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Lim SM, Law BP. Food allergy knowledge, attitude and management among preschool personnel in Malaysia. J Hum Nutr Diet 2023; 36:2073-2084. [PMID: 37475527 DOI: 10.1111/jhn.13213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 06/16/2023] [Accepted: 07/10/2023] [Indexed: 07/22/2023]
Abstract
BACKGROUND Children are vulnerable, and they may experience their first serious food allergy reaction at school, where they spend much of their time. The present study aims to determine the level of food allergy knowledge, attitude and management (KAM) among preschool personnel in Klang Valley, Malaysia. METHODS A cross-sectional study was conducted with 292 personnel working in Klang Valley preschools. The participants completed an online questionnaire asking about sociodemographic information and food allergy KAM. Mann-Whitney U and chi-squared tests were used to compare the KAM level between public and private preschool personnel and examine the association of KAM of food allergy with various sociodemographic factors, respectively. RESULTS Some 86.3% of the participants demonstrated a low level of food allergy knowledge, 64.7% showed a negative food allergy attitude and 57.9% indicated fair food allergy management. The total mean score for food allergy knowledge was higher (p < 0.01) among the private preschool personnel compared to the public group, although there was no significant difference in attitude (p = 0.244) or practice (p = 0.171). Age group (p < 0.01) and monthly income (p < 0.05) were significantly associated with the level of attitude, whereas no sociodemographic factor was associated with knowledge and management of food allergy. CONCLUSIONS Most preschool personnel in Klang Valley have a low level of food allergy knowledge, negative attitudes and a fair level of ability to manage food allergy reactions. The findings of the present study may guide future studies to improve the food allergy KAM of preschool personnel and provide a safer environment for children with food allergies.
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Affiliation(s)
- See Meng Lim
- Nutritional Sciences Programme & Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Bee Pek Law
- Nutritional Sciences Programme & Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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2
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Miraglia del Giudice M, Dinardo G, Klain A, D’Addio E, Bencivenga CL, Decimo F, Indolfi C. Anaphylaxis after Shrimp Intake in a European Pediatric Population: Role of Molecular Diagnostics and Implications for Novel Foods. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1583. [PMID: 37892246 PMCID: PMC10605710 DOI: 10.3390/children10101583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 09/06/2023] [Accepted: 09/18/2023] [Indexed: 10/29/2023]
Abstract
(1) Background: Tropomyosin is a major cause of shellfish allergy and anaphylaxis triggered by food. It acts as a pan-allergen, inducing cross-reactivity in insects, dust mites, crustaceans, and mollusks. Our study investigates anaphylaxis in children with asthma or atopic diseases after consuming tropomyosin-containing food. (2) Methods: We analyzed the molecular sensitization profiles of pediatric patients at the University of Campania 'Luigi Vanvitelli' from 2017 to 2021, with conditions such as allergic rhinitis, asthma, atopic dermatitis, urticaria, and food allergies. (3) Results: Out of a total of 253 patients aged 1 to 18 years (167 males, 86 females), 21 patients (8.3%) experienced anaphylaxis after shrimp ingestion. All 21 (100%) were sensitized to various tropomyosins: Pen m 1 (100%), Der p 10 (90.5%), Ani s 3 (81%), and Bla g 7 (76.2%). Clinical symptoms included allergic asthma (76.2%), atopic dermatitis (61.9%), urticaria (38.1%), and allergic rhinitis (38.1%). (4) Conclusions: Crustaceans and mollusks are major allergens in Italy and Europe, requiring mandatory declaration on food labels. Italian pediatric patients demonstrated significant anaphylaxis after consuming shrimp, often accompanied by multiple atopic disorders such as asthma, rhinitis, and atopic dermatitis. Considering the cross-reactivity of tropomyosin among various invertebrates and the emergence of 'novel foods' containing insect flours in Europe, there is ongoing debate about introducing precautionary labeling for these products.
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Affiliation(s)
| | - Giulio Dinardo
- Department of Woman, Child and of General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80138 Naples, Italy; (M.M.d.G.); (A.K.); (E.D.); (C.L.B.); (F.D.); (C.I.)
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Mastrorilli C, Arasi S, Barni S, Caimmi D, Chiera F, Comberiati P, Dinardo G, Giannetti A, Gismondi M, Gracci S, Paravati F, Pelosi U, Miraglia Del Giudice M, Bernardini R, Pecoraro L. IgE-Mediated and Non-IgE-Mediated Fish Allergy in Pediatric Age: A Holistic Approach-A Consensus by Diagnostic Commission of the Italian Society of Pediatric Allergy and Immunology. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1651. [PMID: 37763770 PMCID: PMC10537060 DOI: 10.3390/medicina59091651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 08/29/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023]
Abstract
Fish is one of the "big nine" foods triggering allergic reactions. For this reason, fish allergens must be accurately specified on food labels. Fish allergy affects less than 1% of the world population, but a higher prevalence is observed in pediatric cohorts, up to 7%. Parvalbumin is the main fish allergen found in the muscles. In childhood, sensitization to fish allergens occurs most frequently through the ingestion of fish, rarely transcutaneously or by inhalation. Fish allergy symptoms usually appear within two hours of the allergen contact. The diagnosis begins with the collection of the history. If it is suggestive of fish allergy, prick tests or the measurement of serum-specific IgE should be performed to confirm the suspicion. The oral food challenge is the gold standard for the diagnosis. It is not recommended in case of a severe allergic reaction. It is important to make a differential diagnosis with anisakiasis or scombroid poisoning, which have overlapping clinical features but differ in pathogenesis. Traditionally, managing fish allergy involves avoiding the triggering species (sometimes all bony fish species) and requires an action plan for accidental exposures. The present review will analyze IgE- and non-IgE-mediated fish allergy in children from epidemiology, pathogenesis to clinical features. Moreover, clinical management will be addressed with a particular focus on potential nutritional deficiencies.
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Affiliation(s)
- Carla Mastrorilli
- Admission and Emergency Pediatric Medicine and Surgery Unit, University Hospital Consortium Corporation Polyclinic of Bari, Pediatric Hospital Giovanni XXIII, 70124 Bari, Italy; (C.M.); (M.G.)
| | - Stefania Arasi
- Area of Translational Research in Pediatric Specialities, Allergy Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy;
| | - Simona Barni
- Allergic Unit, Department of Pediatric, Meyer Children’s Hospital, 50139 Florence, Italy;
| | - Davide Caimmi
- Allergy Unit, CHU de Montpellier, Université de Montpellier, 34295 Montpellier, France;
- IDESP, UMR A11, Université de Montpellier, 34093 Montpellier, France
| | - Fernanda Chiera
- Department of Pediatrics, San Giovanni di Dio Hospital, 88900 Crotone, Italy; (F.C.); (F.P.)
| | - Pasquale Comberiati
- Section of Paediatrics, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy;
| | - Giulio Dinardo
- Department of Woman, Child and of General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (G.D.); (M.M.D.G.)
| | - Arianna Giannetti
- Pediatric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy;
| | - Marco Gismondi
- Admission and Emergency Pediatric Medicine and Surgery Unit, University Hospital Consortium Corporation Polyclinic of Bari, Pediatric Hospital Giovanni XXIII, 70124 Bari, Italy; (C.M.); (M.G.)
| | - Serena Gracci
- Pediatrics and Neonatology Complex Unit, San Giuseppe Hospital, Azienda USL Toscana Centro, 50053 Empoli, Italy;
- Department of Pediatrics, University Hospital of Pisa, 56124 Pisa, Italy
| | - Francesco Paravati
- Department of Pediatrics, San Giovanni di Dio Hospital, 88900 Crotone, Italy; (F.C.); (F.P.)
| | - Umberto Pelosi
- Pediatric Unit, Santa Barbara Hospital, 09016 Iglesias, Italy;
| | - Michele Miraglia Del Giudice
- Department of Woman, Child and of General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (G.D.); (M.M.D.G.)
| | - Roberto Bernardini
- Pediatrics and Neonatology Complex Unit, San Giuseppe Hospital, Azienda USL Toscana Centro, 50053 Empoli, Italy;
| | - Luca Pecoraro
- Pediatric Unit, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37126 Verona, Italy;
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Giannetti A, Pession A, Bettini I, Ricci G, Giannì G, Caffarelli C. IgE Mediated Shellfish Allergy in Children-A Review. Nutrients 2023; 15:3112. [PMID: 37513530 PMCID: PMC10386692 DOI: 10.3390/nu15143112] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 07/08/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023] Open
Abstract
Shellfish is a leading cause of food allergy and anaphylaxis worldwide. Recent advances in molecular characterization have led to a better understanding of the allergen profile. High sequence homology between shellfish species and between shellfish and house dust mites leads to a high serological cross-reactivity, which does not accurately correlate with clinical cross-reactions. Clinical manifestations are immediate and the predominance of perioral symptoms is a typical feature of shellfish allergy. Diagnosis, as for other food allergies, is based on SPTs and specific IgE, while the gold standard is DBPCFC. Cross-reactivity between shellfish is common and therefore, it is mandatory to avoid all shellfish. New immunotherapeutic strategies based on hypoallergens and other innovative approaches represent the new frontiers for desensitization.
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Affiliation(s)
- Arianna Giannetti
- Paediatrics Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (A.G.); (A.P.)
| | - Andrea Pession
- Paediatrics Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (A.G.); (A.P.)
| | - Irene Bettini
- Paediatrics Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (A.G.); (A.P.)
| | - Giampaolo Ricci
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy;
| | - Giuliana Giannì
- Clinica Pediatrica, Azienda Ospedaliero-Universitaria, Medicine and Surgery Department, Università di Parma, 43126 Parma, Italy;
| | - Carlo Caffarelli
- Clinica Pediatrica, Azienda Ospedaliero-Universitaria, Medicine and Surgery Department, Università di Parma, 43126 Parma, Italy;
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Indolfi C, Dinardo G, Klain A, Salvatori A, Esposito M, Vela V, Decimo F, Ciprandi G, Miraglia del Giudice M. Evaluation of Der p 10 in a Cohort of European Children: Role of Molecular Diagnostics and Clinical Features. J Immunol Res 2023; 2023:5551305. [PMID: 37378067 PMCID: PMC10292945 DOI: 10.1155/2023/5551305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 05/09/2023] [Accepted: 06/02/2023] [Indexed: 06/29/2023] Open
Abstract
Background Allergy toward the dust mite is steadily increasing on the European continent. This sensitization may be a risk factor for developing sensitization to other mite molecules such as tropomyosin Der p 10. This molecule often correlates with food allergy and the risk of anaphylaxis after ingesting mollusks and shrimps. Materials and Methods We analyzed the sensitization profiles by ImmunoCAP ISAC of pediatric patients from 2017 to 2021. The patients under investigation were being followed for atopic disorders such as allergic asthma and food allergies. The study aimed to analyze the prevalence of sensitization toward Der p 10 in our pediatric population and assess the related clinical symptoms and reactions after ingestion of foods containing tropomyosins. Results This study included 253 patients; 53% were sensitized toward Der p 1 and Der p 2; 10.4% were also sensitized to Der p 10. Assessing patients sensitized to Der p 1 or Der p 2, and Der p 10, we observed that 78.6% were affected by asthma (p < 0.005) and had a history of prior anaphylaxis after ingestion of shrimp or shellfish (p < 0.0001). Conclusion The component-resolved diagnosis gave us a deeper understanding of patients' molecular sensitization profiles. Our study showed that a fair proportion of children sensitive to Der p 1 or Der p 2 are also sensitive to Der p 10. However, many patients sensitized to all three molecules had a high risk of asthma and anaphylaxis. Therefore, the assessment of Der p 10 sensitization should be considered in atopic patients with sensitization to Der p 1 and Der p 2 to avoid encountering possible adverse reactions after ingesting foods containing tropomyosins.
