Potential Food Allergens Research Articles

Eosinophilic esophagitis and duodenal food challenge - evaluation through endoscopic confocal laser endomicroscopy.

Endoscopic confocal laser endomicroscopy (eCLE) is an established technique that allows clinical evaluation of mucosal integrity by fluorescein leaking through the mucosa upon duodenal food challenge (DFC). Analysis of eCLE with DFC in eosinophilic esophagitis (EoE) would be interesting to evaluate epithelial barrier dysfunction also in other regions of the gastrointestinal tract and to characterize potential individual food allergens that trigger the esophageal inflammation. In an observational and proof of concept study we evaluated 9 patients with histologically proven EoE by eCLE and DFC. Severity of symptoms were graduated according to the validated symptom-based EoE activity index. The endoscopic appearance of the esophagus was described according to the Endoscopic Reference Score System (ERERS). Spontaneous and food induced transfer of fluorescein into duodenal lumen were detected 10 minutes following intravenously application of fluorescein and 10 minutes after DFC. Food allergens were yeast, egg, soy, milk, and wheat, respectively. Local application of sodium chloride solution 10 % to the duodenal mucosa before DFC served as a control. Patients responding to DFC received a dietary exclusion therapy according to the results of DFC. We investigated 9 patients with EoE (8 men, 49.7±13.8, 36-76 years). Symptom-based EoE activity index was 79±27.4, 33-100. In all patients EoE was confirmed by histology with number of esophageal mucosal eosinophilic granulocytes > 15/HPF, (91.4±77.4, 42-263). Mean ERERS score was 4.5±1.3, 3-7. None of the patients was aware of any food intolerance. eCLE revealed one patient with spontaneous transfer of i. v. fluorescein into duodenal lumen before DFC ("leaky gut"). 40 DFC were performed in the remaining 8 patients of whom 5 patients (61 %) responded to DFC. Rank order of fluorescein leakage upon DFC was wheat and milk in 37.5 % each, soy in 25 %, and egg in 12.5 %. The patients were treated by PPI (n=9), esophageal bouginage (n=5) and/or local corticoid therapy (n=3). The 5 patients responding to DFC received an additional food exclusion dietary advice focussed on the results of DFC. All patients reported a reduction of their symptoms. EoE activity indexes of patients with positive DFC were 73.7+28.6, 33-100 before and 22.7+37.9, 0-79 four weeks after food exclusion. The findings of our proof of concept study suggest that eCLE with DFC may be an interesting tool to further evaluate patients with EoE. This technique has the potential to identify patients who may benefit from an additional individual dietary therapy.

IS PEA OUR HIDDEN ALLERGEN? AN AMERICAN PEDIATRIC CASE SERIES

<h3>Introduction</h3> With the growing scope of the health-food industry, efforts are made to incorporate protein into food to attract consumers. Recently, plant-based diets consisting of legumes are becoming a diet trend, thus a focus as a source of protein. Those allergenic legumes (Soybeans,Lupins,Peanuts) are part of the mandatory labeling in the EU and the US, allowing consumers to easily identify and avoid them. Dun-pea proteins are found in minced steak, breadcrumbs that coat meats, pharmaceutics, and specialized food for athletes⁸. Allergies to green and dun-pea have been emerging and reported in several case reports. The two main allergens found are Pis-s 1 and Pis-s 2, members of the Vicilin and Covicilin families. However, in contrast to other allergens, pea-protein is not included on food labels as a potential food allergen in the EU, Canada, and the US, thus, making it a masked potential cause of allergic reactions. There is currently no data on dun-pea allergy in the US and little data regarding green-pea allergy. Thus, with the progressive increase in pea/pea proteins inclusion in foods, we report 6 children who presented to the Hospital-based Allergy clinic with allergic reactions to foods containing green peas or pea protein. <h3>Cases</h3> (Table 1) <h3>Discussion</h3> The prevalence of pea allergies is unknown; however, the sensitization rate was higher than soya beans, lupins, peanuts. Hence, identification of pea allergens should gain more attention by allergists, especially as they can be non-obvious ingredients in foods. Also, several publications reported the coexistence of legumes and pea allergies due to cross-reactive IgEs against peas.

The Role of IgA in Chronic Upper Airway Disease: Friend or Foe?

