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Dinardo G, Fierro V, Del Giudice MM, Urbani S, Fiocchi A. Food-labeling issues for severe food-allergic consumers. Curr Opin Allergy Clin Immunol 2023; 23:233-238. [PMID: 37185828 DOI: 10.1097/aci.0000000000000902] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
PURPOSE OF REVIEW Food label represent the primary and only source of information before consuming a food product. Deputy government agencies on five continents require allergenic ingredients to be declared when used in prepackaged foods to assist patients in identifying allergenic foods and to help them to choose wisely. Unfortunately, the mandatory allergen list and legislation regarding food labels and reference doses is not uniform and varies by country. This may add difficulties to food-allergic patients, especially those with severe food allergy. RECENT FINDINGS A new definition of food allergy severity (the DEFASE grid, developed by the World Allergy Organization), aims to assist clinicians in the identification of the at-risk patients. The FASTER ACT and Natasha's Laws has made important improvements such as the entry of sesame as a major allergen in the United States, and increased evidence of allergens on the food label within prepackaged for direct sale (PPDS) in the UK. The recent introduction of Vital 3.0 brought important new features such as an updated reference doses for many foods. SUMMARY Currently, there are still considerable differences regarding food labels in different countries. Growing public and scientific attention to the problem promises to increase the food safety for allergens. Among the next improvements, we expect a reconsideration of the food reference doses, a harmonization of the food oral challenge process, and the promulgation of regulatory rules for the precautionary labeling.
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Affiliation(s)
- Giulio Dinardo
- University of Campania Luigi Vanvitelli: Universita degli Studi della Campania Luigi Vanvitelli, Naples
| | - Vincenzo Fierro
- Bambino Gesu Pediatric Hospital: Ospedale Pediatrico Bambino Gesu, Rome, Italy
| | | | - Sara Urbani
- Bambino Gesu Pediatric Hospital: Ospedale Pediatrico Bambino Gesu, Rome, Italy
| | - Alessandro Fiocchi
- Bambino Gesu Pediatric Hospital: Ospedale Pediatrico Bambino Gesu, Rome, Italy
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2
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Du Z, Li L, Liu J, Xu Y, Cui L, Yin J. Clinical profiles of patients with wheat-induced anaphylaxis at various ages of onset. World Allergy Organ J 2023; 16:100767. [PMID: 37128249 PMCID: PMC10148224 DOI: 10.1016/j.waojou.2023.100767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 03/16/2023] [Accepted: 03/27/2023] [Indexed: 05/03/2023] Open
Abstract
Background Wheat-induced anaphylaxis (WIA) is a serious and potentially life-threatening wheat allergy, more common in adults than in children. Little is known about the differences in clinical profiles in WIA among patients of various ages in China. Methods We analyzed data retrospectively from an allergy department in a tertiary hospital that included 248 patients (208 adults and 40 children and adolescents) with a history of WIA. Results We found that alcohol was more frequent in patients aged ≥50 years [older adults] (19.0%, 4/21) than in those aged 12-17 years [adolescents] (0%, 0/33; p = 0.019). The frequency of NSAID use in older adults (42.9%, 9/21) was significantly higher than that in adolescents (0%, 0/33; p < 0.001), and patients aged 18-49 years [young adults] (2.8%, 5/178; p < 0.001). During WIA, cardiovascular symptoms in children were less frequent than those in other age groups (children, 28.6%; adolescents, 87.9%; young adults, 93.0%; older adults, 95.2%; p < 0.001). The consciousness loss rate in adults (both age groups; p < 0.001) and the hypotension rate in older adults (p = 0.006) were higher than those in other age groups. Compared with adults (young and older adults), children had a higher rate of allergic comorbidities (p = 0.004, 0.001, respectively) and a higher rate of other food allergies (p < 0.001, <0.001, respectively). Compared with the mild-to-moderate anaphylaxis group, the severe anaphylaxis group had a higher onset age (p = 0.001), higher cofactor prevalence (p = 0.004), lower allergic comorbidity rate (p = 0.014), and higher positive rate of specific IgE to omega-5 gliadin (ω-5 gliadin) (p = 0.023). Conclusion Clinical profiles of patients with WIA are different among various onset age/severity groups. An improved understanding of WIA symptoms in various age/severity groups could help accelerate diagnosis, suggest preventive measures, and contribute to improved patient care.
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Affiliation(s)
- Zhirong Du
- Department of Allergy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
- Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment of Allergic Disease, Beijing, 100730, China
- National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, 100730, China
| | - Lun Li
- Department of Allergy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
- Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment of Allergic Disease, Beijing, 100730, China
- National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, 100730, China
| | - Juan Liu
- Department of Allergy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
- Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment of Allergic Disease, Beijing, 100730, China
- National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, 100730, China
| | - Yingyang Xu
- Department of Allergy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
- Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment of Allergic Disease, Beijing, 100730, China
- National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, 100730, China
| | - Le Cui
- Department of Allergy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
- Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment of Allergic Disease, Beijing, 100730, China
- National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, 100730, China
| | - Jia Yin
- Department of Allergy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
- Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment of Allergic Disease, Beijing, 100730, China
- National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, 100730, China
- Corresponding author. Department of Allergy, Peking Union Medical College Hospital, No. 1 Shuaifuyuan Street, Wangfujing, Beijing, 100730, China.
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3
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Lloyd M, Loke P, Mack DP, Sicherer SH, Perkin MR, Boyle R, Yin Leung AS, Lee BW, Levin M, Blumchen K, Fiocchi A, Ebisawa M, Oliveira LCLD, Tang MLK. Varying Approaches to Management of IgE-Mediated Food Allergy in Children Around the World. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:1010-1027.e6. [PMID: 36805346 DOI: 10.1016/j.jaip.2023.01.049] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/31/2023] [Accepted: 01/31/2023] [Indexed: 02/17/2023]
Abstract
Food allergy is a chronic disease that affects individuals of all ages and is a significant public health problem globally. This narrative overview examines clinical management strategies for IgE-mediated food allergy in children around the world to understand variations in practice. Information was drawn from clinical practice guidelines, recent research, the websites of professional and governmental bodies with expertise in food allergy, and clinical experts from a broad cross-section of geographical regions. The structure and delivery of clinical services, allergen avoidance and food labeling, and resources to support the management of allergic reactions in the community are discussed in detail. The adoption of emerging food immunotherapies is also explored. Wide variations in clinical management of food allergy were apparent across the different countries. Common themes were continuing issues with access to specialist care and recognition of the need to balance risk reduction with dietary and social restrictions to avoid unnecessary detrimental impacts on the quality of life of food allergy sufferers. Findings highlight the need for standardized presentation of practice and priorities, and may assist clinicians and researchers when engaging with government and funding agencies to address gaps.
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Affiliation(s)
- Melanie Lloyd
- Allergy Immunology, Murdoch Children's Research Institute, Parkville, VIC, Australia; Centre for Medicine Use and Safety, Monash University, Parkville, VIC, Australia
| | - Paxton Loke
- Allergy Immunology, Murdoch Children's Research Institute, Parkville, VIC, Australia; Department of Paediatrics, Monash University, Clayton, VIC, Australia; Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
| | - Douglas P Mack
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Scott H Sicherer
- Elliot and Roslyn Jaffe Food Allergy Institute, Division of Allergy and Immunology, Kravis Children's Hospital, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Michael R Perkin
- Population Health Research Institute, St. George's, University of London, London, United Kingdom
| | - Robert Boyle
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Agnes Sze Yin Leung
- Department of Paediatrics, Prince of Wales Hospital, the Chinese University of Hong Kong, Shatin, Hong Kong; Hong Kong Hub of Paediatric Excellence, the Chinese University of Hong Kong, Shatin, Hong Kong
| | - Bee Wah Lee
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Michael Levin
- Division of Paediatric Allergology, University of Cape Town, Cape Town, South Africa
| | - Katharina Blumchen
- Department of Children and Adolescent Medicine, Division of Pneumology, Allergology and Cystic Fibrosis, University Hospital Frankfurt, Goethe-University, Frankfurt, Germany
| | - Alessandro Fiocchi
- Translational Research in Paediatric Specialities Area, Allergy Division, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Motohiro Ebisawa
- Clinical Research Center for Allergy and Rheumatology, National Hospital Organization, Sagamihara National Hospital, Sagamihara, Japan
| | - Lucila Camargo Lopes de Oliveira
- Department of Paediatrics, Division of Allergy, Clinical Immunology and Rheumatology, Federal University of São Paulo, São Paulo, Brazil
| | - Mimi L K Tang
- Allergy Immunology, Murdoch Children's Research Institute, Parkville, VIC, Australia; Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia; Department of Allergy and Immunology, Royal Children's Hospital, Parkville, VIC, Australia.
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4
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Zhou J, Wang Y, Zhou C, Zheng L, Fu L. A ratiometric fluorescent aptasensor based on EXPAR to detect shellfish tropomyosin in food system. Food Control 2023. [DOI: 10.1016/j.foodcont.2022.109380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Jung S, Lee SY, Yoon J, Cho HJ, Park MJ, Song KB, Choi EJ, Paek EY, Yang SI, Lee E, Hong SJ. Atopic Dermatitis With Coexisting Food Allergy in Early Life Is Associated With Childhood Asthma. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2022; 14:565-580. [PMID: 36174996 PMCID: PMC9523419 DOI: 10.4168/aair.2022.14.5.565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/13/2022] [Accepted: 06/28/2022] [Indexed: 06/16/2023]
Abstract
PURPOSE Atopic dermatitis (AD) and food allergy (FA) are associated with respiratory comorbidities, in the concept of 'atopic march.' However, children with AD and a coexisting FA have various disease courses, and the mechanism of atopic march remains unclear. In this study, we investigated whether the phenotype of AD with coexisting FA in early life affected asthma or allergic rhinitis (AR) in school children. METHODS A total of 1,579 children from the Panel Study on Korean Children (PSKC) cohort were followed-up in 2013. The participants diagnosed with AD in this cohort were classified by the age of AD onset and persistence as well as FA history. We compared the presence of comorbidities-asthma and rhinitis-among different AD phenotypes. RESULTS Asthma and AR with current symptoms within 12 months at age 6-8 years were associated with early-onset persistent AD phenotype, regardless of coexisting FA. AD with FA conferred a higher risk of recent wheezing at 8 years of age than AD without FA (adjusted odds ratio, 8.09; 95% confidence interval, 2.54-25.76). Children with early-onset persistent AD with FA manifested a distinctive trajectory with a higher prevalence of wheezing and AR at age 5-8 years than those without AD. CONCLUSIONS AD with FA in early life is strongly associated with asthma and AR in school children, and the early-onset persistent AD with FA had a strong additive effect on the risk of asthma at school age. Classifying AD phenotypes regarding FA in early life will help predict and prevent asthma and AR in school children.
