Functional Foods Based on Postbiotics as a Food Allergy Treatment.

The article presents modern data on the epidemiology, etiology and clinical manifestations of food allergies in children. Evidence-based approaches to diagnosis, including differential, treatment, and prevention of food allergies in children are shown. Patient management tactics and algorithms are presented in detail. The guidelines are based on all available up-to-date data on food allergies. The material is based on the methodological guideline for the management of patients with food allergies previously developed by expert specialists of the Union of Pediatricians of Russia in 2021.

Food allergy anxiety assessment: New tools can promote enhanced clinical care and patient-centered treatment evaluation

Atopic dermatitis (AD) is a form of allergic skin inflammation characterized by late eczematous skin lesions [1]. These skin lesions occur through non-Immunoglobulin E (nonIgE)-mediated immune responses, and therefore, AD can be regarded as a non-IgE-mediated allergic inflammatory skin disease [2]. Many causes, including inhalant allergens, food allergens, and other factors, have been implicated in AD [1]. In addition to information about the causes, knowledge of the immunologic nature of AD is extremely important in order to understand AD. Without an understanding of the immunologic nature of AD, the cause of food allergy in patients with AD may be wrongly identified. Because of this confusion in establishing the cause of a food allergy in AD, the role of food allergy in AD remains poorly understood [2]. However, with the recent advance in the diagnosis and treatment of food allergy, it is necessary inevitably to distinguish between IgEand non-IgE-mediated food allergies that co-exist with AD in order to better understand and control AD [2]. It is well-known that food allergy is an important cause of atopic dermatitis [3]. Although food allergies can be either IgEor non-IgE-mediated, due to a lack of diagnostic modalities such as laboratory tests to diagnose non-IgE-mediated food allergy [4], it is difficult to clarify the nature of the food allergy, leading to confusion about role of food allergy in AD. Tests that determine IgE levels cannot predict the likelihood of an eczematous reaction because eczematous reactions are the result of non-IgE-mediated food allergies [2]. Until recently, discrimination of IgE-mediated and non-IgE-mediated food allergies was not considered necessary for diagnosis or treatment. Therapeutic modalities, including tolerance induction for food allergy (TIFA), have been developed for patients with food allergy [5,6]. However, the principles for diagnosing and treating IgE-mediated or non-IgE-mediated food allergies are quite different [7]. Presently, a differential diagnosis is absolutely necessary for relevant, proper, and successful treatment of IgE-mediated and non-IgEmediated food allergies, independently. Clinical approaches to treat food allergy in AD patients, including laboratory tests and diagnosis, should consider the conceptual differences between IgE-mediated and non-IgE-mediated food allergies. In the past, avoidance has been suggested as the main principle for treating food allergies [8]. More recently, however, the clinical and laboratory characteristics of IgE-mediated and non-IgE-mediated food allergy in atopic dermatitis have been well-characterized, and the

During the last two decades, the prevalence and severity of clinical appearances of food allergy (FA) have a significant rise. FA derives from a breakdown of immune tolerance. In recent year’s clinical evidence have shown that the probiotics have significant influences on FA by improving the immune tolerance. Besides, postbiotics due to their unique characteristics (safe profile, more shelf life, resistance to mammalian enzymes and stable to digestive system conditions), may have safety superiority against their parent live cells and as a novel strategy can be applied for improvement immune tolerance and treatment of FA without any undesirable side-effects or human opportunistic infections, particularly in infants and pediatrics.

Background: In the last few decades, along with the lifestyle changes and the development of diagnostic procedures, food allergies have become a serious public health problem. In addition to health problems, they also lead to deterioration of the quality of life of both patients and their families. The aim of the study was to determine the frequency of clinical manifestations in preschoolers suffering from food allergies Methods and Objectives: Cross-sectional study was performed in kindergarten "Dr Simo Milošević" Total number of children aged 2-6 years included in the study was 4123. Data on the type of food allergy and clinical manifestations were used. Symptoms were divided according to respiratory symptoms, contact allergies, allergies on the skin, lips, and gastrointestinal, diarrhea Study instrument was questionnaire for parents. Descriptive and analytical statistics methods were used in statistical data processing. Statistical data processing was done in the SPSS Windows version 25 software package. Results: Out of the total number of children who participated in the research, 41 had a food allergy. Out of the total number of children with allergies, most of the symptoms were related to changes in the skin, 53.7%, followed by changes in the lips, 22%, and diarrhea, 17.1%. Only 7.3% of children with food allergies had an anaphylactic manifestation of allergy. Conclusions: The obtained data show a high frequency of clinical manifestations of food allergies, indicating the importance of early detection of food allergies.