Chronic upper airway inflammation is amongst the most prevalent chronic disease entities in the Western world with prevalence around 30% (rhinitis) and 11% (rhinosinusitis). Chronic rhinitis and rhinosinusitis may severely impair the quality of life, leading to a significant socio-economic burden. It becomes more and more clear that the respiratory mucosa which forms a physiological as well as chemical barrier for inhaled particles, plays a key role in maintaining homeostasis and driving disease. In a healthy state, the mucosal immune system provides protection against pathogens as well as maintains a tolerance toward non-harmful commensal microbes and benign environmental substances such as allergens. One of the most important players of the mucosal immune system is immunoglobulin (Ig) A, which is well-studied in gut research where it has emerged as a key factor in creating tolerance to potential food allergens and maintaining a healthy microbiome. Although, it is very likely that IgA plays a similar role at the level of the respiratory epithelium, very little research has been performed on the role of this protein in the airways, especially in chronic upper airway diseases. This review summarizes what is known about IgA in upper airway homeostasis, as well as in rhinitis and rhinosinusitis, including current and possible new treatments that may interfere with the IgA system. By doing so, we identify unmet needs in exploring the different roles of IgA in the upper airways required to find new biomarkers or therapeutic options for treating chronic rhinitis and rhinosinusitis.

Detection of chicken DNA in commercial dog foods

BackgroundThese days the number of potential food allergens is very large, but chicken is one of the most common allergens in dogs. Elimination diet is one of the clinical tools for the diagnosis of allergies and allergy tests are not very reliable. The restriction diet is most commonly carried out by feeding pet foods, relying on the ingredients on the label to select an elimination diet not containing previously eaten foods. Unfortunately, mislabeling of pet food is quite common. The purpose of this study was to determine the absence or presence of chicken DNA using both qualitative and quantitative polymerase chain reaction (PCR) analysis methods in dry and wet maintenance complete pet foods for adult dogs. Results were used to verify the declared composition on the labels.ResultsEleven out of fifteen (73%) dog foods were produced as declared by the manufacturer, two of which showed the presence of chicken protein as stated on the label. The remaining nine foods contained amounts of chicken DNA below 1%, consistent with declarations that no chicken was added in the composition. Four of tested dog foods (27%) were not produced consistently with the declaration on the packaging. Two dog foods (one dry and one wet) did not contain the claimed chicken protein. In two foods the addition of chicken DNA was detected at the level of over 2% and almost 6%, respectively.ConclusionsIn this study, we focused on one of the most commonly undeclared animal species on the label—chicken protein—and performed DNA analyzes to investigate possible contamination and mislabeling. The results showed some inaccuracies. However, most of them are trace amounts below 1%, which proves compliance with the label. Our results showed that undeclared animal species can be as common as missing an animal protein declared on the label. The conducted research indicates that both dry and wet analyzed foods should not be recommended as a diagnostic tool in elimination tests, because it may result in false negative results. Over-the-counter maintenance foods for dogs should not be recommended for the diagnosis and treatment of food hypersensitivity.

The Australian Feeding Infants and Toddler Study (OzFITS 2021): Breastfeeding and Early Feeding Practices.

The Australian Feeding Infants and Toddler Study 2021 (OzFITS 2021) is a nationwide survey of Australian caregivers’ infant and toddler feeding practices. Here, we describe breastfeeding rates and duration, use of breastmilk substitutes, and introduction of complementary (solid) foods, including common food allergens. Caregivers (n = 1140) were recruited by a digital marketing company and were interviewed using a structured telephone questionnaire to obtain information. Breastfeeding was initiated in 98% of infants, but the duration of exclusive breastfeeding to six months was less than 1%. Nearly 40% of children continued to receive breastmilk beyond one year, with 10% of toddlers receiving breastmilk at two years. One-quarter of infants were introduced to solid foods between 4 to 5 months, and nearly all infants had received solid foods by 7 months. New guidelines encourage the early introduction of potential food allergens to reduce the risk of allergy, and by 12 months, over 90% of children had been given eggs and peanuts. One-third of children received no breastmilk substitutes during their first year. One-third of infants first received breastmilk substitutes following birth and before discharge from the hospital. Of these infants, 30% ceased breastmilk substitute use after discharge. Our findings suggest a high rate of continued breastfeeding with 44% receiving breastmilk beyond 1 year. One approach to increase the duration of exclusive breastfeeding is to reduce breastmilk substitute use while in hospital.