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Affiliation(s)
- Sungsu Jung
- Department of Pediatrics, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - So-Yeon Lee
- Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jisun Yoon
- Department of Pediatrics, College of Medicine, Chung-Ang University, Seoul, Korea
| | - Hyun-Ju Cho
- Department of Pediatrics, International St. Mary's Hospital, Catholic Kwandong University, Incheon, Korea
| | - Min Jee Park
- Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kun Baek Song
- Department of Pediatrics, Soonchunhyang University Cheonan Hospital, School of Medicine, Soonchunhyang University, Cheonan, Korea
| | - Eom Ji Choi
- Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Eun Young Paek
- Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Song-I Yang
- Department of Pediatrics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Eun Lee
- Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Soo-Jong Hong
- Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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Natsuhara D, Misawa S, Saito R, Shirai K, Okamoto S, Nagai M, Kitamura M, Shibata T. A microfluidic diagnostic device with air plug-in valves for the simultaneous genetic detection of various food allergens. Sci Rep 2022; 12:12852. [PMID: 35896785 PMCID: PMC9329328 DOI: 10.1038/s41598-022-16945-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 07/19/2022] [Indexed: 01/12/2023] Open
Abstract
The identification of accidental allergen contamination in processed foods is crucial for risk management strategies in the food processing industry to effectively prevent food allergy incidents. Here, we propose a newly designed passive stop valve with high pressure resistance performance termed an “air plug-in valve” to further improve microfluidic devices for the detection of target nucleic acids. By implementing the air plug-in valve as a permanent stop valve, a maximal allowable flow rate of 70 µL/min could be achieved for sequential liquid dispensing into an array of 10 microchambers, which is 14 times higher than that achieved with the previous valve arrangement using single-faced stop valves. Additionally, we demonstrate the simultaneous detection of multiple food allergens (wheat, buckwheat, and peanut) based on the colorimetric loop-mediated isothermal amplification assay using our diagnostic device with 10 microchambers compactly arranged in a 20-mm-diameter circle. After running the assays at 60 °C for 60 min, any combination of the three types of food allergens and tea plant, which were used as positive and negative control samples, respectively, yielded correct test results, without any cross-contamination among the microchambers. Thus, our diagnostic device will provide a rapid and easy sample-to-answer platform for ensuring food safety and security.
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Affiliation(s)
- Daigo Natsuhara
- Department of Mechanical Engineering, Toyohashi University of Technology, Toyohashi, Aichi, 441-8580, Japan.
| | - Sae Misawa
- Faculty of Pharmacy and Pharmaceutical Sciences, Josai University, Sakado, Saitama, 350-0295, Japan
| | - Ryogo Saito
- Department of Mechanical Engineering, Toyohashi University of Technology, Toyohashi, Aichi, 441-8580, Japan
| | - Koki Shirai
- Department of Mechanical Engineering, Toyohashi University of Technology, Toyohashi, Aichi, 441-8580, Japan
| | - Shunya Okamoto
- Department of Mechanical Engineering, Toyohashi University of Technology, Toyohashi, Aichi, 441-8580, Japan
| | - Moeto Nagai
- Department of Mechanical Engineering, Toyohashi University of Technology, Toyohashi, Aichi, 441-8580, Japan
| | - Masashi Kitamura
- Faculty of Pharmacy and Pharmaceutical Sciences, Josai University, Sakado, Saitama, 350-0295, Japan
| | - Takayuki Shibata
- Department of Mechanical Engineering, Toyohashi University of Technology, Toyohashi, Aichi, 441-8580, Japan.
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7
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Maeda M, Kuwabara Y, Tanaka Y, Nishikido T, Hiraguchi Y, Yamamoto-Hanada K, Okafuji I, Yamada Y, Futamura M, Ebisawa M. Is oral food challenge test useful for avoiding complete elimination of cow's milk in Japanese patients with or suspected of having IgE-dependent cow's milk allergy? Allergol Int 2022; 71:214-220. [PMID: 34593320 DOI: 10.1016/j.alit.2021.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 08/02/2021] [Accepted: 08/17/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Cow's milk, along with hen's egg, are common causes of food allergies in children worldwide. Accidental ingestion of milk is common and often induces severe allergic reactions. Oral food challenge test (OFC) is usually performed in patients with or suspected of having a food allergy. However, the evidence of whether cow's milk OFC is useful in IgE-dependent cow's milk allergy patients to avoid total elimination is not known. METHODS After setting the clinical question and outcomes, we performed a systematic review for relevant articles published from January 1, 2000 to August 31, 2019 using PubMed® and Ichushi-Web databases. Each article was then evaluated for the level of evidence. All positive results of the OFC were defined as adverse events. RESULTS Forty articles were selected in this study. Our review revealed that cow's milk OFC was able to avoid the complete elimination of cow's milk in 66% of the patients with cow's milk allergy. We also found that adverse events occurred frequently (50.5%). CONCLUSIONS This analysis supports the recommendation of conducting cow's milk OFC to avoid complete elimination of cow's milk, however the test should be conducted with careful consideration of the patient's safety. As the methods of OFC and subjects varied among the articles selected in this study, further studies are needed to obtain higher quality evidence.
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Affiliation(s)
- Mayu Maeda
- Department of Pediatrics, Showa University School of Medicine, Tokyo, Japan
| | - Yu Kuwabara
- Department of Pediatrics, Ehime University Graduate School of Medicine Ehime, Japan
| | - Yuya Tanaka
- Department of Allergy, Kobe Children's Hospital, Hyogo, Japan
| | - Tomoki Nishikido
- Department of Pediatrics Pulmonology and Allergy, Osaka Women's and Children's Hospital, Osaka, Japan
| | - Yukiko Hiraguchi
- Department of Pediatrics, Center of Allergy and Clinical Immunology, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan
| | | | - Ikuo Okafuji
- Department of Pediatrics, Kobe City Medical Center General Hospital, Hyogo, Japan
| | - Yoshiyuki Yamada
- Division of Allergy and Immunology, Gunma Children's Medical Center, Gunma, Japan; Department of Pediatrics, Tokai University School of Medicine, Kanagawa, Japan
| | - Masaki Futamura
- Division of Pediatrics, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Motohiro Ebisawa
- Clinical Research Center for Allergology and Rheumatology, National Hospital Organization Sagamihara National Hospital, Sagamihara, Japan.
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Japanese Food Allergy-Labeling System and Comparison with the International Experience; Detection and Thresholds. Food Saf (Tokyo) 2022; 9:101-116. [PMID: 35004098 PMCID: PMC8691970 DOI: 10.14252/foodsafetyfscj.d-21-00008] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 10/04/2021] [Indexed: 11/21/2022] Open
Abstract
In the Japanese allergy-labeling system, food labeling is mandated for 7 specific ingredients (egg, cow's milk, wheat, buckwheat, peanut, shrimp, and crab) and recommended for 21 food ingredients in reference to case numbers of actual illness and the degree of seriousness. To monitor the validity of the labeling system, official methods for the detection of specific ingredient proteins in processed foods were developed. The official methods consist of ELISA methods for screening, and western blot methods for egg and milk, and PCR methods for wheat, buckwheat, peanut, shrimp/prawn, and crab as confirmation tests. The official methods consist of ELISA methods for screening, and western blot methods for egg and milk, and PCR methods for wheat, buckwheat, peanut, shrimp/prawn, and crab as confirmation tests. Threshold amounts (a few mg/kg) for labeling were set based on the approach of the analytical detections. Any foods containing protein allergens should be labeled if these contain allergens at greater than 10 ppm (mg/kg). Validation protocol criteria were established to standardize the Japanese official method. Food Safety Commission of Japan conducted a risk assessment of egg as a specific ingredient and judged that current labeling system for foods containing allergens is generally appropriate for "eggs". In the future, it is important to accumulate necessary scientific knowledge in order to carry out food health impact assessment including further refinement. The Japanese experience and knowledge of food allergy-labeling system would contribute to harmonize international labeling guidelines to protect allergic consumers globally.
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Wang Y, Zhou J, Peng H, Ma J, Li H, Li L, Li T, Fang Z, Ma A, Fu L. High-Throughput Identification of Allergens in a Food System via Hybridization Probe Cluster-Targeted Next-Generation Sequencing. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2021; 69:11992-12001. [PMID: 34498855 DOI: 10.1021/acs.jafc.1c03595] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Food allergies (FAs) are a crucial public health problem and a severe food safety issue, resulting in an urgent need for an accurate method to detect all of the hidden allergens that exist in food systems. Current methods for detecting allergens typically utilize ELISA, PCR, or LC-MS, which are suitable for the confirmatory analysis of allergens from ingredients rather than unintended contaminants. In this study, we demonstrate a hybridization probe cluster-targeted next-generation sequencing (HPC-NGS) platform for high-throughput screening of potential allergens in food systems. The HPC-NGS successfully captured target DNA fragments and identified 19 allergenic ingredients in a complex food system. Additionally, the HPC-NGS provided expected allergenic species matching rates of 94.24-100% in single food materials and 99.87-99.98% in processed food products. Thus, HPC-NGS enables the accurate characterization of allergenic ingredients and unintended allergenic contaminants in foods. Our results provide new perspectives on the use of HPC-NGS in the accuracy of high-throughput detection technologies for allergens imposed by the complex matrix effect.
