Soy Allergy Research Articles

The predominance of seafood allergy in Vietnamese adults: Results from the first population-based questionnaire survey

BackgroundFood allergy (FA) is a serious, costly and growing health problem worldwide. FA occurs in both children and adults; however, there is a paucity of information on FA prevalence and its clinical features in the adult population, especially in Asia. We sought to assess the prevalence of FAs in Vietnamese adults and the distribution of offending food items among different regions throughout Vietnam. MethodsA nationwide, cross-sectional, population-based survey was conducted among University students aged 16–50 years. We used a structured, anonymous questionnaire, which was modified from recently published FA epidemiologic studies and based on European Academy of Allergy and Clinical Immunology (EAACI) guidelines, to collect data on FA prevalence, clinical presentations, and implicated food groups. Statistical analysis was performed to generate the prevalence of self-reported and doctor-diagnosed FA and to examine the association of key environmental factors and FA incidence in this population. ResultsOf the 14,500 surveys distributed, a total of 9,039 responses were returned, resulting in a response rate of 62.4%. Among participants who reported food-induced adverse reactions, 48.0% have repeated reactions. 18.0% of the participants perceived FA symptoms, but less than half of them sought medical services for confirmation (37.9%). Stratifying for true FA symptoms, the prevalence of self-reported FA was 11.8% and of doctor-diagnosed FA, 4.6%. The most common doctor-diagnosed FA was to crustacean (3.0%; 95% CI, 2.6–3.3), followed by fish (1.6%; 95% CI, 1.3–1.8), mollusk (1.3%; 95% CI, 1.0–1.5) and beef (1.0%; 95% CI, 0.8–1.2). The prevalence of doctor-diagnosed FA differed among participants living in urban (6.5%) and rural regions (4.9%) (P < 0.001). Atopic family history was the strongest predictor for FA (odds ratio 8.0; 95% CI, 6.2–10.4). ConclusionsSeafood allergy among adults is predominant in Vietnam, followed by beef, milk, and egg, while peanut, soy, and tree nut allergy are much less common. Populations in rural regions have considerably less FA; however, the protective environmental factors have yet to be identified.

Soy Skin Prick Test in Patients with Physician-Diagnosed Atopic Disorders

Abstract Background Soy protein is an important component of soybeans and is one the 8 most significant food allergens. Yet, the prevalence of soy allergy in the pediatric population is not well defined. Objectives To evaluate the incidence of IgE mediated soy protein sensitization among children with clinical manifestation of atopic disorders by the use of skin prick test (SPT) for soy protein. Methods Two hundred patients with atopic manifestations attending the Pediatric Allergy and Immunology Clinic at the Pediatric Department of Ain shams University, were recruited between January 2017 till January 2018. They were subjected to SPT to soy protein, measurement of total serum IgE and eosinophilic count in the peripheral blood. Results Of the 200 patients, 108 (54%) were males and 92 (46%) were females with a male to female ratio of 1.17:1. Their ages ranged between 2 years and 15 years (mean±SD; 6.0±33.3 years). Seven patients (3.5%) had positive skin prick test to soy protein. The mean value for the absolute eosinophilic count was 0.4x109/L. The median for the total serum IgE level was 50 IU/L. According to age, the highest percentage of soy protein sensitivity was elicited among patients less than 3 years (57.14%), followed by those between 3 to 6 years (28.5%) and those between 6 and 15 years (14.28%). A positive family history of atopy was recorded in 122 (61%) of all cases. In terms of gender, incidence of soya sensitivity was higher among males than females but with no statistical difference. Although the most common allergic manifestations of all studied patients were respiratory (83%), and atopic dermatitis (22.5%), yet positive SPT to soy proteins was elicited in 43% in allergic rhinitis cases, in 29% of asthma patients, in 14% of patients with combined asthma and allergic rhinitis, and 14.3% of patients having eczema. Conclusion Soy protein sensitization is not uncommon in children especially in those with atopic manifestations. Large scale studies are needed to evaluate the actual incidence of soy protein hypersensitivity in children.

