Food Allergy Research Articles

Introduction: Intravenous lipid emulsions (ILE) containing soy protein may cause reactions in allergic patients. We present a case report of atopic dermatitis (AD) and soy allergy triggered by intravenous lipid emulsion containing soy in an infant with short bowel syndrome (SBS). Case Report: A 9-month-old female infant with SBS who had been fed total parenteral nutrition (PN) since birth was consulted for severe AD. Laboratory tests revealed eosinophilia, elevated total IgE, and soy-specific IgE was found positive at 3.56 KU/L. Lipid emulsion containing 20% soybean-oil in PN was replaced with soy-free. The patient's AD lesions resolved rapidly. The food provocation test with re-administration of a soy-containing lipid emulsion confirmed the diagnosis of soy allergy by causing recurrence of eczematous lesions. Conclusions: This case demonstrates that ILE can cause soy sensitization and trigger AD without oral exposure. Food allergies should also not be forgotten in patients who receive only PN.

Oral immunotherapy (OIT) is an emerging treatment for IgE-mediated food allergy, but eosinophilic esophagitis (EoE) has been reported as a potential complication, especially with milk and egg. Data on wheat OIT are limited. This study examined the incidence, course, and outcomes of EoE in children undergoing wheat OIT. We retrospectively reviewed 79 children with confirmed IgE-mediated wheat allergy treated with OIT between 2020 and 2023 at two tertiary centers in Iran. Patients with suspected EoE underwent endoscopy with histopathology. Diagnosis required ≥15 eosinophils/high-power field. Management included wheat elimination and proton pump inhibitors (PPIs) ± topical corticosteroids. Eight of 79 patients (10.1%) developed EoE. Seven became symptomatic during up-dosing or early maintenance; one asymptomatic patient was diagnosed at parental request. Histopathology confirmed 18-110 eosinophils/HPF. All symptomatic cases improved after OIT discontinuation and medical therapy. No severe anaphylaxis occurred. Follow-up endoscopy was limited by patient refusal. EoE occurred in 10% of children during wheat OIT, mainly in the up-dosing phase. While symptoms resolved with treatment and cessation, distinguishing transient OIT-induced eosinophilia from persistent EoE remains critical. Prospective studies with pre- and post-OIT endoscopy are needed to guide monitoring and management.

Atopic dermatitis (AD) and food allergy (FA) frequently manifest during infancy and share skin barrier dysfunction as a critical early pathogenic event. Recent research has elucidated structural, lipidomic, microbial, and immunologic abnormalities that compromise the skin barrier and contribute to disease onset. Filaggrin gene mutations, altered ceramide profiles, and type 2 cytokine-driven inflammation are among the key factors disrupting epidermal integrity. While AD and FA exhibit overlapping features, including elevated risk in the presence of skin barrier defects, their pathophysiologic pathways are more complicated. This review provides updated evidence on the role of the skin barrier in the pathogenesis of AD and FA. It further highlights the distinction between these conditions and discusses recent findings from birth cohorts and interventional trials. In AD, early emollient application and environmental control show limited but promising preventive effects, particularly in high-risk infants. In FA, prevention strategies should also address the induction of oral immune tolerance through timely introduction of allergenic foods. Future research should focus on refining predictive biomarkers, validating stepwise interventions, and developing safe, barrier-based strategies that integrate both prevention and treatment to reduce the burden of AD and FA from early life.

BackgroundPrimary Atopic Disorders (PAD) represent a recently recognized subset of inborn errors of immunity (IEI), characterized by severe atopy driven by genetic mutations leading to dysregulated type 2 immune responses, excessive mast cell activation, and hyper production of IgE. In PAD patients, severe atopic manifestations, including eczema, asthma, food allergies, and eosinophilic gastrointestinal disorders, are often associated with other signs of immune dysfunction.MethodsRecognizing the need for standardized diagnostic and management guidelines for PAD, a Delphi‐based expert consensus was developed within the Immunology Committee of the Italian Society of Pediatric Allergy and Immunology (SIAIP). After a systematic review of the literature and the development of the clinical statements, 45 specialists from multiple pediatric subspecialties reached an agreement on key aspects of PAD classification, diagnosis, and treatment.ResultsThe consensus focuses on some red flags that could aid clinicians in suspecting PAD. The document also proposes a diagnostic work‐up to differentiate monogenic PAD from polygenic allergic conditions. It also emphasizes the importance of molecular pathway analysis to direct precision treatments, including biological drugs. Given the complexity of the field and the potential overlap between PAD and other IEI, the consensus recommends a multidisciplinary approach to diagnosis and treatment. The document establishes a framework for early recognition of PAD, integrating emerging genetic insights into clinical practice and promoting personalized therapeutic strategies.ConclusionsThe present work is the first structured consensus to standardize PAD diagnosis and management among pediatric subspecialists, aiming to improve patient outcomes through early intervention and tailored therapies.

Association of depression, anxiety with asthma outcomes and allergic comorbidities: results from the National Health Interview Survey.

Measles–mumps–rubella vaccine in children with food allergies

Residential greenness modifies the association between long-term exposure to PM2.5 components and allergic diseases in schoolchildren: A large-scale study in Southern China.