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Affiliation(s)
- Cristiana Indolfi
- Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Giulio Dinardo
- Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Angela Klain
- Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Alessandra Salvatori
- Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Marica Esposito
- Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Viviana Vela
- Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Fabio Decimo
- Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | | | - Michele Miraglia del Giudice
- Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
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Saetang J, Tipmanee V, Benjakul S. In Silico Prediction of Cross-Reactive Epitopes of Tropomyosin from Shrimp and Other Arthropods Involved in Allergy. Molecules 2022; 27:molecules27092667. [PMID: 35566021 PMCID: PMC9104922 DOI: 10.3390/molecules27092667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/17/2022] [Accepted: 04/20/2022] [Indexed: 12/10/2022] Open
Abstract
Tropomyosin in shellfish is considered a major cross-reactive allergen in house dust mites and cockroaches; however, the specific epitopes have not been elucidated. Therefore, this study aimed to identify the consensus antigenic determinant among shrimp, house dust mites, and cockroaches using in silico methods. The protein sequences of tropomyosin, including Der f 10, Mac r 1, Pen a 1, Pen m 1, Per a 7, and Bla g 7, were retrieved from the UniProt database. The 3D structures were derived from the AlphaFold or modeled using the Robetta. The determination of linear epitopes was performed by AlgPRED and BepiPRED for B cell epitope, and NetMHCIIpan and NetMHCII for T cell epitope, while Ellipro was used to evaluate conformational epitopes. Fourteen peptides were discovered as the consensus linear B cell epitopes, while seventeen peptides were identified as linear T cell epitopes specific to high-frequency HLA-DR and HLA-DQ alleles. The conformational determination of B cell epitopes provided nine peptides, in which residues 209, 212, 255–256, and 258–259 were found in both linear B cell and linear T cell epitope analysis. This data could be utilized for further in vitro study and may contribute to immunotherapy for allergic diseases associated with tropomyosin.
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Affiliation(s)
- Jirakrit Saetang
- International Center of Excellence in Seafood Science and Innovation, Faculty of Agro-Industry, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand;
- EZ-Mol-Design Laboratory, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand;
- Correspondence: ; Tel.: +66-7428-6337
| | - Varomyalin Tipmanee
- EZ-Mol-Design Laboratory, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand;
- Department of Biomedical Sciences and Biomedical Engineering, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand
| | - Soottawat Benjakul
- International Center of Excellence in Seafood Science and Innovation, Faculty of Agro-Industry, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand;
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Lee SE, Lee SY, Bae BR, Lee HS, Kang HR. A case of anaphylaxis after ingestion of Liparis tanakae. Asia Pac Allergy 2020; 10:e42. [PMID: 33178567 PMCID: PMC7610087 DOI: 10.5415/apallergy.2020.10.e42] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 10/22/2020] [Indexed: 12/27/2022] Open
Abstract
Liparis tanakae is a kind of fish in the northwestern Pacific Ocean and sometimes it is used for broth or frozen fish fillets on markets in Korea. A 45-year-old female patient visited Emergency Department because of facial edema, generalized urticaria, dyspnea, and hypotension after eating L. tanakae broth. She recovered after administration of epinephrine. Seven weeks later, she experienced generalized urticaria again after tasting a spoon of L. tanakae broth. In 2 months after recovery, the patient showed positive response to skin prick tests with L. tanakae extract. She also showed positive response to skin prick test with cod which did not induce any symptoms after oral ingestion. The patient was diagnosed as L. tanakae induced anaphylaxis based on the repeated clinical history and skin prick test results. We herein report the first case of L. tanakae induced anaphylaxis.
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Affiliation(s)
- Seung-Eun Lee
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea.,Respirology and Allergy Clinic, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Suh-Young Lee
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea.,Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Bo-Ram Bae
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea
| | - Hyun-Seung Lee
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea
| | - Hye-Ryun Kang
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea.,Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
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Food allergies and allergens: Characterization and perceptions among diagnosed food allergic individuals in Lebanon. World Allergy Organ J 2020; 13:100481. [PMID: 33235663 PMCID: PMC7656122 DOI: 10.1016/j.waojou.2020.100481] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 10/16/2020] [Accepted: 10/18/2020] [Indexed: 12/26/2022] Open
Abstract
Background The aim of our study was to assess the knowledge, practices, and attitudes towards food allergens and allergies among diagnosed food allergic individuals in Lebanon. Methods Seventy diagnosed participants were recruited after reaching out to all the allergists of the country. They completed in person or over the phone a comprehensive valid questionnaire composed of 49 questions. Results Wheat was reported as top food allergen (15.7%), while itchy skin and rash were the most reported symptoms (71.4% and 68.6%, respectively). Only 34 (48.6%) of participants indicated they carry medications, 58 (70.7%) were diagnosed using blood test, and 22 (31.4%) stated that they are very knowledgeable on the topic. In terms of knowledge, participants scored on average 84.2 ± 11.5%. In terms of best practices, participants scored on average 47.8 ± 28.3%. Having a health related educational background increased significantly (p < 0.05) both knowledge and best practices scores, while age and gender did not have an effect. Conclusions Our results highlight the importance of organizing ongoing educational initiatives and emphasize the need to lobby policy makers to making allergen-warning labels obligatory in the country.
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The Global Rise and the Complexity of Sesame Allergy: Prime Time to Regulate Sesame in the United States of America? ALLERGIES 2020. [DOI: 10.3390/allergies1010001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Sesame allergy is a life-threatening disease that has been growing globally with poorly understood mechanisms. To protect sensitive consumers, sesame is regulated in many countries. There were four research goals for this work on sesame allergy: (i) to map the timeline, and the extent of its global rise; (ii) to dissect the complexity of the disease, and its mechanisms; (iii) to analyze the global regulation of sesame; and (iv) to map the directions for future research and regulation. We performed a literature search on PubMed and Google Scholar, using combinations of key words and analyzed the output. Regulatory information was obtained from the government agencies. Information relevant to the above goals was used to make interpretations. We found that: (i) the reports appeared first in 1950s, and then rapidly rose globally from 1990s; (ii) sesame contains protein and lipid allergens, a unique feature not found in other allergenic foods; (iii) it is linked to five types of diseases with understudied mechanisms; and (iv) it is a regulated allergen in 32 advanced countries excluding the USA. We also provide directions for filling gaps in the research and identify implications of possible regulation of sesame in the USA.
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Lee MP, Saffari SE, Loh W, Goh SH, Goh A, Chiang WC, Chong KW. A 5-year retrospective review of children with peanut allergy in the largest paediatric hospital in Singapore. Asia Pac Allergy 2020; 10:e6. [PMID: 32099828 PMCID: PMC7016321 DOI: 10.5415/apallergy.2020.10.e6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 01/23/2020] [Indexed: 11/04/2022] Open
Abstract
Background The prevalence of peanut allergy (PA) among children has increased significantly over the past decade. Even though the prevalence of PA in Singapore is considered low, peanut is the top trigger for food-induced anaphylaxis in Singaporean children. Objective To describe the demographic characteristics and clinical features of children with PA. Methods This is a 5-year retrospective review of children diagnosed with PA based on clinical history coupled with a positive skin prick test to peanut or positive oral food challenge results. Results There were 269 patients (53.9% males) with a clinical diagnosis of PA. The median age at first allergic presentation for the PA group was 24 months old, with interquartile range of 13-39 months. The most common form of peanut introduced was roasted peanut. The rate of peanut anaphylaxis was 7.1%. Concomitant tree nut sensitization was found in 32.3% of this cohort, predominantly to cashew nut. Majority of them have a personal history of atopy - 75.8% with eczema, 63.6% with allergic rhinitis, and 19.7% with asthma. Conclusion This is the first large review of peanut-allergic children in Singapore. Prospective population-based studies are needed to establish the true prevalence and risk factors associated with the development of this potentially life-threatening condition.
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Affiliation(s)
- May Ping Lee
- Allergy Service, Department of Paediatric Medicine, KK Women's and Children's Hospital, Singapore
| | - Seyed Ehsan Saffari
- Centre for Quantitative Medicine, Office of Clinical Sciences, Duke-NUS Medical School, Singapore
| | - Wenyin Loh
- Allergy Service, Department of Paediatric Medicine, KK Women's and Children's Hospital, Singapore
| | - Si Hui Goh
- Allergy Service, Department of Paediatric Medicine, KK Women's and Children's Hospital, Singapore
| | - Anne Goh
- Allergy Service, Department of Paediatric Medicine, KK Women's and Children's Hospital, Singapore
| | - Wen Chin Chiang
- Allergy Service, Department of Paediatric Medicine, KK Women's and Children's Hospital, Singapore
| | - Kok Wee Chong
- Allergy Service, Department of Paediatric Medicine, KK Women's and Children's Hospital, Singapore
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Wang HT, Warren CM, Gupta RS, Davis CM. Prevalence and Characteristics of Shellfish Allergy in the Pediatric Population of the United States. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2020; 8:1359-1370.e2. [PMID: 31917365 DOI: 10.1016/j.jaip.2019.12.027] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 11/16/2019] [Accepted: 12/09/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Shellfish allergy (SA) is one of the most common food allergies causing anaphylaxis in adults and children. There are limited data showing the prevalence of SA in US children. OBJECTIVE To determine the prevalence and reaction characteristics of SA in the US pediatric population. METHODS A cross-sectional food allergy prevalence survey was administered via phone and the Web by the National Opinion Research Center at the University of Chicago from 2015 to 2016. Point prevalence SA estimates, complex survey weighted proportions, and 95% CIs were determined. Relative proportions of demographic characteristics were compared using weighted Pearson χ2 statistics. RESULTS The prevalence of SA was 1.3% (95% CI, 1.1-1.5), with more children allergic to crustaceans (1.2%; 95% CI, 1.0-1.3) than to mollusks (0.5%; 95% CI, 0.4-0.6). Mean ages of shellfish, crustacean, and mollusk allergy diagnoses were 5.0 (95% CI, 4.4-5.6), 5.1 (95% CI, 4.6-5.6), and 7.7 (95% CI, 5.7-9.7) years, respectively. More than half (54.9%; 95% CI, 48.1-61.4) of pediatric patients with SA had more than 1 lifetime food allergy-related emergency room visit, but only 45.7% (95% CI, 39.2-52.4) carried an epinephrine autoinjector. Children with SA were more likely to be black/Hispanic/Latino and have comorbid asthma, allergic rhinitis, or a parental history of asthma, environmental, or other food allergies (P < .001). CONCLUSIONS The epidemiology of SA in the US pediatric population shows that crustacean allergy is more common than mollusk allergy. A disparity in SA children and epinephrine autoinjector carriage exists. Results from this study will lead to increased awareness of the need for detailed histories, specific diagnostic tests, and rescue epinephrine for anaphylaxis in US children with SA.
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Affiliation(s)
- Helen T Wang
- Department of Pediatrics, Section of Immunology, Allergy, and Retrovirology, Texas Children's Hospital, Houston, Texas; Department of Medicine, Section of Immunology, Allergy, and Rheumatology, Baylor College of Medicine, Houston, Texas
| | - Christopher M Warren
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, Calif
| | - Ruchi S Gupta
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Carla M Davis
- Department of Pediatrics, Section of Immunology, Allergy, and Retrovirology, Texas Children's Hospital, Houston, Texas; Department of Medicine, Section of Immunology, Allergy, and Rheumatology, Baylor College of Medicine, Houston, Texas.