Tolerance of soya lecithin in children with non-immunoglobulin E-mediated soya allergy: a randomised, double-blind, cross-over trial.

Soya lecithin is present in a wide variety of foods regularly consumed by children, in the form of an emulsifier or stabiliser. Children with non-immunoglobulin (Ig)E-mediated allergies who commonly have to avoid milk and soya will have a significantly restrictive diet with reduced alternative foods if soya lecithin also has to be eliminated. The present study aimed to establish whether children with non-IgE-mediated gastrointestinal soya allergy react to soya lecithin in food products. A double-blind, cross-over study was performed in soya-allergic children aged between 8months and 5years. Eligible children had their soya allergy status confirmed with a home challenge. Children were randomly assigned to either placebo or challenge dose of soya lecithin (1.5g per day) in a custom-made biscuit. This was followed by a 1-week washout period and cross-over to another 1week of challenge or placebo dose. Symptoms were recorded prior to commencing the study and at the end of each week's challenge. Twenty-two children, 16 boys, with a median age of 44months (range 21-58months) were recruited, although only 20 completed the full study. The median number of foods avoided in addition to soya was 3. Over the challenge period, the parents reported reactions in six cases: five cases (23%) to the placebo and one case (5%) to the challenge dose. There was no statistical difference (P=0.025) between the groups. One child with a non-IgE-mediated gastrointestinal allergy had a slight reaction to soya lecithin. Although single cases may react to soya lecithin, we suggest that soya lecithin should be included in children with this delayed allergy, unless they have a confirmed reaction to traces of soya within this emulsifier.

Comparing quality of life in Canadian children with peanut, sesame, and seafood allergy

Children with food allergy (FA) have a worse quality of life (QOL) than children with other chronic diseases, and the impact of FA on QOL depends on various factors, including type of FA.1-3 Three studies have compared QOL across peanut, tree nut, seafood, milk, egg, wheat, and soy allergy, but either relied on self-reported FA,2,3 or measured parent/caregiver but not child QOL.1 The Canadian Food Allergy Registry (CFAR)4 provides a unique opportunity to compare parent-proxy QOL in a large group of pediatric patients with allergist-diagnosed peanut, sesame, and seafood allergy.

Kwashiorkor in Upper Middle Class Suburbia in the United States (FS17-02-19)

ObjectivesMalnutrition continues to be a major cause of death worldwide among children aged 5 years and under. We describe two patients who developed kwashiorkor while being predominantly fed rice milk. MethodsAn 11-month old Caucasian male presented with a 3-day history of worsening edema, decreased oral intake, diffuse maculopapular rash, and poor weight gain. He was diagnosed with dairy, soy, and sesame allergies by two allergists and was placed on rice milk. Labs revealed hypoalbuminemia, anemia, transaminitis, zinc and copper deficiency. He was started on Elecare Jr and vitamin supplementation with clinical improvement.A 2-year-old Caucasian male presented with a 7-day history of abdominal distension, abdominal pain, edema, and rash. He had multiple food allergies. His diet consisted of diluted almond and rice milk, chips, apples, and corn. He had hypoalbuminemia and anemia with multiple vitamin deficiencies. ResultsKwashiorkor is characterized by severe malnutrition, hypoalbuminemia, edema, irritability, and rash. It is rare in the US but is being reported in patients receiving rice milk as their major source of nutrition. Previously described cases were due to dietary manipulations by the parents. Both our patients were under the guidance of physicians. Rice milk has been suggested as an alternative for patients with milk protein allergy however; not all products on the market have the same nutritional value, with significantly varied fortification. A recent study examined patients diagnosed with CMPA fed an extensively hydrolyzed rice protein-based formula called Novarice. This formula contains 21.9 calories and 0.6 grams of protein per ounce. Both our patients were ingesting Rice Dream which contains only 15 calories and 0.13 g of protein per ounce. ConclusionsInfants who ingest rice milk are at high risk of developing severe malnutrition with hypoalbuminemia, edema, and nutritional deficiencies. It is important to educate not only consumers but health care providers on nutritional composition of these products. Translating an evidence-based study on the benefits of fortified rice milk into clinical practice needs to be performed cautiously since not all rice milk products are nutritionally alike. Funding SourcesNone. Supporting Tables, Images and/or GraphsTable 1▪

