Abstract
AbstractA variety of additives found in foodstuffs have been associated with triggering of a number of clinical pictures. Hypersensitivity reactions of allergic and non-allergic etiology have been widely described, but are reported to be rare overall. This review presents a selection of food additives for which anaphylactic reactions have been described. These include colorants (e.g., tartrazine, carmine, patent blue), preservatives (e.g., sulfites, sodium benzoate), and thickeners/gelling agents (e.g., carboxymethylcellulose, guar, gum arabic). Possible diagnostic procedures (skin test, specific IgE, cellular antigen stimulation test, oral provocation) are presented. For those affected, avoidance of consumption is facilitated by the mandatory declaration (class name, E‑number/designation) required in the European Union. Only sulfur dioxide and sulfites have to be highlighted as food allergens, depending on the concentration. Due to the limited diagnostic procedures available, it cannot be excluded that the frequency of hypersensitivity to food additives is underestimated.
Highlights
Food additives are intended to improve taste, appearance, shelf life and/or production
Additives in foods have been associated with triggering a number of clinical pictures
It must be said that the diagnosis of hypersensitivity to additives is complex and often difficult to establish, so that the true prevalence may be underestimated
Summary
Food additives are intended to improve taste, appearance, shelf life and/or production. The Food Information Regulation (FID), adopted on October 25, 2011 as Regulation (EU) No 1169/2011, regulates the label-. Additives in foods have been associated with triggering a number of clinical pictures. These include respiratory and gastrointestinal symptoms, behavioral abnormalities, triggering of chronic urticaria, and anaphylactic reactions [2–4]. Hypersensitivity reactions of allergic or nonallergic etiology to food additives are reported to be rare overall, affecting 0.01–0.23% of the population but 2–7% of people with atopic background [3]. These are mild reactions to the skin, gastrointestinal tract and respiratory tract.
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