Summary. The prevalence of food allergy is increasing, especially among children. The clinical manifestations of food allergy are different, they depend on the mechanisms of pathogenesis. There is a need to improve diagnostic criteria and early diagnosis of gastrointestinal manifestations of food allergy. Objective. Evaluation of gastrointestinal manifestations in children with food allergies. Materials and methods. Clinical and anamnestic data of 29 children (12 girls, 17 boys) with gastrointestinal manifestations and food allergy were analyzed. Results. Most often, gastrointestinal manifestations of food allergies were found in children aged 4 to 7 years (55.17%, 16/29). Epigastric pain (62.07%, 18/29), meteorism (24.14%, 7/29), undecorated stool with undigested food particles and mucus (27.59%, 8/29%) were most common among children with food allergies. The onset of gastrointestinal intolerance by the age of 6 months was in 44.8% (13/29) of children, 76.9% (10/13) of whom were exclusively breastfed. The first gastrointestinal manifestations after the introduction of supplementary feeding were in 20.69% (6/29); 10.34% (3/29) of patients had gastrointestinal complaints from 3 years of age, and 6.9% (2/29) of patients from 7 years of age. Gastrointestinal disorders as the first manifestation of allergic "march" was observed in 20.69% (6/29%) of patients. IgE-mediated food allergy was found in 72.41% (21/29) of the examined children: immediate gastrointestinal hypersensitivity - 65.51% (19/29); oral allergic syndrome - 6.89% (2/29). Non-IgE-mediated food allergy is represented by protein-induced enterocolitis and proctosigmoiditis in 27.58% (8/29) of children. Conclusions. Clinical symptoms of gastrointestinal manifestations of food allergy in children depend on the immunological mechanisms of its occurrence, it should be taken into during of diagnostic. Gastrointestinal food allergy should be diagnosed in time to prevent the evolution and progression of allergic "march". Therefore, it is necessary to develop and search methods and markers for timely diagnosis of these conditions.

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IgE-mediated food allergy (IgE-FA) occurs due to a breakdown in immune tolerance that leads to a detrimental type 2 helper Tcell (TH2) adaptive immune response. While the processes governing this loss of tolerance are incompletely understood, several host-related and environmental factors impacting the risk of IgE-FA development have been identified. Mounting evidence supports the role of an impaired epithelial barrier in the development of IgE-FA, with exposure of allergens through damaged skin and gut epithelium leading to the aberrant production of alarmins and activation of TH2-type allergic inflammation. The treatment of IgE-FA has historically been avoidance with acute management of allergic reactions, but advances in allergen-specific immunotherapy and the development of biologics and other novel therapeutics are rapidly changing the landscape of food allergy treatment. Here, we discuss the pathogenesis and immunobiology of IgE-FA in addition to its diagnosis, prognosis, and treatment. Expected final online publication date for the Annual Review of Immunology, Volume 42 is April 2024. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Program Description: Food allergies are difficult for the patient to understand and challenging for the clinician to treat. The CDC has recently reported that the prevalence of reported food allergies increased 18% over the past 10 years in children under 18. In addition, children with food allergies are 2 to 4 times more likely to suffer from asthma and other allergies. Allergic reactions to foods can produce life-threatening anaphylaxis, but have also been associated with other head and neck problems such as Meniere’s disease, migraine headache, chronic rhinitis, and chronic serous otitis media. There is a wide range of symptoms attributed to food allergies, such as nausea, cramping, diarrhea, dermatitis, urticaria, asthma, and joint pain. However, despite the fact that otolaryngologists see a large number of patients with food allergies, diagnosis and treatment strategies still remain controversial. The first part of the miniseminar will focus on the scientific basis of food allergies by taking a critical look at the latest scientific evidence available in the literature. A basic review of the relevant immunology will be provided along with a comparison of IgE-mediated food reactions versus non-IgE-mediated food reactions. The impact that food preparation and food spoiling has on allergic pathways will also be examined. In the second part of the miniseminar, the manifestations of food allergies will be discussed. The recent literature concerning the rise in prevalence of food allergies will be analyzed and the impact of food allergies on the head and neck and airway will be reviewed. We will examine the role of oral tolerance in human evolution and the relationship of failure to achieve oral tolerance on the health of the individual. The next section will be devoted to the current diagnostic modalities available for the diagnosis of food allergies. The use of structured patient-completed surveys to maximize thoroughness and efficiency will be discussed. We will compare the performance and accuracy of the different methods of food allergy testing, including skin and in vitro methods vs. the traditional gold standard of double-blind, placebo-controlled food challenge. The final part of the presentation will be devoted to treatment strategies for food allergies. Traditional methods, such as elimination diets and recognizing emergencies will be reviewed, as well as more cutting-edge techniques, such as oral and sublingual desensitization and genetically modified foods, will also be discussed. Audio-visual materials will be used to help present this information to the audience. Educational Objectives: 1) Analyze the literature comparing different methods for diagnosing food allergy. 2) Evaluate the scientific basis of IgE and non-IgE mediated food allergy. 3) Understand the currently available treatments for food allergy as well as future directions.