PARENT REPORT OF PHYSICIAN DIAGNOSIS IN PEDIATRIC FOOD ALLERGY: AN UPDATE

Introduction Food allergies (FA) are a significant health concern for children in the United States, yet access to proper diagnosis and management can be limited. This study aims to characterize current childhood FA diagnosis practices in the US. Methods A survey was administered via web and telephone to a sample of US households between 2015-2016, providing parent parent-proxy responses for 41,341 children. Stringent symptom criteria were developed with FA experts to distinguish respondents with “convincing” FA from those with similar conditions. Post stratification-weighted proportions were estimated to compare FA diagnosis characteristics by allergy type. Results Approximately 39% (95% CI: 35.6-42.4) of convincing FA was not physician diagnosed. For families earning between $25,000 and $50,000, children were significantly more likely to not have received a physician diagnosis. Among physician-diagnosed FA, 68.2% (95% CI: 63.6-72.4) were evaluated with a skin prick test, 50% (95% CI: 46.2-54.7) with an IgE test, and 25% (95% CI: 21.2-29.3) with an oral food challenge. Rates of physician diagnosis differed by allergen with 81% of convincing peanut allergies physician diagnosed compared to under 55% of convincing milk, fin fish, wheat, and soy allergies. Odds of physician diagnosis were significantly higher for children with eczema, asthma, and seasonal allergy. Conclusions These data suggest that children with convincing FA are often not receiving a proper diagnosis. It is critical we determine barriers to physician diagnosis of FA to ensure the best care and management of these children.

FOOD ALLERGEN COMPOSITION IN MAJOR RESTAURANTS

Introduction There is no clear research on the percentage of allergens in foods at restaurants. Heavy focus is given to nut allergies when in fact nuts are one of the least common ingredients found in restaurants. This also proves the need for resources to cater to individuals with Gluten, Dairy, Egg, and Soy Allergies. Methods Restaurant allergen information was collected online and from the restaurant sources. This data was then imported into R and using various statistical methods the allergen composition of foods was analyzed. Results Results were recorded. Dairy was the most common allergy found in restaurants, shockingly present in 62 - 74% of all food items. Gluten was second with a presence of 56 - 70% of all food items. Soy was third with a presence of 52 - 65% of food items. Egg was fourth with a presence of 33-45% of food items. Peanuts, Tree Nuts, Shellfish, and Fish had a presence of, 2%,3%,5%,7% respectively. These results are with a 95% confidence interval, and do not include restaurants that specifically cater to those with food allergies as these are not always known or accessible to people. Conclusions This highlights the need to focus on treatments and resources for those with Gluten, Dairy, Egg, and Soy allergies specifically as those are the most impactful on day to day eating life.

Low frequency of soya allergy in peanut‐allergic children: Relevance to allergen labelling on medicines

Low frequency of soya allergy in peanut‐allergic children: Relevance to allergen labelling on medicines

Analysis of Soy Allergy Using Molecular Component Testing

Soy allergy is one of the most common food allergies. The presence of IgE specific to soy component storage proteins Gly m4, m5, and m6 has been indicated as a means to improve the specific identification of systemic and local soy allergic reactions. A retrospective review of national laboratory data was performed over samples testing for IgE to Gly m4, 5, and 6 (Phadia ImmunoCAP). Data from de-identified patient samples were compiled into risk groups based on current research utilizing the international standard cutoff of 0.35kU/L as a positive test for IgE. Of the sample set, 46% of patients were responsive to at least one soy component. Of these, 39% of patients display response to only Gly m5 and 6, the components most indicative of a severe and systemic response to soy. Patients responsive to Gly m4 only represented 37%, and 15% were responsive to all components. Few patients were responsive to Gly m5 or 6 separately or associated with Gly m4. Nearly 60% of positive pediatric (<10Y) patients were responsive to both Gly m5 and 6 and only 14% to Gly m4 alone. Patients older than 10 years predominantly respond to Gly m4 alone over m5 and m6 only (54% to 24%). Molecular component allergy testing represents a major step forward in assessing risk of soy allergies and constructing an appropriate medical response. A significant rate of specificity between the identification of markers for systemic and local/non-specific reactions indicates the importance of this information for patients and their families.