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Affiliation(s)
- Yanbo Wang
- Food Safety Key Laboratory of Zhejiang Province, School of Food Science and Biotechnology, Zhejiang Gongshang University, 18 Xue Zheng Street, Hangzhou 310018, Zhejiang, P. R. China
| | - Jinru Zhou
- Food Safety Key Laboratory of Zhejiang Province, School of Food Science and Biotechnology, Zhejiang Gongshang University, 18 Xue Zheng Street, Hangzhou 310018, Zhejiang, P. R. China
| | - Hai Peng
- Institute for Systems Biology, Jianghan University, Wuhan 430056, Hubei, P. R. China
| | - Junjie Ma
- Food Safety Key Laboratory of Zhejiang Province, School of Food Science and Biotechnology, Zhejiang Gongshang University, 18 Xue Zheng Street, Hangzhou 310018, Zhejiang, P. R. China
| | - Huan Li
- Food Safety Key Laboratory of Zhejiang Province, School of Food Science and Biotechnology, Zhejiang Gongshang University, 18 Xue Zheng Street, Hangzhou 310018, Zhejiang, P. R. China
| | - Lun Li
- Institute for Systems Biology, Jianghan University, Wuhan 430056, Hubei, P. R. China
| | - Tiantian Li
- Institute for Systems Biology, Jianghan University, Wuhan 430056, Hubei, P. R. China
| | - Zhiwei Fang
- Institute for Systems Biology, Jianghan University, Wuhan 430056, Hubei, P. R. China
| | - Aijin Ma
- College of Food and Health, Beijing Technology and Business University, Beijing 100048, P. R. China
| | - Linglin Fu
- Food Safety Key Laboratory of Zhejiang Province, School of Food Science and Biotechnology, Zhejiang Gongshang University, 18 Xue Zheng Street, Hangzhou 310018, Zhejiang, P. R. China
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10
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Yanagida N, Ebisawa M, Katsunuma T, Yoshizawa J. Treatment-requiring accidental ingestion and risk factors among nursery children with food allergy. Pediatr Allergy Immunol 2021; 32:1377-1380. [PMID: 33748998 DOI: 10.1111/pai.13505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 03/04/2021] [Accepted: 03/18/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Noriyuki Yanagida
- Department of Pediatrics, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan.,Japan Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan
| | - Motohiro Ebisawa
- Japan Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan
| | - Toshio Katsunuma
- Department of Pediatrics, The Jikei University Daisan Hospital, Tokyo, Japan
| | - Jyoji Yoshizawa
- Division of Pediatric Surgery, Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
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11
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A survey of food allergen labeling and undeclared allergen residues in pre-packaged food products imported from Thailand. Food Control 2021. [DOI: 10.1016/j.foodcont.2021.107881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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12
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Muramatsu R, Saga M, Muramatsu K. First anaphylaxis case from a deodorant spray including lysozyme chloride. Pediatr Int 2021; 63:469-470. [PMID: 33638259 DOI: 10.1111/ped.14431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 07/18/2020] [Accepted: 08/04/2020] [Indexed: 11/27/2022]
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13
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Surojanametakul V, Srikulnath S, Chamnansin P, Shibata H, Shoji M. Investigation of undeclared food allergens in commercial Thai food products update after enforcing food allergen labeling regulation. Food Control 2021. [DOI: 10.1016/j.foodcont.2020.107554] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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14
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Development of a simple and reliable high-performance liquid chromatography-tandem mass spectrometry approach to simultaneously detect grains specified in food allergen labeling regulation on processed food commodities. J Chromatogr A 2021; 1639:461877. [PMID: 33545578 DOI: 10.1016/j.chroma.2021.461877] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 12/29/2020] [Accepted: 12/30/2020] [Indexed: 01/28/2023]
Abstract
An analytical approach using high-performance liquid chromatography-tandem mass spectrometry (LC-MS/MS) was developed to simultaneously detect Fagopyrum esculentum Moench (buckwheat) and cereals containing gluten (Triticum species including wheat and spelt, rye, barley, and oats) that were specified in regulations for food allergen labeling on processed foods. Trypsin-digested peptides were purified from different processed food commodities and heptapeptides derived from buckwheat 13S globulin (GFIVQAR, m/z 395.8 [precursor] > 177.0 [product]) and Triticum low molecular weight glutenin (QIPEQSR, m/z 429.3 [precursor] > 616.2 [product]) were specifically detected each species at levels as low as 0.050-0.056 µg/L and 0.028-0.032 µg/L, respectively. Detection of these synthetic peptides was quantitative to over 100 µg/L by reference to the synthetic peptide calibration curves and at recovery rates, 76.6 ± 4.1%-104.8 ± 17.1% and 82.4 ± 2.0%-105.8 ± 5.3%, for GFIVQAR and QIPEQSR, respectively, when 1-1,000 µg of these peptides were spiked into a retort tomato sauce for pasta or dried instant soup. In combination with LC-MS/MS detection methods specific to other cereals containing gluten (rye, barley, and oats), the developed analytical approach was applicable to a wide variety of processed food commodities for food allergen labeling.
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15
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Cook EE. Embodied Memory, Affective Imagination, and Vigilance: Navigating Food Allergies in Japan. Cult Med Psychiatry 2021; 45:544-564. [PMID: 32975640 PMCID: PMC7517742 DOI: 10.1007/s11013-020-09689-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/13/2020] [Indexed: 11/25/2022]
Abstract
"Food is relationships isn't it," Yamada san stated in 2017, neatly capturing the importance of food in social life. This article, drawing on the experiences of people with severe food allergies in Japan, illustrates the complexities of safely managing allergies when food-and the importance of sharing the same food-is so important to social life. In particular, I argue that individuals develop and practice skills of vigilance and situational awareness to mitigate physical and social risk which emerge through an affective imagination of what they feel could happen in the future, built on embodied memories of what has been experienced prior (e.g., severe allergic reactions and difficult social experiences with food). The development and enactment of these skills of vigilance happen through an 'education of attention' (Gibson in The ecological approach to visual perception, Psychology Press, New York, 1979; Ingold in The perception of the environment: essays on livelihood, dwelling and skill, Routledge, London, 2000) developed over time and in different social settings and constitute a somatic mode of attention (Csordas in Cult Anthropol 8:135-156, 1993) which shapes social interactions and aims to mitigate against any potential perceived social costs for not being able to eat everything.
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Affiliation(s)
- Emma E. Cook
- Modern Japanese Studies Program, Hokkaido University, Kita 15, Nishi 8, Kita Ku, Sapporo, 060-0815 Japan
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16
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Garcia-Calvo E, García-García A, Madrid R, Martin R, García T. From Polyclonal Sera to Recombinant Antibodies: A Review of Immunological Detection of Gluten in Foodstuff. Foods 2020; 10:foods10010066. [PMID: 33396828 PMCID: PMC7824297 DOI: 10.3390/foods10010066] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 12/23/2020] [Accepted: 12/24/2020] [Indexed: 12/31/2022] Open
Abstract
Gluten is the ethanol-soluble protein fraction of cereal endosperms like wheat, rye, and barley. It is widely used in the food industry because of the physical-chemical properties it gives to dough. Nevertheless, there are some gluten-related diseases that are presenting increasing prevalences, e.g., celiac disease, for which a strict gluten-free diet is the best treatment. Due to this situation, gluten labeling legislation has been developed in several countries around the world. This article reviews the gluten immune detection systems that have been applied to comply with such regulations. These systems have followed the development of antibody biotechnology, which comprise three major methodologies: polyclonal antibodies, monoclonal antibodies (mAbs) derived from hybridoma cells (some examples are 401.21, R5, G12, and α-20 antibodies), and the most recent methodology of recombinant antibodies. Initially, the main objective was the consecution of new high-affinity antibodies, resulting in low detection and quantification limits that are mainly achieved with the R5 mAb (the gold standard for gluten detection). Increasing knowledge about the causes of gluten-related diseases has increased the complexity of research in this field, with current efforts not only focusing on the development of more specific and sensitive systems for gluten but also the detection of protein motifs related to pathogenicity. New tools based on recombinant antibodies will provide adequate safety and traceability methodologies to meet the increasing market demand for gluten-free products.
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17
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Nagakura KI, Yanagida N, Sato S, Nishino M, Takahashi K, Asaumi T, Ogura K, Ebisawa M. Low-dose-oral immunotherapy for children with wheat-induced anaphylaxis. Pediatr Allergy Immunol 2020; 31:371-379. [PMID: 31976576 DOI: 10.1111/pai.13220] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 01/02/2020] [Accepted: 01/13/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND Oral immunotherapy (OIT) use in patients with wheat anaphylaxis is not well studied. We assessed the efficacy of low-dose OIT for patients with wheat-induced anaphylaxis. METHODS Eligible subjects were aged 5-18 years with a history of wheat anaphylaxis and confirmed symptoms during oral food challenge (OFC) to 53 mg of wheat protein. After admission to the hospital for a 5-day buildup phase, patients in the OIT group gradually increased wheat ingestion to 53 mg/day and then ingested 53 mg daily at home. One year later, they underwent 53- and 400-mg OFCs after OIT cessation for 2 weeks. The historical control group was defined as patients who avoided wheat during the same period. RESULTS Median wheat- and ω-5 gliadin-specific immunoglobulin E (sIgE) levels were 293 and 7.5 kUA /L, respectively, in the OIT group (16 children). No patients dropped out. Within 1 year, 88% of patients in the OIT group reached 53 mg. After 1 year, 69% and 9% patients passed the 53-mg OFC and 25% and 0% passed the 400-mg OFC in the OIT and control groups (11 children), respectively (P = .002 and 0.07, respectively). In the OIT group, wheat- and ω-5 gliadin-sIgE levels significantly decreased to 154 and 4.1 kUA /L, respectively, at 1 year, and wheat- and ω-5 gliadin-specific IgG and IgG4 levels significantly increased at 1 month. Anaphylaxis developed 7 times and promptly improved without adrenaline. CONCLUSION For patients with wheat anaphylaxis, low-dose OIT safely induces immunologic changes, achieves low-dose desensitization, and may allow for a 400 mg dose.
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Affiliation(s)
- Ken-Ichi Nagakura
- Department of Pediatrics, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan.,Department of Pediatrics, Jikei University School of Medicine, Tokyo, Japan
| | - Noriyuki Yanagida
- Department of Pediatrics, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan
| | - Sakura Sato
- Department of Allergy, Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan.,Course of Allergy and Clinical Immunology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Makoto Nishino
- Department of Pediatrics, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan.,Course of Allergy and Clinical Immunology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kyohei Takahashi
- Department of Pediatrics, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan.,Course of Allergy and Clinical Immunology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Tomoyuki Asaumi
- Department of Pediatrics, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan
| | - Kiyotake Ogura
- Department of Pediatrics, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan.,Course of Allergy and Clinical Immunology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Motohiro Ebisawa
- Department of Pediatrics, Jikei University School of Medicine, Tokyo, Japan.,Department of Allergy, Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan
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18
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Muramatsu K, Imamura H, Tokutsu K, Fujimoto K, Fushimi K, Matsuda S. Epidemiological Study of Hospital Admissions for Food-Induced Anaphylaxis Using the Japanese Diagnosis Procedure Combination Database. J Epidemiol 2020; 32:163-167. [PMID: 33250454 PMCID: PMC8918617 DOI: 10.2188/jea.je20200309] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Food allergies are common among children, and food-induced anaphylaxis (FIA) is a serious disease with a risk of death; however, there is yet to be a large-scale epidemiological study on causative foods in Japan. The purpose of this study was to identify foods that cause FIA in Japan. Methods We identified 9,079 patients from the Japanese Diagnosis Procedure Combination Database who were admitted for treatment for FIA from April 1, 2014 through March 31, 2017. We extracted data on patient sex, age, use of epinephrine injections on the first day, prescription for epinephrine self-injection on the day of discharge, length of stay, readmission, and causative foods. Results The most common causative food was eggs, followed by wheat, milk, peanuts, and buckwheat. The most common causative food in each age group was eggs among 0–3-year-olds, milk among 4–6-year-olds, peanuts among 7–19-year-olds, and wheat among those aged 20 years and older. Epinephrine was used at admission among about 40%, 50%, and over 60% of cases in which the causative food was eggs; wheat, milk and peanuts; and buckwheat, respectively. The proportion of cases with a prescription for epinephrine self-injection at discharge was highest among those in which the causative food was wheat, followed by peanuts, buckwheat, milk, and eggs. Conclusions FIA due to peanuts has become as common in Japan as it is in the West. These results suggest the importance of taking measures to prevent peanut allergies because children cannot make adequate decisions regarding food.