Food Allergy Prevention and Management in Children

Food allergy is a reaction mediated by immunological mechanisms that cause various symptoms in susceptible individuals while harmless in individuals who are not sensitive to the specific allergen. The reactions that take place are divided into three: IgE-mediated reactions, non-IgE-mediated reactions, and mixed-type reactions. While many types of food have the potential to cause allergen reactions, fewer foods are responsible for the most clinically severe reactions and for the majority of reported cases. Food allergy, which is increasingly common worldwide, is becoming an important public health problem. Although there are no clear epidemiological data, the prevalence of food allergy varies between 6-10% in preschool children and decreases to 2-5% in adulthood. Food allergy has long been recognized as a pediatric disease, as most cases tend to begin in childhood and disappear with growth. There is increasing evidence to support the role of early administration of potential food allergens to prevent food allergy. The management process of food allergy cases includes plans and innovative treatment strategies aimed at a personalized approach.

Food/Feed and Environmental Risk Assessment of Herbicide-tolerant and Insect-resistant Genetically Modified Maize NK603 x MON810 for Import, Processing, Food and Feed Uses under Regulation (EC) No 1829/2003 (EFSA/GMO/UK/2004/01)

Food/Feed and Environmental Risk Assessment of Herbicide-tolerant and Insect-resistant Genetically Modified Maize NK603 x MON810 for Import, Processing, Food and Feed Uses under Regulation (EC) No 1829/2003 (EFSA/GMO/UK/2004/01)

Final Health and Environmental Risk Assessment of Genetically Modified Soybean MON 87701

Soybean MON 87701 expresses the cry1Ac gene from Bacillus thuringiensis. The encoded Cry1Ac protein confers resistance against specific lepidopteran pests. Updated bioinformatics analyses of the inserted DNA and flanking sequences in soybean MON 87701 have not indicated a potential production of harmful toxins and allergens or polypeptides caused by the genetic modification. Genomic stability of the functional insert and consistent expression of the cry1Ac gene, have been shown over several generations of soybean MON 87701. Data from several field trials performed in USA, Canada, Chile and Argentina during 2005-2006 show that soybean MON 87701 is compositionally, morphologically and agronomically equivalent to its conventional counterpart and other commercial soybean cultivars. Subchronic feeding studies with rats as well as nutritional assessment with broilers have not revealed relevant adverse effects of MON 87701. These studies indicate that MON 87701 is nutritionally equivalent to and as safe as conventional soybean cultivars. The Cry1Ac protein produced in soybean MON 87701 do not show sequence resemblance to known toxins or IgE-dependent allergens, nor has the whole GM plant been reported to cause changes in IgE-mediated allergic reactions in patients reactive to soybean or in non-ectopic control individuals. Soybean is not cultivated in Norway, and there are no cross-compatible wild or weedy relatives of soybean in Europe. Based on current knowledge and considering the intended uses, which exclude cultivation, the VKM GMO Panel concludes that soybean MON 87701 with the Cry1Ac protein:&#x0D; &#x0D; - Is compositionally, morphologically and agronomically equivalent to its conventional counterpart and other commercial soybean cultivars&#x0D; - Is unlikely to introduce a toxic or allergenic potential in food or feed compared to conventional soybean cultivars&#x0D; - Is nutritionally equivalent to and as safe as its conventional counterpart and other conventional soybean cultivars&#x0D; - Does not represent an environmental risk in Norway.

Restaurant disclosure of food allergens: Analysis and economic implications

Research suggests that between 20–30% of consumers self-identify as having some form of food allergy or sensitivity and demand for allergy-safe foods is growing. European Union regulations require restaurants to inform diners of the presence of 14 primary food allergens. The method of disclosure, however, is left to the discretion of the restaurant and may include verbal communication, menu labels, or separate informational pamphlets. Despite these requirements, 74% of allergen related food incidents arise from the non-prepackaged (restaurant) environment. Individuals with allergens, therefore, may avoid restaurants or intentionally seek out, especially in the tourism context, venues with publicly disclosed allergen prevention protocols. Due to group effects and social media's ability to channel consumers, implementing allergy-friendly practices could substantially increase restaurant profits. This research examines the performance of the restaurant industry in leading tourist destinations in Croatia with respect to self-disclosure of potential food allergens. Menus, accompanying websites and social media reviews of 973 restaurants across 43 locations were analyzed. Results indicate that very few restaurants have taken affirmative steps to disclose food allergens on their websites (1.3% of English and 0.8% of Croatian websites). Of the subset of restaurants with on-line menus, 6.5% disclosed specific food allergens. In contrast, third-party social media reviews of 24.6% of the restaurants included some statement relating to food allergens. Based on the results, this paper suggests strategies for improved food allergen communication. Specifically, restaurants should make greater efforts to affirmatively disclose allergen information on their websites and monitor social media reviews. Very few restaurants responded to consumer comments, thereby allowing others to dictate the narrative. In light of the strong consumer interest and relatively weak self-disclosure efforts, the hospitality industry has a ready opportunity to attract new consumers by moving beyond regulatory minimums through enhanced allergen communication efforts and social media engagement.

