Food Allergy Research Articles

Cohort studies on 71 outcomes among people with atopic eczema in UK primary care data.

Atopic eczema may be related to multiple subsequent adverse health outcomes. Here, we provide evidence to judge and compare associations between eczema and a comprehensive set of outcomes. We conducted 71 cohort studies (age, sex, general practice-matched) using Clinical Practice Research Datalink Aurum primary care records (1997-2023), comparing up to 3.6 million people with eczema to 16.8 million without. Eczema was associated with subsequent diagnosis of outcomes with adjusted hazard ratios (99% confidence intervals) from Cox regression of up to 4.02(3.95-4.10) for food allergy (rate difference [RD] per 1,000 person-years of 1.5). Besides strong associations with atopic and allergic conditions (e.g., asthma 1.87[1.39-1.82], RD5.4) and skin infections (e.g., molluscum contagiosum 1.81[1.64-1.96], RD1.8), the strongest associations were with Hodgkin's lymphoma (1.85[1.66-2.06], RD0.02), Alopecia Areata (1.77[1.71-1.83], RD0.2), Crohn's disease (1.62[1.54-1.69], RD0.1), Urticaria (1.58[1.57-1.60], RD1.9), Coeliac disease (1.42[1.37-1.47], RD0.1), Ulcerative colitis (1.40[1.34-1.46], RD0.1), Autoimmune liver disease (1.32[1.21-1.43], RD0.01), and Irritable bowel syndrome (1.31[1.29-1.32], RD0.7). Sensitivity analyses revealed the impact of consultation bias or choice of cohort age cut-off on findings. Comparatively large HRs in severe eczema were seen for some liver, gastrointestinal and cardiovascular conditions, osteoporosis, and fractures. Most cancers and neurological conditions were not associated with eczema.

Pathogenesis-related protein, thaumatin-like protein 1b is a transdermal sensitizing allergen of mango fruits in mouse models

ABSTRACT Food allergens can enter the skin and increase the susceptibility to food allergies by producing immunoglobulin (Ig) E. Mango is a popular fruit worldwide and known to be allergenic. Dermal sensitization may occur around the oral cavity during ingestion of mangoes. However, to date, no allergenic proteins in mangoes have been shown to cause dermal sensitization in humans or animal models. Therefore, we aimed to identify mango proteins that sensitize mice percutaneously. The occiput of BALB/c mice was shaved, and a crude mango extract containing sodium dodecyl sulfate was applied to the skin. Mango protein-specific IgE and IgG1 were produced in response to this treatment. Proteins in mangoes that bind to mouse IgG1 and IgE were purified and identified as thaumatin-like protein 1b (TLP1b). This is the first study to identify TLP1b, a pan-allergen belonging to a family of pathogenesis-related proteins, as a mango allergen causing transdermal sensitization in mice.

Sea Buckthorn Flavonoid Extracted with High Hydrostatic Pressure Alleviated Shrimp Allergy in Mice through the Microbiota and Metabolism.

Sea buckthorn (Hippophaë rhamnoides L.) known as the deciduous shrub has been reported to have effects of antioxidant, anti-inflammatory, and immunomodulatory activities. Tropomyosin (TM) induced a regulatory immune response associated with food allergy. In this study, a mouse model of food allergy sensitized to tropomyosin (TM) was established to assess the antiallergic properties of sea buckthorn flavonoid extract (SBF). SBF alleviated mice's allergic symptoms and exhibited a significant reduction in the levels of IgE and histamine. Meanwhile, SBF repaired the allergic Th2 cell overpolarization generated by TM, via downregulating the IL-4 production and upregulating IFN-γ production to restore the balance of Th1/Th2 cells. Furthermore, the 16S RNA analysis showed that SBF primarily restored the gut microbiota via increasing the abundance in Chitinophilidae and decreasing in Burkholderiaceae, Pneumatobacteriaceae, and Sphingomonadaceae. Gut metabolomes determined by liquid chromatography-mass spectrometry (LC-MS) suggested that TM upregulated PE (14:0/22:1(13Z)) and SBF decreased formimino-l-glutamic acid and urocanic acid levels. According to the KEGG pathway analysis, SBF treatment has been shown to modulate glycerophospholipid and histidine metabolism to improve allergic reactions. SBF holds great promise as a novel potential agent for the treatment of food allergies.

