
- Allergy and Clinical Immunology Department, Hospital Infantil De México Federico Gómez, Mexico
| | - Patricia Latour Staffeld
- Universidad Nacional Pedro Henriquez Ureña, Centro Avanzado De Alergia Y Asma. Santo Domingo, Dominican Republic
| | - Pedro Piraino
- Universidad Católica Ntra. Señora De La Asunción, Paraguay
| | | | - Juan C. Ivancevich
- Associate Professor of Immunology, Faculty of Medicine, Universidad Del Salvador, Buenos Aires, Argentina
| | | | - Pedro Giavina-Bianchi
- Associate Professor Clinical Immunology and Allergy Division, Universidade De São Paulo, São Paulo, Brazil
| | | | - Fabiana A. Nunes Oliviera
- Division of Allergy and Clinical Immunology, Federal University of São Paulo (Unifesp), São Paulo, Brazil
| | - Silvana Monsell
- Fundación Libra. Facultad De Medicina Universidad De Buenos Aires. Buenos Aires, Argentina
| | | | - Alfonso M. Cepeda
- Clinical Allergy - Pediatric Allergy Fundación Hospital Universitario Metropolitano Universidad Metropolitana Barranquilla, Colombia
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Belyayeva IA, Turti TV, Namazova-Baranova LS, Bombardirova EP, Vishneva EA, Shukenbaeva RA, Sadchikov PE. Features of Molecular Sensitisation Profile in Infants with Risk of Allergic Diseases. CURRENT PEDIATRICS 2023. [DOI: 10.15690/vsp.v21i6.2496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Background. For now, there is little data on sensitivity features to specific allergen antigens in infants with initial allergy manifestations. Objective. The aim of the study is to determine the features of the primary molecular sensitisation profile in infants with risk of atopic disease according to their postnatal age. Methods. Full-term infants with burdened familial allergic history and/or skin/gastrointestinal allergy symptoms were examined: Group 1 — 50 children, age — 2.0 [1.0–3.0] months; Group 2 — 35 children, age — 9.0 [8.0–11.0] months. Results. The hereditary atopy risk was observed in 74% of cases (37/50) in Group 1 and in 71% of cases (25/35) in Group 2. 38% of children (19/50) in Group 1 were breastfed, in Group 2 — 60% of children (21/35). Supplemental feeding was implemented in 5.5 [5.0–6.0] months. Sensitisation was reported in 10% and 37% of cases respectively. Children of Group 1 were sensitised to food allergen antigens: cow's milk/meat (Bos d 6, Bos d 8), egg-white (Gal d 1, Gal d 2, Gal d 3), soybeans (Gly m 6), shrimps (Pen m 4); airborne allergens: house dust mite (Blo t 5, Der h 10), Anisakidae (Ani s 3), cockroach (Bla g 7). Children of Group 2 were sensitised to food allergen antigens: cow's milk (Bos d 6), egg-white (Gal d 1, Gal d 2), soybeans (Gly m 6), peanut (Ara h 1, Ara h 2, Ara h 6), kiwi (Act d 1), corn (Tri a 19); airborne allergens: cat (Fel d 1, Fel d 4), birch pollen (Bet v 1). Polyvalent sensitisation was revealed in 4% and 6% of cases, respectively. Conclusion. Infants have much wider range of allergens to which they are sensitive than it is commonly believed. Beside obligate food allergens, sensitisation can be caused by airborne allergens: house dust mites, epidermal, birch pollen; cross-reactive component — tropomyosin.
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Affiliation(s)
- Irina A. Belyayeva
- Morozovskaya Children’s City Hospital; Research Institute of Pediatrics and Children’s Health in Petrovsky National Research Centre of Surgery; Pirogov Russian National Research Medical University
| | - Tatyana V. Turti
- Research Institute of Pediatrics and Children’s Health in Petrovsky National Research Centre of Surgery; Pirogov Russian National Research Medical University; Research Institute for Healthcare Organization and Medical Management
| | - Leyla S. Namazova-Baranova
- Research Institute of Pediatrics and Children’s Health in Petrovsky National Research Centre of Surgery; Pirogov Russian National Research Medical University
| | - Elena P. Bombardirova
- Research Institute of Pediatrics and Children’s Health in Petrovsky National Research Centre of Surgery
| | - Elena A. Vishneva
- Research Institute of Pediatrics and Children’s Health in Petrovsky National Research Centre of Surgery; Pirogov Russian National Research Medical University
| | | | - Pavel E. Sadchikov
- Research Institute of Pediatrics and Children’s Health in Petrovsky National Research Centre of Surgery; Pirogov Russian National Research Medical University
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Open sesame: Shedding light on an emerging global allergen. Ann Allergy Asthma Immunol 2023; 130:40-45. [PMID: 35973653 DOI: 10.1016/j.anai.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 08/01/2022] [Accepted: 08/02/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Sesame allergy has been characterized in the Middle East for some time. However, it has become more widely recognized as foods containing sesame and sesame seeds have become increasingly available in Australia, Europe, and North America. With the passage of the Food Allergy Safety, Treatment, Education, and Research Act in 2021, the United States will join other countries in identifying sesame as a major food allergen and require sesame to be labeled as a food allergen beginning in 2023. OBJECTIVE To review the literature related to sesame allergy as an increasingly recognized food allergen around the world. DATA SOURCES English-language articles retrieved by PubMed searches with relevance to sesame allergy. STUDY SELECTIONS Articles were included using the search terms "sesame allergy" and "sesame seed allergy." RESULTS A total of 69 relevant articles regarding sesame allergy, relating to its prevalence, clinical presentation, natural history, allergenic epitopes, diagnosis, and treatment, were selected. CONCLUSION In recent decades, considerable gains have been made in determining prevalence and natural history of sesame allergy. With increased recognition and prevalence come the need for reliable methods of identification of sesame allergy and approaches for management.
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Ali HS, Badr AN, Alsulami T, Shehata MG, Youssef MM. Quality Attributes of Sesame Butter (Tahini) Fortified with Lyophilized Powder of Edible Mushroom ( Agaricus blazei). Foods 2022; 11:foods11223691. [PMID: 36429283 PMCID: PMC9689749 DOI: 10.3390/foods11223691] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 10/19/2022] [Accepted: 11/02/2022] [Indexed: 11/19/2022] Open
Abstract
Sesame butter (tahini) is a common appetizer and food additive in the Mediterranean basin. Pathogenic strains and mycotoxin content are the most hazardous issues in the final product. This investigation aimed to enhance the quality and safety properties of tahini products against microbial hazards and mycotoxins. Local samples of tahini were evaluated for natural contamination, including mycotoxin level determinations. Agaricus blazei was utilized as a bioactive source and evaluated for the bioactive content of laccase, B-glucan, antioxidant activity, and phenolic content, as well as antimicrobial and antioxidant potency. Two fortification ratios (0.5% and 1.0%) were chosen to apply Agaricus in tahini sesame as a model. Chemical composition, color attributes, sensory properties, emulsion, and oxidative stability were evaluated for the fortified samples versus the control. The results reflected increments of protein (22.91 ± 0.64% to 29.34 ± 0.96%), fiber content (3.09 ± 0.05% to 6.27 ± 0.06%), emulsion stability (84.9 ± 1.24% to 95.41 ± 0.56%), oxidative stability, and bioactive group content. The fortification process is reflected by the absence of Salmonella, Listeria, and E. coli bacteria from contaminated samples after 30 days of storage. The water activity for 1.0% fortification (0.154 ± 0.001) was recorded as lower than the control sample (0.192 ± 0.002). Moreover, the degradation of aflatoxins and zearalenone content was recorded during storage. The degradation ratio reached 68% and 97.2% for 0.5% and 1.0% fortifications, respectively, while zearalenone degradation recorded a decline of 26.7% and 33.7%, respectively, for the same fortification ratios. These results recommended 1.0% lyophilized mushroom fortification as a quality and ameliorative safety treatment for tahini products.