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12
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Li J, Ogorodova LM, Mahesh PA, Wang MH, Fedorova OS, Leung TF, Fernandez-Rivas M, Mills ENC, Potts J, Kummeling I, Versteeg SA, van Ree R, Yazdanbakhsh M, Burney PGJ, Wong GWK. Comparative Study of Food Allergies in Children from China, India, and Russia: The EuroPrevall-INCO Surveys. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2019; 8:1349-1358.e16. [PMID: 31857266 DOI: 10.1016/j.jaip.2019.11.042] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 10/30/2019] [Accepted: 11/21/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND A clear understanding of the differences in the epidemiology of food allergy between rural and urban populations may provide insights into the causes of increasing prevalence of food allergy in the developed world. OBJECTIVE We used a standardized methodology to determine the prevalence and types of food-specific allergic sensitization and food allergies in schoolchildren from urban and rural regions of China, Russia, and India. METHODS The current study is a multicenter epidemiological survey of children recruited from 5 cities in China (Hong Kong and Guangzhou), Russia (Tomsk), and India (Bengaluru and Mysore) and 1 rural county in Southern China (Shaoguan). A total of 35,549 children aged 6 to 11 years from 3 countries participated in this survey. Random samples of children from 3 countries were first screened by the EuroPrevall screening questionnaire. Children with and without a history of adverse reactions to foods were then recruited for the subsequent case-control comparative studies. We determined the prevalence rates of food-specific IgE sensitization and food allergies using the predefined criteria. RESULTS The prevalence rates of food-specific IgE sensitization (≥0.7 kU/L) to at least 1 food were 16.6% in Hong Kong, 7.0% in Guangzhou, 16.8% in rural Shaoguan, 8.0% in Tomsk, and 19.1% in India. Using a definition of probable food allergy as reporting allergic symptoms within 2 hours of ingestion of a specific food plus the presence of allergic sensitization to the specific food (positive IgE and/or positive skin prick test result), the prevalence of food allergy was highest in Hong Kong (1.50%), intermediate in Russia (0.87%), and lowest in Guangzhou (0.21%), Shaoguan (0.69%), and India (0.14%). For children recruited from Hong Kong, both sensitization and food allergy were significantly higher in children who were born and raised in Hong Kong when compared with those who were born in mainland China and migrated to Hong Kong, highlighting the importance of early-life exposures in affecting the subsequent development of food sensitization and food allergy. CONCLUSIONS There are wide variations in the prevalence of food-specific IgE sensitization and food allergy in the 3 participating countries. Food allergy appears to be less common when compared with developed countries. The variations in the prevalence of food allergen sensitization cannot be explained by the differences in the degree of urbanization. Despite the high prevalence of food-specific IgE sensitization in India and rural China, food allergy is still extremely uncommon. In addition to IgE sensitization, other factors must play important roles resulting in the clinical manifestations of food allergies.
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Affiliation(s)
- Jing Li
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | | | - Padukudru Anand Mahesh
- Department of TB and Respiratory Medicine, JSS Medical College, JSS University and Allergy Asthma Associates, Mysore, India
| | - Maggie Haitian Wang
- School of Public Health, Chinese University of Hong Kong, Shatin, NT, Hong Kong, China
| | | | - Ting Fan Leung
- Department of Pediatrics, Chinese University of Hong Kong, Hong Kong, China
| | | | - E N Clare Mills
- School of Translational Medicine, Manchester Academic Health Science Centre and Manchester Interdisciplinary Biocentre, The University of Manchester, Manchester, United Kingdom
| | - James Potts
- Department of Respiratory Epidemiology and Public Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Ischa Kummeling
- Department of Experimental Immunology, Academic Medical Center, Amsterdam, The Netherlands
| | - Serge A Versteeg
- Department of Experimental Immunology, Academic Medical Center, Amsterdam, The Netherlands
| | - Ronald van Ree
- Department of Experimental Immunology, Academic Medical Center, Amsterdam, The Netherlands; Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, The Netherlands
| | - Maria Yazdanbakhsh
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
| | - Peter G J Burney
- Department of Respiratory Epidemiology and Public Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Gary W K Wong
- Department of Pediatrics, Chinese University of Hong Kong, Hong Kong, China.
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Chan CJ, Yong YS, Song AAL, Abdul Rahim R, In LLA, Lim RLH. Lactococcus lactis harbouring Ara h 2.02 alleviates allergen-specific Th2-associated responses in sensitized mice. J Appl Microbiol 2019; 128:862-874. [PMID: 31758869 DOI: 10.1111/jam.14524] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 10/28/2019] [Accepted: 11/19/2019] [Indexed: 12/21/2022]
Abstract
AIM To study the prophylactic effect of recombinant Lactococcus lactis (rLl) harbouring Ara h 2.02 peanut allergen, in sensitized and challenged mice. METHODS AND RESULTS Ara h 2.02 cDNA was cloned into pNZ8048 for heterologous expression in L. lactis. The purified recombinant allergen showed IgE binding comparable with native Ara h 2. Balb/c mice were fed with either recombinant (rLl), nonrecombinant L. lactis (Ll) or NaHCO3 (Sham) prior to sensitization and challenged with rAra h 2.02, whereas the baseline group was only fed with Ll. Allergen-specific immunoglobulin and splenocyte cytokines responses were determined for each mouse. Mice fed with either Ll or rLl showed significant alleviation of IgE and IgG1 compared to the Sham group. Despite no significant decrease in Th2 (IL-4, IL-13, IL-6) or increase in Th1 (IFN-γ) cytokines, both groups showed lower IL-10 level, while the IL-4 : IFN-γ ratio was significantly lower for rLl compared to Ll group. CONCLUSIONS Oral administration of rLl harbouring Ara h 2.02 demonstrated alleviation of Th2-associated responses in allergen-challenged mice and a possible added allergen-specific prophylactic effect. SIGNIFICANCE AND IMPACT OF THE STUDY Ara h 2.02 coupled with the intrinsic properties of probiotic L. lactis as a delivery vehicle can be explored for the development of a commercially scalable vaccine.
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Affiliation(s)
- C J Chan
- Faculty of Applied Sciences, UCSI University, UCSI Heights, Cheras, Kuala Lumpur, Malaysia
| | - Y S Yong
- Faculty of Applied Sciences, UCSI University, UCSI Heights, Cheras, Kuala Lumpur, Malaysia
| | - A A L Song
- Department of Microbiology, Faculty of Biotechnology and Biomolecular Sciences, University Putra Malaysia, UPM Serdang, Selangor, Malaysia
| | - R Abdul Rahim
- Department of Cell and Molecular Biology, Faculty of Biotechnology and Biomolecular Sciences, University Putra Malaysia, UPM Serdang, Selangor, Malaysia
| | - L L A In
- Faculty of Applied Sciences, UCSI University, UCSI Heights, Cheras, Kuala Lumpur, Malaysia
| | - R L H Lim
- Faculty of Applied Sciences, UCSI University, UCSI Heights, Cheras, Kuala Lumpur, Malaysia
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Abstract
The prevalence of food allergies is increasing worldwide. To understand the regional specificities of food allergies and develop effective therapeutic interventions, extensive regional epidemiological studies are necessary. While data regarding incidence, prevalence, regional variation, and treatment in food allergies are available for western countries, such studies may not be available in many Asian countries. China accounts for almost 20% of the world's population and has a vast ethnic diversity, but large-scale meta-analyses of epidemiological studies of food allergy in China are lacking. A literature search revealed 22 publications on the prevalence of food allergy in Chinese populations. A review of these studies showed that the prevalence of food allergies in China is comparable to that in western countries, even though the Chinese diet is vastly different from that of the West and may vary even greatly within China, and finally, specific antigenic triggers of food allergy vary between China and the West and also within China. Current clinical management of food allergy in China includes allergen-specific immunotherapy, Chinese herbal medicine, acupuncture, and Western medicine. This study demonstrates an unmet need in China for a thorough investigation of the prevalence of food allergies in China, the specific foods involved, and characterization of the specific antigenic triggers of food allergy with respect to ethnicity, age, and diet in China.
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15
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Xia F, Li MS, Liu QM, Liu M, Yang Y, Cao MJ, Chen GX, Jin T, Liu GM. Crystal Structure Analysis and Conformational Epitope Mutation of Triosephosphate Isomerase, a Mud Crab Allergen. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2019; 67:12918-12926. [PMID: 31668066 DOI: 10.1021/acs.jafc.9b05279] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The triosephosphate isomerase (TIM), Scy p 8, is a crab allergen and shows cross-reactivity in the shellfish. Here, recombinant Scy p 8 was expressed, and its crystal structure was determined at a resolution of 1.8 Å. The three-dimensional structure of Scy p 8 is primarily composed of a (β/α)8-barrel motif prototype. Additionally, Scy p 8 showed cross-reactivity with high sequential and secondary structural identity among TIMs from shellfish species. The site-directed mutagenesis of critical amino acids of conformational epitopes was carried out, and the mutants of Trp 168 and Lys 237 to Ala reduced immunoglobulin E (IgE)-binding activity by approximately 30%, compared with wild-type TIM in an inhibition ELISA; however, it still induced basophil activation despite the interpatient variability between patients. These results can help to provide an accurate template for the analysis of the IgE binding and establish meaningful relationships between structure and allergenicity.