Particularities of the Diet Used in Milk Allergy

Abstract Allergies become more common nowadays because of numerous risk factors and better medical resources for diagnostics. So, it is imperative to have at least an idea how to control them rather than treating them. A proper diet for an allergy may prevent it to be clinically significant and improve the patient’s life quality and symptoms. Milk allergy is one of the most common ones together with gluten and soy allergies. Older children and adults are easy to manage because they can communicate, and they eat almost everything. But the problem occurs especially in young infants, the most challenging ones because milk is vital for their survival and development. In the following article, we will try to highlight its particularities and explain what a patient with this condition should eat, taking into consideration processed food, found nowadays in every supermarket. We will detail what is allowed what is not allowed to consume, so this kind of a diet should be easy to prescribe by any nutritionist and easy to follow by every patient.

Suppressive activity of enzymatically-educed soy protein hydrolysates on degranulation in IgE-antigen complex-stimulated RBL-2H3 cells

Background: Soy protein isolate (SPI) is increasingly used in foods because it is a high quality non-dairy protein with excellent functional properties. However, soy allergy is one of the world’s major eight food allergies. Objective: To investigate the anti-allergic activity of soy protein hydrolysates (SPHs) produced with alcalase and pepsin proteases.Methods: SPI was enzymatically hydrolysed using the proteases, while evaluating the reaction conditions which include E/S (enzyme to substrate ratio) of 0.5%, 1.0% and 1.5% (250 u/mg and 5 u/g of pepsin and alcalase respectively); and hydrolysis time (0 min, 30 min, 1h, 2h, 4h and 8h). Afterwards, rat basophilic leukaemia (RBL)-2H3 cells activated by the IgE-antigen complex were used to assess mast cell degranulation inhibitory activity of the SPHs by the release of β-hexosaminidase. RBL-2H3 cells were sensitized with monoclonal anti-dinitrophenol (DNP) specific IgE and challenged with the antigen DNP-bovine serum albumin in the presence or absence of SPHs.Results: It was observed that 0.1 mg/mL concentration of the 0.5% E/S SPHs prepared in the first 4h significantly (P &lt; 0.05) inhibited β-hexosaminidase release in an IgE-antigen complex-stimulated RBL-2H3 cells compared to those produced at other time intervals, E/S, and concentrations.Conclusion: This is the first report of its kind that shows the ability of SPHs to suppress degranulation of RBL-2H3 cells. Consequently, SPHs have good prospects to be used as potential sources of low cost hypo or anti-allergic protein.Keywords: Soy Protein Isolate, Soy Protein Hydrolysates, RBL-2H3 Cells, β-Hexosaminidase, Anti-allergy

Health impact of childhood and adolescent soy consumption.

Soyfoods have been intensely researched, primarily because they provide such abundant amounts of isoflavones. Isoflavones are classified as both plant estrogens and selective estrogen receptor modulators. Evidence suggests that these soybean constituents are protective against a number of chronic diseases, but they are not without controversy. In fact, because soyfoods contain such large amounts of isoflavones, concerns have arisen that these foods may cause untoward effects in some individuals. There is particular interest in understanding the effects of isoflavones in young people. Relatively few studies involving children have been conducted, and many of those that have are small in size. While the data are limited, evidence suggests that soy does not exert adverse hormonal effects in children or affect pubertal development. On the other hand, there is intriguing evidence indicating that when soy is consumed during childhood and/or adolescence, risk of developing breast cancer is markedly reduced. Relatively few children are allergic to soy protein, and most of those who initially are outgrow their soy allergy by 10 years of age. The totality of the available evidence indicates that soyfoods can be healthful additions to the diets of children, but more research is required to allow definitive conclusions to be made.

Propofol Use in Pediatric Patients With Food Allergy and Eosinophilic Esophagitis.