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Affiliation(s)
- Hatem Salama Ali
- Food Technology Department, National Research Center, Dokki, Cairo 12622, Egypt
| | - Ahmed Noah Badr
- Food Toxicology and Contaminants Department, National Research Centre, Dokki, Cairo 12622, Egypt
- Correspondence: ; Tel.: +20-100-032-764-0
| | - Tawfiq Alsulami
- Food Science and Nutrition Department, Food and Agriculture Science College, King Saud University, Riyadh 12372, Saudi Arabia
| | - Mohamed Gamal Shehata
- Food Science Department, Arid Lands Cultivation Research Institute, City of Scientific Research and Technological Applications (SRTA-City), New Borg El-Arab 21934, Egypt
- Food Research Section, R&D Division, Abu Dhabi Agriculture and Food Safety Authority (ADAFSA), Abu Dhabi P.O. Box 52150, United Arab Emirates
| | - Mohamed Mahmoud Youssef
- Food Science and Technology Department, Faculty of Agriculture, Alexandria University, Alexandria 21545, Egypt
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13
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Villa C, Costa J, Mafra I. Sesame as a source of food allergens: clinical relevance, molecular characterization, cross-reactivity, stability toward processing and detection strategies. Crit Rev Food Sci Nutr 2022; 64:4746-4762. [PMID: 36377716 DOI: 10.1080/10408398.2022.2145263] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Sesame is an allergenic food with an increasing allergy prevalence among the European/USA population. Sesame allergy is generally life-persisting, being the cause of severe/systemic adverse immune responses in sesame-allergic individuals. Herein, clinical data about sesame allergy, including prevalence, diagnosis, relevance, and treatments are described, with focus on the molecular characterization of sesame allergens, their cross-reactivity and co-sensitization phenomena. The influence of food processing and digestibility on the stability/immunoreactivity of sesame allergens is critically discussed and the analytical approaches available for their detection in foodstuffs. Cross-reactivity between sesame and tree nuts or peanuts is frequent because of the high similarities among proteins of the same family. However, cross-reactivity phenomena are not always correlated with true clinical allergy in sensitized patients. Data suggest that sesame allergens are resistant to heat treatments and digestibility, with little effect on their immunoreactivity. Nevertheless, data are scarce, evidencing the need for more research to understand the effect of food processing on sesame allergenicity modulation. The demands for identifying trace amounts of sesame in foods have prompted the development of analytical methods, which have targeted both protein and DNA markers, providing reliable, specific, and sensitive tools, crucial for the effective management of sesame as an allergenic food.
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Affiliation(s)
- Caterina Villa
- REQUIMTE-LAQV, Faculdade de Farmácia, Universidade do Porto, Rua de Jorge Viterbo Ferreira, 228, Porto, Portugal
| | - Joana Costa
- REQUIMTE-LAQV, Faculdade de Farmácia, Universidade do Porto, Rua de Jorge Viterbo Ferreira, 228, Porto, Portugal
| | - Isabel Mafra
- REQUIMTE-LAQV, Faculdade de Farmácia, Universidade do Porto, Rua de Jorge Viterbo Ferreira, 228, Porto, Portugal
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14
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Pi X, Peng Z, Liu J, Jiang Y, Wang J, Fu G, Yang Y, Sun Y. Sesame allergy: mechanisms, prevalence, allergens, residue detection, effects of processing and cross-reactivity. Crit Rev Food Sci Nutr 2022; 64:2847-2862. [PMID: 36165272 DOI: 10.1080/10408398.2022.2128031] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Sesame allergy is a serious public health problem and is mainly induced by IgE-mediated reactions, whose prevalence is distributed all over the world. Sesame has been included on the priority allergic food list in many countries. This review summarizes the mechanism and prevalence of sesame allergy. The characteristics, structures and epitopes of sesame allergens (Ses i 1 to Ses i 7) are included. Moreover, the detection methods for sesame allergens are evaluated, including nucleic-acid, immunoassays, mass spectrometry, and biosensors. Various processing techniques for reducing sesame allergenicity are discussed. Additionally, the potential cross-reactivity of sesame with other plant foods is assessed. It is found that the allergenicity of sesame is related to the structures and epitopes of sesame allergens. Immunoassays and mass spectrometry are the major analytical tools for detecting and quantifying sesame allergens in food. Limited technologies have been successfully used to reduce the antigenicity of sesame, involving microwave heating, high hydrostatic pressure, salt and pH treatment. More technologies for reducing the allergenicity of sesame should be widely investigated in future studies. The reduction of allergenicity in processed sesames should be ultimately confirmed by clinical studies. What's more, sesame may exhibit cross-reactivity with peanut and tree nuts.
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Affiliation(s)
- Xiaowen Pi
- College of Food Science, Northeast Agricultural University, Harbin, Heilongjiang, China
| | - Zeyu Peng
- College of Food Science, Northeast Agricultural University, Harbin, Heilongjiang, China
| | - Jiafei Liu
- College of Food Science, Northeast Agricultural University, Harbin, Heilongjiang, China
| | - Yunqing Jiang
- College of Food Science, Northeast Agricultural University, Harbin, Heilongjiang, China
| | - Jiarong Wang
- School of Forestry, Northeast Forestry University, Harbin, Heilongjiang, China
| | - Guiming Fu
- State Key Laboratory of Food Science and Technology, School of Food Science and Technology, Nanchang University, Nanchang, Jiangxi, China
| | - Yili Yang
- Suzhou Institute of Systems Medicine, Center for Systems Medicine, Chinese Academy of Medical Sciences, Suzhou, Jiangsu, China
| | - Yuxue Sun
- College of Food Science, Northeast Agricultural University, Harbin, Heilongjiang, China
- Key Laboratory of Soybean Biology of Chinese Education Ministry, Harbin, Heilongjiang, China
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15
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Sesame-induced anaphylaxis in pediatric patients from the cross-Canada anaphylaxis registry. Ann Allergy Asthma Immunol 2022; 129:342-346. [PMID: 35697193 DOI: 10.1016/j.anai.2022.06.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 06/02/2022] [Accepted: 06/02/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Sesame can cause severe allergic reactions and is a priority allergen in Canada. OBJECTIVE To assess clinical characteristics and management of pediatric sesame-induced anaphylaxis and identify factors associated with epinephrine treatment. METHODS Between 2011 and 2021, children with sesame-induced anaphylaxis presenting to 7 emergency departments (ED) in 4 Canadian provinces and 1 regional emergency medical service were enrolled in the Cross-Canada Anaphylaxis Registry. Standardized recruitment forms provided data on symptoms, severity, triggers, and management. Multivariate logistic regression evaluated associations with epinephrine treatment pre-ED and multiple epinephrine dosages. RESULTS Of all food-induced anaphylactic reactions (n = 3279 children), sesame accounted for 4.0% (n = 130 children), of which 61.5% were boys, and the average (SD) age was 5.0 (4.9) years. Hummus containing sesame paste triggered 58.8% of reactions. In the pre-ED setting, 32.3% received epinephrine, and it was more likely to be used in boys (adjusted odds ratio [aOR], 1.27; 95% confidence interval [CI], 1.08-1.50) and those with a known food allergy (aOR, 1.36; 95% CI, 1.11-1.68]). In the ED, 47.7% of cases received epinephrine, with older children more likely to receive multiple epinephrine doses (aOR, 1.00; 95% CI, 1.00-1.02). CONCLUSION In Canada, hummus is the major trigger of sesame-induced anaphylaxis. Knowledge translation focused on prompt epinephrine use and product-labeling policies are required to limit sesame reactions in communities.
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Salari F, Bemanian MH, Fallahpour M, Mahdaviani SA, Shokri S, Khoshmirsafa M, Seif F, Nabavi M, Arshi S. The Effectiveness of Oral Immunotherapy in Patients with Sesame Anaphylaxis using Omalizumab. Clin Med Res 2022; 20:cmr.2022.1730. [PMID: 35998948 PMCID: PMC9544196 DOI: 10.3121/cmr.2022.1730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 03/12/2022] [Accepted: 06/20/2022] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Sesame allergy is the most prevalent allergy to seeds. Oral immunotherapy (OIT) is defined as continuous consumption of an allergen at special doses and time. Omalizumab (Anti-IgE) increases tolerance to allergens used in OIT. This study evaluated the effectiveness of a new sesame OIT protocol in patients with sesame anaphylaxis in combination with omalizumab. METHODS In this prospective open-label interventional trial study, 11 patients with a history of sesame anaphylaxis were enrolled after confirmation by oral food challenge (OFC) test. At baseline, skin prick test (SPT) and skin prick to prick (SPP) test were performed. Serum sesame-specific IgE (sIgE) levels were measured. The maintenance phase was continued at home with daily sesame intake for 4 months. At the end of month 4, the OFC and above-mentioned tests were repeated to evaluate the treatment effectiveness. RESULTS All 11 patients who underwent sesame OIT after 4 months could tolerate a dietary challenge of 22 ml tahini (natural sesame seed, equal to 5,000 mg of sesame protein and higher) and the average of wheal diameter in the SPT and SPP tests significantly decreased after desensitization. CONCLUSION This OIT protocol may be a promising desensitization strategy for patients with sesame anaphylaxis. Also, omalizumab appears to have reduced the severity of reactions.