Ayurveda management of Oral Lichen Planus

Background: Oral Lichen Planus (OLP) is a chronic inflammatory disease that affects the mucus membrane of the oral cavity. It is a T-cell mediated autoimmune disease in which the cytotoxic CD8+ T cells trigger apoptosis of the basal cells of the oral epithelium. It is characterized by lesions consisting of radiating white, gray, velvety, thread-like papules in a linear, annular and retiform arrangement forming typical lacy, reticular patches, rings and streakes. Although the exact etiology of this disease is still unknown, but some factors are associated with it like dental materials, autoimmunity, food allergies, stress, trauma, bowel diseases, infectious diseases, genetics etc. Aims and Objectives: To study the role of Ayurveda Chikitsa in the management of Oral Lichen Planus. Materials and Methods: A female patient aged 41 years presented with complaints of oral lesion with burning, pain, occasionally bleeding from gums while brushing. Patient was diagnosed with disease Oral Lichen Planus. Patient was treated with administration of Deepana Pachana Aushadhis followed by Trivritta Churna, Guduchyadi Kwatha internally and with Rasayanadi Yoga being used as local application. After the two month’s treatment, a significant response seen in symptoms like burning, pain and bleeding from gums while brushing. Result: There is a need to make treatments that are widely recognized, widely successful, and capable of withstanding systematic replication available. These treatments should be able to significantly reduce the volume, recurrence and impact of Oral Lichen Planus. Conclusion: Ayurveda has great approach in curing the Oral Lichen Planus.

Comparing two Peanut Desensitization Protocols in pre-school children: a Real-World Clinical Practice.

Peanut allergy is the main food allergy in childhood and poses significant health concerns. This study aimed to critically evaluate the effectiveness and safety of Oral Immune Therapy (OIT) using crushed peanuts versus peanut puffs. Children with an allergist diagnosed peanut allergy based on a history of an IgE-mediated reaction and a positive skin prick test for peanuts were recruited at the Montreal Children's Hospital and the Children's Clinic located in Montreal. Based on age and personal preference, initial doses of peanut were given in either puff (Bamba) or crushed peanut form. Patients continued the same dose for 2-5 weeks at home, filled out a symptom diary, and returned to the clinic for up-dosing until maintenance was reached (2 teaspoons of peanut butter). A continuation ratio regression model was used to evaluate the effect of the allergen type on the severity of anaphylactic and allergic reactions during OIT while adjusting for potential confounders. Between October 2020 and June 2023, 191 children (59.6% male; median age 1.95 years) were recruited. Most patients (75.1%) had eczema, and 12.7% had asthma. Oral desensitization was performed using one of two strategies according to the allergist: Crushed peanut (n=60 (31.4%)( and peanut puff (n=131 (68.6%)). Of the participants, the consumption of puff lowered reaction severity by a factor of 3.39 (95% CI, 1.4 to 8.22), in comparison to crushed peanuts. Older age markedly elevates the adjusted odds of reacting to a particular severity level as compared to a lower level by 1.19 (95% CI, 1.04 to 1.37). Modified peanut desensitization using peanut puffs has shown potential in reducing the severity of allergic reactions in younger children. Older children may experience a higher risk of severe reactions, indicating the need for age-specific approaches to desensitization protocols.

Adverse food reactions and alterations in nutritional status in children with autism spectrum disorders: results of the NAFRA project