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Affiliation(s)
- Keiji Muramatsu
- Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health
| | - Hanaka Imamura
- Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health
| | - Kei Tokutsu
- Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health
| | - Kenji Fujimoto
- Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health
| | - Kiyohide Fushimi
- Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences
| | - Shinya Matsuda
- Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health
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Kwon J, Lee YM, Wen H. Knowledge, attitudes, and behaviors about dining out with food allergies: A cross-sectional survey of restaurant customers in the United States. Food Control 2020. [DOI: 10.1016/j.foodcont.2019.106776] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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20
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Marsh JT, Jayasena S, Gaskin F, Baumert JL, Johnson P. Thermal processing of peanut impacts detection by current analytical techniques. Food Chem 2019; 313:126019. [PMID: 31931421 DOI: 10.1016/j.foodchem.2019.126019] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 12/02/2019] [Accepted: 12/03/2019] [Indexed: 11/17/2022]
Abstract
Recalls of spice containing products due to undeclared peanut have highlighted the importance of analytical methods in these foods. We examined the performance of peanut detection methods in cumin and garlic, focusing on quantitative ELISA. Although suitable for qualitative detection, accurate quantitation proved difficult. Roasting of peanut contaminants influenced ELISA results, with raw peanut over-detected (3.9-fold) and roasted peanut under-detected (3.5-fold). Further investigation demonstrated the importance of protein targets for ELISA. The kit which gave the least variable results was based on detection of 2S albumin proteins. Additionally, we show that these proteins are more efficiently extracted from roasted peanut. We conclude that current methods are largely suitable for the qualitative detection of peanut in cumin and garlic. Quantitation relies on assumptions as to the state of thermal processing of peanut. We suggest that analytical method providers address robust detection by target selection, including identifying targets by MS.
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Affiliation(s)
- Justin T Marsh
- Department of Food Science & Technology, Food Allergy Research & Resource Program, University of Nebraska-Lincoln, Food Innovation Center, 1901 North 21st Street Lincoln, NE 68588-6205, United States.
| | - Shyamali Jayasena
- Department of Food Science & Technology, Food Allergy Research & Resource Program, University of Nebraska-Lincoln, Food Innovation Center, 1901 North 21st Street Lincoln, NE 68588-6205, United States
| | - Ferdelie Gaskin
- Department of Food Science & Technology, Food Allergy Research & Resource Program, University of Nebraska-Lincoln, Food Innovation Center, 1901 North 21st Street Lincoln, NE 68588-6205, United States
| | - Joseph L Baumert
- Department of Food Science & Technology, Food Allergy Research & Resource Program, University of Nebraska-Lincoln, Food Innovation Center, 1901 North 21st Street Lincoln, NE 68588-6205, United States
| | - Philip Johnson
- Department of Food Science & Technology, Food Allergy Research & Resource Program, University of Nebraska-Lincoln, Food Innovation Center, 1901 North 21st Street Lincoln, NE 68588-6205, United States.
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21
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Panda R, Garber EAE. Western blot analysis of fermented-hydrolyzed foods utilizing gluten-specific antibodies employed in a novel multiplex competitive ELISA. Anal Bioanal Chem 2019; 411:5159-5174. [DOI: 10.1007/s00216-019-01893-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 04/25/2019] [Accepted: 05/03/2019] [Indexed: 12/11/2022]
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22
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Fu L, Wang C, Zhu Y, Wang Y. Seafood allergy: Occurrence, mechanisms and measures. Trends Food Sci Technol 2019. [DOI: 10.1016/j.tifs.2019.03.025] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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23
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Jeon YH, Kim HH, Park YM, Jang GC, Kim HY, Yum HY, Kim J, Ahn K, Min TK, Pyun BY, Lee S, Kim KW, Kim YH, Lee J, Lee SY, Kim WK, Song TW, Kim JH, Lee YJ. The current status and issue of food allergen labeling in Korea. ALLERGY ASTHMA & RESPIRATORY DISEASE 2019. [DOI: 10.4168/aard.2019.7.2.67] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- You Hoon Jeon
- Department of Pediatrics, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea
| | - Hyun Hee Kim
- Department of Pediatrics, The Catholic University of Korea Uijeongbu St. Mary's Hospital, Uijeongbu, Korea
| | - Yong Mean Park
- Department of Pediatrics, Konkuk University School of Medicine, Seoul, Korea
| | - Gwang Cheon Jang
- Department of Pediatrics, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea
| | - Hye-Young Kim
- Department of Pediatrics, Pusan National University School of Medicine, Yangsan, Korea
| | - Hye Yung Yum
- Department of Pediatrics, Seoul Medical Center, Seoul, Korea
| | - Jihyun Kim
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kangmo Ahn
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Taek Ki Min
- Department of Pediatrics, Soonchunhyang University Hospital, Seoul, Korea
| | - Bok Yang Pyun
- Department of Pediatrics, Soonchunhyang University Hospital, Seoul, Korea
| | - Sooyoung Lee
- Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea
| | - Kyung Won Kim
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Yoon Hee Kim
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Jeongmin Lee
- Department of Pediatrics, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - So-Yeon Lee
- Department of Pediatrics, Childhood Asthma Atopy Center, Environmental Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Woo Kyung Kim
- Department of Pediatrics, Inje University Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Tae Won Song
- Department of Pediatrics, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Jeong Hee Kim
- Department of Pediatrics, Inha University Hospital, Incheon, Korea
| | - Yong Ju Lee
- Department of Pediatrics, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea
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24
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Maruyama N, Sato S, Cabanos C, Tanaka A, Ito K, Ebisawa M. Gly m 5/Gly m 8 fusion component as a potential novel candidate molecule for diagnosing soya bean allergy in Japanese children. Clin Exp Allergy 2018; 48:1726-1734. [PMID: 29992645 DOI: 10.1111/cea.13231] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 05/14/2018] [Indexed: 01/17/2023]
Abstract
BACKGROUND Soya bean is a major food allergen in children. Component-resolved diagnostics has improved the accuracy of diagnosing immunoglobulin E (IgE)-mediated food allergies. OBJECTIVE We aimed to develop a novel component for the diagnosis of soya bean allergy using recombinant technology. METHODS Japanese paediatric patients with suspected soya bean allergy (n = 91) were included, and symptomatic (n = 40) and asymptomatic (n = 51) cases were divided through oral food challenge testing. Specific IgE (sIgE) antibodies to each recombinant allergen component were analysed by enzyme-linked immunosorbent assay, and the diagnostic performances of the components were assessed by area under the receiver operating characteristic curves (AUC). RESULTS Among the recombinant components, sIgE antibody levels to Gly m 8 showed the highest AUC (0.706). A combination of Gly m 8 and α' subunit of Gly m 5, improved the diagnostic performance of the single components. Moreover, the N-terminal extension region of α' subunit of Gly m 5, which has low cross-reactivity among the vicilins, showed higher diagnostic performance (AUC 0.695) than the full-length α' subunit of Gly m 5 (AUC 0.613). Based on these findings, we developed a fusion protein of Gly m 8 plus the extension region of α' subunit of Gly m 5; this fusion protein was very efficient for diagnosing soya bean allergy (AUC 0.801). CONCLUSION A fusion protein of Gly m 8 and the extension region of α' subunit of Gly m 5 could potentially diagnose soya bean allergy in paediatric patients. Fusion proteins may be useful for producing novel allergen components with improved diagnostic value.
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Affiliation(s)
- Nobuyuki Maruyama
- Laboratory of Food Quality Design and Development, Graduate School of Agriculture, Kyoto University, Kyoto, Japan
| | - Sakura Sato
- Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Kanagawa, Japan
| | - Cerrone Cabanos
- Laboratory of Food Quality Design and Development, Graduate School of Agriculture, Kyoto University, Kyoto, Japan
| | | | - Komei Ito
- Department of Allergy, Aichi Children's Health and Medical Center, Obu, Japan
| | - Motohiro Ebisawa
- Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Kanagawa, Japan
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25
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Acquisition of tolerance to egg allergy in a child with repeated egg-induced acute pancreatitis. Allergol Int 2018; 67:535-537. [PMID: 29754972 DOI: 10.1016/j.alit.2018.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 03/26/2018] [Accepted: 04/08/2018] [Indexed: 11/21/2022] Open
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26
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27
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Nagakura KI, Yanagida N, Sato S, Nishino M, Asaumi T, Ogura K, Ebisawa M. Low-dose oral immunotherapy for children with anaphylactic peanut allergy in Japan. Pediatr Allergy Immunol 2018; 29:512-518. [PMID: 29603410 DOI: 10.1111/pai.12898] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/17/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND Oral immunotherapy (OIT) is a promising treatment for persons with allergy; however, it can also cause adverse allergic reactions. In this study, we investigated the efficacy of low-dose OIT for anaphylactic peanut allergy. METHODS Twenty-four children (median age, 9.6 years) with anaphylaxis to peanuts were hospitalized for 5 days and then gradually fed increasing amounts of peanut powder up to 133 mg/day. One year later, they underwent an oral food challenge after 2 weeks of peanut avoidance. Those who were asymptomatic after ingesting 795 mg of peanut protein were defined as having achieved sustained unresponsiveness. We measured peanut- and Ara h2-specific immunoglobulin (Ig) E, IgG, and IgG4 levels at 0, 1, 3, 6, and 12 months in the OIT group and at 0 and 12 months in the control group. RESULTS At baseline, all children in the OIT group and 8 in the control group had a history of anaphylaxis. The median peanut-/Ara h2-specific IgE levels in the OIT and control groups were 55.4/48.6 and 58.2/38.1 kUa/L, respectively. One year later, 8 (33.3%) children in the OIT group exhibited sustained unresponsiveness, while none in the control group did. In the OIT group, the median peanut-specific IgE levels significantly increased to 194.0 kUa/L, after 1 month and then significantly decreased to 57.5 kUa/L at 12 months. Meanwhile, the median peanut- and Ara h2-specific IgG and IgG4 levels increased significantly after 1 month. CONCLUSION Low-dose OIT induces immunological changes and has the capability of achieving sustained unresponsiveness in children with peanut anaphylaxis.
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Affiliation(s)
- Ken-Ichi Nagakura
- Department of Pediatrics, Sagamihara National Hospital, Kanagawa, Japan.,Department of Pediatrics, Jikei University School of Medicine, Tokyo, Japan
| | - Noriyuki Yanagida
- Department of Pediatrics, Sagamihara National Hospital, Kanagawa, Japan
| | - Sakura Sato
- Department of Allergy, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Kanagawa, Japan
| | - Makoto Nishino
- Department of Pediatrics, Sagamihara National Hospital, Kanagawa, Japan
| | - Tomoyuki Asaumi
- Department of Pediatrics, Sagamihara National Hospital, Kanagawa, Japan
| | - Kiyotake Ogura
- Department of Pediatrics, Sagamihara National Hospital, Kanagawa, Japan
| | - Motohiro Ebisawa
- Department of Allergy, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Kanagawa, Japan
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28
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Yanagida N, Sato S, Maruyama N, Takahashi K, Nagakura KI, Ogura K, Asaumi T, Ebisawa M. Specific IgE for Fag e 3 Predicts Oral Buckwheat Food Challenge Test Results and Anaphylaxis: A Pilot Study. Int Arch Allergy Immunol 2018; 176:8-14. [PMID: 29635254 PMCID: PMC5969075 DOI: 10.1159/000487135] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 01/19/2018] [Accepted: 01/19/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Buckwheat (BW) is the source of a life-threatening allergen. Fag e 3-specific serum IgE (sIgE) is more useful than BW-sIgE for diagnosis; however, it is unknown whether Fag e 3-sIgE can predict oral food challenge (OFC) results and anaphylaxis. This study aimed to clarify the efficacy of Fag e 3-sIgE in predicting OFC results and anaphylaxis. METHODS We conducted a retrospective review of BW- and Fag e 3-sIgE data obtained using the ImmunoCAP® assay system and fluorescent enzyme-linked immunosorbent assay from children who underwent OFC using 3,072 mg of BW protein between July 2006 and March 2014 at Sagamihara National Hospital, Kanagawa, Japan. RESULTS We analyzed 60 patients aged 1.9-13.4 years (median 6.0 years); 20 (33%) showed objective symptoms upon BW OFC. The patients without symptoms had significantly lower Fag e 3-sIgE than those with non-anaphylactic (p < 0.001) and anaphylactic reactions to BW (p = 0.004). Fag e 3-sIgE was the only tested factor that significantly predicted positive OFC results (odds ratio 8.93, 95% confidence interval 3.10-25.73, p < 0.001) and OFC-induced anaphylaxis (2.67, 1.12-6.35, p = 0.027). We suggest that a threshold Fag e 3-sIgE level of 18.0 kUE/L has 95% probability of provoking a positive reaction to BW. CONCLUSIONS Fag e 3-sIgE predicted OFC results and OFC-induced anaphylaxis. We further emphasize paying careful attention to the risk of BW OFC-induced anaphylaxis.