At present, the only treatment for food allergy is to avoid the allergy-causing food. Some trials of specific oral tolerance induction (SOTI) have been carried out, but the rate of tolerance induction was low despite long treatment periods, at least 3 months to several years. A new type of treatment is long desired. The objectives of this study are to perform our rush SOTI for school-age patients with severe egg allergy, and to evaluate the safety and efficacy of this method for one year. Six school-age children (7-12 years of age) with severe IgE-mediated egg allergy confirmed by double-blind, placebo-controlled food challenge (DBPCFC) underwent rush SOTI, in which patients ingested increasing doses of egg several times every day. After rush SOTI, patients ingested the maintenance dose of egg at least twice a week. In DBPCFC, the median threshold dose of egg white inducing allergic reactions was 0.152 g (0.012-0.360 g). All subjects acquired tolerance to more than one whole egg (60 g). It took only 12 days (9-18 days). None experienced any serious reaction. We observed a decrease in IL-10 and an increase in TGF-beta1 at 6 months and a decrease in egg-specific IgE and an increase in egg white-specific IgG4 at 12 months after rush SOTI in blood. All subjects have been able to ingest more than one whole egg ever since. Our rush SOTI is a safe and effective treatment for severe food allergy since only a few weeks are needed to acquire tolerance. It would replace allergen avoidance as the treatment for food allergy.

Background: Yacon has recently been introduced into farmer's markets and natural food stores in the U.S., but its preventive activity for breast cancer has rarely been evaluated. Yacon contains a large amount of non-digestible oligosaccharide called inulin that belongs to a class of carbohydrates known as fructans. Inulin-type fructans (ITF) decreases the rate of aberrant crypt foci (ACF), a pre-neoplastic lesion found in colon. The mechanism by which ITF inhibits ACF is associated with butyrate produced by the anaerobic bacterial fermentation of ITF in the colon. Butyrate can also be absorbed through the colonic epithelial cells into the portal blood and exert its effects within the body. Butyrate modulates gene transcription by inhibiting HDAC. Cancer cells appear to be more sensitive than non-transformed cells to HDAC inhibitory compounds. In addition, the yacon ITF promotes satiety and retard the absorption of food-derived energy via reducing a gastrointestinal peptide-ghrelin that is a growth hormone secretagogue. Reduction of serum ghrelin results in decreases of IGF-1. Subsequently, the PI3K/Akt-mTOR signaling pathway will be inactivated via increasing AMPK activity and its downstream events, inhibition of cell proliferation and induction of cell apoptosis. However, few studies have been shown the effect of the ITF on breast cancer. Objective: 1) To determine mammary carcinogenic responses to yacon in experimental animals; 2) To evaluate the association of the circulating growth factors and cytokines with the carcinogenic responses; 3) To determine the HDAC and identify AMPK/PI3K/Akt-mTOR cell signaling pathway. Methods: Mammary carcinogenesis was initiated by injection of female Sprague Dawley rats with 50 mg of 1-methyl-1-nitrosourea/kg body weight (i.p.) at 21 days of age. One week later, the rats were fed diets containing yacon powder at 0%, 15%, 30% or 60% (30 rats/group) for 8 weeks, respectively. Effects of yacon on mammary carcinomas, circulating growth factors and cytokines and molecular biological assessments in carcinomas, including HDAC and regulators that are associated with AMPK/PI3K/Akt-mTOR pathway, were evaluated. Difference between among different dietary groups was statistically analyzed by ANOVA and Chi-square test. Results/Relevance: Dietary yacon reduced the promotion and progression of MNU-induced mammary carcinogenesis in rat, which is associated with downregulation of IGF-1/HDAC/Akt/mTOR signaling pathway and anti-inflammation, i.e. reduction of plasma IL-6, TNFα, and C-reactive protein. Future work will focus on the effect of yacon on obesity and antiinflammation. The study provides crucial biological information to complement the knowledge of natural functional foods that is relevant to a number of foods rich in non-digestible, fermentable oligosaccharides. This could lead the way to develop a new type of functional whole food with a low calorie density and the ability to promote the intra-intestinal production of cancer inhibitory factors. Consequently, the new type of functional food will significantly contribute to the goal of preventing initiation of breast cancer and reduce survivor recurring because it is natural, tolerant and acceptable for the clinic patients. Supported by W81XWH-09-1-0428 from the Department of Defense-Army. Citation Information: Cancer Prev Res 2010;3(12 Suppl):B60.