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Affiliation(s)
- Fereshteh Salari
- Department of Allergy and Clinical Immunology, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hassan Bemanian
- Department of Allergy and Clinical Immunology, Iran University of Medical Sciences, Tehran, Iran
| | - Morteza Fallahpour
- Department of Allergy and Clinical Immunology, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Alireza Mahdaviani
- Pediatric Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sima Shokri
- Department of Allergy and Clinical Immunology, Iran University of Medical Sciences, Tehran, Iran
| | - Majid Khoshmirsafa
- Immunology Research Center, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran
| | - Farhad Seif
- Academic Center for Education, Culture, and Research (ACECR), Tehran University of Medical Sciences, Tehran, Iran
- Neuroscience Research Center (NRC), Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Nabavi
- Department of Allergy and Clinical Immunology, Iran University of Medical Sciences, Tehran, Iran
| | - Saba Arshi
- Department of Allergy and Clinical Immunology, Iran University of Medical Sciences, Tehran, Iran
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Sindher SB, Kumar D, Cao S, Purington N, Long A, Sampath V, Zedeck SS, Woch MA, Garcia‐Lloret M, Chinthrajah RS. Phase 2, randomized multi oral immunotherapy with omalizumab 'real life' study. Allergy 2022; 77:1873-1884. [PMID: 35014049 DOI: 10.1111/all.15217] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 12/17/2021] [Accepted: 12/22/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Oral immunotherapy (OIT) is frequently discontinued due to adverse events (AEs) and current data suggests that lowering OIT doses can minimize severity and frequency of AEs. However, the minimum daily dose that can enable desensitization and induce immune responses in multi-food OIT (mOIT) is unknown. METHODS Participants aged 2-25 years with multi-food allergies were pretreated with fixed-dose omalizumab (150 mg, 3 doses, every 4 weeks), and randomized 1:1 to receive mOIT to a total maintenance dose of either 300 or 1200 mg total protein, (total dose includes at least two and up to a max of five allergens) and then transitioned to real-food protein equivalents after 18 weeks of treatment. The primary endpoint was the proportion of subjects with increases in IgG4/IgE ratio of at least 2 allergens by ≥25% from baseline after 18 weeks of therapy. The primary efficacy and safety analyses were done in the intention-to-treat population. RESULTS Sixty participants were enrolled across two sites. Seventy percent of participants in both arms showed changes in sIgG4/sIgE ratio in at least 2 allergens with no difference between the treatment groups (OR [95% CI] = 1.00 [0.29, 3.49]). Overall, there were no differences in AEs between the 300 and 1200 mg groups (19% vs. 17%, p = .69), respectively. CONCLUSIONS Our data suggest that plasma marker changes are induced early, even at a total protein dose of 300 mg inclusive of multiple allergens when mOIT is combined with fixed-dose omalizumab. Identification of optimal mOIT dosing with adjunct omalizumab is needed for the long-term success of OIT. TRIAL REGISTRATION ClinicalTrials.gov (NCT03181009).
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Affiliation(s)
- Sayantani B. Sindher
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University Stanford California USA
- Division of Pulmonary and Critical Care Medicine Stanford University Stanford California USA
| | - Divya Kumar
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University Stanford California USA
- Division of Pulmonary and Critical Care Medicine Stanford University Stanford California USA
| | - Shu Cao
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University Stanford California USA
- Division of Pulmonary and Critical Care Medicine Stanford University Stanford California USA
| | - Natasha Purington
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University Stanford California USA
- Quantitative Sciences Unit Stanford University Stanford California USA
| | - Andrew Long
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University Stanford California USA
- Division of Pulmonary and Critical Care Medicine Stanford University Stanford California USA
| | - Vanitha Sampath
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University Stanford California USA
- Division of Pulmonary and Critical Care Medicine Stanford University Stanford California USA
| | - Stacey S. Zedeck
- University of California Los Angeles California USA
- Department of Pediatrics Division of Immunology Allergy, and Rheumatology Los Angeles California USA
| | - Margaret A. Woch
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University Stanford California USA
| | - Maria Garcia‐Lloret
- University of California Los Angeles California USA
- Department of Pediatrics Division of Immunology Allergy, and Rheumatology Los Angeles California USA
| | - Rebecca Sharon Chinthrajah
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University Stanford California USA
- Division of Pulmonary and Critical Care Medicine Stanford University Stanford California USA
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Mahlab-Guri K, Guri A, Kadar L, Asher I, Sthoeger Z, Elbirt D, Rosenberg-Bezalel S. Characteristics of patients with spontaneous resolution of sesame allergy. Ann Allergy Asthma Immunol 2022; 128:206-212. [PMID: 34737038 DOI: 10.1016/j.anai.2021.10.031] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 10/06/2021] [Accepted: 10/19/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND The prevalence of sesame allergy is increasing; strict avoidance is the mainstay of therapy. Lately, sesame oral immunotherapy was presented as an alternative treatment, with a high rate of success. Therefore, data on the natural history and the clinical characteristics of patients with persistent sesame allergy are important for the management of patients with sesame allergy. OBJECTIVE To describe the natural history of patients with sesame allergy and the clinical characteristics of patients with spontaneous resolution of sesame allergy compared with patients with persistent sesame allergy. METHODS In our retrospective study, electronic health records of patients with sesame allergy diagnosis were reviewed for demographic and clinical data. Statistical analysis of clinical characteristics of patients with spontaneous resolution compared with persistent sesame allergy was performed. RESULTS A total of 190 patients with sesame allergy were followed for 3.86 ±4.43 years. Of these patients, 61 (32.1%) had spontaneous resolution of sesame allergy. Patients with mild, early (before the age of 10 months) first sesame allergic reaction, with smaller than 7-mm skin prick test and without concomitant tree nut allergy had better resolution rate (56.1%). CONCLUSION Sesame allergy spontaneously resolved in approximately one-third of our patients and in more than half of the patients with mild first reaction (grade 1) at a young age (<10 months), with small skin prick test (<7 mm) and no concomitant tree nut allergy. Larger prospective studies with longer follow-up period are needed to better characterize the sesame allergic patients with persistent allergy who may need oral immunotherapy.
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Affiliation(s)
- Keren Mahlab-Guri
- The Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel; Department of Allergy and Clinical Immunology, Kaplan Medical Center, Rehovot, Israel.
| | - Alex Guri
- The Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel; Department of Pediatrics, Kaplan Medical Center, Rehovot, Israel
| | - Laliv Kadar
- The Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel; Department of Allergy and Clinical Immunology, Kaplan Medical Center, Rehovot, Israel
| | - Ilan Asher
- The Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel; Department of Allergy and Clinical Immunology, Kaplan Medical Center, Rehovot, Israel
| | - Zev Sthoeger
- The Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel; Department of Allergy and Clinical Immunology, Kaplan Medical Center, Rehovot, Israel
| | - Daniel Elbirt
- The Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel; Department of Allergy and Clinical Immunology, Kaplan Medical Center, Rehovot, Israel
| | - Shira Rosenberg-Bezalel
- The Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel; Department of Allergy and Clinical Immunology, Kaplan Medical Center, Rehovot, Israel
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Ocak M, Sahiner UM, Soyer O, Sekerel BE. The role of diagnostic tests and oral food challenge results to predict sesame allergy. Ann Allergy Asthma Immunol 2022; 128:46-52.e1. [PMID: 34543766 DOI: 10.1016/j.anai.2021.09.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 08/01/2021] [Accepted: 09/08/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND The presence of sesame allergy and its importance are increasing. OBJECTIVE To determine the results of sesame and tahini oral food challenges (OFCs) and whether sesame-specific immunoglobulin E and skin prick tests (SPTs) accurately predicted sesame allergy in children. METHODS Patients with suspected sesame allergy between June 1, 2018, and June 1, 2020, were examined. RESULTS Of 92 patients (n = 65, 70.7% of the patients were boys) with a median age of 2 years (interquartile range, 1.2-3.8 years), 64 were reactive to tahini. Of 64 patients, 41 had a positive OFC result and 23 had a consistent history. Of 54 sesame OFCs, 10 patients had a positive outcome. Of 44 with a negative outcome of sesame OFC, 4 experienced allergic reactions with tahini at home and 22 patients had a positive result for tahini OFC. In multivariate logistic regression analysis, clinical reactivity of sesame (either a consistent history or a positive OFC) was positively associated with sesame SPT (odds ratio, 2.120; 95% confidence interval, 1.136-3.957; P = .01) and tahini SPT (odds ratio, 1.661; 95% confidence interval, 1.143-2.413; P = .008). Nevertheless, sesame-specific immunoglobulin E did not predict clinical reactivity. Tahini OFC outcomes were well predicted for both sesame and tahini SPTs (area under the curves of 0.937 and 0.896, respectively, P < .001 for both). A sesame SPT wheal size of 5.25 mm had 90.6% sensitivity, 82.1% specificity, and 5.1 positive likelihood ratio. For tahini SPT, the 6-mm threshold had 100% sensitivity, 82.1% specificity, and 5.6 positive likelihood ratio. CONCLUSION In the OFC, tahini emerged as a more optimal diagnostic tool to avoid false negatives. Furthermore, both high sesame and tahini SPT levels individually can help predict the diagnosis of sesame allergy.