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Affiliation(s)
- Noriyuki Yanagida
- Department of Pediatrics, Sagamihara National Hospital, Kanagawa, Japan
| | - Sakura Sato
- Department of Allergy, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Kanagawa, Japan
| | - Nobuyuki Maruyama
- Laboratory of Food Quality Design and Development, Graduate School of Agriculture, Kyoto University, Kyoto, Japan
| | - Kyohei Takahashi
- Department of Pediatrics, Sagamihara National Hospital, Kanagawa, Japan
| | - Ken-ichi Nagakura
- Department of Pediatrics, Sagamihara National Hospital, Kanagawa, Japan
| | - Kiyotake Ogura
- Department of Pediatrics, Sagamihara National Hospital, Kanagawa, Japan
| | - Tomoyuki Asaumi
- Department of Pediatrics, Sagamihara National Hospital, Kanagawa, Japan
| | - Motohiro Ebisawa
- Department of Allergy, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Kanagawa, Japan
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29
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Ito K, Ono M, Kando N, Matsui T, Nakagawa T, Sugiura S, Ebisawa M. Surveillance of the use of adrenaline auto-injectors in Japanese children. Allergol Int 2018; 67:195-200. [PMID: 28784272 DOI: 10.1016/j.alit.2017.07.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 06/05/2017] [Accepted: 06/17/2017] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The appropriate usage of an adrenaline auto-injector (AAI, Epipen®) is a key aspect of patient and social education in the management of anaphylaxis. However, although AAIs are being prescribed increasingly frequently, there are few reports on their actual use. METHODS The Anaphylaxis Working Group of the Japanese Society of Pediatric Allergy and Clinical Immunology requested that society members register cases in which AAIs were used. Two hundred and sixty-six cases were collected from March 2014 to March 2016. RESULTS The cases included 240 events of immediate-type food allergies caused by cow's milk (n = 100), hen's egg (n = 42), wheat (n = 40), and peanuts (n = 11). Exercise-related events were reported in 19 cases; however, the diagnosis of food-dependent exercise-induced anaphylaxis with a specific causative food was only made in 4 cases (wheat, n = 2; fish, n = 1; squid, n = 1). The frequent reasons for the causative intake included programmed intake (n = 48), failure to check the food labeling (n = 43), and consuming an inappropriate food (n = 26). AAIs were used at schools or nurseries in 67 cases, with school or nursery staff members administering the AAI in 39 cases (58%). On arriving at the hospital, the symptom grade was improved in 71% of the cases, while grade 4 symptoms remained in 20% of the cases. No lethal cases or sequelae were reported. CONCLUSIONS AAIs were used effectively, even by school teachers. The need to visit a hospital after the use of an AAI should be emphasized because additional treatment might be required.
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Affiliation(s)
- Komei Ito
- Department of Allergy, Aichi Children's Health and Medical Center, Aichi, Japan; Anaphylaxis Working Group, The Japanese Society of Pediatric Allergy and Clinical Immunology, Tokyo, Japan.
| | - Manabu Ono
- Department of Allergy, Aichi Children's Health and Medical Center, Aichi, Japan
| | - Naoyuki Kando
- Department of Allergy, Aichi Children's Health and Medical Center, Aichi, Japan
| | - Teruaki Matsui
- Department of Allergy, Aichi Children's Health and Medical Center, Aichi, Japan
| | - Tomoko Nakagawa
- Department of Allergy, Aichi Children's Health and Medical Center, Aichi, Japan
| | - Shiro Sugiura
- Department of Allergy, Aichi Children's Health and Medical Center, Aichi, Japan
| | - Motohiro Ebisawa
- Anaphylaxis Working Group, The Japanese Society of Pediatric Allergy and Clinical Immunology, Tokyo, Japan; Department of Allergy, Clinical Research Center for Allergy and Rheumatology, National Sagamihara Hospital, Kanagawa, Japan
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30
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Soon JM. Food allergen labelling: "May contain" evidence from Malaysia. Food Res Int 2018; 108:455-464. [PMID: 29735079 DOI: 10.1016/j.foodres.2018.03.068] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 03/23/2018] [Accepted: 03/25/2018] [Indexed: 10/17/2022]
Abstract
Food allergen labelling is mandatory and regulated whilst precautionary allergen labelling (PAL) remains voluntary in most countries. It is the aim of this study to identify the food allergens declared in food products sold in a developing country and to what extent food allergens and PAL are emphasised in the products. A total of 505 food and beverages (snacks, baked goods, confectionary, baby food, condiments & jams, beverages, powder & paste, instant food, chilled & frozen food and canned food) were evaluated in Malaysia. Soybean represents the largest group of food allergen declared in labels, followed by wheat and milk products. Thirteen variations of contains statement were found with "Contains [allergen(s)]" being the most common (55.02%). There were 22 different types of "may contain" statements with 'May contain traces of [allergen(s)]' being the most common advice labelling used (55.41%). Different font type or emphasis such as brackets (51.57%) and bold font (33.86%) were used to inform consumers about presence of allergens. The national regulations on food allergen labelling are then critically contrasted with other Asian countries and the EU Regulation No. 1169/2011, which represents one of the most stringent food regulations in the world. Improving current allergen labelling limitations and practices would be of great benefit to consumers to prevent risk of food hypersensitivity.
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Affiliation(s)
- Jan Mei Soon
- Faculty of Health and Wellbeing, University of Central Lancashire, Preston PR1 2HE, UK.
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31
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Satsuki-Murakami T, Kudo A, Masayama A, Ki M, Yamano T. An optimized extraction method for gluten analysis in cacao-containing products using an extraction buffer with polyvinylpyrrolidone. Food Control 2018. [DOI: 10.1016/j.foodcont.2017.07.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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32
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Tham EH, Shek LPC, Van Bever HP, Vichyanond P, Ebisawa M, Wong GW, Lee BW. Early introduction of allergenic foods for the prevention of food allergy from an Asian perspective-An Asia Pacific Association of Pediatric Allergy, Respirology & Immunology (APAPARI) consensus statement. Pediatr Allergy Immunol 2018; 29:18-27. [PMID: 29068090 DOI: 10.1111/pai.12820] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 10/03/2017] [Accepted: 10/15/2017] [Indexed: 12/29/2022]
Abstract
Emerging evidence for the early introduction of allergenic foods for the prevention of food allergies, such as peanut allergy in Western populations, has led to the recent publication of guidelines in the USA and Europe recommending early peanut introduction for high-risk infants with severe eczema or egg allergy. Peanut allergy is, however, much less prevalent in Asia compared to the West. Varying patterns of food allergy are seen even within Asian countries-such as a predominance of wheat allergy in Japan and Thailand and shellfish allergy in Singapore and the Philippines. Customs and traditions, such as diet and infant feeding practices, also differ between Asian populations. Hence, there are unique challenges in adapting guidelines on early allergenic food introduction to the Asian setting. In this paper, we review the evidence and discuss the possible approaches to guide the timely introduction of allergenic food in high-risk infants in Asia.
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Affiliation(s)
- Elizabeth Huiwen Tham
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore
| | - Lynette Pei-Chi Shek
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore
| | - Hugo Ps Van Bever
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore
| | - Pakit Vichyanond
- Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Motohiro Ebisawa
- Department of Allergy, Clinical Research Center for Allergy & Rheumatology, Sagamihara National Hospital, Sagamihara, Kanagawa, Japan
| | - Gary Wk Wong
- Department of Pediatrics, Prince of Wales Hospital, Chinese University of Hong Kong, Sha Tin, Hong Kong, China
| | - Bee Wah Lee
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Khor SS, Morino R, Nakazono K, Kamitsuji S, Akita M, Kawajiri M, Yamasaki T, Kami A, Hoshi Y, Tada A, Ishikawa K, Hine M, Kobayashi M, Kurume N, Kamatani N, Tokunaga K, Johnson TA. Genome-wide association study of self-reported food reactions in Japanese identifies shrimp and peach specific loci in the HLA-DR/DQ gene region. Sci Rep 2018; 8:1069. [PMID: 29348432 PMCID: PMC5773682 DOI: 10.1038/s41598-017-18241-w] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 12/07/2017] [Indexed: 12/20/2022] Open
Abstract
Food allergy is an increasingly important health problem in the world. Several genome-wide association studies (GWAS) focused on European ancestry samples have identified food allergy-specific loci in the HLA class II region. We conducted GWAS of self-reported reactivity with common foods using the data from 11011 Japanese women and identified shrimp and peach allergy-specific loci in the HLA-DR/DQ gene region tagged by rs74995702 (P = 6.30 × 10−17, OR = 1.91) and rs28359884 (P = 2.3 × 10−12, OR = 1.80), respectively. After HLA imputation using a Japanese population-specific reference, the most strongly associated haplotype was HLA-DRB1*04:05-HLA-DQB1*04:01 for shrimp allergy (P = 3.92 × 10−19, OR = 1.99) and HLA-DRB1*09:01-HLA-DQB1*03:03 for peach allergy (P = 1.15 × 10−7, OR = 1.68). Additionally, both allergies’ associated variants were eQTLs for several HLA genes, with HLA-DQA2 the single eQTL gene shared between the two traits. Our study suggests that allergy to certain foods may be related to genetic differences that tag both HLA alleles having particular epitope binding specificities as well as variants modulating expression of particular HLA genes. Investigating this further could increase our understanding of food allergy aetiology and potentially lead to better therapeutic strategies for allergen immunotherapies.
