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Food allergies and other food sensitivities - A publication of the Institute of Food Technologists' Expert Panel on Food Safety and Nutrition

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... Food allergy is an adverse immune response reaction to food and estimated to affect nearly 3-8% of children in America [1][2][3]. In Korea, the prevalence of food allergy in children aged [6][7][8][9][10][11][12] years was estimated at 10.9% in 1995, 8.9% in 2000 and 12.6% in 2012, according to a survey from the Korean version of International Study of Asthma and Allergy in Childhood (ISAAC) [4,5]. In 2005, a survey of children living in Seoul showed that 11.7% experienced a food-related allergic reaction more than once [6]. ...
... Food allergy is an adverse immune response reaction to food and estimated to affect nearly 3-8% of children in America [1][2][3]. In Korea, the prevalence of food allergy in children aged [6][7][8][9][10][11][12] years was estimated at 10.9% in 1995, 8.9% in 2000 and 12.6% in 2012, according to a survey from the Korean version of International Study of Asthma and Allergy in Childhood (ISAAC) [4,5]. In 2005, a survey of children living in Seoul showed that 11.7% experienced a food-related allergic reaction more than once [6]. ...
... Food allergy presents a variety of symptoms on the skin (urticaria, dermatitis, eczema, angioedema, itching) and in the gastrointestinal tract (nausea, vomiting, diarrhea, abdominal cramping) and respiratory tract (rhinitis, asthma, laryngeal edema) [8]. Food-induced anaphylactic shock is the most frightening symptom that is acute in onset, occurring within minutes or hours, and may lead to death if prompt treatment is not administered [9]. ...
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The prevalence of food allergies in Korean children aged 6 to 12 years increased from 10.9% in 1995 to 12.6% in 2012 according to nationwide population studies. Treatment for food allergies is avoidance of allergenic-related foods and epinephrine auto-injector (EPI) for accidental allergic reactions. This study compared knowledge and perception of food allergy labeling and dietary practices of students. The study was conducted with the fourth to sixth grade students from an elementary school in Yongin. A total of 437 response rate (95%) questionnaires were collected and statistically analyzed. The prevalence of food allergy among respondents was 19.7%, and the most common food allergy-related symptoms were urticaria, followed by itching, vomiting and nausea. Food allergens, other than 12 statutory food allergens, included cheese, cucumber, kiwi, melon, clam, green tea, walnut, grape, apricot and pineapple. Children with and without food allergy experience had a similar level of knowledge on food allergies. Children with food allergy experience thought that food allergy-related labeling on school menus was not clear or informative. To understand food allergies and prevent allergic reactions to school foodservice among children, schools must provide more concrete and customized food allergy education.
... Food allergies are associated with a variety of symptoms, ranging from mild to severe or life-threatening, affecting the skin (urticaria, dermatitis, eczema, angioedema, and itching), gastrointestinal tract (nausea, vomiting, diarrhea, and abdominal cramping), and respiratory tract (rhinitis, asthma, and laryngeal edema), in addition to anaphylactic shock [6]. Anaphylactic shock is the most frightening food-allergic symptom and develops very rapidly after ingestion of allergenic foods, leading to death if prompt treatment is not provided [7]. ...
... Anaphylactic shock is the most frightening food-allergic symptom and develops very rapidly after ingestion of allergenic foods, leading to death if prompt treatment is not provided [7]. There are more than 160 foods confirmed to cause food allergies [6]. However, the most common allergenic foods are eggs, cow's milk, soy, and peanuts in infant and children. ...
... Third, some respondents may have been unaware of tolerance to food allergens (eggs and cow's milk) after diagnosis of food allergies at an earlier age. Forth, up to 60% of allergies from fruits and vegetables may actually be oral allergy syndrome instead of anaphylaxis shock in accordance with a previous study [4,6,[25][26][27][28]. ...