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Affiliation(s)
- Melike Ocak
- Division of Allergy and Asthma, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Umit Murat Sahiner
- Division of Allergy and Asthma, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Ozge Soyer
- Division of Allergy and Asthma, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Bulent Enis Sekerel
- Division of Allergy and Asthma, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
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20
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Ovadia A, Yoffe S, Orr YB, Tasher D, Dalal I. Sesame-allergic patients can tolerate intact sesame seeds food challenge. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2022; 10:336-338. [PMID: 34695598 DOI: 10.1016/j.jaip.2021.10.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 09/22/2021] [Accepted: 10/06/2021] [Indexed: 06/13/2023]
Affiliation(s)
- Adi Ovadia
- Pediatric Allergy Unit, E. Wolfson Medical Center, Holon, Israel; Department of Pediatrics, E. Wolfson Medical Center, Holon, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Siril Yoffe
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Allergy and Immunology Unit, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
| | - Yizhak Bar Orr
- Department of Pediatrics, E. Wolfson Medical Center, Holon, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Diana Tasher
- Department of Pediatrics, E. Wolfson Medical Center, Holon, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ilan Dalal
- Pediatric Allergy Unit, E. Wolfson Medical Center, Holon, Israel; Department of Pediatrics, E. Wolfson Medical Center, Holon, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Kakieu Djossi S, Khedr A, Neupane B, Proskuriakova E, Jada K, Mostafa JA. Food Allergy Prevention: Early Versus Late Introduction of Food Allergens in Children. Cureus 2022; 14:e21046. [PMID: 35155013 PMCID: PMC8824233 DOI: 10.7759/cureus.21046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 01/08/2022] [Indexed: 11/10/2022] Open
Abstract
The emergence of food allergies in children is crucial for various medical fields seeking a viable strategy for allergy prevention. The most well-recognized approach adopted by numerous health care and government institutions hinges on the delay in the introduction of food allergens, which supposedly protects infants from sensitization and decreases the possibility of allergy development. However, recent experimental findings indicate that the benefits of this approach might be overestimated, as early exposure to allergenic foods has been shown to yield more advantageous outcomes. Multiple investigations on the causes of allergic diseases report that avoiding food allergies might be related to early consumption of these allergens. Alternatively, delaying the contact with allergenic nourishments, explored in contemporary research, has been proven to result in a higher prevalence of allergies among children, originating such conditions as atopic diseases and extreme sensitization to foods. The current paper compares the two prominent strategies of allergenic food introduction, gathering the most pertinent modern evidence to distinguish whether exposure to food allergens should be delayed or advanced.
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Affiliation(s)
- Sandrine Kakieu Djossi
- Medical Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Anwar Khedr
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Bandana Neupane
- Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Ekaterina Proskuriakova
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Keji Jada
- Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Jihan A Mostafa
- Psychiatry, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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Abstract
Food allergies are an important global health concern, with many countries following the World Health Organisation’s guidelines with regards to due labelling of foods and, as such, providing forewarning about the presence of potential allergens to potential consumers. While for some produce, the link to specific allergens might be very clear to most consumers, this is not the case for all produce. People with specific food-related allergies usually know what to look out for, but occasionally, unexpected allergens are present in trusted produce. Beer is known to most to contain barley, which will contain gluten-like proteins that can cause allergic reactions in some people. Similarly, beer might contain sulphites and other potential allergens traditionally associated with beers. This review aims to examine a wide range of allergens that have entered the beer production process in recent years. As a result, examples of beers that contain one or more of the 14 EU-UK listed allergens are described, different allergen regulations in different countries are emphasised and their impact explained, and a number of case studies involving allergic reactions following exposure to and the ingestion of beer are highlighted.
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Nguyen K, Greenthal E, Sorscher S, Lurie P, Spergel JM, Kennedy K. Adverse Events and Labeling Issues Related to Suspected Sesame Allergy Reported in an Online Survey. Ann Allergy Asthma Immunol 2021; 128:279-282. [PMID: 34883240 DOI: 10.1016/j.anai.2021.12.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 11/01/2021] [Accepted: 12/01/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Allergen avoidance is critical for those with IgE-mediated food allergy (FA) but can only be successful with accurate product information. While the Food and Drug Administration (FDA) maintains the Center for Food Safety and Nutrition (CFSAN) Adverse Event Reporting System (CAERS) to collect adverse event (AE) reports related to foods, there is significant under-reporting and information regarding product labeling issues is limited. OBJECTIVE The purpose of this study was to describe allergic reactions associated with accidental oral exposure to sesame and the role of product labeling. METHODS A questionnaire was developed and disseminated to online communities focused on sesame allergy. The questionnaire included questions on clinical characteristics, treatments, outcomes, and labelling issues. RESULTS 360 clinical reactions related to sesame were reviewed in 327 individuals. Anaphylaxis occurred in 68.9% of reactions. Hospitalization occurred in 47.8% of events and epinephrine was administered in 36.4% of cases. Events involving a packaged food-product occurred in 67.5% of AEs with only 43.8% of these using the term "sesame." An alternate name was noted in 46.0% of products that did not include "sesame" on labeling, most of which was "tahini". CONCLUSION We demonstrate considerable sesame FA morbidity in part due to inconsistent allergen labeling. Our findings support development of a swifter process for the FDA to update the major allergen list as well as formulation of an improved system for reporting AEs related to foods.
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Affiliation(s)
- Kim Nguyen
- Children's Hospital of Philadelphia, Philadelphia, PA
| | - Eva Greenthal
- Center for Science in the Public Interest, Washington, DC
| | - Sarah Sorscher
- Center for Science in the Public Interest, Washington, DC
| | - Peter Lurie
- Center for Science in the Public Interest, Washington, DC
| | | | - Katie Kennedy
- Children's Hospital of Philadelphia, Philadelphia, PA.
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Roy A, Geetha RV, Magesh A, Vijayaraghavan R, Ravichandran V. Autoinjector - A smart device for emergency cum personal therapy. Saudi Pharm J 2021; 29:1205-1215. [PMID: 34703373 PMCID: PMC8523323 DOI: 10.1016/j.jsps.2021.09.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 09/11/2021] [Indexed: 12/18/2022] Open
Abstract
Autoinjectors are self-injectable devices; they are important class of medical devices which can deliver drugs through subcutaneous or intramuscular route. They enclose prefilled syringes or cartridges which are driven by a spring system. The major benefits of this device are easy self-administration, improved patient compliance, reduced anxiety, and dosage accuracy. Immediate treatment during emergency conditions such as anaphylaxis, migraine, and status epilepticus or for chronic conditions like psoriasis, diabetes, multiple sclerosis, and rheumatoid arthritis, Reformulation of first-generation biologics, technical advancements, innovative designs, patient compliance, overwhelming interest for self-administration all these made entry of more and more autoinjectors into use. In this review, intensive efforts have been made for exploring the different types of currently available autoinjectors for the management of emergency and chronic diseases.
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Affiliation(s)
- Anitha Roy
- Department of Pharmacology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
| | - Royapuram Veeraragavan Geetha
- Department of Microbiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
| | - Anitha Magesh
- Department of Research and Development, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
| | - Rajagopalan Vijayaraghavan
- Department of Research and Development, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
| | - Veerasamy Ravichandran
- Pharmaceutical Chemistry Unit, Faculty of Pharmacy, AIMST University, Semeling-08100, Bedong, Malaysia.,Centre of Excellence for Biomaterials Engineering, AIMST University, Semeling-08100, Bedong, Malaysia.,Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
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Honjoya S, Cottel N, Saf S, Just J, Bidat E, Benoist G. Allergie au sésame : revue générale. REVUE FRANÇAISE D'ALLERGOLOGIE 2021. [DOI: 10.1016/j.reval.2021.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Sesame allergy is more prevalent among Middle Eastern/North African patients in an urban healthcare system. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 9:3833-3835. [PMID: 34146751 DOI: 10.1016/j.jaip.2021.05.036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 05/07/2021] [Accepted: 05/27/2021] [Indexed: 11/24/2022]
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Nemni A, Stern R, Billard-Larue C, Guiddir T. Allergie aux graines : revue de la littérature. REVUE FRANÇAISE D'ALLERGOLOGIE 2021. [DOI: 10.1016/j.reval.2020.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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28
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Touma J, La Vieille S, Guillier L, Barrere V, Manny E, Théolier J, Dominguez S, Godefroy SB. Occurrence and risk assessment of sesame as an allergen in selected Middle Eastern foods available in Montreal, Canada. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2021; 38:550-562. [DOI: 10.1080/19440049.2021.1881622] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Joseph Touma
- Food Risk Analysis and Regulatory Excellence Platform (PARERA), Department of Food Science and Institute of Nutrition and Functional Foods (INAF), Laval University, Quebec, Canada
- Department of Heavy Metals and Colorants, Lebanese Agricultural Research Institute, Beirut, Lebanon
| | - Sébastien La Vieille
- Food Risk Analysis and Regulatory Excellence Platform (PARERA), Department of Food Science and Institute of Nutrition and Functional Foods (INAF), Laval University, Quebec, Canada
- Food Directorate, Health Canada, Ottawa, Ontario, Canada
| | - Laurent Guillier
- Risk Assessment Department, French Agency for Food, Environmental and Occupational Health & Safety (ANSES), Maisons-Alfort, France
| | - Virginie Barrere
- Food Risk Analysis and Regulatory Excellence Platform (PARERA), Department of Food Science and Institute of Nutrition and Functional Foods (INAF), Laval University, Quebec, Canada
| | - Emilie Manny
- Food Risk Analysis and Regulatory Excellence Platform (PARERA), Department of Food Science and Institute of Nutrition and Functional Foods (INAF), Laval University, Quebec, Canada
| | - Jérémie Théolier
- Food Risk Analysis and Regulatory Excellence Platform (PARERA), Department of Food Science and Institute of Nutrition and Functional Foods (INAF), Laval University, Quebec, Canada
| | - Silvia Dominguez
- Food Risk Analysis and Regulatory Excellence Platform (PARERA), Department of Food Science and Institute of Nutrition and Functional Foods (INAF), Laval University, Quebec, Canada
| | - Samuel Benrejeb Godefroy
- Food Risk Analysis and Regulatory Excellence Platform (PARERA), Department of Food Science and Institute of Nutrition and Functional Foods (INAF), Laval University, Quebec, Canada
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Midun E, Radulovic S, Brough H, Caubet JC. Recent advances in the management of nut allergy. World Allergy Organ J 2021; 14:100491. [PMID: 33510829 PMCID: PMC7811165 DOI: 10.1016/j.waojou.2020.100491] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 11/02/2020] [Accepted: 11/03/2020] [Indexed: 11/25/2022] Open
Abstract
Peanut/tree nut allergy is common and has been associated with particularly severe reactions. Epidemiological data have shown that the prevalence ranges between 0.05% and 4.9% for tree nut and between 0.5% and 3% for peanut. These large variations can be explained by differences in the age of included patients and the geographical region. In addition, the food consumption modality (ie, raw versus roasted) plays a major role, as heat treatment has the capacity to modify the allergenicity of nuts and legumes. Nut allergies tend to persist into adulthood and consequently have a high impact on quality of life. Recently, it has been demonstrated that a significant proportion of nut allergic patients are able to tolerate other nuts. As opposed to the avoidance of all nuts, this approach is currently proposed in several tertiary allergy centers. However, diagnosis of nut allergy is particularly difficult due to co-sensitization leading to high rate of false positive skin prick tests and/or specific IgE to whole allergen extracts. The use of component resolved diagnosis leads to major improvement of diagnosis, particularly to distinguish between primary and secondary nut allergies. The basophil activation test has been suggested to be useful but is still used mainly as a research tool. Thus, diagnosis remains mainly based on the oral food challenge, which is considered as the gold standard. Regarding treatment, avoidance remains the cornerstone of management of nut allergy. Oral immunotherapy is increasingly proposed as an alternative management strategy.