Propofol is a safe, well-tolerated anesthetic that is labeled as contraindicated in patients with egg or soy allergy. This contraindication has become increasingly problematic given the rising incidence of food allergy and eosinophilic esophagitis (EoE). To address this issue, we studied practice patterns of propofol use for esophagogastroduodenoscopies in children with EoE and food allergies at our institution. A retrospective observational study of 1365 esophagogastroduodenoscopies from January 2013 to June 2014 was performed. Data were analyzed using Student t tests, chi square tests, Fisher exact tests, and multivariable logistic regression. We found that propofol was used significantly less in patients with egg or soy allergy, and in patients with EoE, even after adjusting for the presence of food allergy. There was no difference in complication rates relative to propofol use. Propofol was used safely in pediatric patients with EoE and food allergy in this limited single-center review.

Kronik Kabızlığı Olan Çocuklarda Besin Allerjisinin Rolü

Objective: We aimed to evaluate the role of food allergies in the etiology of constipation in children who presented with chronic constipation. We investigated the effects of the allergens on constipation by eliminating the relevant allergen from diet in cases with positive food allergy testing in the study. Materials and Methods: The study included 75 patients aged 6 months-10 years with functional constipation. The severity of constipation was assessed with the constipation symptom score. Food-specific IgE levels were evaluated in the sera while skin prick and atopy patch tests were performed by using milk, egg white, egg yolk, wheat, and soybean in all patients. For the patients with positive test results, the allergen was eliminated from the diet over 2 months. Two months later, these patients were re-evaluated by using the constipation symptom score. Results: There was a female predominance (62.7%) in the study group. The mean age was 4.69±0.295 (mean±SD) years. The mean duration of constipation was 24±2 (mean±SD) months. The atopy patch test was positive in 4 of the 75 (5.3%) patients. Atopy patch test positivity was found for egg white and yolk in the first patient, wheat and soy in the second, wheat alone in the third, and soy alone in the fourth. The skin prick test was found to be negative in all four patients. Food mixed specific IgE levels were positive in three of the four patients with a positive atopy patch test (2.31kU/L, 2.35 kU/L, 0.1 kU/L and 1.16 kU/L, respectively). When patients were reevaluated after an elimination diet by using the constipation symptom score, the symptom score had improved in only one patient, the one with soy allergy. Conclusion: Our findings support that food allergy has no role in chronic constipation. The atopy patch test did not make an additional contribution to the diagnosis of food allergy.

The BASALIT multicenter trial: Gly m 4 quantification for consistency control of challenge meal batches and toward Gly m 4 threshold data.

The BASALIT clinical trial (EudraCT 2009-011737-27) investigated efficacy of birch allergen immunotherapy on lowest observed adverse effect levels after soy food challenge in patients with birch-associated and Glym4 allergen mediated soy allergy. Thus, consistently stable Glym4 levels were required in standardized challenge meals. Soy meal included soy protein isolate (SPI, 88% total protein). A Glym4 specific ELISA was developed and validated. Six SPIs and 24 meal batches were analyzed for Glym4. (Repeated-measures) analyses of variance were done to identify potential changes between batches and time intervals. Glym4 was below the ELISA detection limit (2ng/mL) in placebo batches. With <20% mean coefficient of variation, Glym4 levels were consistent in 24 soy meal batches and within individual 12-wk shelf-life. The novel Glym4 specific ELISA proved consistency of challenge meal batches over a 56-month study period. With an average of 178 μg/g Glym4 in SPI, Glym4 lowest observed adverse effect level can be calculated once clinical lowest observed adverse effect level data based on SPI are available. Hence, sensitivity of patients can be correlated to the relevant allergen content instead of total protein of the allergenic source.

Standardization of double blind placebo controlled food challenge with soy within a multicentre trial.

