Food Allergy and Asthma: Is There a Link?

Joyce A M Emons,Roy Gerth Van Wijk

doi:10.1007/s40521-018-0185-1

Abstract

Purpose of reviewTo describe and understand the links and interactions between food allergy and asthmaRecent findingsFood allergy and asthma are characterized by an increasing prevalence. Moreover, food allergy and asthma often coexist. Both conditions are associated with each other in different ways. It has been shown that food allergy is a risk factor of developing asthma. Atopic dermatitis appears to be the common denominator in this interaction. Loss-of-function variants of the filaggrin mutation result in an impaired epidermal barrier function and have been shown to be a risk factor for the development of atopic dermatitis, allergies, and asthma. Early introduction of food allergens and optimal treatment of the skin barrier are preventive interventions for the development of food allergy and asthma. Asthma is also a risk factor for the development of severe or even fatal anaphylaxis in patients with food allergy. Isolated asthma is not a feature of a food allergic reaction; however, respiratory symptoms may be part of anaphylactic reactions. In addition, during an allergic reaction to food, non-specific bronchial hyperreactivity may increase. Cross-reactive allergens may be responsible for asthma-associated food allergy. This is particularly true for severe asthma upon ingestion of snail in patients allergic to house-dust mites. Finally, airborne allergens from occupational sources such as wheat, fish, and seafood may induce asthmatic reactions. This phenomenon is sometimes seen in non-occupational settings.SummaryFood allergy and asthma are interconnected with each other beyond the presence of simple comorbidity. Food allergy precedes and predisposes to asthma, and mutual interactions range from respiratory symptoms and bronchial hyperreactivity during food-induced anaphylaxis to severe asthma due to cross-reactive food allergens and to occupational asthma upon exposure to airborne allergens. Moreover, coexisting asthma in food allergies may result in severe and sometimes fatal anaphylactic reactions.

Highlights

Asthma is a common global health problem affecting all age groups
Food allergy prevalence varies widely and this is most likely caused by different methods in how to define a food allergy and in geographical differences
A systematic review of Tsakok et al reported an increased risk of six times of food sensitization in patients with atopic dermatitis compared to healthy controls in populationbased studies [17]

Summary

Introduction

Asthma is a common global health problem affecting all age groups. Epidemiologic studies have shown that up to 20% of children aged 6–7 year experience a wheezing episode within a year and in adults, global prevalence rates are reported up to 21% [1, 2]. A systematic review of Tsakok et al reported an increased risk of six times of food sensitization in patients with atopic dermatitis compared to healthy controls in populationbased studies [17]. In children with severe atopic dermatitis, 100% sensitization to food was found with a clinical relevance of increase of their atopic dermatitis for almost all patients after intake of food allergens [19] Based on these and a number of other epidemiologic observations, the dualallergen-exposure hypothesis was postulated in 2008, which described that oral antigen exposure tends to induce tolerance, whereas skin exposure tends to induce allergic sensitization, leading to food allergy [20].

Conclusion

Findings

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