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Key Words
- Component-resolved diagnostic, CRD
- Cross reactivity
- Double-blind, placebo-controlled, food challenge, DBPCFC
- Food allergy
- Lipid transfer protein, LTP
- Oral allergy syndrome, OAS
- Oral food challenge, OFC
- Oral immunotherapy
- Oral induction tolerance, OIT
- Pathogenesis related protein type 10, PR-10
- Peanut
- Platelet-activating factor, PAF
- Pollen-food syndrome, PFS
- Precautionary Allergen Labels, (PAL)
- Skin prick test, SPT
- Tree nut
- Tree nut, TN
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Affiliation(s)
- Elise Midun
- Pediatric Allergy Unit, University Hospitals of Geneva and University of Geneva, Rue Willy Donzé 6, 1205 Geneva, Switzerland, University Lyon 1 Claude Bernard, 43 Boulevard Du 11-Novembre-1918, 69100, Villeurbanne, France
- Corresponding author.
| | - Suzana Radulovic
- Paediatric Allergy Group, Department of Women and Children's Health, King's College London, London, United Kingdom, Paediatric Allergy Group, Peter Gorer Dept of Immunobiology, School of Immunology & Microbial Sciences, King's College London, Guys' Hospital, London, United Kingdom, Children's Allergy Service, Evelina Children's Hospital, Guy's and St. Thomas' Hospital NHS Foundation Trust, London, United Kingdom
| | - Helen Brough
- Paediatric Allergy Group, Department of Women and Children's Health, King's College London, London, United Kingdom, Paediatric Allergy Group, Peter Gorer Dept of Immunobiology, School of Immunology & Microbial Sciences, King's College London, Guys' Hospital, London, United Kingdom, Children's Allergy Service, Evelina Children's Hospital, Guy's and St. Thomas' Hospital NHS Foundation Trust, London, United Kingdom
| | - Jean-Christoph Caubet
- Pediatric Allergy Unit, University Hospitals of Geneva and University of Geneva, Rue Willy Donzé 6, 1205, Geneva, Switzerland
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Florsheim EB, Sullivan ZA, Khoury-Hanold W, Medzhitov R. Food allergy as a biological food quality control system. Cell 2021; 184:1440-1454. [PMID: 33450204 DOI: 10.1016/j.cell.2020.12.007] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 10/21/2020] [Accepted: 12/04/2020] [Indexed: 12/17/2022]
Abstract
Food is simultaneously a source of essential nutrients and a potential source of lethal toxins and pathogens. Consequently, multiple sensory mechanisms evolved to monitor the quality of food based on the presence and relative abundance of beneficial and harmful food substances. These include the olfactory, gustatory, and gut chemosensory systems. Here we argue that, in addition to these systems, allergic immunity plays a role in food quality control by mounting allergic defenses against food antigens associated with noxious substances. Exaggeration of these defenses can result in pathological food allergy.
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Affiliation(s)
- Esther B Florsheim
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Zuri A Sullivan
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT 06510, USA
| | - William Khoury-Hanold
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Ruslan Medzhitov
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT 06510, USA; Howard Hughes Medical Institute, New Haven, CT 06510, USA.
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31
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Eisenstein AS, Hilliard B, Silwal S, Wang A. Food Allergy: Searching for the Modern Environmental Culprit. THE YALE JOURNAL OF BIOLOGY AND MEDICINE 2020; 93:733-747. [PMID: 33380935 PMCID: PMC7757057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Food allergy is a modern disease. Its exponential increase in prevalence in the last 70 years cannot be explained by genetic factors alone. In this review we discuss the hypotheses that have been suggested previously, and the evidence that supports them, to explain this rise in prevalence as well as the medical treatments that have developed as a result of basic exploration within these paradigms. We argue that one major area of fruitful exploration that would help generate new ideas may be systematic analyses of the unknown factors of the modern environment that may contribute to the formation of food allergy. Through this lens, we review the current understanding of food allergy pathogenesis and propose novel research directions, with implications for the current strategies for managing food allergy.
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Affiliation(s)
- Anna S. Eisenstein
- Department of Dermatology, Yale University School of Medicine, New Haven, CT,To whom all correspondence should be addressed: Anna Eisenstein, The Anlyan
Center, 300 Cedar Street, New Haven, CT, 06519; Tel: 203-500-3918; Fax: 203-785-7053;
. Andrew Wang, The Anlyan Center, 300 Cedar Street, New
Haven, CT, 06519; Tel: 203-785-2454; Fax: 203-785-7053;
| | - Brandon Hilliard
- Department of Dermatology, Yale University School of Medicine, New Haven, CT,Department of Immunobiology, Yale University School of Medicine, New Haven, CT
| | | | - Andrew Wang
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT,Department of Medicine (Rheumatology), Yale
University School of Medicine, New Haven, CT,To whom all correspondence should be addressed: Anna Eisenstein, The Anlyan
Center, 300 Cedar Street, New Haven, CT, 06519; Tel: 203-500-3918; Fax: 203-785-7053;
. Andrew Wang, The Anlyan Center, 300 Cedar Street, New
Haven, CT, 06519; Tel: 203-785-2454; Fax: 203-785-7053;
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32
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Muthukumar J, Selvasekaran P, Lokanadham M, Chidambaram R. Food and food products associated with food allergy and food intolerance – An overview. Food Res Int 2020; 138:109780. [DOI: 10.1016/j.foodres.2020.109780] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 10/01/2020] [Accepted: 10/04/2020] [Indexed: 02/07/2023]
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33
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Kotecka-Majchrzak K, Sumara A, Fornal E, Montowska M. Oilseed proteins – Properties and application as a food ingredient. Trends Food Sci Technol 2020. [DOI: 10.1016/j.tifs.2020.10.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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34
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Torricelli M, Pierboni E, Rondini C, Altissimi S, Haouet N. Sesame, Pistachio, and Macadamia Nut: Development and Validation of New Allergenic Systems for Fast Real-Time PCR Application. Foods 2020; 9:E1085. [PMID: 32784504 PMCID: PMC7464690 DOI: 10.3390/foods9081085] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 08/03/2020] [Accepted: 08/05/2020] [Indexed: 01/06/2023] Open
Abstract
Food allergy is a worldwide health problem that concerns infants to adults. The main health risk for sensitised individuals is due to the presence of traces of allergens as the result of an accidental contamination during food processing. The labelling of allergens such as sesame, pistachio, and macadamia nut on food products is mandatory according to Regulation (EU) N. 1169/2011; therefore, the development of suitable and specific analytical methodologies is advisable. The aim of this study was to perform a multi-allergen real-time PCR system that works well in fast mode at the same annealing temperature and with the same thermal profile. The real-time PCR was developed designing new, specific, and efficient primer and probe systems for the 2S albumingene for sesame and pistachio and for the vicilin precursorgene for macadamia nut. These systems were subjected to a robust intra-laboratory qualitative validation process prior to their application, by DNA extraction and fast real-time PCR, on some real market samples to reproduce a potential allergen contamination along the food chain. The developed system results were specific and robust, with a sensible limit of detection (0.005% for sesame; 0.004% for pistachio; 0.006% for macadamia nut). The performance and the reliability of the target systems were confirmed on commercial food samples. This molecular approach could be used as a screening or as a support tool, in association with the other widespread monitoring techniques (such as ELISA).