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Affiliation(s)
- Seik-Soon Khor
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, 113-0033, Japan
| | - Ryoko Morino
- EverGene Ltd., Shinjuku-ku, Tokyo, 163-1435, Japan
| | | | | | | | | | - Tatsuya Yamasaki
- Life Science Group, Healthcare Division, Department of Healthcare Business, MTI Ltd., Shinjuku-ku, Tokyo, 163-1435, Japan
| | - Azusa Kami
- EverGene Ltd., Shinjuku-ku, Tokyo, 163-1435, Japan
| | - Yuria Hoshi
- Life Science Group, Healthcare Division, Department of Healthcare Business, MTI Ltd., Shinjuku-ku, Tokyo, 163-1435, Japan
| | - Asami Tada
- EverGene Ltd., Shinjuku-ku, Tokyo, 163-1435, Japan
| | | | - Maaya Hine
- LunaLuna Division, Department of Healthcare Business, MTI Ltd., Shinjuku-ku, Tokyo, 163-1435, Japan
| | - Miki Kobayashi
- LunaLuna Division, Department of Healthcare Business, MTI Ltd., Shinjuku-ku, Tokyo, 163-1435, Japan
| | - Nami Kurume
- LunaLuna Division, Department of Healthcare Business, MTI Ltd., Shinjuku-ku, Tokyo, 163-1435, Japan
| | | | - Katsushi Tokunaga
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, 113-0033, Japan
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34
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Yanagida N, Sato S, Takahashi K, Nagakura KI, Ogura K, Asaumi T, Ebisawa M. Skin prick test is more useful than specific IgE for diagnosis of buckwheat allergy: A retrospective cross-sectional study. Allergol Int 2018; 67:67-71. [PMID: 28479284 DOI: 10.1016/j.alit.2017.04.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 03/23/2017] [Accepted: 04/04/2017] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Buckwheat (BW) is a potentially life-threatening allergen. Usefulness of BW-specific immunoglobulin-E (BW-sIgE) level for diagnosis of BW allergy is controversial, while the skin prick test (SPT) is widely used because of its less invasive procedure and immediate results. However, there are no data comparing usefulness of the SPT and BW-sIgE level. Therefore, our study aimed to clarify efficacy of the SPT for diagnosis of BW allergy. METHODS This retrospective cross-sectional study evaluated patients who underwent an oral food challenge (OFC) for diagnosis or confirmation of acquired tolerance using 3072 mg of BW protein between July 2006 and April 2014. We then compared the diagnostic performance of BW sIgE and SPT to predict positive OFC results. RESULTS We analyzed 126 patients aged 2-16 years (median, 7.7 years), 18 (14%) of whom showed positive OFC results. Between patients with positive and negative OFC results, there was no significant difference in BW-sIgE level. However, patients with positive OFC results had a larger SPT wheal diameter. Area under the curve for positive OFC results for BW-sIgE level and SPT wheal diameter were 0.583 and 0.791, respectively. The 5%, 10%, 50%, and 90% positive predictive values of SPT wheal diameter were 2.0 mm, 5.2 mm, 14.7 mm, and 24.1 mm, respectively. CONCLUSIONS Our study revealed that the SPT was more useful than BW-sIgE level for diagnosis of BW allergy. Thus, an OFC may be avoided if the patient's SPT wheal diameter is at least 24.1 mm.
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Affiliation(s)
- Noriyuki Yanagida
- Department of Pediatrics, Sagamihara National Hospital, Kanagawa, Japan.
| | - Sakura Sato
- Department of Allergy, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Kanagawa, Japan
| | - Kyohei Takahashi
- Department of Pediatrics, Sagamihara National Hospital, Kanagawa, Japan
| | - Ken-Ichi Nagakura
- Department of Pediatrics, Sagamihara National Hospital, Kanagawa, Japan
| | - Kiyotake Ogura
- Department of Pediatrics, Sagamihara National Hospital, Kanagawa, Japan
| | - Tomoyuki Asaumi
- Department of Pediatrics, Sagamihara National Hospital, Kanagawa, Japan
| | - Motohiro Ebisawa
- Department of Allergy, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Kanagawa, Japan
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35
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Tham EH, Leung DYM. How Different Parts of the World Provide New Insights Into Food Allergy. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2018; 10:290-299. [PMID: 29949829 PMCID: PMC6021584 DOI: 10.4168/aair.2018.10.4.290] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 11/21/2017] [Accepted: 12/05/2017] [Indexed: 12/12/2022]
Abstract
The prevalence and patterns of food allergy are highly variable in different parts of the world. Differences in food allergy epidemiology may be attributed to a complex interplay of genetic, epigenetic, and environmental factors, suggesting that mechanisms of food allergy may differ in various global populations. Genetic polymorphisms, migration, climate, and infant feeding practices all modulate food allergy risk, and possibly also the efficacy of interventions aimed at primary prevention of food allergy development. Approaches to diagnosis, treatment, and prevention of food allergy should thus be tailored carefully to each population's unique genetic and environmental make-up. Future research in the context of food allergy prevention should focus on elucidating factors determining differential responses between populations.
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Affiliation(s)
- Elizabeth Huiwen Tham
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, Singapore.,Department of Pediatrics, National Jewish Health, Denver, Colorado, USA
| | - Donald Y M Leung
- Department of Pediatrics, National Jewish Health, Denver, Colorado, USA.,Department of Pediatrics, University of Colorado at Denver Health Sciences Center, Aurora, Colorado, USA.
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36
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Kiyota K, Sakata J, Satsuki-Murakami T, Yoshimitsu M, Akutsu K, Ki M, Hashimoto H, Kajimura K, Yamano T. Evaluation of cleaning methods for residual orange extract on different cookware materials using ELISA with profilin allergen indicator. J FOOD PROCESS ENG 2017. [DOI: 10.1111/jfpe.12652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Kyohei Kiyota
- Osaka Institute of Public Health, 1-3-69 Nakamichi; Higashinari-ku Osaka 537-0025 Japan
| | - Junko Sakata
- Osaka Institute of Public Health, 1-3-69 Nakamichi; Higashinari-ku Osaka 537-0025 Japan
| | | | - Masato Yoshimitsu
- Osaka Institute of Public Health, 1-3-69 Nakamichi; Higashinari-ku Osaka 537-0025 Japan
| | - Kazuhiko Akutsu
- Osaka Institute of Public Health, 1-3-69 Nakamichi; Higashinari-ku Osaka 537-0025 Japan
| | - Masami Ki
- Osaka Institute of Public Health, 8-34 Tojo-cho; Tennoji-ku Osaka 543-0026 Japan
| | - Hiroyuki Hashimoto
- Osaka International College, 6-21-57 Toda-cho; Moriguchi-shi Osaka 570-8555 Japan
| | - Keiji Kajimura
- Osaka Institute of Public Health, 1-3-69 Nakamichi; Higashinari-ku Osaka 537-0025 Japan
| | - Tetsuo Yamano
- Osaka Institute of Public Health, 1-3-69 Nakamichi; Higashinari-ku Osaka 537-0025 Japan
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37
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A harmonized immunoassay with liquid chromatography-mass spectrometry analysis in egg allergen determination. Anal Bioanal Chem 2017; 410:325-335. [PMID: 29138881 DOI: 10.1007/s00216-017-0721-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 10/08/2017] [Accepted: 10/23/2017] [Indexed: 01/26/2023]
Abstract
Food allergy is a serious health issue worldwide. Implementing allergen labeling regulations is extremely challenging for regulators, food manufacturers, and analytical kit manufacturers. Here we have developed an "amino acid sequence immunoassay" approach to ELISA. The new ELISA comprises of a monoclonal antibody generated via an analyte specific peptide antigen and sodium lauryl sulfate/sulfite solution. This combination enables the antibody to access the epitope site in unfolded analyte protein. The newly developed ELISA recovered 87.1%-106.4% ovalbumin from ovalbumin-incurred model processed foods, thereby demonstrating its applicability as practical egg allergen determination. Furthermore, the comparison of LC-MS/MS and the new ELISA, which targets the amino acid sequence conforming to the LC-MS/MS detection peptide, showed a good agreement. Consequently the harmonization of two methods was demonstrated. The complementary use of the new ELISA and LC-MS analysis can offer a wide range of practical benefits in terms of easiness, cost, accuracy, and efficiency in food allergen analysis. In addition, the new assay is attractive in respect to its easy antigen preparation and predetermined specificity. Graphical abstract The ELISA composing of the monoclonal antibody targeting the amino acid sequence conformed to LC-MS detection peptide, and the protein conformation unfolding reagent was developed. In ovalbumin determination, the developed ELISA showed a good agreement with LC-MS analysis. Consequently the harmonization of immunoassay with LC-MS analysis by using common target amino acid sequence was demonstrated.
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38
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Rzychon M, Brohée M, Cordeiro F, Haraszi R, Ulberth F, O'Connor G. The feasibility of harmonizing gluten ELISA measurements. Food Chem 2017; 234:144-154. [PMID: 28551218 PMCID: PMC5460520 DOI: 10.1016/j.foodchem.2017.04.092] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 12/01/2016] [Accepted: 04/16/2017] [Indexed: 02/07/2023]
Abstract
Many publications have highlighted that routine ELISA methods do not give rise to equivalent gluten content measurement results. In this study, we assess this variation between results and its likely impact on the enforcement of the EU gluten-free legislation. This study systematically examines the feasibility of harmonizing gluten ELISA assays by the introduction of: a common extraction procedure; a common calibrator, such as a pure gluten extract and an incurred matrix material. The comparability of measurements is limited by a weak correlation between kit results caused by differences in the selectivity of the methods. This lack of correlation produces bias that cannot be corrected by using reference materials alone. The use of a common calibrator reduced the between-assay variability to some extent, but variation due to differences in selectivity of the assays was unaffected. Consensus on robust markers and their conversion to "gluten content" are required.
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Affiliation(s)
- Malgorzata Rzychon
- European Commission, Joint Research Centre, Institute for Reference Materials and Measurements, Retieseweg 111, Geel 2440, Belgium
| | - Marcel Brohée
- European Commission, Joint Research Centre, Institute for Reference Materials and Measurements, Retieseweg 111, Geel 2440, Belgium
| | - Fernando Cordeiro
- European Commission, Joint Research Centre, Institute for Reference Materials and Measurements, Retieseweg 111, Geel 2440, Belgium
| | - Reka Haraszi
- European Commission, Joint Research Centre, Institute for Reference Materials and Measurements, Retieseweg 111, Geel 2440, Belgium
| | - Franz Ulberth
- European Commission, Joint Research Centre, Institute for Reference Materials and Measurements, Retieseweg 111, Geel 2440, Belgium
| | - Gavin O'Connor
- European Commission, Joint Research Centre, Institute for Reference Materials and Measurements, Retieseweg 111, Geel 2440, Belgium.