BackgroundMulticentre trials investigating food allergies by double blind placebo controlled food challenges (DBPCFC) need standardized procedures, challenge meals and evaluation criteria. We aimed at developing a standardized approach for identifying patients with birch related soy allergy by means of DBPCFC to soy, including determination of threshold levels, in a multicentre setting.MethodsMicrobiologically stable soy challenge meals were composed of protein isolate with consistent Gly m 4 levels. Patients sensitized to main birch allergen Bet v 1 and concomitant sensitization to its soy homologue Gly m 4 underwent DBPCFC. Outcome was defined according to presence and/or absence of ten objective signs and intensity of eight subjective symptoms as measured by visual analogue scale (VAS).Results138 adult subjects (63.8% female, mean age 38 years) underwent DBPCFC. Challenge meals and defined evaluation criteria showed good applicability in all centres involved. 45.7% presented with objective signs and 65.2% with subjective symptoms at soy challenge. Placebo challenge meals elicited non-cardiovascular objective signs in 11.6%. In 82 (59.4%) subjects DBPCFC was judged as positive. 70.7% of DPBCFC+ showed objective signs and 85.4% subjective symptoms at soy challenge. Subjective symptoms to soy challenge meal in DBPCFC+ subjects started at significantly lower dose levels than objective signs (p < 0.001). Median cumulative eliciting doses for first objective signs in DBPCFC+ subjects were 4.7 g [0.7–24.7] and 0.7 g [0.2–4.7] total soy protein for first subjective symptoms (p = 0.01).ConclusionsWe present the hitherto largest group of adults with Bet v 1 and Gly m 4 sensitization being investigated by DBPCFC. In this type of food allergy evaluation of DBPCFC outcome should not only include monitoring of objective signs but also scoring of subjective symptoms. Our data may contribute to standardize DBPCFC in pollen-related food allergy in multicentre settings.Trial registrationEudraCT: 2009-011737-27.

Industrial Applications of Selected JFS Articles

Industrial Applications of Selected <i>JFS</i> Articles

The conformational IgE epitope profile of soya bean allergen Gly m 4

Birch pollen-related soya allergy is mediated by Gly m 4. Conformational IgE epitopes of Gly m 4 are unknown. To identify the IgE epitope profile of Gly m 4 in subjects with birch pollen-related soya allergy utilizing an epitope library presented by Gly m 4-type model proteins. Sera from patients with (n = 26) and without (n = 19) allergy to soya as determined by oral provocation tests were studied. Specific IgE (Bet v 1/Gly m 4) was determined by ImmunoCAP. A library of 59 non-allergenic Gly m 4-type model proteins harbouring individual and multiple putative epitopes for IgE was tested in IgE binding assays. Primary, secondary and tertiary protein structures were assessed by mass spectrometry, circular dichroism and nuclear magnetic resonance spectroscopy. All subjects were sensitized to Gly m 4 and Bet v 1. Allergen-specific serum IgE levels ranged from 0.94 to > 100 kUA /L. The avidities of serum IgE were 5.06 ng (allergic) and 1.8 ng (tolerant) as determined by EC50 for IgE binding to Gly m 4. 96% (46/48) of the protein variants bound IgE. Model proteins had Gly m 4-type conformation and individual IgE binding clustered in six major surface areas. Gly m 4-specific IgE binding could be inhibited to up to 80% by model proteins harbouring individual IgE binding sites in an epitope-wise equimolar fashion. Receiver operating curve analysis revealed an area under fitted curve of up to 0.88 for model proteins and 0.66 for Gly m 4. Serum levels and avidity of Gly m 4-specific IgE do not correlate with clinical reactivity to soya. Six IgE-binding areas, represented by 23 amino acids, account for more than 80% of total IgE binding capacity of Gly m 4. Model proteins may be used for epitope-resolved diagnosis to differentiate birch-soya allergy from clinical tolerance.