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Affiliation(s)
- Martina Torricelli
- Experimental Zooprophylactic Institute of Umbria and Marche Regions “Togo Rosati” (IZSUM), Via Salvemini 1, 06126 Perugia, Italy; (C.R.); (S.A.); (N.H.)
| | - Elisa Pierboni
- Experimental Zooprophylactic Institute of Umbria and Marche Regions “Togo Rosati” (IZSUM), Via Salvemini 1, 06126 Perugia, Italy; (C.R.); (S.A.); (N.H.)
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Saf S, Sifers TM, Baker MG, Warren CM, Knight C, Bakhl K, Kattan JD, Sampson HA, Nowak-Wegrzyn A. Diagnosis of Sesame Allergy: Analysis of Current Practice and Exploration of Sesame Component Ses i 1. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2019; 8:1681-1688.e3. [PMID: 31786253 DOI: 10.1016/j.jaip.2019.11.028] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 11/14/2019] [Accepted: 11/15/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND Sesame is an allergen of increasing importance. OBJECTIVE We sought to characterize the outcomes of oral food challenges (OFCs) to sesame and evaluate the diagnostic accuracy of skin prick testing (SPT), sesame, and Ses i 1-specific IgE (sIgE). METHODS We reviewed sesame OFCs performed at the Mount Sinai pediatric allergy clinic between January 2010 and April 2018. We assessed the accuracy of diagnostic tests by calculating the area under the curve (AUC) of the receiver operating characteristic curves. The association between OFC outcome and sesame sensitization was analyzed using a logistic regression, which was then used to estimate the 95% positive predictive value (PPV) of these tests. RESULTS We identified 341 patients (69% male, mean age 7.7 years) who underwent sesame OFC. Among 106 (31%) positive OFCs, the median cumulative eliciting dose was 500 mg sesame protein (1/2 teaspoon tahini). Sesame SPT wheal ≥6 mm had sensitivity 54.1% and specificity 87.8%; AUC 0.756 (95% confidence interval [CI], 0.699-0.814). SPT wheal size ≥14 mm had 95% PPV. Sesame-sIgE level did not correlate with OFC outcome. Ses i-sIgE levels were analyzed in 30 patients using the Immuno Solid-phase Allergen Chip (ISAC) microarray and were significantly associated with OFC outcome (AUC: 0.715 [95% CI, 0.541-0.890]). Ses i 1-sIgE ≥0.3 ISAC Standardized Units had sensitivity 58.3% and specificity 83.3%. CONCLUSIONS This is the largest study of sesame allergy to date. Sesame SPT is a more accurate predictor of sesame allergy compared with sesame sIgE. Ses i 1-sIgE appears promising but requires further study regarding diagnostic accuracy.
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Affiliation(s)
- Sarah Saf
- Division of Allergy and Immunology, Department of Pediatrics, Kravis Children's Hospital, Jaffe Food Allergy Institute, Icahn School of Medicine at Mount Sinai, New York, NY; Department of Allergology-Centre de l'Asthme et des Allergies, Hôpital d'Enfants Armand Trousseau, Paris, France
| | - Travis M Sifers
- Division of Allergy and Immunology, Department of Pediatrics, Kravis Children's Hospital, Jaffe Food Allergy Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Mary Grace Baker
- Division of Allergy and Immunology, Department of Pediatrics, Kravis Children's Hospital, Jaffe Food Allergy Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Christopher M Warren
- Northwestern University Feinberg School of Medicine, Institute for Public Health and Medicine, Chicago, Ill
| | - Christopher Knight
- Division of Allergy and Immunology, Department of Pediatrics, Kravis Children's Hospital, Jaffe Food Allergy Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Katrina Bakhl
- Division of Allergy and Immunology, Department of Pediatrics, Kravis Children's Hospital, Jaffe Food Allergy Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Jacob D Kattan
- Division of Allergy and Immunology, Department of Pediatrics, Kravis Children's Hospital, Jaffe Food Allergy Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Hugh A Sampson
- Division of Allergy and Immunology, Department of Pediatrics, Kravis Children's Hospital, Jaffe Food Allergy Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Anna Nowak-Wegrzyn
- Allergy and Immunology, Department of Pediatrics, New York University Langone Health, New York, NY; Department of Pediatrics, Gastroenterology and Nutrition, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland.
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Epov L, Garkaby J, Almog M, Ben-Or O, Schichter-Konfino V, Toker O, Bamberger E, Kessel A. Using skin prick test to sesame paste in the diagnosis of sesame seed allergy. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2019; 8:1456-1458. [PMID: 31730914 DOI: 10.1016/j.jaip.2019.10.038] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 10/26/2019] [Accepted: 10/28/2019] [Indexed: 11/17/2022]
Affiliation(s)
- Larisa Epov
- Division of Allergy & Clinical Immunology, Bnai Zion Medical Center, Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Jenny Garkaby
- Division of Allergy & Clinical Immunology, Bnai Zion Medical Center, Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Meital Almog
- Division of Allergy & Clinical Immunology, Bnai Zion Medical Center, Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Orly Ben-Or
- Department of Pediatrics, Carmel Medical Center, Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Vered Schichter-Konfino
- Department of Pediatrics, Hillel Yaffe Medical Center, Hadera, Israel; Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Ori Toker
- Allergy and Clinical Immunology Clinic, Department of Pediatrics, Shaare Zedek Medical Center, Hadassah-Hebrew University Medical School, Jerusalem, Israel
| | - Ellen Bamberger
- Department of Pediatrics, Bnai Zion Medical Center, Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Aharon Kessel
- Division of Allergy & Clinical Immunology, Bnai Zion Medical Center, Rappaport Faculty of Medicine, Technion, Haifa, Israel.
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37
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Calamelli E, Liotti L, Beghetti I, Piccinno V, Serra L, Bottau P. Component-Resolved Diagnosis in Food Allergies. ACTA ACUST UNITED AC 2019; 55:medicina55080498. [PMID: 31426616 PMCID: PMC6723663 DOI: 10.3390/medicina55080498] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 07/31/2019] [Accepted: 08/15/2019] [Indexed: 12/18/2022]
Abstract
Component-resolved diagnostics (CRD) in food allergies is an approach utilized to characterize the molecular components of each allergen involved in a specific IgE (sIgE)-mediated response. In the clinical practice, CRD can improve diagnostic accuracy and assist the physician in many aspects of the allergy work-up. CRD allows for discriminatory co-sensitization versus cross-sensitization phenomena and can be useful to stratify the clinical risk associated with a specific sensitization pattern, in addition to the oral food challenge (OFC). Despite this, there are still some unmet needs, such as the risk of over-prescribing unnecessary elimination diets and adrenaline auto-injectors. Moreover, up until now, none of the identified sIgE cutoff have shown a specificity and sensitivity profile as accurate as the OFC, which is the gold standard in diagnosing food allergies. In light of this, the aim of this review is to summarize the most relevant concepts in the field of CRD in food allergy and to provide a practical approach useful in clinical practice.