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Onizawa Y, Noguchi E, Okada M, Sumazaki R, Hayashi D. The Association of the Delayed Introduction of Cow's Milk with IgE-Mediated Cow's Milk Allergies. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2017; 4:481-488.e2. [PMID: 27157937 DOI: 10.1016/j.jaip.2016.01.012] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 12/29/2015] [Accepted: 01/21/2016] [Indexed: 01/21/2023]
Abstract
BACKGROUND Although exclusive breastfeeding at least 4 to 6 months has been recommended to prevent IgE-mediated cow's milk allergy (IgE-CMA), early introduction of food allergens has received a lot of attention in recent years for the prevention of food allergies. OBJECTIVES We aimed to determine whether IgE-CMA is associated with a feeding pattern in early infancy. METHODS In a case-control study, we retrospectively compared the patient background, past history of atopic dermatitis, bronchial asthma, family history of allergic diseases, feeding patterns in early infancy, and the reason for choosing early infancy feeding patterns of patients with IgE-CMA with age- and sex-matched healthy controls using a questionnaire completed by their mothers. To minimize the influence of confounders, we also compared patients with IgE-CMA with those with IgE-mediated egg allergy (IgE-EA). RESULTS A total of 51 patients with IgE-CMA were compared with 102 controls (1:2 matching) and 32 unmatched patients with IgE-EA. In a multivariable logistic regression analysis, the adjusted odds ratio of delayed (started more than 1 month after birth) or no regular cow's milk formula (less than once daily) was 23.74 (95% CI, 5.39-104.52) comparing the CMA group with the Control group, and 10.16 (95% CI, 2.48-41.64) comparing the CMA group with the EA group. Only 3 (6.5%), 2 (4.8%), and 3 (14.3%) mothers in the CMA group, the Control group, and the EA group chose "To prevent allergic disease" as a reason for choosing exclusive or almost exclusive breastfeeding in the first month of life, respectively. CONCLUSIONS The early introduction of cow's milk formula is associated with lower incidence of IgE-CMA.
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Affiliation(s)
- Yutaro Onizawa
- Department of Pediatrics, Ryugasaki Saiseikai Hospital, Ibaraki, Japan
| | - Emiko Noguchi
- Department of Medical Genetics, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.
| | - Masafumi Okada
- Department of Epidemiology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Ryo Sumazaki
- Department of Child Health, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Daisuke Hayashi
- Department of Pediatrics, Ryugasaki Saiseikai Hospital, Ibaraki, Japan
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Abstract
PURPOSE OF REVIEW This study aimed to review important hidden causes of anaphylaxis in ingestants, non-ingestants, and uncommon settings. RECENT FINDINGS Multiple new and elusive causes of anaphylaxis have been described over the past 35 years. Further research is required to identify the epidemiology, pathophysiology, and clinical impact of these hidden causes. Although these culprits should be considered in the appropriate clinical scenarios, many remain exceedingly rare.
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Food allergen extracts to diagnose food-induced allergic diseases: How they are made. Ann Allergy Asthma Immunol 2017; 119:101-107. [PMID: 28801015 DOI: 10.1016/j.anai.2016.11.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 11/01/2016] [Accepted: 11/10/2016] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To review the manufacturing procedures of food allergen extracts and applicable regulatory requirements from government agencies, potential approaches to standardization, and clinical application of these products. The effects of thermal processing on allergenicity of common food allergens are also considered. DATA SOURCES A broad literature review was conducted on the natural history of food allergy, the manufacture of allergen extracts, and the allergenicity of heated food. Regulations, guidance documents, and pharmacopoeias related to food allergen extracts from the United States and Europe were also reviewed. STUDY SELECTIONS Authoritative and peer-reviewed research articles relevant to the topic were chosen for review. Selected regulations and guidance documents are current and relevant to food allergen extracts. RESULTS Preparation of a food allergen extract may require careful selection and identification of source materials, grinding, defatting, extraction, clarification, sterilization, and product testing. Although extractions for all products licensed in the United States are performed using raw source materials, many foods are not consumed in their raw form. Heating foods may change their allergenicity, and doing so before extraction may change their allergenicity and the composition of the final product. CONCLUSION The manufacture of food allergen extracts requires many considerations to achieve the maximal quality of the final product. Allergen extracts for a select number of foods may be inconsistent between manufacturers or unreliable in a clinical setting, indicating a potential area for future improvement.
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Food labeling issues in patients with severe food allergies: solving a hamlet-like doubt. Curr Opin Allergy Clin Immunol 2017; 17:204-211. [DOI: 10.1097/aci.0000000000000362] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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43
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Navarro V, del Pilar Fernández-Gil M, Simón E, Bustamante MÁ. Gluten: General Aspects and International Regulations for Products for Celiac People. ACTA ACUST UNITED AC 2017. [DOI: 10.1007/978-3-319-53342-1_2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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44
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Akashi M, Yasudo H, Narita M, Nomura I, Akasawa A, Ebisawa M, Takahashi T, Ohya Y. Randomized controlled trial of oral immunotherapy for egg allergy in Japanese patients. Pediatr Int 2017; 59:534-539. [PMID: 27914210 DOI: 10.1111/ped.13210] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 11/02/2016] [Accepted: 11/28/2016] [Indexed: 01/23/2023]
Abstract
BACKGROUND Egg allergy is one of the most common food allergies in young children. While oral immunotherapy (OIT) is not routinely recommended in current guidelines, it has been considered as a potential alternative treatment strategy. Studies on OIT for food allergy have been explored, but no controlled trials have been reported in Japan. METHODS The first oral food challenge (OFC) was performed before treatment to ensure diagnosis and evaluate the threshold dose for egg using the double-blind, placebo-controlled food challenge. Participants were randomly assigned by computerized algorithm to receive OIT using egg (OIT group) or no egg (egg elimination [EE] group). A second OFC was performed in both groups approximately 6 months after therapy. Blood samples were collected and egg white-specific immunoglobulin (Ig)E and IgG4 were measured before and after the treatment period. RESULTS Eight of the 14 patients (57%) in the OIT group had no allergic reaction to 4 g dry egg powder whereas none of the 16 patients in the EE group did. All 14 patients in the OIT group had increased threshold for egg powder in the second OFC compared with baseline. There was no significant change in egg white-specific IgE level during therapy. After therapy, egg white-specific IgG4 increased significantly in the OIT group, but not in the EE group. CONCLUSION OIT is effective in increasing the threshold for allergens and inducing desensitization in Japanese egg allergy patients, similarly to North American and European patients.
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Affiliation(s)
- Masayuki Akashi
- Department of Pediatrics, Saitama City Hospital, Saitama, Japan.,Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Hiroki Yasudo
- Division of Allergy, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan.,Department of Pediatrics, Tokyo University School of Medicine, Tokyo, Japan
| | - Masami Narita
- Division of Allergy, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan
| | - Ichiro Nomura
- Division of Allergy, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan
| | - Akira Akasawa
- Division of Allergy, Department of Internal Physical Medicine, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - Motohiro Ebisawa
- Department of Allergy, Clinical Research Center for Allergy and Rheumatology, National Hospital Organization, Sagamihara National Hospital, Sagamihara, Japan
| | - Takao Takahashi
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Yukihiro Ohya
- Division of Allergy, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan
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45
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Abstract
In the field of pharmaceutical sciences, the subject of regulatory science (RS) includes pharmaceuticals, food, and living environments. For pharmaceuticals, considering the balance between efficacy and safety is a point required for public acceptance, and in that balance, more importance is given to efficacy in curing disease. For food, however, safety is the most important consideration for public acceptance because food should be essentially free of risk. To ensure food safety, first, any hazard that is an agent in food or condition of food with the potential to cause adverse health effects should be identified and characterized. Then the risk that it will affect public health is scientifically analyzed. This process is called risk assessment. Second, risk management should be conducted to reduce a risk that has the potential to affect public health found in a risk assessment. Furthermore, risk communication, which is the interactive exchange of information and opinions concerning risk and risk management among risk assessors, risk managers, consumers, and other interested parties, should be conducted. Food safety is ensured based on risk analysis consisting of the three components of risk assessment, risk management, and risk communication. RS in the field of food safety supports risk analysis, such as scientific research and development of test methods to evaluate food quality, efficacy, and safety. RS is also applied in the field of living environments because the safety of environmental chemical substances is ensured based on risk analysis, similar to that conducted for food.
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46
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Sato S, Ogura K, Takahashi K, Sato Y, Yanagida N, Ebisawa M. Usefulness of antigen-specific IgE probability curves derived from the 3gAllergy assay in diagnosing egg, cow's milk, and wheat allergies. Allergol Int 2017; 66:296-301. [PMID: 27523600 DOI: 10.1016/j.alit.2016.06.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 06/21/2016] [Accepted: 06/28/2016] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Specific IgE (sIgE) antibody detection using the Siemens IMMULITE® 3gAllergy™ (3gAllergy) assay have not been sufficiently examined for the diagnosis of food allergy. The aim of this study was to evaluate the utility of measuring sIgE levels using the 3gAllergy assay to diagnose allergic reactions to egg, milk, and wheat. METHODS This retrospective study was conducted on patients with diagnosed or suspected allergies to egg, milk and wheat. Patients were divided into two groups according to their clinical reactivity to these allergens based on oral food challenge outcomes and/or convincing histories of immediate reaction to causative food(s). The sIgE levels were measured using 3gAllergy and ImmunoCAP. Predicted probability curves were estimated using logistic regression analysis. RESULTS We analyzed 1561 patients, ages 0-19 y (egg = 436, milk = 499, wheat = 626). The sIgE levels determined using 3gAllergy correlated with those of ImmunoCAP, classifying 355 patients as symptomatic: egg = 149, milk = 123, wheat = 83. 3gAllergy sIgE levels were significantly higher in symptomatic than in asymptomatic patients (P < 0.0001). Predictive probability for positive food allergy was significantly increased and correlated with increased sIgE levels. The cut-offs for allergic reaction with 95% predictive probability as determined by the 3gAllergy probability curves were different from those of ImmunoCAP. CONCLUSIONS Measurements of sIgE against egg, milk, and wheat as determined by 3gAllergy may be used as a tool to facilitate the diagnosis of food allergy in subjects with suspected food allergies. However, these probability curves should not be applied interchangeably between different assays.
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Affiliation(s)
- Sakura Sato
- Department of Allergy, Clinical Research Center for Allergology and Rheumatology, Sagamihara National Hospital, Kanagawa, Japan.
| | - Kiyotake Ogura
- Department of Pediatrics, Sagamihara National Hospital, Kanagawa, Japan
| | - Kyohei Takahashi
- Department of Pediatrics, Sagamihara National Hospital, Kanagawa, Japan
| | - Yasunori Sato
- Department of Biostatistics, Clinical Research Center, Chiba University, Chiba, Japan
| | - Noriyuki Yanagida
- Department of Pediatrics, Sagamihara National Hospital, Kanagawa, Japan
| | - Motohiro Ebisawa
- Department of Allergy, Clinical Research Center for Allergology and Rheumatology, Sagamihara National Hospital, Kanagawa, Japan
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47
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Kiyota K, Kawatsu K, Sakata J, Yoshimitsu M, Akutsu K, Satsuki-Murakami T, Ki M, Kajimura K, Yamano T. Development of monoclonal antibody-based ELISA for the quantification of orange allergen Cit s 2 in fresh and processed oranges. Food Chem 2017; 232:43-48. [PMID: 28490094 DOI: 10.1016/j.foodchem.2017.03.140] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 10/17/2016] [Accepted: 03/25/2017] [Indexed: 01/29/2023]
Abstract
The aim of this study was to develop a monoclonal antibody (mAb)-based enzyme-linked immunosorbent assay (ELISA) for the quantification of a major allergen (Cit s 2) in fresh and processed oranges. Purified recombinant Cit s 2 (rCit s 2)-small ubiquitin-like modifier (SUMO) was used for the production of mAbs. In the optimized ELISA, the recovery of rCit s 2 from Navel oranges or orange juice was 107-132%, and the intra- and inter-assay coefficients of variation were 3.1-8.8% and 4.4-11%, respectively. The Cit s 2 content in fresh oranges was determined to be 1,800±430ng/g, while this content was much lower in the processed foods. The developed ELISA demonstrated high reproducibility, sensitivity, and accuracy, and this assay may help individuals with orange allergy by determining Cit s 2 quantities in food products and controlling their Cit s 2 intake.