Are Dietary Lectins Relevant Allergens in Plant Food Allergy?

Lectins or carbohydrate-binding proteins are widely distributed in seeds and vegetative parts of edible plant species. A few lectins from different fruits and vegetables have been identified as potential food allergens, including wheat agglutinin, hevein (Hev b 6.02) from the rubber tree and chitinases containing a hevein domain from different fruits and vegetables. However, other well-known lectins from legumes have been demonstrated to behave as potential food allergens taking into account their ability to specifically bind IgE from allergic patients, trigger the degranulation of sensitized basophils, and to elicit interleukin secretion in sensitized people. These allergens include members from the different families of higher plant lectins, including legume lectins, type II ribosome-inactivating proteins (RIP-II), wheat germ agglutinin (WGA), jacalin-related lectins, GNA (Galanthus nivalis agglutinin)-like lectins, and Nictaba-related lectins. Most of these potentially active lectin allergens belong to the group of seed storage proteins (legume lectins), pathogenesis-related protein family PR-3 comprising hevein and class I, II, IV, V, VI, and VII chitinases containing a hevein domain, and type II ribosome-inactivating proteins containing a ricin B-chain domain (RIP-II). In the present review, we present an exhaustive survey of both the structural organization and structural features responsible for the allergenic potency of lectins, with special reference to lectins from dietary plant species/tissues consumed in Western countries.

Practical Challenges and Considerations for Early Introduction of Potential Food Allergens for Prevention of Food Allergy

Recent randomized controlled trials aimed at the prevention of food allergy have led to sweeping changes in food allergy prevention guidelines. Emphasis is now on the introduction of potential food allergens, particularly peanut and egg, rather than avoidance. Although guidelines recommend against delaying the introduction of other potential allergens, there remains little or no evidence of the benefit of their early introduction. Parents and physicians alike report a need for greater guidance and resources on early potential allergen introduction in the complementary feeding period. A thorough understanding of early introduction literature, current prevention guidelines, and infant nutrition will empower physicians to address patient needs and concerns both when advice is established as effective and where uncertainty remains. We discuss the state of the science, compare recommendations between guidelines, and provide practical options to introduce allergenic foods, alongside other complementary foods, within the first year of life. We include a review of the available literature, including review and suggestions of potential doses of food allergens, and the first published comparison of commercially available products and homemade early introduction foods to help clinicians support their patients. We address the nutritional, dietary, and practical considerations of introducing food allergens in the first year of life while adhering to infant feeding guidelines. Finally, given the limitations of existing guidelines, we review the need for shared decision-making between physicians and parents regarding early allergen introduction.

Nutrition and Avoidance Diets in Children With Food Allergy.

Food allergy (FA) is a significant health issue which considerably influences the quality of life of both children and their family. The increasing prevalence of FA, documented in the last 3 decades, has led to the reassessment of FA prevention strategies and particularly to giving up the approach based on delaying the introduction of potential food allergens. Several observational and interventional studies demonstrated a potential effectiveness of the early food introduction strategy in FA prevention, although strong evidence from randomized controlled trials are lacking and, sometimes, contrasting. The current approach to FA is mainly based on avoidance diet and the use of rescue medications in case of allergic reaction, although active allergen immunotherapy has recently become an increasingly important therapeutic strategy to approach IgE-mediated FA, potentially able to induce improvement through desensitization to a specific food. This review provides an overview on the historical evolution of recommendations about FA and on evidence published in the last 15 years on nutritional intervention strategy, i.e., early introduction of allergen or avoidance diet, in the prevention and management of IgE-mediated and non-IgE-mediated FA in children.

Restaurant Disclosure of Food Allergens: Analysis and Economic Implications

Individuals increasing express concern regarding food allergies. Research suggests that between 20-30% of consumers self-identify as having some form of food allergy or sensitivity. Demand for allergy-safe foods is growing, especially in the restaurant and tourism sector. European Union regulations require restaurants to inform diners of the presence of 14 primary food allergens. The method of disclosure, however, is left to the discretion of the restaurant and may include verbal communication, menu labels, or separate informational pamphlets. Not surprising, given the lack of standardization and potential for misinformation, 74% of allergen related food incidents arise from the non-prepackaged (restaurant) environment. Individuals with allergens, therefore, may avoid restaurants or intentionally seek out, especially in the tourism context, venues with publicly disclosed allergen prevention protocols. Due to group effects and social media's ability to channel consumers, implementing allergy-friendly practices could substantially increase restaurant profits. In some regions, social media platforms rate restaurant responsiveness to allergens and governments maintain voluntary databases listing restaurants that conform to allergy-prevention standards. This research examines the performance of the restaurant industry in leading tourist destinations in Croatia with respect to self-disclosure of potential food allergens. Menus, accompanying websites and social media reviews of 973 restaurants across 43 locations were analyzed to determine the level of disclosure for food allergens. Based on the results, this paper suggests strategies for improved food allergen communication, engagement with social media networks and potential government support for allergy-friendly tourism initiatives.