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Affiliation(s)
- Fei Xia
- College of Food and Biological Engineering, Xiamen Key Laboratory of Marine Functional Food, Fujian Provincial Engineering Technology Research Center of Marine Functional Food, Fujian Collaborative Innovation Center for Exploitation and Utilization of Marine Biological Resources , Jimei University , Xiamen , Fujian 361021 , China
| | - Meng-Si Li
- College of Food and Biological Engineering, Xiamen Key Laboratory of Marine Functional Food, Fujian Provincial Engineering Technology Research Center of Marine Functional Food, Fujian Collaborative Innovation Center for Exploitation and Utilization of Marine Biological Resources , Jimei University , Xiamen , Fujian 361021 , China
| | - Qing-Mei Liu
- College of Food and Biological Engineering, Xiamen Key Laboratory of Marine Functional Food, Fujian Provincial Engineering Technology Research Center of Marine Functional Food, Fujian Collaborative Innovation Center for Exploitation and Utilization of Marine Biological Resources , Jimei University , Xiamen , Fujian 361021 , China
| | - Meng Liu
- College of Food and Biological Engineering, Xiamen Key Laboratory of Marine Functional Food, Fujian Provincial Engineering Technology Research Center of Marine Functional Food, Fujian Collaborative Innovation Center for Exploitation and Utilization of Marine Biological Resources , Jimei University , Xiamen , Fujian 361021 , China
| | - Yang Yang
- College of Food and Biological Engineering, Xiamen Key Laboratory of Marine Functional Food, Fujian Provincial Engineering Technology Research Center of Marine Functional Food, Fujian Collaborative Innovation Center for Exploitation and Utilization of Marine Biological Resources , Jimei University , Xiamen , Fujian 361021 , China
| | - Min-Jie Cao
- College of Food and Biological Engineering, Xiamen Key Laboratory of Marine Functional Food, Fujian Provincial Engineering Technology Research Center of Marine Functional Food, Fujian Collaborative Innovation Center for Exploitation and Utilization of Marine Biological Resources , Jimei University , Xiamen , Fujian 361021 , China
| | - Gui-Xia Chen
- Women and Children's Hospital Affiliated to Xiamen University , Xiamen , Fujian 361003 , China
| | - Tengchuan Jin
- Hefei National Laboratory for Physical Sciences at Microscale, CAS Key Laboratory of Innate Immunity and Chronic Disease, Division of Life Sciences and Medicine , University of Science & Technology of China , Hefei , Anhui 230027 , China
| | - Guang-Ming Liu
- College of Food and Biological Engineering, Xiamen Key Laboratory of Marine Functional Food, Fujian Provincial Engineering Technology Research Center of Marine Functional Food, Fujian Collaborative Innovation Center for Exploitation and Utilization of Marine Biological Resources , Jimei University , Xiamen , Fujian 361021 , China
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Tham EH, Leung ASY, Pacharn P, Lee S, Ebisawa M, Lee BW, Wong GWK. Anaphylaxis - Lessons learnt when East meets West. Pediatr Allergy Immunol 2019; 30:681-688. [PMID: 31220363 DOI: 10.1111/pai.13098] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 05/28/2019] [Accepted: 06/11/2019] [Indexed: 11/28/2022]
Abstract
The rapidly increasing prevalence of allergic disorders over the past 2 decades highlights the need to understand the epidemiology of anaphylaxis. In Europe, the United States, and Australia, the incidence of anaphylaxis is estimated to be between 60 and 950 cases per 100 000 population, with a lifetime prevalence of anaphylaxis of 0.05%-2%. The incidence appears to be increasing over time. Although the existing Asian literature is heterogeneous and limited by under-reporting, it also suggests a similar increasing trend in anaphylaxis incidence in Asia. Anaphylaxis triggers in Asia, such as the predominance of shellfish and wheat in older children and adolescents, differ from those seen in Western populations. Triggers unique to Asia such as traditional Chinese medications, galacto-oligosaccharides, and food delicacies have also been reported. Low usage of adrenaline as first-line treatment of anaphylaxis is evident across all countries and is particularly concerning. There is a need to establish prospective, standardized protocols for anaphylaxis data collection and reporting, to enhance the collective understanding of anaphylaxis and its burden, gaps in management and to identify areas for future research and intervention in each region. Understanding of the underlying reasons explaining the difference between East and West will facilitate future primary preventive strategies.
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Affiliation(s)
- Elizabeth H 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
| | - Agnes S Y Leung
- Department of Pediatrics, Prince of Wales Hospital, Chinese University of Hong Kong, Sha Tin, Hong Kong, China
| | - Punchama Pacharn
- Department of Pediatrics, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Sooyoung Lee
- Department of Pediatrics, Ajou University School of Medicine, Suwon, South Korea
| | - Motohiro Ebisawa
- Clinical Research Center for Allergy and Rheumatology, National Hospital Organization, Sagamihara National Hospital, Sagamihara, Japan
| | - Bee Wah Lee
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Gary W K Wong
- Department of Pediatrics, Prince of Wales Hospital, Chinese University of Hong Kong, Sha Tin, Hong Kong, China
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17
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Chong KW, Saffari SE, Chan N, Seah R, Tan CH, Goh SH, Goh A, Loh W. Predictive value of peanut skin prick test, specific IgE in peanut-sensitized children in Singapore. Asia Pac Allergy 2019; 9:e21. [PMID: 31384576 PMCID: PMC6676064 DOI: 10.5415/apallergy.2019.9.e21] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 05/29/2019] [Indexed: 11/04/2022] Open
Abstract
Background The predictive decision points for both peanut skin prick test (SPT) wheal size and serum IgE concentrations, in peanut-sensitized children, have not been evaluated in Singapore. Objective We aim to derive clinically useful predictive decision points to be used for risk stratification of oral food challenge (OFC) in peanut-sensitized patients. Methods Patients with a positive SPT to peanut, performed during a 4-year period between 2012 and 2016, were included in a retrospective chart review. The patients were assessed for their peanut allergy status based on a convincing clinical history. Their first SPT and serum IgE results done at presentation to our centre were used. Results There were 269 patients with a clinical diagnosis of peanut allergy based on recent immediate reaction to peanut and 59 patients whom were tolerating peanuts regularly. There were 251 patients sensitized to peanut, without prior known peanut exposure. A wheal size of ≥8 mm and a peanut-specific IgE of ≥6 kU/L each provided for a 95% positive predictive value of clinical reaction to peanuts; the larger the wheal size on SPT, the higher the probability. Conclusion The cutoff values derived in this study can help clinicians in the risk assessment of OFC in peanut-sensitized patients. Prospective studies using OFCs for the diagnosis of peanut allergy are needed to confirm the diagnostic performance of these tests in predicting OFC outcomes.
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Affiliation(s)
- Kok Wee Chong
- Allergy Service, Department of Paediatric Medicine, KK Women's and Children's Hospital, Singapore
| | - Seyed Ehsan Saffari
- Centre for Quantitative Medicine, Office of Clinical Sciences, Duke-NUS Medical School, Singapore
| | - Nicole Chan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Raynian Seah
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Chek Han Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Si Hui Goh
- Allergy Service, Department of Paediatric Medicine, KK Women's and Children's Hospital, Singapore
| | - Anne Goh
- Allergy Service, Department of Paediatric Medicine, KK Women's and Children's Hospital, Singapore
| | - Wenyin Loh
- Allergy Service, Department of Paediatric Medicine, KK Women's and Children's Hospital, Singapore
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19
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Park DJ, Lee J, Kim SY, Kwon HJ, Lee HK, Kim Y. Evaluation of AdvanSure AlloScreen Max Panel With 92 Different Allergens for Detecting Allergen-Specific IgE. Am J Clin Pathol 2019; 151:628-637. [PMID: 30984971 DOI: 10.1093/ajcp/aqz023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES The objective of this study was to examine the performance of AdvanSure AlloScreen Max with 92 different allergens compared to Polycheck Allergy and ImmunoCAP. The relationship of serum IgE concentration with the number and the highest class/level of positive allergen-specific IgEs was also examined. METHODS A total of 406 serum samples were included in this study. Discrepant cases between AdvanSure AlloScreen Max and Polycheck Allergy underwent ImmunoCAP testing for allergen-specific IgE. RESULTS Total agreement of the two multiple allergen simultaneous tests (MAST) was 92.5%. Compared to ImmunoCAP, total agreement rate was higher with AdvanSure AlloScreen Max (60.8%) than that with Polycheck Allergy (39.2%). Serum IgE concentration showed a significant and positive correlation with the number and the highest class/level of positive allergen-specific IgEs. CONCLUSIONS A MAST assay panel containing as many allergens as possible would be more helpful in the allergen screening for patients with high serum IgE concentration.
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Affiliation(s)
- Dong Jin Park
- Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul
| | - Jehoon Lee
- Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul
| | - Soo-Young Kim
- Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul
| | - Hi Jeong Kwon
- Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul
| | - Hae Kyung Lee
- Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul
| | - Yeongsic Kim
- Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul
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20
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Ziyab AH. Prevalence of food allergy among schoolchildren in Kuwait and its association with the coexistence and severity of asthma, rhinitis, and eczema: A cross-sectional study. World Allergy Organ J 2019; 12:100024. [PMID: 30976380 PMCID: PMC6441753 DOI: 10.1016/j.waojou.2019.100024] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 12/25/2018] [Accepted: 03/11/2019] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Food allergy (FA) is a common public health problem that affects both children and adults. Empirical knowledge of the burden of FA in Kuwait is limited. This study sought to estimate the prevalence of FA among schoolchildren in Kuwait and assess associations between FA and the coexistence and severity of asthma, rhinitis, and eczema. METHODS Schoolchildren aged 11-14 years (n = 3,864) were enrolled in a cross-sectional study. Parents completed questionnaires regarding their children's early life exposures and clinical history of FA and allergic diseases. Study-defined FA was ascertained by a convincing clinical history. Associations were assessed using Poisson regression with robust variance estimation, and adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) were estimated. RESULTS The 12-month prevalence of study-defined FA was estimated to be 4.1% (154/3,738), with more girls being affected than boys (aPR = 1.44, 95% CI: 1.04-1.99). Egg (2.7%), fish (1.6%), shellfish (1.3%), peanut (1.3%), and tree nut (1.2%) were the most reported offending food allergens. Underweight and adiposity, cesarean section delivery, exposure to household dogs during infancy, and parental history of doctor-diagnosed FA were associated with an increased prevalence of study-defined FA. However, later birth order was associated with a reduced prevalence of study-defined FA. The prevalence of eczema only was higher in children with study-defined FA than in those without study-defined FA (aPR = 3.49, 95% CI: 2.37-5.14). In contrast, this association was not pronounced for children who had asthma only (aPR = 1.56, 95% CI: 0.94-2.57) or rhinitis only (aPR = 1.40, 95% CI: 0.86-2.28). Study-defined FA was associated with a 9.20-fold (95% CI: 4.50-18.78) higher prevalence of coexisting asthma, rhinitis, and eczema. Moreover, study-defined FA was associated with increased severity of symptoms of asthma, rhinitis, and eczema. CONCLUSIONS FA affects a considerable proportion of schoolchildren in Kuwait, and the most reported offending food allergens are similar to those reported in Western countries. Study-defined FA was associated with the coexistence and increased severity of asthma, rhinitis, and eczema, indicating that FA may link the comanifestations of allergic diseases and contribute to their chronicity and severity.
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Faisal M, Vasiljevic T, Donkor ON. A review on methodologies for extraction, identification and quantification of allergenic proteins in prawns. Food Res Int 2019; 121:307-318. [PMID: 31108753 DOI: 10.1016/j.foodres.2019.03.040] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 03/13/2019] [Accepted: 03/17/2019] [Indexed: 12/26/2022]
Abstract
Prawn allergy is one of the most common food-borne allergies and current prevention is by avoidance. This review paper summarised different methodologies for the extraction, identification and quantification of prawn protein allergens, reported in various research studies. Following extraction, allergenic components have been analysed using well-established methodologies, such as SDS-PAGE, Immunoblotting, ELISA, CD Spectroscopy, HPLC, DBPCFC, SPT etc. Moreover, the preference towards Aptamer-based technique for allergenicity analysis has also been highlighted in this review paper. The summary of these methodologies will provide a reference platform for present and future research directions.
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Affiliation(s)
- M Faisal
- Advanced Food Systems Research Unit, Institute of Sustainable Industries & Liveable Cities and College of Health and Biomedicine, Victoria University, Werribee Campus, PO Box 14428, Melbourne, Victoria 8001, Australia.
| | - T Vasiljevic
- Advanced Food Systems Research Unit, Institute of Sustainable Industries & Liveable Cities and College of Health and Biomedicine, Victoria University, Werribee Campus, PO Box 14428, Melbourne, Victoria 8001, Australia.
| | - O N Donkor
- Advanced Food Systems Research Unit, Institute of Sustainable Industries & Liveable Cities and College of Health and Biomedicine, Victoria University, Werribee Campus, PO Box 14428, Melbourne, Victoria 8001, Australia.