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Affiliation(s)
- Kyohei Kiyota
- Osaka Institute of Public Health, 1-3-69 Nakamichi, Higashinari-ku, Osaka 537-0025, Japan.
| | - Kentaro Kawatsu
- Osaka Institute of Public Health, 1-3-69 Nakamichi, Higashinari-ku, Osaka 537-0025, Japan.
| | - Junko Sakata
- Osaka Institute of Public Health, 1-3-69 Nakamichi, Higashinari-ku, Osaka 537-0025, Japan.
| | - Masato Yoshimitsu
- Osaka Institute of Public Health, 1-3-69 Nakamichi, Higashinari-ku, Osaka 537-0025, Japan.
| | - Kazuhiko Akutsu
- Osaka Institute of Public Health, 1-3-69 Nakamichi, Higashinari-ku, Osaka 537-0025, Japan.
| | | | - Masami Ki
- Osaka Institute of Public Health, 8-34 Tojo-cho, Tennoji-ku, Osaka 543-0026, Japan.
| | - Keiji Kajimura
- Osaka Institute of Public Health, 1-3-69 Nakamichi, Higashinari-ku, Osaka 537-0025, Japan.
| | - Tetsuo Yamano
- Osaka Institute of Public Health, 1-3-69 Nakamichi, Higashinari-ku, Osaka 537-0025, Japan.
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48
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Yanagida N, Sato S, Takahashi K, Nagakura KI, Ogura K, Asaumi T, Ebisawa M. Reactions of Buckwheat-Hypersensitive Patients during Oral Food Challenge Are Rare, but Often Anaphylactic. Int Arch Allergy Immunol 2017; 172:116-122. [PMID: 28268211 PMCID: PMC5452282 DOI: 10.1159/000456008] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 01/09/2017] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Buckwheat (BW) is a common cause of life-threatening allergy in Asia. Few have examined oral food challenges (OFCs) using BW. We here describe the OFC outcomes for the diagnosis or confirmation of tolerance acquisition and clarify risk factors for positive OFCs. METHODS Between July 2005 and March 2014, we retrospectively reviewed data from children who underwent OFCs using 3,072 mg of BW protein at Sagamihara National Hospital. Children were suspected of having BW allergy because of positive results for BW-specific IgE or because they had been previously diagnosed with BW allergy owing to immediate reactions to BW. RESULTS Of 476 such patients, we analyzed 419 aged 1-17 years (median age 6.7 years). Forty-four (10.5%) reacted to the BW OFC and 24 (54.5%) experienced anaphylaxis. Among patients with suspected BW allergies (n = 369), 30 (8.1%) reacted to OFC. However, among patients with definitive BW allergies (n = 50) who underwent OFCs a median of 7.0 years after their last immediate reaction, 14 (28.0%) reacted to OFC. Among 12 patients with past anaphylactic reactions to BW, 8 exhibited tolerance to BW. A history of immediate reaction to BW and high BW-specific IgE levels were significant risk factors for a positive OFC. CONCLUSIONS BW allergies are rare among children suspected of having BW allergies due to positivity for BW-specific IgE. Most children with definitive BW allergies can tolerate BW, even after anaphylactic reactions. Nevertheless, careful observation is needed when performing BW OFCs, considering the high incidence of anaphylactic reactions.
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Affiliation(s)
- Noriyuki Yanagida
- Department of Pediatrics, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Sagamihara, Japan
| | - Sakura Sato
- Department of Allergy, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Sagamihara, Japan
| | - Kyohei Takahashi
- Department of Pediatrics, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Sagamihara, Japan
| | - Ken-ichi Nagakura
- Department of Pediatrics, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Sagamihara, Japan
| | - Kiyotake Ogura
- Department of Pediatrics, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Sagamihara, Japan
| | - Tomoyuki Asaumi
- Department of Pediatrics, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Sagamihara, Japan
| | - Motohiro Ebisawa
- Department of Allergy, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Sagamihara, Japan
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49
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Jeong K, Kim J, Ahn K, Lee SY, Min TK, Pyun BY, Kim YH, Kim KW, Sohn MH, Kim KE, Jang GC, Song TW, Kim JH, Jeon YH, Lee YJ, Park YM, Yum HY, Kim HH, Kim WK, Lee S. Age-Based Causes and Clinical Characteristics of Immediate-Type Food Allergy in Korean Children. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2017; 9:423-430. [PMID: 28677356 PMCID: PMC5500697 DOI: 10.4168/aair.2017.9.5.423] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 04/17/2017] [Accepted: 04/24/2017] [Indexed: 11/20/2022]
Abstract
PURPOSE Age-based causes and clinical characteristics of immediate-type food allergy (FA) have not been sufficiently studied. Therefore, we investigated age-dependent clinical profiles of FA in Korean children through an extensive multicenter investigation. METHODS Using a case report form developed by the authors, a retrospective medical record review was performed of patients (0-18 years old) diagnosed with immediate-type FA between September 2014 and August 2015 in 14 tertiary hospitals in Korea. RESULTS A total of 1,353 children and adolescents, 93% younger than 7 years, were enrolled in the present study, and 1,661 cases of immediate-type FA were recorded in these patients. The 7 major causative foods were cow's milk (28.1%), hen's eggs (27.6%), wheat (7.9%), walnuts (7.3%), peanuts (5.3%), buckwheat (1.9%), and shrimps (1.9%). Categorizing the patients into 4 age groups revealed that the most common causative food was different for each age group: cow's milk (<2 years), walnuts (2-6 years), walnuts (7-12 years), and buckwheat (13-18 years). The onset time of symptoms was less than 10 minutes in 49%, between 10 and 30 minutes in 17%, and between 30 minutes and 2 hours in 34% of cases. Food-induced anaphylaxis was reported in 506 (30.5%) out of 1,661 cases, and the 7 major causes of food-induced anaphylaxis was cow's milk (27.5%), hen's eggs (21.9%), wheat (11.3%), walnuts (10.5%), peanuts (5.9%), buckwheat (4.2%), and pine nuts (3.0%). The proportion of anaphylaxis was highest in the patients allergic to buckwheat (67.7%), followed by those allergic to pine nuts (57.7%), walnuts (43.8%), wheat (43.5%), and peanuts (34.1%). CONCLUSIONS The 5 major causative foods of immediate-type FA in Korean children were cow's milk, hen's eggs, wheat, walnuts, and peanuts. The distribution of causative foods was considerably distinctive according to different age groups. Anaphylaxis was reported in 30.5% of immediate-type FA cases.
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Affiliation(s)
- Kyunguk Jeong
- Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea
| | - Jihyun Kim
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kangmo Ahn
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - So Yeon Lee
- Department of Pediatrics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Taek Ki Min
- Department of Pediatrics, Soonchunhyang University Hospital, Seoul, Korea
| | - Bok Yang Pyun
- Department of Pediatrics, Soonchunhyang University Hospital, Seoul, Korea
| | - Yoon Hee Kim
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea
| | - Kyung Won Kim
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea
| | - Myung Hyun Sohn
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea
| | - Kyu Earn Kim
- Department of Pediatrics, Severance Hospital, Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea
| | - Gwang Cheon Jang
- Department of Pediatrics, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea
| | - Tae Won Song
- Department of Pediatrics, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Jung Hee Kim
- Department of Pediatrics, Inha University Hospital, Incheon, Korea
| | - You Hoon Jeon
- Department of Pediatrics, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
| | - Yong Ju Lee
- Department of Pediatrics, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Yong Mean Park
- Department of Pediatrics, Konkuk University School of Medicine, Seoul, Korea
| | - Hye Yung Yum
- Department of Pediatrics, Atopy Clinic, Seoul Medical Center, Seoul, Korea
| | - Hyun Hee Kim
- Department of Pediatrics, The Catholic University of Korea, Uijeongbu St. Mary's Hospital, The Catholic University of Korea College of Medicine, Uijeongbu, Korea
| | - Woo Kyung Kim
- Department of Pediatrics, Inje University Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Sooyoung Lee
- Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea.
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50
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Okada Y, Yamashita T, Kumagai H, Morikawa Y, Akasawa A. Accurate Determination of Childhood Food Allergy Prevalence and Correction of Unnecessary Avoidance. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2017; 9:322-328. [PMID: 28497919 PMCID: PMC5446947 DOI: 10.4168/aair.2017.9.4.322] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 12/06/2016] [Accepted: 01/17/2017] [Indexed: 12/11/2022]
Abstract
Purpose Because the true prevalence of food allergy (FA), as based on the results of an oral food challenge test (OFC), is unknown, it is likely that children with suspected FA unnecessarily eliminate potentially causative foods. This study aimed to identify the prevalence of FA and to determine the proportion of children who unnecessarily eliminate food. Methods To identify children with FA, a primary survey was conducted via a questionnaire with all children aged 0-18 years in Niijima village (remote islands of Japan). In the secondary survey, a detailed medical interview was conducted by doctors with children who currently did not eat some foods. The third survey involved serum food-specific immunoglobulin E (IgE) tests and an OFC for children with suspected FA. Results Of 376 enrolled children, 374 (99.5%) completed the questionnaire. Some foods were eliminated by 18.6% and 13.0% of all children and those ≥6 years old, respectively. The target population for the secondary survey included 69 children who all completed the medical interview. The target population for the third survey consisted of 35 children, of whom 26 (74.3%) underwent the blood test. An OFC was performed 35 times with 20 children. As a result, the prevalence of FA was 4.9% in children of all ages and 4.7% in those ≥6 years old. Moreover, 55.0% children were able to cease eliminating food intake. Conclusions It is possible that a considerable number of children unnecessarily eliminate food because of suspected FA.
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Affiliation(s)
- Yuki Okada
- Department of General Pediatrics, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan. .,Niijima Clinic, Tokyo, Japan.,Department of Pediatrics, Jichi Medical University, Tochigi, Japan
| | - Takumi Yamashita
- Shikinejima Clinic, Tokyo, Japan.,Department of Pediatrics, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan
| | - Hideki Kumagai
- Department of Pediatrics, Jichi Medical University, Tochigi, Japan
| | - Yoshihiko Morikawa
- Clinical Research Support Center, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - Akira Akasawa
- Department of Allergy, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
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