BackgroundTo assess the adverse food reactions (AFR) prevalence in children with autism spectrum disorder (ASD) and in non-ASD healthy controls (NASD). Nutritional status alterations, food selectivity and adherence to Mediterranean Diet (MD) were also evaluated.MethodsThe NAFRA (Nutritional status and Adverse Food Reactions in children with Autism Spectrum Disorder) project was an observational, case-control, comparative study conducted at a tertriary center for pediatrics involving Caucasian patients of both sexes, aged 18 months-7 years, with a diagnosis of ASD, and matched NASD controls.ResultsFrom October 2017 to December 2023, 100 ASD patients [79 male, mean (± SD) age 49.9 months (± 15.4)] and 100 NASD controls [75 male, mean (± SD) age 49.8 months (± 17.7)] were enrolled at the Pediatric Section of the Department of Translational Medical Science of the University of Naples Federico II. A significantly higher prevalence of AFR was observed in ASD patients if compared with NASD (16% vs. 2%, p = 0.001), mainly due to a higher prevalence of food allergy (7% vs. 1%, p = 0.03). A significantly higher prevalence of food intolerance and celiac disease was also observed in ASD children. The rate of obesity was significantly higher in ASD patients compared to NASD. Food selectivity and low MD-adherence were more frequent in ASD children (26% vs. 2%, p < 0.0001 and 28% vs. 16%, p = 0.041, respectively).ConclusionsThe high rate of AFR, obesity and unhealthy dietary habits observed in ASD children strongly suggest the importance of a multidisciplinary approach, providing early diagnosis of AFR and appropriate nutritional management to improve core and associated ASD-related conditions.Trial registrationThe NAFRA Project was registered on https://clinicaltrials.gov/ with the identifier NCT04719923. Registered 18 January 2021. https://clinicaltrials.gov/study/NCT04719923.

Zéro allergie research clinic: a clinical and research initiative in oral immunotherapy for managing IgE-mediated food allergy

Background and methodsThe Zéro allergie research clinic (Saguenay, Canada) is a clinical and research initiative in oral immunotherapy (OIT) for managing IgE-mediated food allergy (FA). A total of 183 children with FA and 27 non-allergic siblings were recruited to date in the Zéro allergie cohort (ZAC) to better understand biological mechanisms underlying FA and OIT prognosis. The primary aims are to (a) better understand the genetic, epigenetic, transcriptomic, metabolomic, and microbial diversity associated with FA; (b) establish the multi-omics and microbial diversity profiles of children following OIT to identify predictive prognosis biomarkers, (c) make OIT more accessible to the population of the Saguenay–Lac-Saint-Jean region, and (d) build a biobank of data and biological material.ResultsThe ZAC constitutes a unique and rich biobank of biological samples (blood, buccal swabs, microbiota samples [intestinal, buccal, nasal, and cutaneous]) combined with clinical data and more than 75 phenotypic characteristics.ConclusionsThis represents an innovative interdisciplinary initiative by researchers, allergists, and paediatricians to make FA care accessible to a greater number of children with IgE-mediated FA. Ultimately, it will contribute to provide more accessible treatment options with greater chances of success through a better understanding of the biological nature of FA and OIT.

Validation of a Food Frequency Questionnaire: VioScreen-Allergy

Background/Objectives: An adapted version of an online pictorial food frequency questionnaire (FFQ), VioScreen-Allergy, assesses total dietary intake and intake of allergens and foods in the maternal diet index (MDI), linked to offspring allergy. This study assessed intermethod reliability, test–retest reliability, and external validity of the VioScreen-Allergy. Methods: Females of childbearing age were recruited at Denver Health and Children’s Hospital, Colorado, USA, and were asked to complete four 24 h recalls and two VioScreen-Allergy FFQs over the course of a month. All those with at least two 24 h dietary recalls and both VioScreen-Allergy assessments were analyzed. Energy-adjusted and non-adjusted linear mixed models (1) compared MDI scores and intake of nutrients and allergens as measures of intermethod reliability; (2) evaluated VioScreen-Allergy test–retest reliability as differences between repeated measurements; and (3) assessed external validity by modeling associations between VioScreen-Allergy-derived intake of beta-carotene and orange vegetables and Veggie Meter®-assessed skin carotenoids. Bonferroni corrections controlled multiple comparisons within the assessment. Results: Of 53 participants enrolled, 25 demographically dissimilar participants were included in the analysis. There were no significant differences between 24 h recall and VioScreen-Allergy mean intakes of macronutrients, micronutrients, allergens, or MDI, except for Vitamin C, niacin, and cashew allergen protein. There were no significant differences between repeated measurements of VioScreen-Allergy, either energy-adjusted or unadjusted. Both beta-carotene and orange vegetable servings were significantly associated with Veggie Meter®. Conclusions: Although non-significance could have been due to low power, clinical as well as statistical assessments of intermethod reliability, test–retest reliability, and external validity suggest that VioScreen-Allergy has reasonable utility for trials assessing food allergens and MDI in the context of overall intake. The VioScreen questionnaire can also be used in future studies to assess macro- and micronutrient intake. Additional validation studies assessing different portion sizes and foods eaten by infants and young children are currently undergoing.