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22
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Joo Chan C, Richardo T, Lim RLH. Current Trend in Immunotherapy for Peanut Allergy. Int Rev Immunol 2019; 37:279-290. [DOI: 10.1080/08830185.2018.1509967] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Chong Joo Chan
- Department of Biotechnology, Faculty of Applied Sciences, UCSI University, Cheras, Kuala Lumpur, Malaysia
| | - Timmy Richardo
- Department of Biomedicine, Indonesia International Institute for Life Sciences (i3L), Jakarta, Indonesia
| | - Renee Lay Hong Lim
- Department of Biotechnology, Faculty of Applied Sciences, UCSI University, Cheras, Kuala Lumpur, Malaysia
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23
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Soogali NB, Soon JM. Food allergies and perceptions towards food allergen labelling in Mauritius. Food Control 2018. [DOI: 10.1016/j.foodcont.2018.06.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Pascal M, Kamath SD, Faber M. Diagnosis and Management of Shellfish Allergy: Current Approach and Future Needs. CURRENT TREATMENT OPTIONS IN ALLERGY 2018. [DOI: 10.1007/s40521-018-0186-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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25
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Tong WS, Yuen AW, Wai CY, Leung NY, Chu KH, Leung PS. Diagnosis of fish and shellfish allergies. J Asthma Allergy 2018; 11:247-260. [PMID: 30323632 PMCID: PMC6181092 DOI: 10.2147/jaa.s142476] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Seafood allergy is a hypersensitive disorder with increasing prevalence worldwide. Effective and accurate diagnostic workup for seafood allergy is essential for clinicians and patients. Parvalbumin and tropomyosin are the most common fish and shellfish allergens, respectively. The diagnosis of seafood allergies is complicated by cross-reactivity among fish allergens and between shellfish allergens and other arthropods. Current clinical diagnosis of seafood allergy is a complex algorithm that includes clinical assessment, skin prick test, specific IgE measurement, and oral food challenges. Emerging diagnostic strategies, such as component-resolved diagnosis (CRD), which uses single allergenic components for assessment of epitope specific IgE, can provide critical information in predicting individualized sensitization patterns and risk of severe allergic reactions. Further understanding of the molecular identities and characteristics of seafood allergens can advance the development of CRD and lead to more precise diagnosis and improved clinical management of seafood allergies.
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Affiliation(s)
- Wai Sze Tong
- School of Life Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong, SAR, China
| | - Agatha Wt Yuen
- School of Life Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong, SAR, China
| | - Christine Yy Wai
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China,
| | - Nicki Yh Leung
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China,
| | - Ka Hou Chu
- School of Life Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong, SAR, China
| | - Patrick Sc Leung
- Division of Rheumatology, Allergy and Clinical Immunology, School of Medicine, University of California Davis, Davis, CA, USA,
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Soon JM. Structural modelling of food allergen knowledge, attitude and practices among consumers in Malaysia. Food Res Int 2018; 111:674-681. [PMID: 30007732 DOI: 10.1016/j.foodres.2018.06.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 05/30/2018] [Accepted: 06/01/2018] [Indexed: 10/14/2022]
Abstract
The aim of this study was to assess food allergen knowledge, attitude and self-reported practices among consumers in Malaysia. An online survey was conducted and data were analysed using descriptive statistics and exploratory factor analysis. A model linking food allergen knowledge and attitude and their direct effects on practices were confirmed using structural equation modelling (SEM). Consumers demonstrated moderate food allergen knowledge in this study but scored highly in their attitude towards food allergens. Although participants scored moderately in food allergen knowledge, this does not necessarily translate into practices. There is a possibility that an increase in food allergen knowledge can increase optimistic bias or a sense of over-confidence to manage allergen risks. Consumers' attitude towards food allergens has a positive and significant influence on practices. A positive attitude represents personal beliefs and reflects the level of motivation and care required to manage food allergens effectively. There was insignificant relationship between food allergen knowledge and attitude. This demonstrates a need to tailor targeted risk communication and learning strategies to influence consumers' practices.
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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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Khan MU, Ahmed I, Lin H, Li Z, Costa J, Mafra I, Chen Y, Wu YN. Potential efficacy of processing technologies for mitigating crustacean allergenicity. Crit Rev Food Sci Nutr 2018; 59:2807-2830. [DOI: 10.1080/10408398.2018.1471658] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Mati Ullah Khan
- College of Food Science and Engineering, Ocean University of China, Qingdao, Shandong Province, P.R. China
| | - Ishfaq Ahmed
- College of Food Science and Engineering, Ocean University of China, Qingdao, Shandong Province, P.R. China
| | - Hong Lin
- College of Food Science and Engineering, Ocean University of China, Qingdao, Shandong Province, P.R. China
| | - Zhenxing Li
- College of Food Science and Engineering, Ocean University of China, Qingdao, Shandong Province, P.R. China
| | - Joana Costa
- REQUIMTE-LAQV, Faculdade de Farmácia, Universidade do Porto, Rua de Jorge Viterbo Ferreira, Porto, Portugal
| | - Isabel Mafra
- REQUIMTE-LAQV, Faculdade de Farmácia, Universidade do Porto, Rua de Jorge Viterbo Ferreira, Porto, Portugal
| | - Yan Chen
- China National Center for Food Safety Risk Assessment, Chaoyang, Beijing, P.R. China
| | - Yong-Ning Wu
- China National Center for Food Safety Risk Assessment, Chaoyang, Beijing, P.R. China
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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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Rosenfield L, Tsoulis MW, Milio K, Schnittke M, Kim H. High rate of house dust mite sensitization in a shrimp allergic southern Ontario population. Allergy Asthma Clin Immunol 2017; 13:5. [PMID: 28115965 PMCID: PMC5244585 DOI: 10.1186/s13223-017-0177-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 01/02/2017] [Indexed: 11/18/2022] Open
Abstract
Background Shrimp and house dust mite (HDM) allergies are common in Canadians. Often, both of these allergies occur in the same patient. This may be due to homology of tropomyosin or other potentially shared proteins. The aim of our study was to assess the frequency of house dust mite sensitization in a shrimp allergic Canadian population. Methods We undertook a retrospective chart review of shrimp allergic patients at an outpatient allergy clinic in Kitchener, Ontario, Canada. Our primary endpoint was to assess for presence of HDM sensitization in this population. Patients were categorized into approximate quartiles. We assessed the severity of the shrimp reactions, correlated shrimp skin test size to HDM skin test size, and measured the proportion of patients with atopic symptoms. Results We identified 95 shrimp allergic patients who were tested for house dust mite. 86 (90.5%) of these patients had a positive skin test to HDM. Patients with a shrimp skin test ≥5 mm were 5.31 times (95% CI, 1.55–18.14; p = 0.008) more likely to exhibit a dust mite skin test ≥5 mm than patients with a shrimp skin test <5 mm. The odds of a patient with a shrimp skin test between 10 and 18 mm having a larger HDM skin test were 3.93 times (95% CI 1.03–14.98, p = 0.045) the odds for a patient with a shrimp skin test size between 3 and 4 mm. We did not find a correlation between shrimp skin test size and shrimp reaction symptom grade (p = 0.301). Conclusion In our Canadian patients, we found a large majority of shrimp allergic patients to be sensitized to HDM. We found that patients with a large skin test to shrimp were more likely to have a large skin test to HDM compared to those patients with a small skin test to shrimp. We did not find a correlation between shrimp skin test size and shrimp reaction symptom severity. Most of these patients had symptoms of rhinitis and/or asthma that may have been caused by house dust mite allergy.
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Affiliation(s)
- Lana Rosenfield
- Division of Clinical Immunology and Allergy, Department of Medicine Michael D. DeGroote School of Medicine, McMaster University, Hamilton, ON Canada
| | | | - Kirolos Milio
- Faculty of Science, University of Waterloo, Waterloo, ON Canada
| | | | - Harold Kim
- Division of Clinical Immunology and Allergy, Department of Medicine Michael D. DeGroote School of Medicine, McMaster University, Hamilton, ON Canada.,Grandriver Allergy, Kitchener, ON Canada.,Schulich School of Medicine & Dentistry, Western University, London, ON Canada
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30
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Gao Y, Hou R, Fei Q, Fang L, Han Y, Cai R, Peng C, Qi Y. The Three-Herb Formula Shuang-Huang-Lian stabilizes mast cells through activation of mitochondrial calcium uniporter. Sci Rep 2017; 7:38736. [PMID: 28045016 PMCID: PMC5206722 DOI: 10.1038/srep38736] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 11/14/2016] [Indexed: 12/31/2022] Open
Abstract
Mast cells (MCs) are key effector cells of IgE-FcεRI- or MrgprX2-mediated signaling event. Shuang-Huang-Lian (SHL), a herbal formula from Chinese Pharmacopoeia, has been clinically used in type I hypersensitivity. Our previous study demonstrated that SHL exerted a non-negligible effect on MC stabilization. Herein, we sought to elucidate the molecular mechanisms of the prominent anti-allergic ability of SHL. MrgprX2- and IgE-FcεRI-mediated MC activation in vitro and in vivo models were developed by using compound 48/80 (C48/80) and shrimp tropomyosin (ST), respectively. Our data showed that SHL markedly dampened C48/80- or ST-induced MC degranulation in vitro and in vivo. Mechanistic study indicated that cytosolic Ca2+ (Ca2+[c]) level decreased rapidly and sustainably after SHL treatment, and then returned to homeostasis when SHL was withdrawn. Moreover, SHL decreases Ca2+[c] levels mainly through enhancing the mitochondrial Ca2+ (Ca2+[m]) uptake. After genetically silencing or pharmacologic inhibiting mitochondrial calcium uniporter (MCU), the effect of SHL on the Ca2+[c] level and MC degranulation was significantly weakened. Simultaneously, the activation of SHL on Ca2+[m] uptake was completely lost. Collectively, by activating MCU, SHL decreases Ca2+[c] level to stabilize MCs, thus exerting a remarkable anti-allergic activity, which could have considerable influences on clinical practice and research.
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Affiliation(s)
- Yuan Gao
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences &Peking Union Medical College, Beijing, 100193, China.,Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
| | - Rui Hou
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences &Peking Union Medical College, Beijing, 100193, China
| | - Qiaoling Fei
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences &Peking Union Medical College, Beijing, 100193, China
| | - Lei Fang
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences &Peking Union Medical College, Beijing, 100193, China
| | - Yixin Han
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences &Peking Union Medical College, Beijing, 100193, China
| | - Runlan Cai
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences &Peking Union Medical College, Beijing, 100193, China
| | - Cheng Peng
- Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
| | - Yun Qi
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences &Peking Union Medical College, Beijing, 100193, China
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31
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Freidl R, Gstoettner A, Baranyi U, Swoboda I, Stolz F, Focke-Tejkl M, Wekerle T, van Ree R, Valenta R, Linhart B. Blocking antibodies induced by immunization with a hypoallergenic parvalbumin mutant reduce allergic symptoms in a mouse model of fish allergy. J Allergy Clin Immunol 2016; 139:1897-1905.e1. [PMID: 27876628 PMCID: PMC5438872 DOI: 10.1016/j.jaci.2016.10.018] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Revised: 08/18/2016] [Accepted: 10/05/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Fish is a frequent elicitor of severe IgE-mediated allergic reactions. Beside avoidance, there is currently no allergen-specific therapy available. Hypoallergenic variants of the major fish allergen, parvalbumin, for specific immunotherapy based on mutation of the 2 calcium-binding sites have been developed. OBJECTIVES This study sought to establish a mouse model of fish allergy resembling human disease and to investigate whether mouse and rabbit IgG antibodies induced by immunization with a hypoallergenic mutant of the major carp allergen protect against allergic symptoms in sensitized mice. METHODS C3H/HeJ mice were sensitized with recombinant wildtype Cyp c 1 or carp extract by intragastric gavage. Antibody, cellular immune responses, and epitope specificity in sensitized mice were investigated by ELISA, rat basophil leukemia assay, T-cell proliferation experiments using recombinant wildtype Cyp c 1, and overlapping peptides spanning the Cyp c 1 sequence. Anti-hypoallergenic Cyp c 1 mutant mouse and rabbit sera were tested for their ability to inhibit IgE recognition of Cyp c 1, Cyp c 1-specific basophil degranulation, and Cyp c 1-induced allergic symptoms in the mouse model. RESULTS A mouse model of fish allergy mimicking human disease regarding IgE epitope recognition and symptoms as close as possible was established. Administration of antisera generated in mice and rabbits by immunization with a hypoallergenic Cyp c 1 mutant inhibited IgE binding to Cyp c 1, Cyp c 1-induced basophil degranulation, and allergic symptoms caused by allergen challenge in sensitized mice. CONCLUSIONS Antibodies induced by immunization with a hypoallergenic Cyp c 1 mutant protect against allergic reactions in a murine model of fish allergy.