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Affiliation(s)
| | - Lucia Liotti
- Pediatric Unit, Civic Hospital, 60019 Senigallia, Italy
| | - Isadora Beghetti
- Pediatric Unit, Department of Medical and Surgical Sciences (DIMEC), S.Orsola-Malpighi Hospital, University of Bologna, 40138 Bologna, Italy
| | | | - Laura Serra
- Pediatric and Neonatology Unit, Imola Hospital, 40026 Imola, Italy
| | - Paolo Bottau
- Pediatric and Neonatology Unit, Imola Hospital, 40026 Imola, Italy
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Abstract
IMPORTANCE Sesame allergy is of growing concern in the United States. The US Food and Drug Administration recently issued a request for epidemiological data on the prevalence and severity of sesame allergies in the United States to inform possible regulatory action requiring sesame to be labeled as an allergen on packaged foods. OBJECTIVE To provide current estimates of the prevalence, severity, distribution, and clinical characteristics of sesame allergy in the United States. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study assessed findings of web- and telephone-based food allergy questionnaires. Study participants were first recruited from NORC (National Opinion Research Center) at the University of Chicago's probability-based AmeriSpeak panel, and additional participants were recruited through Survey Sampling International. Surveys were administered to a nationally representative sample of 51 819 US households from October 1, 2015, through September 31, 2016. Responses for 40 453 adults and 38 408 children were included in the analysis. Data were analyzed from January 1, 2017, through May 1, 2019. EXPOSURES Demographic and allergic characteristics of participants. MAIN OUTCOMES AND MEASURES Self-reported sesame allergy was the main outcome and was considered convincing if reported symptoms to sesame-allergic reactions were consistent with an IgE-mediated reaction. Diagnostic history of specific allergens and use of food allergy-related health care services were also primary outcomes. RESULTS Using survey responses from 78 851 individuals, an estimated 0.49% (95% CI, 0.40%-0.58%) of the US population reported a current sesame allergy, whereas 0.23% (95% CI, 0.19%-0.28%) met symptom-report criteria for convincing IgE-mediated allergy. An additional 0.11% (95% CI, 0.08%-0.16%) had a sesame allergy reported as physician diagnosed but did not report reactions fulfilling survey-specified convincing reaction symptoms. Among individuals with convincing IgE-mediated sesame allergy, an estimated 23.6% (95% CI, 16.9%-32.0%) to 37.2% (95% CI, 29.2%-45.9%) had previously experienced a severe sesame-allergic reaction, depending on the definition used, and 81.6% (95% CI, 71.0%-88.9%) of patients with convincing sesame allergy had at least 1 additional convincing food allergy. Roughly one-third of patients with convincing sesame allergy (33.7%; 95% CI, 26.3%-42.0%) reported previous epinephrine use for sesame allergy treatment. CONCLUSIONS AND RELEVANCE These data indicate a substantial burden of sesame allergy and provide valuable context to physicians and policy makers in their efforts to evaluate and reduce the public health burden of sesame allergy. Moreover, the relatively low rates of physician diagnosis observed among individuals with convincing IgE-mediated sesame allergy seem to indicate the need for clear diagnosis and appropriate management.
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Affiliation(s)
- Christopher M. Warren
- Center for Food Allergy and Asthma Research, Northwestern University Feinberg School of Medicine and Ann & Robert H Lurie Children’s Hospital of Chicago, Chicago, Illinois
| | - Avneet S. Chadha
- Center for Food Allergy and Asthma Research, Northwestern University Feinberg School of Medicine and Ann & Robert H Lurie Children’s Hospital of Chicago, Chicago, Illinois
| | - Scott H. Sicherer
- Elliot and Roslyn Jaffe Food Allergy Institute, Division of Allergy, Department of Pediatrics, Mount Sinai School of Medicine, New York, New York
| | - Jialing Jiang
- Center for Food Allergy and Asthma Research, Northwestern University Feinberg School of Medicine and Ann & Robert H Lurie Children’s Hospital of Chicago, Chicago, Illinois
| | - Ruchi S. Gupta
- Center for Food Allergy and Asthma Research, Northwestern University Feinberg School of Medicine and Ann & Robert H Lurie Children’s Hospital of Chicago, Chicago, Illinois
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39
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D'Auria E, Abrahams M, Zuccotti GV, Venter C. Personalized Nutrition Approach in Food Allergy: Is It Prime Time Yet? Nutrients 2019; 11:E359. [PMID: 30744105 PMCID: PMC6412250 DOI: 10.3390/nu11020359] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 02/03/2019] [Accepted: 02/05/2019] [Indexed: 02/06/2023] Open
Abstract
The prevalence of food allergy appears to be steadily increasing in infants and young children. One of the major challenges of modern clinical nutrition is the implementation of individualized nutritional recommendations. The management of food allergy (FA) has seen major changes in recent years. While strict allergen avoidance is still the key treatment principle, it is increasingly clear that the avoidance diet should be tailored according to the patient FA phenotype. Furthermore, new insights into the gut microbiome and immune system explain the rising interest in tolerance induction and immunomodulation by microbiota-targeted dietary intervention. This review article focuses on the nutritional management of IgE mediated food allergy, mainly focusing on different aspects of the avoidance diet. A personalized approach to managing the food allergic individual is becoming more feasible as we are learning more about diagnostic modalities and allergic phenotypes. However, some unmet needs should be addressed to fully attain this goal.
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Affiliation(s)
- Enza D'Auria
- Department of Pediatrics, Children's Hospital V. Buzzi, University of Milan, Milan 20154, Italy.
| | - Mariette Abrahams
- Faculty of Social Sciences, University of Bradford, Bradford BD7 1DP, UK.
| | - Gian Vincenzo Zuccotti
- Department of Pediatrics, Children's Hospital V. Buzzi, University of Milan, Milan 20154, Italy.
| | - Carina Venter
- Section of Allergy and Immunology, Children's Hospital Colorado, University of Colorado, Aurora, CO 80045, USA.
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40
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Ovadia A, Nahum A, Tasher D, Abiri S, Epov L, Kessel A, Dalal I. Sesame: An unrecognized trigger of food protein-induced enterocolitis syndrome. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2019; 7:305-306. [PMID: 29802907 DOI: 10.1016/j.jaip.2018.05.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 04/22/2018] [Accepted: 05/03/2018] [Indexed: 10/16/2022]
Affiliation(s)
- Adi Ovadia
- Pediatric Allergy Unit, E. Wolfson Medical Center, Holon, Israel; Department of Pediatrics, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Pediatrics, E. Wolfson Medical Center, Holon, Israel.
| | - Amit Nahum
- Pediatrics Department A, Saban Pediatric Medical Center, Soroka University Medical Center, and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Diana Tasher
- Department of Pediatrics, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Pediatrics, E. Wolfson Medical Center, Holon, Israel
| | - Shirli Abiri
- Department of Pediatrics, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Pediatrics, E. Wolfson Medical Center, Holon, Israel
| | - Larisa Epov
- Division of Allergy and Clinical Immunology, Bnai Zion Medical Center, Technion Faculty of Medicine, Haifa, Israel
| | - Aharon Kessel
- Division of Allergy and Clinical Immunology, Bnai Zion Medical Center, Technion Faculty of Medicine, Haifa, Israel
| | - Ilan Dalal
- Pediatric Allergy Unit, E. Wolfson Medical Center, Holon, Israel; Department of Pediatrics, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Pediatrics, E. Wolfson Medical Center, Holon, Israel
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41
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Sindher S, Long AJ, Purington N, Chollet M, Slatkin S, Andorf S, Tupa D, Kumar D, Woch MA, O'Laughlin KL, Assaad A, Pongracic J, Spergel JM, Tam J, Tilles S, Wang J, Galli SJ, Nadeau KC, Chinthrajah RS. Analysis of a Large Standardized Food Challenge Data Set to Determine Predictors of Positive Outcome Across Multiple Allergens. Front Immunol 2018; 9:2689. [PMID: 30538699 PMCID: PMC6277531 DOI: 10.3389/fimmu.2018.02689] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 10/31/2018] [Indexed: 12/12/2022] Open
Abstract
Background: Double-blind placebo-controlled food challenges (DBPCFCs) remain the gold standard for the diagnosis of food allergy; however, challenges require significant time and resources and place the patient at an increased risk for severe allergic adverse events. There have been continued efforts to identify alternative diagnostic methods to replace or minimize the need for oral food challenges (OFCs) in the diagnosis of food allergy. Methods: Data was extracted for all IRB-approved, Stanford-initiated clinical protocols involving standardized screening OFCs to a cumulative dose of 500 mg protein to any of 11 food allergens in participants with elevated skin prick test (SPT) and/or specific IgE (sIgE) values to the challenged food across 7 sites. Baseline population characteristics, biomarkers, and challenge outcomes were analyzed to develop diagnostic criteria predictive of positive OFCs across multiple allergens in our multi-allergic cohorts. Results: A total of 1247 OFCs completed by 427 participants were analyzed in this cohort. Eighty-five percent of all OFCs had positive challenges. A history of atopic dermatitis and multiple food allergies were significantly associated with a higher risk of positive OFCs. The majority of food-specific SPT, sIgE, and sIgE/total IgE (tIgE) thresholds calculated from cumulative tolerated dose (CTD)-dependent receiver operator curves (ROC) had high discrimination of OFC outcome (area under the curves > 0.75). Participants with values above the thresholds were more likely to have positive challenges. Conclusions: This is the first study, to our knowledge, to not only adjust for tolerated allergen dose in predicting OFC outcome, but to also use this method to establish biomarker thresholds. The presented findings suggest that readily obtainable biomarker values and patient demographics may be of use in the prediction of OFC outcome and food allergy. In the subset of patients with SPT or sIgE values above the thresholds, values appear highly predictive of a positive OFC and true food allergy. While these values are relatively high, they may serve as an appropriate substitute for food challenges in clinical and research settings.