Enfant présentant une allergie alimentaire en crèche : quelle est la place du Projet d’Accueil Individualisé ? Quels ressentis pour le personnel ?

ContextThe nursery welcomes children from a few months to the age of 3 years, age range where there is an increase in cases of anaphylaxis related to food allergies (FA). ObjectivesTo draw up an inventory of the training and knowledge of staff with regard to FA. Observe the organization of the Individualized Reception Project (IRP) in the nursery. Take stock of the feelings and possible apprehensions of professionals to work on a daily basis with a child with FA. MethodsSurvey conducted in 2023 with 50 staff working in different childcare facilities. ResultsSeventy-four per cent had initial training on FA, 64% had no training on FA since taking a position in nursery and 66% never handled an adrenaline auto-injector (AAI). Twenty-one per cent of the structures have an internal medicine cabinet to support an inaugural reaction of FA and 14% are equipped with AAI (internal stock not taking into account the AAI of possible IRP). Sixty-eight per cent know that they are allowed to apply the IRP themselves in emergency situations in the nursery, in connection with the ministerial circular of 2021. Sixty-six per cent are comfortable in the daily reception of the child with FA, 38% are comfortable with the handling of the AAI. ConclusionGiven the increasing frequency of FA in small children, it is necessary for early childhood professionals to be better trained and informed during their studies and in the nursery, especially on the administration of AAI. It is desirable that an in-house pharmacy be equipped with AAI for the management of inaugural FA.

GA2LEN ANACARE consensus statement: Potential of omalizumab in food allergy management.

Immunoglobulin E (IgE)-mediated food allergies are the most common type of food allergy, often causing rapid symptoms after exposure to allergens posing a serious health risk and a high impact on patient's and caregiver's quality of life. Omalizumab, a humanized anti-IgE monoclonal antibody, reduces allergic reactions by binding to circulating IgE. Omalizumab has been successfully used in allergic asthma, chronic rhinosinusitis with nasal polyps, and chronic urticaria, and was recently approved for treating IgE-mediated food allergies by the US Food and Drug Administration (FDA). This GA2LEN ANACARE Consensus Statement presents our position on the use of omalizumab for treating IgE-mediated food allergies, based on a systematic review and meta-analysis, experience with use for other conditions, and expert consensus achieved via an eDelphi process. Following publication of the recent OUtMATCH study (stage 1) results and subsequent FDA approval, we propose that there is now sufficient evidence to recommend omalizumab as the only drug currently available that can mechanistically reduce IgE-mediated food allergic reactions. We acknowledge that the evidence does not reach the highest level of evidence which would be needed for a guideline recommendation.

The Role of Bacterial Toxins and Environmental Factors in the Development of Food Allergies

Food allergies (FAs) represent a significant and growing global health issue, with increasing prevalence across different age groups. This review provides a comprehensive analysis of the epidemiology, mechanisms, and risk factors involved in FA development. Currently, FAs are estimated to affect 2% of the general population, with higher rates in children (~8%). However, these figures may be inaccurate because of the reliance on self-reported data and immunoglobulin E (IgE) testing, which may not reflect clinically confirmed cases. Environmental and genetic factors, including exposure to bacterial toxins, dietary habits, and the gut microbiota, play critical roles in FA development. Specifically, Staphylococcus aureus enterotoxins are implicated in disrupting intestinal barriers and enhancing immune sensitization to allergenic proteins. This immune dysregulation promotes Th2 responses and compromises regulatory T cell function, crucial elements in allergy pathogenesis. As the prevalence of FAs continues to rise, there is a pressing need for accurate diagnostic tools, heightened public awareness, and effective prevention strategies. Further research is needed to elucidate the specific role of bacterial toxins and other environmental factors in FA development to advance clinical management approaches.