High pressure processing assisted enzymatic hydrolysis – An innovative approach for the reduction of soy immunoreactivity

Abstract Soybean (Glycine max (L.) MERR.) is recognized as a potent food allergen causing one of the most frequent food allergies worldwide. The effect of high pressure processing (HPP) prior to and during enzymatic hydrolysis using the enzyme preparation Flavourzyme® on the degree of hydrolysis (DH), molecular weight distribution (SDS-PAGE) and β-conglycinin (Gly m5) immunoreactivity of soy protein isolate (SPI) was studied. Enzymatic hydrolysis was carried out at atmospheric pressure (0.1 MPa) and HPP (100–600 MPa) at 50 °C for 15 min. Pressures higher than 300 MPa enhanced the degradation of Gly m5, which was confirmed by SDS-PAGE and LC-MS/MS analyses. The immunoreactivity of the samples was assessed by in vitro sandwich ELISA using mouse monoclonal anti-Gly m5 antibodies. Depending on the antibody tested, the residual immunoreactivity was completely inhibited or significantly impaired up to 99.5% applying HPP during hydrolysis at 400 and 500 MPa. By means of principal component analysis, the beany and green off-flavors characteristic for unprocessed SPI could be reduced by pressure enhanced hydrolysis at 400–500 MPa. The resulting hydrolysates possessed improved protein solubility, foaming activities and oil-binding capacities, which were improved by 45%, 66%, and 210%, respectively. HPP prior to and during enzymatic hydrolysis at 400–500 MPa constitutes an innovative approach for the production of low-allergen food ingredients that combine good taste and enhanced functional properties. Industrial relevance Food allergy has emerged in the last years as the incidence and prevalence are rising dramatically. Up to now, enzymatic hydrolysis is the only feasible method to mitigate soy allergy. However, the major drawback associated with enzymatic hydrolysis is the incomplete destruction of allergenic epitopes and the formation of a strong bitter taste. This research activity demonstrates that high pressure assisted enzymatic hydrolysis using the enzyme preparation Flavourzyme effectively reduces the immunoreactivity of soy proteins. Degree of hydrolysis analysis, SDS-PAGE, mass spectrometry as well as sandwich ELISA with mouse monoclonal anti-Gly m5 antibodies have been applied to analyze the destruction of allergenic proteins as well as to determine the residual immunoreactivity. This study provides preliminary evidence that this innovative combination process of high pressure and enzymatic hydrolysis has great potential to produce tasty low-allergen soy-based food ingredients with good physicochemical properties, i.e. protein solubility and foamability.

Quality of life in patients with food allergy.

Food allergy has increased in developed countries and can have a dramatic effect on quality of life, so as to provoke fatal reactions. We aimed to outline the socioeconomic impact that food allergy exerts in this kind of patients by performing a complete review of the literature and also describing the factors that may influence, to a greater extent, the quality of life of patients with food allergy and analyzing the different questionnaires available. Hitherto, strict avoidance of the culprit food(s) and use of emergency medications are the pillars to manage this condition. Promising approaches such as specific oral or epicutaneous immunotherapy and the use of monoclonal antibodies are progressively being investigated worldwide. However, even that an increasing number of centers fulfill those approaches, they are not fully implemented enough in clinical practice. The mean annual cost of health care has been estimated in international dollars (I$) 2016 for food-allergic adults and I$1089 for controls, a difference of I$927 (95 % confidence interval I$324–I$1530). A similar result was found for adults in each country, and for children, and interestingly, it was not sensitive to baseline demographic differences. Cost was significantly related to severity of illness in cases in nine countries. The constant threat of exposure, need for vigilance and expectation of outcome can have a tremendous impact on quality of life. Several studies have analyzed the impact of food allergy on health-related quality of life (HRQL) in adults and children in different countries. There have been described different factors that could modify HRQL in food allergic patients, the most important of them are perceived disease severity, age of the patient, peanut or soy allergy, country of origin and having allergy to two or more foods. Over the last few years, several different specific Quality of Life questionnaires for food allergic patients have been developed and translated to different languages and cultures. It is important to perform lingual and cultural translations of existent questionnaires in order to ensure its suitability in a specific region or country with its own socioeconomic reality and culture. Tools aimed at assessing the impact of food allergy on HRQL should be always part of the diagnostic work up, in order to provide a complete basal assessment, to highlight target of intervention as well as to evaluate the effectiveness of interventions designed to cure food allergy. HRQL may be the only meaningful outcome measure available for food allergy measuring this continuous burden.