Article
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BACKGROUND/OBJECTIVES The objective of this study was to investigate food allergens and prevalence rates of food allergies, followed by comparison of consumer attitudes and preferences regarding food allergy labeling by diagnosis of food allergies. SUBJECTS/METHODS A total of 543 individuals living in Seoul and Gyeonggi area participated in the survey from October 15 to 22 in 2013. RESULTS The results show that the prevalence of doctor-diagnosed food allergies was 17.5%, whereas 6.4% of respondents self-reported food allergies. The most common allergens of doctor-diagnosed and self-reported food allergy respondents were peaches (30.3%) and eggs (33.3%), respectively, followed by peanuts, cow's milk, and crab. Regarding consumer attitudes toward food labeling, checking food allergens as an item was only significantly different between allergic and non-allergic respondents among all five items (P < 0.001). All respondents reported that all six items (bold font, font color, box frame, warning statement, front label, and addition of potential allergens) were necessary for an improved food allergen labeling system. PLSR analysis determined that the doctor-diagnosed group and checking of food allergens were positively correlated, whereas the non-allergy group was more concerned with checking product brands. CONCLUSIONS An effective food labeling system is very important for health protection of allergic consumers. Additionally, government agencies must develop policies regarding prevalence of food allergies in Korea. Based on this information, the food industry and government agencies should provide clear and accurate food labeling practices for consumers.
... Indeed, resistance to digestion is a property common to some, but not all, dietary proteins thought to sensitize by the human gastrointestinal tract (GIT) (Mills et al. 2004). To sensitize an individual via the GIT, an allergen must have properties which preserve its structure from degradation (such as resistance to low pH, bile salts, and proteolysis), thus allowing enough allergen to survive in a sufficiently intact form to be taken up by the gut and sensitize the mucosal immune system (Taylor and Hefle 2001;Mills et al. 2004). Investigations into the role of digestion in allergenicity of proteins have been hindered by a lack of common approaches and protocols for modeling gastrointestinal digestion in vitro. ...
... reported that the validity of any animal model should be based on the demonstration of a rank order of potency for several allergens, comparable to what is known regarding their prevalence and severity of responses in humans (Osterballe et al. 2005;Rona et al. 2007;Bjorksten et al. 2008). Importantly, regarding the potency of food allergens/allergenic foods in humans, there is only information available on their severity in challenge reactions, as little is known on the sensitizing potential of these food items in humans (Taylor and Hefle 2001;Crevel et al. 2008;McClain et al. 2014; . Given the questions raised above, it is not surprising that currently no animal model(s) has been extensively evaluated and validated with pure proteins or unprocessed or processed foods and is included in current regulatory guidance on predicting potential protein allergenicity . ...
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An extensive safety assessment process exists for genetically-engineered (GE) crops. The assessment includes an evaluation of the introduced protein as well as the crop containing the protein with the goal of demonstrating the GE crop is “as-safe-as” non-GE crops in the food supply. One of the evaluations for GE crops is to assess the expressed protein for allergenic potential. Currently, no single factor is recognized as a predictor for protein allergenicity. Therefore, a weight-of-the-evidence approach, which accounts for a variety of factors and approaches for an overall assessment of allergenic potential, is conducted. This assessment includes an evaluation of the history of exposure and safety of the gene(s) source; protein structure (e.g. amino acid sequence identity to human allergens); stability of the protein to pepsin digestion in vitro; heat stability of the protein; glycosylation status; and when appropriate, specific IgE binding studies with sera from relevant clinically allergic subjects. Since GE crops were first commercialized over 20 years ago, there is no proof that the introduced novel protein(s) in any commercialized GE food crop has caused food allergy.
... Although not commonly seen, metabolic disorders can significantly impact on dental treatment in diverse ways, and its knowledge is essential for the safe management of pediatric patients, including special precautions to facilitate this purpose. For some highly sensitive children, consuming certain drugs or foods will elicit adverse reactions, which could imply a debilitating or even life-threatening experience for them [1,2]. Glucose-6-phosphate dehydrogenase (G6PD) is a cytoplasmic X chromosome-linked enzyme that prevents oxidative damage to cells by promoting detoxification of free radicals. ...
... Clinical manifestations of G6PD include acute or chronic hemolytic anemia with hemoglobin denaturation and puddling (a pathological condition known as methahemoglobinemia), neonatal hyperbilirubinemia, and neonatal jaundice, although the disease is clinically asymptomatic and rarely fatal [1,5,6]. In children with G6PD deficiency, hemolysis can be precipitated by diverse factors, such as oxidative drugs, infectious diseases, and ingesting fava beans [7,8]. ...