Exploring the effect of diet programs on the behavior of Sudanese children with autism and the prevalence and association of gastrointestinal symptoms: a multi-center cross-sectional study

Background and aims: Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by social difficulties, speech and nonverbal communication issues, and restricted behaviors. Nutritional issues, such as food allergies and intolerances, can affect children with ASD. This study aimed to evaluate the impact of diet programs on ASD behavior and gastrointestinal symptoms, which would be considered as a starting point to increase the family’s knowledge about how to practice healthy and suitable dieting for their children. Materials and methods: The study was a cross-sectional observational study on 45 children with an autism spectrum disorder in four centers aged 2–18 in Khartoum state. Data was collected through an interview questionnaire, which included sociodemographic, diet, gastrointestinal, and behavioral assessments. The data was analyzed using SPSS to find the correlation between the various variables. Independent t-test, Analysis of Variance, and Mann–Whitney test were used in univariant analysis to assess the association between study variables, while multiple linear regression was used in multivariant analysis for the same purpose Results: The study involved a large number of children with autism spectrum disorder (ASD), with 80% being male and 73.3% being school-aged. Most had parents as guardians and 71.1% were in intermediate financial status. About 20% were overweight or obese, and 57.8% did not have a specific diet program. Food selectivity was prevalent, with 22.7% having allergies to milk and wheat. ASD children experienced vomiting, gastric reflux, abdominal pain, and changes in stool characteristics. A significant link was found between financial status, behavioral status and gastrointestinal changes. High financial status was significantly different from intermediate and low statuses based on behavioral changes. However, no significant association was found in multivariant analysis. Conclusion: The study found that ASD children generally have good nutritional health, with a higher degree of dietary selection. The financial status of guardians significantly influenced behavioral and gastrointestinal changes in the children. Further interventional studies are recommended to assess the direct impact of diet programs on these symptoms.

Exploring food-specific IgG responses in pediatric allergic disorders: A retrospective cross-sectional study

Background: The role of immunoglobulin G (IgG) responses to food as potential triggering factors in allergic disorders continues to be debatable, and is not endorsed by most allergy societies. Objective: To explore the prevalence of specific IgG immune responses to common foods in pediatric allergic disorders and any potential relationship between them. Methods: A retrospective study was conducted on children and adolescents diagnosed with allergic disorders at the Ekthar Clinic in Jeddah City. Food-specific IgG (FS-IgG) antibody test results were collected from their medical records. Results: Seventy-five children with a mean age of 8.5 years (SD = 5.3) were included. The overall allergic diagnosis determined atopic dermatitis as the most common (57.3%, 43 participants), followed by food allergy and allergic rhinitis (each 40%, 30 participants), and bronchial asthma (29.3%, 22 participants). Food-specific IgG levels were elevated in all participants. The foods with the highest levels of FS-IgG were dairy products (88%: cow’s milk [86.6%], sour milk [81.3%], sheep’s milk [74.7%], cheese [72%], and goat’s milk [70.7%]), followed by gluten-containing products (81.3%: wheat [70.7%], gluten [69.3%], and spelt [66.6%]), and eggs (66.6%). Significant correlations (P &lt; 0.05) were found between atopic dermatitis and several foods; chronic urticaria and chicken and lamb; asthma and ocean perch; allergic rhinitis and rennet cheese; and allergic conjunctivitis and potato, pollock, and lamb. Conclusion: Among pediatric allergic disorders, dairy, gluten, and eggs were the most detected foods in FS-IgG tests, with some notable correlations with other foods. FS-IgG testing may help identify potential triggers in refractory allergic disorders.

Aptamer-based sensitive fluorescence β-lactoglobulin food allergen bioassay via dual and cyclic bidirectional strand displacement amplifications.