BackgroundSkin prick testing (SPT) is a cornerstone diagnostic procedure for identifying allergic sensitizations in children. Despite being minimally invasive, it often provokes considerable anxiety, fear, and pain, potentially compromising test accuracy due to poor compliance. Virtual reality (VR) has emerged as a promising non‐pharmacological tool for procedural distress management, yet its application in allergy diagnostics remains underexplored.ObjectiveTo evaluate the effectiveness of VR in reducing procedural anxiety, fear, and pain, and improving compliance in children undergoing SPT.MethodsThis single‐center, cross‐over interventional study enrolled 108 children (aged 4–18 years) with suspected or confirmed environmental or food allergies. Each participant underwent two SPT sessions: one with immersive VR distraction and one using standard‐of‐care (SOC) distraction methods, separated by a 6‐month washout period. Outcomes were assessed using validated scales for anxiety (Children's Anxiety Meter), fear (Children's Fear Scale), pain (Wong‐Baker FACES), and procedural compliance (modified Induction Compliance Checklist). Physiological parameters and staff satisfaction were also recorded.ResultsVR significantly reduced anxiety, fear, and pain compared to SOC across multiple time points, with marked improvements in compliance (100% full compliance in the VR group vs. 0% in SOC) and staff satisfaction. No adverse events were reported, confirming the safety of VR in this setting.ConclusionsVR is a safe and effective tool for minimizing procedural distress and enhancing compliance in children undergoing SPT. Its integration into routine allergy diagnostics may improve patient experience and procedural success.

Following a request from the European Commission, the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) was asked to deliver an opinion on synthetic cannabidiol as a novel food (NF) pursuant to Regulation (EU) 2015/2283. The NF which is subject of the application is the (−)‐cannabidiol (CBD) produced by chemical synthesis and proposed to be used in food supplements at a maximum use level of 150 mg/day. The target population is the general population above 6 years of age, excluding pregnant and lactating women. During the risk assessment, the Panel identified a number of data gaps, which needed to be addressed by the applicant. EFSA's request for additional information was sent to the applicant. The requested data concerned the identity, the production process, the compositional data, the specifications, the genotoxicity, the reproductive and developmental toxicity and the human data of the NF. The applicant did not reply or provide sufficient information on the identity (small particles and/or nanoparticles), stability, genotoxicity, reproductive and developmental toxicity and the human data for the NF. The applicant did not reply to the latest EFSA's request (in June 2022) for additional data. Based on the available data, the Panel concludes that the safety of the NF cannot be established.

Investigation of α-dicarbonyl compounds induced glycation on the digestive stability of shrimp tropomyosin and intestinal microbiota.

A new perspective on the regulation of food allergy: the tilt from a single component to a multi-component system.

Ultrasensitive and rapid screening of food allergy risk via aptamer-engineered AuMBA@AgNPs core-shell nanoparticle SERS tags-based lateral flow immunoassay

Moisture-dependent cold plasma pretreatment enhances allergen Ara h 1 reduction during heat processing in peanuts.

Unraveling the mysteries of food allergens: aptamer-driven detection and suppression strategies.

Storage proteins (SPs), including 2S albumins, vicilins, and legumins, are key allergenic molecules (AMs) of peanuts, tree nuts (TNs), and sesame. Their structural stability contributes to allergenicity and sensitization. This study explored SP AM clustering patterns and evaluated the test performance of multiplex microarray (MM) testing in a pediatric cohort. We retrospectively analyzed 350 children (median age: 3.7 years) with detectable SP sensitizations (≥0.1 kUA/L) using the ALEX2 MM platform. Sensitization interrelationships were analyzed using correlation heatmaps, hierarchical clustering (HC), dimensionality reduction, and feature elimination. Predictive utility was assessed through ROC curve analysis at different sensitization cut-offs (>0.1 and >0.3 kUA/L) and total IgE thresholds (>0, >20, and >50 kU/L). HC identified a broad SP cluster spanning peanuts, TNs, sesame, poppy seed, and buckwheat. Strong correlations and early HC linkages suggested extensive cross-sensitization (e.g., Ana o 3-Pis v 1 and Jug r 4-Cor a 9), alongside evidence of co-sensitization and molecular spreading. Unexpected clustering of structurally dissimilar peanut and pistachio AMs pointed to shared epitopes and/or cross-contamination. 2S albumins (Ara h 2, Cor a 14, Jug r 1, Ana o 3, and Ses i 1) were most predictive for clinical reactivity. Lower cut-offs and exclusion of patients with low total IgE improved test performance. Alpha-hairpinin (Pap s 2S albumin) showed potential as specific markers. MM testing enables detailed SP sensitization profiling. Cluster-based interpretation may clarify cross- vs. co-sensitization, supporting informed clinical decisions. Use of recombinant AMs and IgE stratification may further enhance MM utility in food allergy diagnostics.

Thirty year trends in childhood asthma and allergic conditions in Poland.

Negative pressure-controlled microneedle-microfluidic hybrid chip for painless in situ detection of ovalbumin-sIgE in skin interstitial fluid.

Application of droplet digital PCR for the detection of fish DNA in food products.

Component-resolved diagnostics study on nut sensitization and cross-reactivity in China.

Comparative study on the mechanisms of citrus pectin and polygalacturonic acid in alleviating food allergies