Induction and suppression of allergic diarrhea and systemic anaphylaxis in a murine model of food allergy

Moving FORWARD Toward Racial Equity in Food Allergy

Adult patients with atopic bronchial asthma are susceptible to food allergy, in more than one third of cases, while asthma is a risk factor for severe life-threatening factors. The aim of the study was to determine the prevalence and relationship of food allergies with atopic bronchial asthma in adults living in Chelyabinsk. Materials and methods. An analysis of 313 outpatient case histories of patients with atopic bronchial asthma over the age of 18 was performed. Results. The presence of food allergy was a factor in the earlier onset of atopic bronchial asthma, which is consistent with the concept of comorbidity of these diseases. Patients with seasonal allergic rhinitis and pollen sensitization have an increased risk of developing food allergies (OR – 2.075 [1.27- 3.39]), p=0,004. The overall incidence of oral allergic syndrome among all patients with atopic asthma and plant sensitization was 33% [28; 37]. Plant products (fruits, honey, nuts) were the cause of food allergic reactions in 87% [80; 92] of adult cases. The main clinical manifestations were: oral allergic syndrome, urticaria, angioedema, shortness of breath. Sensitization to pollen of trees, grasses and weeds approximately equally increases the risk of developing an oral allergic syndrome, upon sensitization to tree pollen (OR – 3.08 [2.32-4.25]), to grass pollen (OR – 3.5 [2.23-5.61]), to weed pollen (OR – 2.86 [2.02-4.03]). The combination of several types of pollen sensitization increases by 4 times the risk of developing oral allergic syndrome to a wide range of foods. Conclusion. Data on the causes and clinical manifestations of food allergies in combination with bronchial asthma have been obtained. The notion of a significant risk of developing dangerous clinical manifestations of food allergy in patients with atopic bronchial asthma will make it possible to reasonably prescribe emergency drugs for independent use.

Adverse reactions to foods are a diverse group of clinical syndromes resulting from immunologic and non-immunologic responses to food ingestion. Symptoms can range from mild, self-limiting reactions to severe, life-threatening reactions depending on the mechanism. This review primarily focuses on the clinical manifestations of immunologically derived adverse food reactions or food allergies.The true prevalence of food allergy is unknown. Up to 25% of the general population believes that they may be allergic to some food; however, the actual prevalence of food allergy diagnosed by a provider appears to be 1.5% to 2% of the adult population and approximately 6% to 8% of children. This discrepancy makes it imperative that clinicians are aware of the different food allergy syndromes. With a clear understanding of the clinical manifestations of food allergies, an accurate diagnosis and treatment plan can be formulated. Failing to do so may result in unnecessary dietary restrictions that may adversely affect nutritional status, growth, and quality of life.Most food allergic reactions are secondary to a limited number of foods, and the most common foods causing allergic reactions in children include milk, egg, peanuts, tree nuts, and fish. In adolescents and adults, allergies to peanuts, tree nuts, fish, and shellfish are most prevalent. Food allergies can result from immunoglobulin E (IgE)-mediated, non-IGE-mediated, or mixed IgE/non-IgE mechanisms. The purpose of this review is to discuss the clinical manifestations of each of these types of food allergy.