β-Lactoglobulin (β-Lg) is a prevalent allergenic protein found in most dairy products, which poses great food safety risks for individuals with allergies, especially for infants. Sensitive and effective detection methods for such allergens are essential to reduce the risk of allergies in daily life. Herein, a fluorescent aptamer bioassay based on a dual and cyclic bidirectional strand displacement means is developed for thesensitive detection of β-Lg in infant rice porridge and milk. The aptamer in the duplex DNA probe binds β-Lg to release the assistance strand to further hybridize with two hairpins, which triggers the initiation of two cyclic amplification cycles through the polymerization, displacement, and nicking of the strands under the action of DNA polymerase and endonuclease restriction enzymes. The amplification cycles lead to the unfolding of many fluorescently quenched signal probes to exhibit substantially enhanced fluorescence recovery for detecting β-Lg. The assay can realize detection of β-Lg in concentrations as low as 4.41pM within the range of 0.01 to 10nM. Furthermore, our sensing method has the capability to discriminate β-Lg from other proteins with high selectivity, resulting in low levels of β-Lg detection in rice porridge and milk samples, demonstrating promising potentials of the developed sensing method for monitoring various food allergens.

Guidance for establishing and applying tolerable upper intake levels for vitamins and essential minerals.

Vitamins and essential minerals are micronutrients that are required for the normal functioning of the human body. However, they may lead to adverse health effects if consumed in excess. A tolerable upper intake level (UL) is a science-based reference value that supports policy-makers and other relevant actors in managing the risks of excess nutrient intake. EFSA's principles for establishing ULs for vitamins and minerals were originally developed by the Scientific Committee on Food in 2000. This guidance from the EFSA Panel on Nutrition, Novel Foods and Food Allergens provides an updated framework for UL assessments. A draft was published in 2022 and underwent a 2-year piloting period. The present document incorporates revisions based on the experience gained through its practical implementation. It covers aspects related to the planning of the risk assessment (problem formulation and definition of methods) and its implementation (evidence retrieval, appraisal, synthesis, integration, uncertainty analysis). As in the previous framework, the general principles developed for the risk assessment of chemicals in food are applied, i.e. hazard identification, hazard characterisation, intake assessment, risk characterisation. Specific to nutrients are their biochemical and physiological roles and the specific and selective mechanisms that maintain the systemic homeostasis and accumulation of the nutrient in the body. Such considerations must also be taken into account when conducting risk assessments of nutrients.

Assessment of parental self-efficacy in managing child food-induced anaphylaxis and using adrenaline autoinjectors.

Anaphylaxis is a life-threatening allergic reaction, associated with mental health burden in patients and caregivers. Intramuscular adrenaline via autoinjector (AAI) is the recommended treatment for the management of anaphylaxis in non-hospital settings; however, AAIs are underused. This study aimed to assess parental self-efficacy in managing child's anaphylaxis and administering AAI to understand how to effectively support families. Seventy-five parents of children with severe food allergy completed a questionnaire to measure parental self-efficacy in managing child food-induced anaphylaxis (PSEMA). We conducted an exploratory factor analysis with 12 items, using principal axis factoring as the extraction method. We used Cronbach's alpha to assess the internal consistency of the factors. We used the Anderson-Rubin approach to estimate the factors' scores and provide a kernel density estimate of their distributions. An assessment through linear regression between the total factors' score and total score was performed. A five-factor model was identified. The factors that emerged were conceptually related to "F1. Manage Injection," "F2. Manage AAI Device," "F3. Manage Anaphylaxis," "F4. Manage Emergency," and "F5. Manage Emotions." The questionnaire demonstrated high internal consistency, with a Cronbach's alpha of 0.91 (95% CI: 0.87-0.94) The variation in the total score explained 90% of the variation in the factor score. The PSEMA questionnaire promises to be an easy and effective tool for measuring parents' self-efficacy in managing anaphylaxis and AAI, allowing clinicians to identify gaps in education and provide effective training.