Food/Feed and Environmental Risk Assessment of Insect-resistant and Herbicide-tolerant Genetically Modified Maize GA21 from Syngenta Seeds for Food and Feed Uses, Import and Processing under Regulation (EC) No 1829/2003 (EFSA/GMO/UK/2005/19)

Food/Feed and Environmental Risk Assessment of Insect-resistant and Herbicide-tolerant Genetically Modified Maize GA21 from Syngenta Seeds for Food and Feed Uses, Import and Processing under Regulation (EC) No 1829/2003 (EFSA/GMO/UK/2005/19)

Food/Feed and Environmental Risk Assessment of Insect-Resistant and Herbicide-Tolerant Genetically Modified Maize Bt11 x GA21 in the European Union under Regulation (EC) No 1829/2003 (EFSA/GMO/UK/2007/49)

Food/Feed and Environmental Risk Assessment of Insect-Resistant and Herbicide-Tolerant Genetically Modified Maize Bt11 x GA21 in the European Union under Regulation (EC) No 1829/2003 (EFSA/GMO/UK/2007/49)

Food/Feed and Environmental Risk Assessment of Insect-resistant Genetically Modified Maize MIR604 for Food and Feed Uses, Import and Processing under Regulation (EC) No 1829/2003 (EFSA/GMO/UK/2005/11)

Food/Feed and Environmental Risk Assessment of Insect-resistant Genetically Modified Maize MIR604 for Food and Feed Uses, Import and Processing under Regulation (EC) No 1829/2003 (EFSA/GMO/UK/2005/11)

Food/Feed and Environmental Risk Assessment of Insect-Resistant and Herbicide-Tolerant Genetically Modified Maize Bt11 from Syngenta Seeds for Food and Feed Uses, Import and Processing under Regulation (EC) No 1829/2003 (EFSA/GMO/RX/Bt11)

Food/Feed and Environmental Risk Assessment of Insect-Resistant and Herbicide-Tolerant Genetically Modified Maize Bt11 from Syngenta Seeds for Food and Feed Uses, Import and Processing under Regulation (EC) No 1829/2003 (EFSA/GMO/RX/Bt11)

Food/Feed and Environmental Risk Assessment of Application (Reference EFSA/GMO/UK/2008/56) for Authorization of Insect Resistant and Herbicide Tolerant Genetically Modified Maize Bt11 x MIR604 x GA21 for Food and Feed Uses, Import and Processing under Regulation (EC) No 1829/2003 from Syngenta Seeds

Food/Feed and Environmental Risk Assessment of Application (Reference EFSA/GMO/UK/2008/56) for Authorization of Insect Resistant and Herbicide Tolerant Genetically Modified Maize Bt11 x MIR604 x GA21 for Food and Feed Uses, Import and Processing under Regulation (EC) No 1829/2003 from Syngenta Seeds

Food/feed and Environmental Risk Assessment of Insect-resistant and Herbicide-tolerant Genetically Modified Maize MIR604 x GA21 in the European Union under Regulation (EC) No 1829/2003 (EFSA/GMO/UK/2007/48)

Food/feed and Environmental Risk Assessment of Insect-resistant and Herbicide-tolerant Genetically Modified Maize MIR604 x GA21 in the European Union under Regulation (EC) No 1829/2003 (EFSA/GMO/UK/2007/48)

Food/Feed and Environmental Risk Assessment of Insect Resistant Genetically Modified Maize 1507 for Cultivation, Import, Processing, Food and Feed Uses under Directive 2001/18/EC and Regulation (EC) No 1829/2003 (C/ES/01/01, C/NL/00/10, EFSA/GMO/NL/2004/02)

Food/Feed and Environmental Risk Assessment of Insect Resistant Genetically Modified Maize 1507 for Cultivation, Import, Processing, Food and Feed Uses under Directive 2001/18/EC and Regulation (EC) No 1829/2003 (C/ES/01/01, C/NL/00/10, EFSA/GMO/NL/2004/02)