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Affiliation(s)
- Sayantani Sindher
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Stanford, CA, United States
| | - Andrew J Long
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Stanford, CA, United States.,Department of Pharmacy, Lucile Packard Children's Hospital Stanford, Stanford, CA, United States
| | - Natasha Purington
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Stanford, CA, United States
| | - Madeleine Chollet
- Department of Medicine, School of Medicine, Stanford, CA, United States
| | - Sara Slatkin
- Department of Medicine, School of Medicine, Stanford, CA, United States
| | - Sandra Andorf
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Stanford, CA, United States
| | - Dana Tupa
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Stanford, CA, United States
| | - Divya Kumar
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Stanford, CA, United States
| | - Margaret A Woch
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Stanford, CA, United States
| | - Katherine L O'Laughlin
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Stanford, CA, United States
| | - Amal Assaad
- Division of Allergy and Immunology, Cincinnati Children's Medical Center, Cincinnati, OH, United States
| | - Jacqueline Pongracic
- Division of Allergy and Immunology, The Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States
| | - Jonathan M Spergel
- Division of Allergy and Immunology, The Children's Hospital of Philadelphia Department of Pediatrics, Perelman School of Medicine at University of Pennsylvania, Philadelphia, PA, United States
| | - Jonathan Tam
- Division of Clinical Immunology and Allergy, Children's Hospital Los Angeles, Los Angeles, CA, United States
| | - Stephen Tilles
- ASTHMA Inc. Clinical Research Center, Northwest Asthma and Allergy Center, University of Washington, Seattle, WA, United States
| | - Julie Wang
- Division of Allergy and Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Stephen J Galli
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Stanford, CA, United States.,Department of Pathology, Stanford University School of Medicine, Stanford, CA, United States.,Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA, United States
| | - Kari C Nadeau
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Stanford, CA, United States
| | - R Sharon Chinthrajah
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Stanford, CA, United States
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42
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Yuan D, Kong J, Li X, Fang X, Chen Q. Colorimetric LAMP microfluidic chip for detecting three allergens: peanut, sesame and soybean. Sci Rep 2018; 8:8682. [PMID: 29875429 PMCID: PMC5989197 DOI: 10.1038/s41598-018-26982-5] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 04/26/2018] [Indexed: 02/07/2023] Open
Abstract
Food allergies can greatly harm people's health, and therefore detecting allergens in foods is extremely important. By integrating loop-mediated isothermal amplification (LAMP) with a microfluidic chip, we have developed a method for detecting the allergen genes of peanut (Arachis hypogaea), sesame (Sesamum indicum), and soybean (Glycine max) using a colorimetric method suitable for the naked eye, known as the colorimetric LAMP microfluidic chip. In the presence of peanut, sesame, or soybean in the samples, the corresponding reaction well of the microfluidic chip will appear pink, or otherwise remain light brown. This method of detection is specific and can easily distinguish these three allergens from others in foods. The detection limit for peanut, sesame and soybean allergens was 0.4 ng/μL using the LAMP-microfluidic chip. The accuracy of this novel and rapid method was validated using allergenic foods obtained commercially and was comparable with that of the typical TaqMan real-time PCR method.
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Affiliation(s)
- Dan Yuan
- Shanghai Key Laboratory of Bio-Energy Crops, School of Life Sciences, Shanghai University, Shanghai, 200444, P.R. China
| | - Jilie Kong
- Department of Chemistry and Institutes of Biomedical Sciences, Fudan University, Shanghai, 200433, P.R. China
| | - Xinxin Li
- Shanghai Suchuang Diagnostics Co., Ltd., Shanghai, 201318, P.R. China
| | - Xueen Fang
- Department of Chemistry and Institutes of Biomedical Sciences, Fudan University, Shanghai, 200433, P.R. China.
| | - Qin Chen
- Shanghai Key Laboratory of Bio-Energy Crops, School of Life Sciences, Shanghai University, Shanghai, 200444, P.R. China.
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43
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Mühlenbein S, Pfützner W. Allergien auf Sesam: klinische Bedeutung, Diagnostik und Therapie. ALLERGO JOURNAL 2018. [DOI: 10.1007/s15007-018-1567-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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44
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Venter C, Groetch M, Netting M, Meyer R. A patient-specific approach to develop an exclusion diet to manage food allergy in infants and children. Clin Exp Allergy 2018; 48:121-137. [DOI: 10.1111/cea.13087] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 11/07/2017] [Accepted: 11/08/2017] [Indexed: 12/19/2022]
Affiliation(s)
- C. Venter
- Children's Hospital Colorado; University of Colorado; Aurora CO USA
| | - M. Groetch
- Icahn School of Medicine at Mount Sinai; Jaffe Food Allergy Institute; New York NY USA
| | - M. Netting
- Healthy Mothers Babies and Children's Theme; South Australian Health & Medical Research Institute; Adelaide SA Australia
- Discipline of Paediatrics; School of Medicine; University of Adelaide; Adelaide SA Australia
- Nutrition Department; Women's and Children's Health Network; Adelaide SA Australia
| | - R. Meyer
- Department Paediatrics; Imperial College; London UK
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45
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Abstract
Food allergies manifest in a variety of clinical conditions within the gastrointestinal tract, skin and lungs, with the most dramatic and sometimes fatal manifestation being anaphylactic shock. Major progress has been made in basic, translational and clinical research, leading to a better understanding of the underlying immunological mechanisms that lead to the breakdown of clinical and immunological tolerance against food antigens, which can result in either immunoglobulin E (IgE)-mediated reactions or non-IgE-mediated reactions. Lifestyle factors, dietary habits and maternal-neonatal interactions play a pivotal part in triggering the onset of food allergies, including qualitative and quantitative composition of the microbiota. These factors seem to have the greatest influence early in life, an observation that has led to the generation of hypotheses to explain the food allergy epidemic, including the dual-allergen exposure hypothesis. These hypotheses have fuelled research in preventive strategies that seek to establish desensitization to allergens and/or tolerance to allergens in affected individuals. Allergen-nonspecific therapeutic strategies have also been investigated in a number of clinical trials, which will eventually improve the treatment options for patients with food allergy.
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46
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Abunada T, Al-Nesf MA, Thalib L, Kurdi R, Khalil S, ElKassem W, Mobayed HM, Zayed H. Anaphylaxis triggers in a large tertiary care hospital in Qatar: a retrospective study. World Allergy Organ J 2018; 11:20. [PMID: 30214658 PMCID: PMC6122634 DOI: 10.1186/s40413-018-0200-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 07/26/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Anaphylaxis is a serious allergic disease that may lead to death if not immediately recognized and treated. Triggers of anaphylaxis including food, drugs, and insect stings can vary widely. The incidence of anaphylaxis seems to be affected by age, sex, atopy, and geographic location. This study aims to examine the common triggers of anaphylaxis in Qatar. METHODS A total of 1068 electronic medical records were audited using power chart system: 446 from the medical coding system of anaphylaxis and 622 from the epinephrine auto-injectors (EAIs) dispensed during January 2012-December 2017. RESULTS Of 1068 patients, 574 (53.5%) had anaphylaxis; male to female ratio was 1.2, and 300 patients (77.9%) were less than 10 years old. The common triggers were food (n = 316, 55.0%), insect stings (n = 161, 28.0%), and drugs (n = 103, 17.9%). Common anaphylaxis food triggers were nuts (n = 173, 30.1%), eggs (n = 89, 15.5%), and seafood (n = 72, 12.5%), and common anaphylaxis medication triggers were antibiotics (n = 49, 8.5%) and nonsteroidal anti-inflammatory drugs (n = 30, 5.2%). Interestingly, 135 anaphylactic patients (23.5%) were due to black ant stings. The anaphylaxis triggers varied significantly between children and adults. Among children (less than 10 years), three quarters of the events were triggered by food (223, 74.3%) while among adults (20-55 years), insect stings (n = 59, 43.0%) and drugs (n = 44, 32.0%) were dominant. DISCUSSION This is the first national study stratifying anaphylaxis triggers among different age groups in Qatar. This study will serve as a guide for clinical practice in allergy clinics in Qatar and will help to assess future trends of anaphylaxis in Qatar.
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Affiliation(s)
- Taghreed Abunada
- 0000 0004 0634 1084grid.412603.2Biomedical Science Department, College of Health Science, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Maryam Ali Al-Nesf
- 0000 0004 0571 546Xgrid.413548.fAllergy and Immunology Unit, Hamad Medical Corporation, P.O. Box 3050, Doha, Qatar
| | - Lukman Thalib
- 0000 0004 0634 1084grid.412603.2College of Health Science, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Rana Kurdi
- 0000 0004 0634 1084grid.412603.2Department, College of Health Science, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Sally Khalil
- 0000 0004 0571 546Xgrid.413548.fAllergy & Clinical Immunology Unit, Hamad Medical Corporation, P.O. Box 3050, Doha, Qatar
| | - Wessam ElKassem
- 0000 0004 0571 546Xgrid.413548.fPharmacy Department, Women’s Hospital, Hamad Medical Corporation, P.O. Box 3050, Doha, Qatar
| | - Hassan M. Mobayed
- 0000 0004 0571 546Xgrid.413548.fHamad Medical Corporation, P.O. Box 3050, Doha, Qatar
| | - Hatem Zayed
- 0000 0004 0634 1084grid.412603.2Biomedical Science Department, College of Health Science, Qatar University, P.O. Box 2713, Doha, Qatar
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