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Affiliation(s)
- Raphaela Freidl
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Antonia Gstoettner
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Ulrike Baranyi
- Section of Transplantation Immunology, Department of Surgery, Medical University of Vienna, Vienna, Austria
| | - Ines Swoboda
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | | | - Margarete Focke-Tejkl
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Thomas Wekerle
- Section of Transplantation Immunology, Department of Surgery, Medical University of Vienna, Vienna, Austria
| | - Ronald van Ree
- Department of Experimental Immunology, Academic Medical Center, Amsterdam, The Netherlands; Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, The Netherlands
| | - Rudolf Valenta
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Birgit Linhart
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.
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32
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Transforming insect biomass into consumer wellness foods: A review. Food Res Int 2016; 89:129-151. [DOI: 10.1016/j.foodres.2016.10.001] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 09/28/2016] [Accepted: 10/02/2016] [Indexed: 02/01/2023]
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33
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Park KH, Son YW, Lee SC, Jeong K, Sim DW, Park HJ, Lee S, Lee JH, Park JW. Clinical Significance of Component Allergens in Fagales Pollen-Sensitized Peanut Allergy in Korea. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2016; 8:505-11. [PMID: 27582401 PMCID: PMC5011050 DOI: 10.4168/aair.2016.8.6.505] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Revised: 03/15/2016] [Accepted: 04/25/2016] [Indexed: 11/20/2022]
Abstract
PURPOSE Clinical features of peanut allergy can range from localized to systemic reactions. Because peanut and birch pollen have cross-reactivity, peanut can lead to localized allergic reaction in Fagales pollen-sensitized oral allergy syndrome (OAS) patients without peanut sensitization per se. The purpose of this study was to discriminate true peanut food allergy from cross-reactive hypersensitivity in birch-sensitized peanut allergy. METHODS Birch-sensitized (n=81) and peanut anaphylaxis patients (n=12) were enrolled. Peanut-related allergic reactions and sensitization profiles were examined. Specific IgE to Fagales tree pollens (birch, oak), peanut, and their component allergens (Bet v 1, Bet v 2, Ara h 1, Ara h 2, Ara h 3, Ara h 8, and Ara h 9) were evaluated. Based on these specific IgEs and clinical features, the patients were classified into 4 groups: group 1 (Fagales pollen allergy without OAS), group 2 (Fagales pollen allergy with OAS), group 3 (OAS with peanut anaphylaxis), and group 4 (peanut anaphylaxis). RESULTS After peanut consumption, one-third of OAS patients experienced oral symptoms not associated with peanut sensitization. Ara h 1 or Ara h 2 was positive in peanut anaphylaxis patients, whereas Ara h 8 was positive in OAS patients. There were 4 patients with both peanut anaphylaxis and OAS (group 3). Both Ara h 2 and Ara h 8 were positive in these patients. Foods associated with OAS in Korea showed unique patterns compared to Westernized countries. CONCLUSIONS Ara h 2 and Ara h 8 may be important component allergens for discriminating peanut allergy.
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Affiliation(s)
- Kyung Hee Park
- Division of Allergy and Immunology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea
| | - Young Woong Son
- Division of Allergy and Immunology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Sang Chul Lee
- Division of Allergy and Immunology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Kyunguk Jeong
- Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea
| | - Da Woon Sim
- Division of Allergy and Immunology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea
| | - Hye Jung Park
- Division of Allergy and Immunology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea
| | - Sooyoung Lee
- Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea
| | - Jae Hyun Lee
- Division of Allergy and Immunology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea
| | - Jung Won Park
- Division of Allergy and Immunology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea.
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Pedrosa M, Boyano-Martínez T, García-Ara C, Quirce S. Shellfish Allergy: a Comprehensive Review. Clin Rev Allergy Immunol 2016; 49:203-16. [PMID: 24870065 DOI: 10.1007/s12016-014-8429-8] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Shellfish allergy is of increasing concern, as its prevalence has risen in recent years. Many advances have been made in allergen characterization. B cell epitopes in the major allergen tropomyosin have been characterized. In addition to tropomyosin, arginine kinase, sarcoplasmic calcium-binding protein, and myosin light chain have recently been reported in shellfish. All are proteins that play a role in muscular contraction. Additional allergens such as hemocyanin have also been described. The effect of processing methods on these allergens has been studied, revealing thermal stability and resistance to peptic digestion in some cases. Modifications after Maillard reactions have also been addressed, although in some cases with conflicting results. In recent years, new hypoallergenic molecules have been developed, which constitute a new therapeutic approach to allergic disorders. A recombinant hypoallergenic tropomyosin has been developed, which opens a new avenue in the treatment of shellfish allergy. Cross-reactivity with species that are not closely related is common in shellfish-allergic patients, as many of shellfish allergens are widely distributed panallergens in invertebrates. Cross-reactivity with house dust mites is well known, but other species can also be involved in this phenomenon.
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Affiliation(s)
- María Pedrosa
- Allergy Department, Hospital La Paz Institute for Health Research (IdiPAZ), Paseo de la Castellana 261, 28046, Madrid, Spain.
| | - Teresa Boyano-Martínez
- Allergy Department, Hospital La Paz Institute for Health Research (IdiPAZ), Paseo de la Castellana 261, 28046, Madrid, Spain
| | - Carmen García-Ara
- Allergy Department, Hospital La Paz Institute for Health Research (IdiPAZ), Paseo de la Castellana 261, 28046, Madrid, Spain
| | - Santiago Quirce
- Allergy Department, Hospital La Paz Institute for Health Research (IdiPAZ), Paseo de la Castellana 261, 28046, Madrid, Spain
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Abstract
Shellfish are diverse, serve as main constituents of seafood, and are extensively consumed globally because of their nutritional values. Consequently, increase in reports of IgE-mediated seafood allergy is particularly food associated to shellfish. Seafood-associated shellfish consists of crustaceans (decapods, stomatopods, barnacles, and euphausiids) and molluskans (gastropods, bivalves, and cephalopods) and its products can start from mild local symptoms and lead to severe systemic anaphylactic reactions through ingestion, inhalation, or contact like most other food allergens. Globally, the most commonly causative shellfish are shrimps, crabs, lobsters, clams, oysters, and mussels. The prevalence of shellfish allergy is estimated to be 0.5-2.5% of the general population but higher in coastal Asian countries where shellfish constitute a large proportion of the diet. Diversity in allergens such as tropomyosin, arginine kinase, myosin light chain, and sarcoplasmic binding protein are from crustaceans whereas tropomyosin, paramyosin, troponin, actine, amylase, and hemoyanin are reported from molluskans shellfish. Tropomyosin is the major allergen and is responsible for cross-reactivity between shellfish and other invertebrates, within crustaceans, within molluskans, between crustaceans vs. molluskans as well as between shellfish and fish. Allergenicity diagnosis requires clinical history, in vivo skin prick testing, in vitro quantification of IgE, immunoCAP, and confirmation by oral challenge testing unless the reactions borne by it are life-threatening. This comprehensive review provides the update and new findings in the area of shellfish allergy including demographic, diversity of allergens, allergenicity, their cross-reactivity, and innovative molecular genetics approaches in diagnosing and managing this life-threatening as well as life-long disease.
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Affiliation(s)
- Samanta S Khora
- a Medical Biotechnology Lab, Department of Medical Biotechnology , School of Biosciences and Technology, VIT University , Vellore , India
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Caraballo L, Zakzuk J, Lee BW, Acevedo N, Soh JY, Sánchez-Borges M, Hossny E, García E, Rosario N, Ansotegui I, Puerta L, Sánchez J, Cardona V. Particularities of allergy in the Tropics. World Allergy Organ J 2016; 9:20. [PMID: 27386040 PMCID: PMC4924335 DOI: 10.1186/s40413-016-0110-7] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 05/25/2016] [Indexed: 12/27/2022] Open
Abstract
Allergic diseases are distributed worldwide and their risk factors and triggers vary according to geographical and socioeconomic conditions. Allergies are frequent in the Tropics but aspects of their prevalence, natural history, risk factors, sensitizers and triggers are not well defined and some are expected to be different from those in temperate zone countries. The aim of this review is to investigate if allergic diseases in the Tropics have particularities that deserve special attention for research and clinical practice. Such information will help to form a better understanding of the pathogenesis, diagnosis and management of allergic diseases in the Tropics. As expected, we found particularities in the Tropics that merit further study because they strongly affect the natural history of common allergic diseases; most of them related to climate conditions that favor permanent exposure to mite allergens, helminth infections and stinging insects. In addition, we detected several unmet needs in important areas which should be investigated and solved by collaborative efforts led by the emergent research groups on allergy from tropical countries.