LUPIN FOOD ALLERGY AND CROSS REACTIVITY WITH PEANUT ALLERGY

LUPIN FOOD ALLERGY AND CROSS REACTIVITY WITH PEANUT ALLERGY

Epitope profiling of cow's milk allergen-specific antibodies with determining IgE content in epitopes-ALL, a 14-epitopes mixture

Allergen-specific antibodies (Abs), IgE, and IgG4 increase during the early phase of oral immunotherapy (OIT) of allergen food in patients; subsequently, IgE levels decrease and specific IgG4 levels increase after successful OIT treatment. The detailed profile of these Abs during OIT remains largely unclear. We developed a diagnostic tool to assess the OIT efficacy and extent of responsiveness based on a profiling method by identifying epitopes recognized by the Ab classes of IgE or IgG4.A peptide microarray followed by microplate analysis using synthetic peptides was used to identify 14 epitopes widely recognized by IgE and/or IgG4 in the serum samples of patients with OIT among the amino acid sequences of five major cow's milk allergens. The set of defined 14 epitopes clarified different epitope profiles of allergen-specific IgE and IgG4 in each patient's serum samples. Moreover, the total signal of Abs recognizing all 14 epitopes was equal to the sum of all individual epitope-specific Abs. It was further observed that the quantitative value of IgE concentrations of 14 epitopes-ALL correlated with the ImmunoCAP IgE value.These findings strongly imply that the quantity of IgE and IgG4 recognizing epitopes-ALL may easily be used to measure allergy severity. To investigate this potential, we developed an immunochromatographic method that can detect IgE and IgG4 levels in patient samples.This study clearly demonstrated the usefulness of the defined 14 epitopes and their mixture, “epitopes-ALL,” and that the simple and reliable methods of immunochromatography and microplate analyses demonstrating the epitope profile of allergen-specific Abs are applicable for diagnostic use at multiple disease stages and the OIT-treatment course in patients with cow's milk allergy.

Expert consensus on the diagnosis and management of IgE mediated food allergy in children

The prevalence of food allergy in children is increasing, which seriously affects the quality of life of children and their families. Among children and adolescents, IgE-mediated food allergy is the most common type. In recent years, allergen specific IgE (sIgE) and skin prick testing (SPT) have been widely used in clinical practice, with component resolved diagnosis (CRD) also gaining traction for precise diagnosis of IgE-mediated food allergy. However, a challenge persists in clinical practice due to the tendency to over-interpret food allergen test results without considering the patient's clinical history. While food avoidance remains the most effective treatment for IgE-mediated food allergy, there are varying approaches to clinical management. Strict food avoidance for non-severe food allergies may increase the patient's burden and impact their quality of life. To address these challenges, a consensus on the diagnosis and management of IgE-mediated food allergy in children has been developed based on the latest guidelines and research evidence. This consensus aims to guide physicians in standardizing the management of IgE-mediated food allergy in children.

Interpreting epidemiologic distribution of total and specific IgE levels for food allergy in Southern China from 2004 to 2023: understanding the mechanisms and focusing on prevention

BackgroundThe burgeoning prevalence of food allergy-related diseases is closely associated with geographical allergen distribution and societal lifestyle paradigms. This study aims to shed light on the distribution patterns of specific IgE (sIgE) and total IgE (tIgE) reactivity to common food allergens in the Southern Chinese populace.MethodsEmploying an analytical technique spanning two decades, we conducted specific IgE and total IgE on serum samples harvested from patients with food allergy-related pathologies at First Affiliated Hospital of Guangzhou Medical University from 2004 to 2023. This comprehensive examination of eight prototypical food allergens: egg white, milk, wheat, sesame, peanut, soybean, shrimp, and crab.ResultsOur analysis showed a 100% positivity rate for sIgE and an 86.54% positivity rate for tIgE. Milk had the highest positive response rate, followed by egg white and shrimp. Age-stratified data indicated that milk sensitization peaked in children aged 2 years or younger, while egg white sensitization peaked between 3 and 5 years of age. Sensitization rates for the remaining six allergens increased with age. Additionally, co-sensitization was observed between milk, egg white, crab, and shrimp with other allergens.ConclusionIn common allergens of Southern China, egg white, milk, and shrimp ascend as the dominant subjects, underlining their imperative role in food allergy pathogenesis. This landscape-wide allergenic profiling, segregated across age clusters and enhanced by co-sensitization data, augments our power for early diagnosis and strategic intervention in food allergy diseases.