Article
Full-text available
Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an uncommon inherited enzyme deficiency characterized by hemolytic anemia, caused by the inability of erythrocytes to detoxify oxidizing agents such as drugs, infectious diseases, or fava bean ingestion. In this later case, the disorder is known as favism. The aim of the present report was to present a review of the literature in this disease, to describe a case report concerning an affected 9-year-old male, and to review the main implications and precautions in pediatric dental management.
... Heat-stable and gastric acid-resistant allergens generally cause more severe reactions compared with heat-and gastric acid-labile allergens [7, 9, 10, 11, 12]. e only causal treatment for food allergy to date comprises consistent avoidance of the relevant food, which can be associated with a signi cant reduction in quality of life [13,14]. e approach taken by a number of scienti c working groups using a variety of allergenic plant models and various technologies is to reduce or modify known allergens in planta. ...
... However, the term hypoallergenicity -although frequently used in conjunction with foods -is not precisely de ned. Foods de ned as hypoallergenic to date have primarily included cow's milk formulations in the form of hypoallergenic (HA) infant for-mulas; here, the proteins of various raw materials have been treated to varying extents using food processing techniques (enzymatic protein hydrolysis, heat treatment, and/or ultra ltration), with the aim of destroying or inactivating IgE-binding and T-cell epitopes [13,16]. is requires that at least 90 % of children with proven cow's milk allergy tolerate these formulations in double-blind, placebo-controlled food challenge (DBPCFC) [13,14,15,16,17,18 ]. ...
Article
The most common food allergies in adulthood are to plant foods (nuts, legumes, fruits, and vegetables). Eliminating relevant allergens in the plant itself represents a new approach to allergen avoidance for the primary, secondary, and tertiary prevention of food allergies. A variety of methods have been used to date with varying success in proof-of-concept investigations into the design of hypoallergenic foods. The present paper provides an overview of the current status of various hypoallergenic foods produced in model allergen plants (rice, soy, apple, tomato, carrot, peanut). Perspectives and challenges are discussed. The marketing of genetically modified hypoallergenic foods produced in this way is not currently foreseeable.
... It has been estimated that up to 2% of adults, and up to 8% of infants are affected by food allergies (Fiocchi et al. 2011). Food allergens are typically proteins, and small regions (= epitopes) are responsible for the IgE-mediated allergic response (Taylor and Hefle 2001). Soy (Glycine max) is an important vegetable protein source for food industry due to its considerable amount of high quality proteins as well as nutritional value and functional properties. ...
... Soy (Glycine max) is an important vegetable protein source for food industry due to its considerable amount of high quality proteins as well as nutritional value and functional properties. However, it is among the socalled "big 8" food allergens (Taylor and Hefle 2001). Currently, eight allergenic proteins (Gly m1 -Gly m8) with molecular masses ranging from 7.5 to 97 kDa have been registered by the International Union of Immunological Societies (IUIS) Allergen Nomenclature Sub-Committee (www.allergen.org). ...