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Affiliation(s)
- Luis Caraballo
- />Institute for Immunological Research, University of Cartagena, Cra. 5 # 7-77, Cartagena, Colombia
| | - Josefina Zakzuk
- />Institute for Immunological Research, University of Cartagena, Cra. 5 # 7-77, Cartagena, Colombia
| | - Bee Wah Lee
- />Khoo Teck Puat- National University Children’s Medical Institute, National University Health System, Singapore, Singapore
- />Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Nathalie Acevedo
- />Department of Medicine Solna, Karolinska Institutet, Translational Immunology Unit, Stockholm, Sweden
| | - Jian Yi Soh
- />Khoo Teck Puat- National University Children’s Medical Institute, National University Health System, Singapore, Singapore
- />Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Mario Sánchez-Borges
- />Allergy and Clinical Immunology Department, Centro Médico- Docente La Trinidad and Clínica El Avila, Caracas, Venezuela
| | - Elham Hossny
- />Pediatric Allergy and Immunology Unit, Children’s Hospital, Ain Shams University, Cairo, Egypt
| | - Elizabeth García
- />Allergy Section, Fundación Santa Fe de Bogotá, Faculty of Medicine, Universidad de los Andes, Bogotá, Colombia
| | - Nelson Rosario
- />Federal University of Parana, Rua General Carneiro, Curitiba, Brazil
| | - Ignacio Ansotegui
- />Department of Allergy and Immunology, Hospital Quirón Bizkaia, Bilbao, Spain
| | - Leonardo Puerta
- />Institute for Immunological Research, University of Cartagena, Cra. 5 # 7-77, Cartagena, Colombia
| | - Jorge Sánchez
- />Department of Pediatrics, Graduate Program on Allergology, University of Antioquia, Medellín, Colombia
| | - Victoria Cardona
- />Allergy Section, Department of Internal Medicine, Hospital Vall d’Hebron, Barcelona, Spain
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Liu T, Navarro S, Lopata AL. Current advances of murine models for food allergy. Mol Immunol 2016; 70:104-17. [DOI: 10.1016/j.molimm.2015.11.011] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 11/21/2015] [Accepted: 11/28/2015] [Indexed: 12/16/2022]
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38
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Zeng GQ, Luo JY, Huang HM, Zheng PY, Luo WT, Wei NL, Sun BQ. Food allergy and related risk factors in 2540 preschool children: an epidemiological survey in Guangdong Province, southern China. World J Pediatr 2015; 11:219-25. [PMID: 26253412 DOI: 10.1007/s12519-015-0030-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 03/16/2015] [Indexed: 12/23/2022]
Abstract
BACKGROUND Although the number of studies on allergic diseases in the general population of southern China is increasing, only a few have addressed food allergy (FA) in children in this region. The present study aimed to investigate the prevalence, clinical manifestations, spectrum of allergens, and related risk factors of FA in preschool children in Guangdong Province, southern China. METHODS A random cluster-sampling method was used to select 24 kindergartens from 12 cities in Guangdong Province. The parents or guardians of the children were requested to complete a questionnaire on general information and data regarding FA diagnosis and symptoms in the children and their first-degree relatives. Thereafter, the Chi-square test, multivariate regression analysis, and Spearman's rank-order correlation coefficient analysis were performed to identify statistically significant differences. RESULTS Analysis of 2540 valid questionnaires revealed an FA prevalence rate of 4%. Adverse food reactions were due to the consumption of shrimp (4.4%), crab (3.2%), mango (2.3%), cow's milk and dairy products (1.9%), and eggs (1.4%). Logistic regression analysis indicated that a history of FA and a history of allergic rhinitis in the first-degree relatives were the major factors leading to FA in children. CONCLUSIONS The incidence of FA in children in Guangdong Province is higher than that commonly believed. An individual's genetic background is an important risk factor for FA. Hence, mitigation of the impact of lifestyle and environmental factors should be carefully considered to reduce the incidence of childhood FA.
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Affiliation(s)
- Guang-Qiao Zeng
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Diseases, Guangzhou Institute of Respiratory Diseases, First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
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Wong L, Huang CH, Lee BW. Shellfish and House Dust Mite Allergies: Is the Link Tropomyosin? ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2015; 8:101-6. [PMID: 26739402 PMCID: PMC4713872 DOI: 10.4168/aair.2016.8.2.101] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 05/12/2015] [Indexed: 11/20/2022]
Abstract
Crustacean shellfish allergy is an important cause of food allergy and anaphylaxis in Asia. The major allergen in shellfish allergy is tropomyosin, a pan-allergen that is also found in house dust mites and cockroaches. Tropomyosins from house dust mites (HDMs) have a high sequence homology to shellfish tropomyosins, and cross-reactivity between HDM and shrimp tropomyosins has been demonstrated. Exposure to inhaled tropomyosins from house dust mites has been postulated to be the primary sensitizer for shellfish allergy, in a reaction analogous to the oral allergy (inhalant-food) syndrome. This notion is supported by indirect data from the effects of HDM immunotherapy on shellfish allergy, and strong correlations of shellfish and HDM sensitization. HDM immunotherapy has been reported to induce both shrimp allergy in non-allergic patients and shrimp tolerance in shrimp-allergic patients. Epidemiological surveys have also demonstrated a strong correlation between shellfish and HDM sensitization in both hospital-based and community-based studies. Unexposed populations have also been shown to develop sensitization-shellfish sensitization in orthodox Jews with no history of shellfish consumption was associated with HDM sensitization. Reciprocally, HDM sensitization in an Icelandic population living in a HDM-free environment was associated with shrimp sensitization. In vitro IgE inhibition studies on sera in shrimp-allergic Spanish patients indicate that mites are the primary sensitizer in shrimp-allergic patients living in humid and warm climates. Current data supports the hypothesis that tropomyosin is the link between HDM and shellfish allergies. The role of tropomyosin in HDM and shellfish allergies is a fertile field for investigation as it may provide novel immunotherapeutic strategies for shellfish allergy.
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Affiliation(s)
- Lydia Wong
- Pediatrics, Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore
| | - Chiung Hui Huang
- Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Bee Wah Lee
- Pediatrics, Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore.,Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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40
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Abstract
With the exception of shellfish, the overall food allergy rates in Singapore have not reached the epidemic proportions of the West. The rates of egg, milk and fish allergies remain low. However, the patterns of some food allergies in Singapore have changed over the last decade. For example, peanut allergy, once rare in Singapore, is now the most common cause of anaphylaxis in children. Studies analysing lifestyle practices, particularly with respect to prevention of food allergy, are necessary in order for practitioners to understand global differences and maintain this low prevalence.
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Affiliation(s)
| | - Lynette Pei-Chi Shek
- Department of Paediatrics, National University Hospital, Level 12, NUHS Tower Block, 1E Kent Ridge Road, Singapore 119228.
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41
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Yadav A, Naidu R. Clinical manifestation and sensitization of allergic children from Malaysia. Asia Pac Allergy 2015; 5:78-83. [PMID: 25938072 PMCID: PMC4415183 DOI: 10.5415/apallergy.2015.5.2.78] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 03/01/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND An epidemiological rise of allergic diseases in developing countries raises new challenges. Currently a paucity of data exists describing allergy symptomology and sensitization to common food and aeroallergens in young children from developing countries. OBJECTIVE To compare changes in symptomology, food allergen sensitization and aeroallergen sensitization in a cross-sectional study of children <2 years and 2-10 years. METHODS A total of 192 allergic children (aged <2 years, 35 children; aged 2-10 years, 157 children) underwent specific IgE (>0.35 kU/L) to common food (egg white, cow's milk, cod fish, wheat, peanut, soya, peanut, and shrimp) and house dust mites (Dermatophagoides pteronyssinus and Blomia tropicalis). RESULTS In children <2 years, atopic dermatitis (65.7%) was the most common symptom whereas in children 2-10 years it was rhinoconjunctivitis (74.5%). Higher sensitization rate to eggs (p < 0.01) and cow's milk (p = 0.044) was seen in <2 years group when compared to the 2-10 years group, but no significant differences for shrimp (p = 0.29), wheat (p = 0.23) and soya (p = 0.057). Interestingly, sensitization to peanut (p = 0.012) and fish (p = 0.035) was significantly decreased in the 2-10 years group. Sensitization to house dust mites (p < 0.01) dramatically increased in the older children. CONCLUSION Our study supports concept of atopic march from a developing country like Malaysia.
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Affiliation(s)
- Aravind Yadav
- Department of Pediatric Pulmonary, University of Texas Health Science Center at Houston, Houston Medical School, Houston, TX 77030, USA
- Department of Molecular Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Rakesh Naidu
- Department of Molecular Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
- School of Medicine and Health Sciences, Monash University Sunway Campus, 46150 Bandar Sunway, Malaysia
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42
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Abstract
Reported fish allergy prevalence varies widely, with an estimated prevalence of 0.2% in the general population. Sensitization to fish can occur by ingestion, skin contact or inhalation. The manifestations can be IgE or non-IgE mediated. Several fish allergens have been identified, with parvalbumins being the major allergen in various species. Allergenicity varies among fish species and is affected by processing or preparation methods. Adverse reactions after eating fish are often claimed to be 'allergy' but could be a reaction to hidden food allergen, fish parasite, fish toxins or histamine in spoiled fish. Identifying such causes would allow free consumption of fish. Correct diagnosis of fish allergy, including the specific species, might provide the patient with safe alternatives. Patients have been generally advised for strict universal avoidance of fish. However, testing with various fish species or preparations might identify one or more forms that can be tolerated.
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Affiliation(s)
- Ahmad A Mourad
- Allergy and Immunology Section, Louisiana State University Health Sciences Center, Shreveport, LA, USA
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43
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Abstract
Since 1943, cases of sensitization or allergy to soy-based formulas (SBFs) have been described without any consensus on their real prevalence. We identified the adjusted prevalence of IgE-mediated soy allergies in children and performed a secondary analysis of the impact of age (less than and more than 6 months). We performed a systematic review with meta-analysis of studies published from 1909 to 2013 in PubMed, Embase, LILACS, ARTEMISA, Cochrane, Bandolier, DARE and the GRADE system for grading quality. Results are presented in tables and graphs using a forest plot. The 40 studies identified established weighted prevalence of soy allergies of 0 to 0.5 % (0.27) for the general population, 0.4 to 3.1 % (1.9) for the referred population, and 0 to 12.9 % (2.7) for allergic children. Prevalence of sensitization after the use of SBFs is 8.7 and 8.8 %, depending on the method used. The prevalence of allergies to soy and IgE sensitization to the use of SBFs is less than reported. Not enough evidence exists to show a higher risk of allergy in infants younger than 6 months. The concern about soy allergy is no reason to postpone the use of SBFs in IgE-mediated cow's milk allergy infants until the age of 6 months.
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44
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Abstract
Globally, the rising consumption of fish and its derivatives, due to its nutritional value and divergence of international cuisines, has led to an increase in reports of adverse reactions to fish. Reactions to fish are not only mediated by the immune system causing allergies, but are often caused by various toxins and parasites including ciguatera and Anisakis. Allergic reactions to fish can be serious and life threatening and children usually do not outgrow this type of food allergy. The route of exposure is not only restricted to ingestion but include manual handling and inhalation of cooking vapors in the domestic and occupational environment. Prevalence rates of self-reported fish allergy range from 0.2 to 2.29 % in the general population, but can reach up to 8 % among fish processing workers. Fish allergy seems to vary with geographical eating habits, type of fish processing, and fish species exposure. The major fish allergen characterized is parvalbumin in addition to several less well-known allergens. This contemporary review discusses interesting and new findings in the area of fish allergy including demographics, novel allergens identified, immunological mechanisms of sensitization, and innovative approaches in diagnosing and managing this life-long disease.
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Affiliation(s)
- Michael F Sharp
- Molecular Immunology Group, Center of Biodiscovery and Molecular Development of Therapeutics, School of Pharmacy and Molecular Science, James Cook University, Townsville, Australia
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45
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Schulkes KJ, Klemans RJ, Knigge L, de Bruin-Weller M, Bruijnzeel-Koomen CA, Marknell deWitt A, Lidholm J, Knulst AC. Specific IgE to fish extracts does not predict allergy to specific species within an adult fish allergic population. Clin Transl Allergy 2014; 4:27. [PMID: 25225608 PMCID: PMC4164331 DOI: 10.1186/2045-7022-4-27] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Accepted: 07/30/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Fish is an important cause of food allergy. Studies on fish allergy are scarce and in most cases limited to serological evaluation. Our objective was to study patterns of self-reported allergy and tolerance to different commonly consumed fish species and its correlation to IgE sensitization to the same species. METHODS Thirty-eight adult fish allergic patients completed a questionnaire regarding atopy, age of onset and symptoms to 13 commonly consumed fish species in the Netherlands (pangasius, cod, herring, eel, hake, pollock, mackerel, tilapia, salmon, sardine, tuna, plaice and swordfish). Specific IgE to these fish extracts were analyzed by ImmunoCAP. RESULTS Median age of onset of fish allergy was 8.5 years. Severe reactions were reported by the majority of patients (n = 20 (53%) respiratory and of these 20 patients, 6 also had cardiovascular symptoms). After diagnosis, 66% of the patients had eliminated all fish from their diet. Allergy to all species ever tried was reported by 59%. In relation to species ever tried, cod (84%) and herring (79%) were the most frequently reported culprit species while hake (57%) and swordfish (55%) were the least frequent. A positive sIgE (value ≥ 0.35 kUA/L) to the culprit species ranged between 50% (swordfish) and 100% (hake). In tolerant patients, a negative sIgE (value < 0.35 kUA/L) ranged from 0% (hake, pollock and swordfish) to 75% (sardine). For cod, the agreement between sIgE test results and reported allergy or tolerance was 82% and 25%, respectively. Sensitization to cod parvalbumin (Gad c 1) was present in 77% of all patients. CONCLUSION Serological cross-reactivity between fish species is frequent, but in a significant proportion of patients, clinical relevance appears to be limited to only certain species. A well-taken history or food challenge is required for discrimination between allergy to the different fish species.
