Editor's Choice

Abstract

Clinical & Experimental AllergyVolume 40, Issue 9 p. 1289-1289 Free Access Editor's Choice The Editor takes a closer look at some of this month's articles First published: 04 August 2010 https://doi.org/10.1111/j.1365-2222.2010.03588.xAboutSectionsPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Food allergy: risk and resolution Food allergy, particularly due to nuts, is an increasing problem with a big impact on quality of life for children and their parents. As the cohort of children with food allergy grows up it is becoming an increasing problem in adults as well. Although thankfully unusual considering how common food allergy has become, it is still an important and avoidable cause of death. Our reviews this week explore two important aspects of food allergy. The link with asthma and the conundrum of resolution and tolerance. For reasons that are not well understood, poorly controlled asthma is thought to be an important risk factor for severe reactions including death from food allergy. Gillman and Douglas (pp. 1295–1302) explore the evidence and reasons for this link and emphasise the importance of recognition and optimal control of asthma in people with food allergy. Every parent wants to know how likely it is that their child will grow out of their food allergy and whether anything can be done to cure it. A topical issue in nut allergy is the extent to which it is possible to induce tolerance by oral or sublingual immunotherapy. Byrne et al (pp. 1303–1311) explore this issue placing it in the overall context of resolution of nut allergy. They describe the factors that relate to resolution, but point out that there is no biomarker and that tolerance needs to be confirmed with a food challenge. They discuss the exciting possibility that immunotherapy may help patients with nut allergy, but emphasise that this is still an experimental procedure which requires more data before its introduction into routine clinical practice can be recommended. Non-atopic allergy: set the light chains free [ Adapted by the authors from Fig.1 in [2] ] Some patients with apparently typical allergic symptoms to common allergens have negative skin prick tests and normal levels of specific IgE in the peripheral blood. Several explanations have been advanced for this observation including the production of local IgE [1]. However Redegeld and colleagues in an opinion article last year advanced the idea that the allergic symptoms could be due to free light chains triggering mast cell degranulation in the tissue [2]. In this issue they have provided further evidence for this argument by showing in a mouse model of food allergy to whey protein that under certain conditions free light chains could mediate the allergic effects usually attributed to IgE dependent mechanisms. The next challenge is to block these responses in the clinic and see if that proves beneficial. Peach allergy: a new thaumatin like protein as a major allergen [ Thaumatococcus danielli ] Peach allergy is of considerable importance in the Mediterranean area. Cross reactivity between peach allergy and other fruits is common and thought to be due principally to the lipid transfer protein Pru p 3. However a number of other plant protein families can cause cross-sensitisation including members of the thaumatin like protein family. Thaumatin is a sweet-tasting protein derived from Thaumatococcus daniellii, a west African forest shrub. Proteins with close sequence homology are called thaumatin-like proteins (TLP). TLPs are one member of a wide group of functionally, but not structurally related host defence proteins called pathogenesis-related proteins. TLPs are thought to be particularly important in host defence against fungi. They are a common source of allergens [3]. Palacin et al (pp. 1422–1430) have isolated three isoforms of a TLP from peach and demonstrated that this is a major allergen with about 50% of people with peach allergy showing sensitisation. It is therefore a potentially significant source of cross-reactivity between peach and other fruits. One more for the allergen chip.