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Affiliation(s)
- Karlijn Jg Schulkes
- Department of Dermatology/Allergology, University Medical Center Utrecht, PO Box 85500, Utrecht 3508, GA the Netherlands
| | - Rob Jb Klemans
- Department of Dermatology/Allergology, University Medical Center Utrecht, PO Box 85500, Utrecht 3508, GA the Netherlands
| | - Lidy Knigge
- Department of Dermatology/Allergology, University Medical Center Utrecht, PO Box 85500, Utrecht 3508, GA the Netherlands
| | - Marjolein de Bruin-Weller
- Department of Dermatology/Allergology, University Medical Center Utrecht, PO Box 85500, Utrecht 3508, GA the Netherlands
| | - Carla Afm Bruijnzeel-Koomen
- Department of Dermatology/Allergology, University Medical Center Utrecht, PO Box 85500, Utrecht 3508, GA the Netherlands
| | | | | | - André C Knulst
- Department of Dermatology/Allergology, University Medical Center Utrecht, PO Box 85500, Utrecht 3508, GA the Netherlands
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46
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Food allergen selective thermal processing regimens may change oral tolerance in infancy. Allergol Immunopathol (Madr) 2013; 41:407-17. [PMID: 23253679 DOI: 10.1016/j.aller.2012.08.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2012] [Accepted: 08/03/2012] [Indexed: 12/20/2022]
Abstract
Food allergy can be considered a failure in the induction of oral tolerance. Recently, great interest has been focused on understanding the mechanisms and the contributing factors of oral tolerance development, hoping for new definitive interventions in the prevention and treatment of food allergy. Given that food processing may modify the properties and the nature of dietary proteins, several food processing methods could affect the allergenicity of these proteins and consequently may favour oral tolerance induction to food allergic children. Indeed, effective thermal food processing regimens of altering food proteins to reduce allergenicity have been recently reported in the literature. This article is mainly focused on the effect of selective thermal processing regimens on the main infant allergenic foods, with a potential clinical relevance on their allergenicity and therefore on oral tolerance induction. In the light of recent findings, the acquisition of tolerance in younger age and consequently the ability of young children to "outgrow" food allergy could be achieved through the application of selective thermal processing regimens on certain allergenic foods. Therefore, the ability of processed foods to circumvent clinical disease and at the same time to have an impact on the immune system and facilitate tolerance induction could be invaluable as a component of a successful therapeutic strategy. The opening in the new avenues of research in the use of processed foods in clinical practice for the amelioration of the impact on the quality of life of patients and possibly in food allergy prevention is warranted.
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47
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Rosmilah M, Shahnaz M, Meinir J, Masita A, Noormalin A, Jamaluddin M. Identification of parvalbumin and two new thermolabile major allergens of Thunnus tonggol using a proteomics approach. Int Arch Allergy Immunol 2013; 162:299-309. [PMID: 24193115 DOI: 10.1159/000354544] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Accepted: 07/12/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The longtail tuna (Thunnus tonggol) is widely consumed in Asia. Parvalbumin, the main major allergen of fish, has been well identified in multiple fish species, yet little is known about the allergenic proteins in T. tonggol. Thus, the aim of this study was to characterize the major allergens of T. tonggol using a proteomics approach. METHODS Raw and boiled extracts of the fish were prepared. Fish proteins were separated by means of SDS-PAGE and two-dimensional (2-DE) electrophoresis. 1-DE immunoblotting of raw extract was performed with sera from fish-allergic patients. Ten sera were further analysed by 2-DE immunoblotting. Selected major allergenic protein spots were excised, trypsin digested and analysed by means of mass spectrometry. RESULTS SDS-PAGE of raw extract revealed 26 protein fractions, while boiled extract demonstrated fewer bands. The 2-DE gel profile of the raw extract further fractionated the protein bands to more than 100 distinct protein spots. 1-DE immunoblotting of raw extract exhibited two thermolabile protein fractions of 42 and 51 kDa as the major allergens, while the boiled extract only revealed a single IgE-binding band at 151 kDa. 2-DE immunoblotting of raw extract further detected numerous major IgE-reactive spots of 11-13, 42 and 51 kDa. Mass spectrometry analysis of the peptides generated from the 12, 42 and 51 kDa digested spots indicated that these spots were parvalbumin, creatine kinase and enolase, respectively. CONCLUSIONS In addition to parvalbumin, two new thermolabile allergens were identified as major allergenic proteins of T. tonggol. This study proved that both thermostable and thermolabile proteins are important in local tuna allergy and should be included in diagnostic strategies.
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Affiliation(s)
- Misnan Rosmilah
- Department of Biology, Faculty of Science and Mathematics, Sultan Idris Education University, Tanjong Malim, Perak, Malaysia
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48
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Wu TC, Tsai TC, Huang CF, Chang FY, Lin CC, Huang IF, Chu CH, Lau BH, Wu L, Peng HJ, Tang RB. Prevalence of food allergy in Taiwan: a questionnaire-based survey. Intern Med J 2013; 42:1310-5. [PMID: 22530688 DOI: 10.1111/j.1445-5994.2012.02820.x] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2011] [Accepted: 03/19/2012] [Indexed: 11/29/2022]
Abstract
AIM Food allergy is common in children and adults, and could be potentially fatal in minor groups. It is important for physicians to identify the prevalence of food allergies and to recognise common food allergens to make precise diagnosis and choose correct therapeutic approaches. METHODS We used a nationwide, cross-sectional, random questionnaire-based survey to estimate the self-reported and expert-screened prevalence of food allergies and to identify the common food allergens in Taiwan. In this study, the perceptional diagnosis of food allergies was screened by physicians according to descriptions of convincing symptoms and medical recordings; in the meantime, non-allergic adverse reactions to foods, including food intolerance or food avoidance, were clarified. RESULTS A total of 30 018 individuals who met the inclusion criteria was evaluated, and 6.95% of them were diagnosed as victims of food allergies. The prevalence was 3.44% in children under 3 years of age, 7.65% in children aged 4-18 years and 6.40% in adults respectively. About 77.33% of the food allergy population had experienced recurrent allergic attacks. Systemic reactions happened about 4.89% in food allergies group. The most commonly reported food allergen in Taiwan is seafood, including shrimp, crab, fish and mollusc. In addition, mango, milk, peanuts and eggs were also important food allergens in the general population; while milk, shellfish, peanuts and eggs were common in children. CONCLUSIONS Less than 10% of the Taiwan population suffers from food allergy with different allergic symptoms to variable food allergens in different age groups.
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Affiliation(s)
- T-C Wu
- Children’s Medical Center, Taipei Veterans General Hospital, 201 Sec. 2 Shih-Pai Road, Taipei, Taiwan.
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49
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Ruan WW, Cao MJ, Chen F, Cai QF, Su WJ, Wang YZ, Liu GM. Tropomyosin Contains IgE-Binding Epitopes Sensitive to Periodate but Not to Enzymatic Deglycosylation. J Food Sci 2013; 78:C1116-21. [DOI: 10.1111/1750-3841.12169] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Accepted: 04/24/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Wei-Wei Ruan
- College of Biological Engineering, The Key Laboratory of Science and Technology for Aquaculture and Food Safety; Jimei Univ.; 43 Yindou Rd.; Xiamen; Fujian 361021; China
| | - Min-Jie Cao
- College of Biological Engineering, The Key Laboratory of Science and Technology for Aquaculture and Food Safety; Jimei Univ.; 43 Yindou Rd.; Xiamen; Fujian 361021; China
| | - Feng Chen
- Dept. of Food, Nutrition, and Packaging Sciences; Clemson Univ.; Clemson; SC 29634; U.S.A
| | - Qiu-Feng Cai
- College of Biological Engineering, The Key Laboratory of Science and Technology for Aquaculture and Food Safety; Jimei Univ.; 43 Yindou Rd.; Xiamen; Fujian 361021; China
| | - Wen-Jin Su
- College of Biological Engineering, The Key Laboratory of Science and Technology for Aquaculture and Food Safety; Jimei Univ.; 43 Yindou Rd.; Xiamen; Fujian 361021; China
| | - You-Zhao Wang
- College of Biological Engineering, The Key Laboratory of Science and Technology for Aquaculture and Food Safety; Jimei Univ.; 43 Yindou Rd.; Xiamen; Fujian 361021; China
| | - Guang-Ming Liu
- College of Biological Engineering, The Key Laboratory of Science and Technology for Aquaculture and Food Safety; Jimei Univ.; 43 Yindou Rd.; Xiamen; Fujian 361021; China
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50
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Liew WK, Chiang WC, Goh AE, Lim HH, Chay OM, Chang S, Tan JH, Shih E, Kidon M. Paediatric anaphylaxis in a Singaporean children cohort: changing food allergy triggers over time. Asia Pac Allergy 2013; 3:29-34. [PMID: 23403810 PMCID: PMC3563018 DOI: 10.5415/apallergy.2013.3.1.29] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2012] [Accepted: 12/12/2012] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND We have noticed changes in paediatric anaphylaxis triggers locally in Singapore. OBJECTIVE We aimed to describe the demographic characteristics, clinical features, causative agents and management of children presenting with anaphylaxis. METHODS This is a retrospective study of Singaporean children presenting with anaphylaxis between January 2005 and December 2009 to a tertiary paediatric hospital. RESULTS One hundred and eight cases of anaphylaxis in 98 children were included. Food was the commonest trigger (63%), followed by drugs (30%), whilst 7% were idiopathic. Peanut was the top food trigger (19%), followed by egg (12%), shellfish (10%) and bird's nest (10%). Ibuprofen was the commonest cause of drug induced anaphylaxis (50%), followed by paracetamol (15%) and other nonsteroidal anti-inflammatory drugs (NSAIDs, 12%). The median age of presentation for all anaphylaxis cases was 7.9 years old (interquartile range 3.6 to 10.8 years), but food triggers occurred significantly earlier compared to drugs (median 4.9 years vs. 10.5 years, p < 0.05). Mucocutaneous (91%) and respiratory features (88%) were the principal presenting symptoms. Drug anaphylaxis was more likely to result in hypotension compared to food anaphylaxis (21.9% vs. 2.7%, Fisher's exact probability < 0.01). There were 4 reported cases (3.6%) of biphasic reaction occurring within 24 h of anaphylaxis. CONCLUSION Food anaphylaxis patterns have changed over time in our study cohort of Singaporean children. Peanuts allergy, almost absent a decade ago, is currently the top food trigger, whilst seafood and bird's nest continue to be an important cause of food anaphylaxis locally. NSAIDs and paracetamol hypersensitivity are unique causes of drug induced anaphylaxis locally.
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Affiliation(s)
- Woei Kang Liew
- Allergy Service, Department of Paediatric Medicine, KK Women's and Children's Hospital, Singapore 229899, Singapore
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