Conference Paper
The increasing prevalence of allergic disorders is currently a serious concern with public health. Up to 250 million people worldwide suffer from food allergies. Soybean belongs to the “Big 8” food allergens, which cause 90% of all immunoglobulin E (IgE)-mediated allergenic responses1. While scientists are exploring various treatments including vaccines to eliminate food allergies, the most common recommendation is simply to avoid the offending foods. An effective technology to sufficiently reduce allergy to a level of safe food consumption is not implemented in food industry. Fermentation might be an interesting approach to reduce allergenicity, but scientific literature is rather scarce. This study investigates the reduction of immunoreactivity by induced fermentation of soy protein isolate (SPI) with Lactobacillus helveticus, Bacillus subtilis, Rhizopus oryzae, and Saccharomyces cerevisiae for 24 h. Concomitantly, the sensory and physicochemical properties were considered. Sandwich enzyme-linked immunosorbent assay (ELISA) and western blot were used to measure immunoreactivity using newly developed antibodies and serum from soy sensitive individuals, respectively. Quantitative descriptive analysis (QDA) using principal component analysis (PCA) was employed to identify the most important sensory attributes of the samples. Growth behaviour of microbiota was analyzed with statistical MALDI-TOF MS. Among the strains tested, Lactobacillus helveticus showed the highest reduction in immunoreactivity up to nearly 100% and a binding to a selected human serum sample could not be found in western blot. Hence, samples fermented with Lactobacillus helveticus were analyzed in more detail. Fermentation led to increased water- and oil-binding capacity (3.5 mL g-1 and 2.9 mL g-1), foaming activity (1084.7%), and protein solubility at pH 4.0 (12.4%). A decrease in emulsifying capacity, foaming density, and soluble proteins at pH 7.0 was observed. By means of PCA, it was evidenced that fermentation enhanced the sensory properties. The samples exhibit lower “bitter”, “beany” and “green” taste than native SPI. Consequently, fermentation represents an interesting opportunity to produce low-allergen food ingredients. 1 FDA (2004). Food Allergen and Labeling and Consumer Protection (FALCP) Act of 2004.
... The prevalence of food allergies is rising dramatically, and approximately 220 to 250 million people worldwide suffer from some kind of food allergy (WAO, 2013). Food allergens are typically naturally occurring proteins, with small regions, called epitopes, responsible for the immunoglobulin E (IgE)-mediated allergic response (Taylor & Hefle, 2001). ...
... Soybean (Glycine max (L.) MERR.) is an important vegetable protein source for the food industry due to its considerable amount of high quality proteins and nutritional value. However, soybean is among the so-called ''big 8" food allergens, which together account for over 90% of all documented food allergies in the U.S. (FDA., 2004;Taylor & Hefle, 2001). The prevalence of soy allergy is not precisely known and it is expected to escalate due to the increasing consumption of soybean products. ...
Article
The effect of induced liquid state fermentation (Bacillus subtilis, Rhizopus oryzae, Saccharomyces cerevisiae, Lactobacillus helveticus) on the immunoreactivity, physicochemical and sensory properties of soy protein isolate (SPI) was studied. Lactobacillus helveticus revealed the most abundant reduction in terms of immunoreactivity within soluble protein fractions, up to 100%, which could be measured by in vitro sandwich ELISA using mouse monoclonal anti-Gly°m5 antibodies (mAbs). Almost no binding was found in western blot analysis using mouse monoclonal mAbs and sera from soy sensitive individuals. Fermentation increased water- and oil-binding capacity as well as protein solubility at pH 4.0. Foaming activity was nearly doubled compared to non-fermented SPI. A decreased emulsifying capacity, foaming density, and quantity of soluble proteins at pH 7.0 were observed. Principal component analysis (PCA) confirmed decreased bitter and beany off-flavors of fermented samples compared to non-fermented SPI. Consequently, fermentation might be a promising method to produce tasty low-allergen food ingredients with good physicochemical properties.
... Both the number of incriminated foods and the frequency of severe reactions appear to be rising dramatically. Food allergens are naturally occurring proteins of the allergenic foods, and small regions, called epitopes, are responsible for the immunoglobulin E (IgE)-mediated allergic response by acting as an antigen (Taylor & Hefle, 2001). ...
... Soybean (Glycine max (L.) Merr.) is one of the most important valuable crops in the world due to its considerable amount of high quality proteins and excellent functional properties. However, soy ranks among the "big 8" allergens which comprises those foods that causes over 90% of all documented food allergies in the U.S (FDA, 2004;Taylor & Hefle, 2001). Although 16 IgE-reactive allergenic proteins have been identified, just the two storage proteins glycinin (Gly m6) and b-conglycinin (Gly m5) are considered as major soybean allergens (Amnuaycheewa & de Mejia, 2010;FARRP, 2015;Holzhauser et al., 2009). ...
Article
The debittering effect of induced liquid state fermentation (Lactobacillus perolens, Rhizopus oryzae, and Actinomucor elegans) on different soy protein hydrolysates has been investigated. The hydrolytic action was monitored by SDS-PAGE and degree of hydrolysis analyses. Sensory perception using quantitative descriptive analysis (QDA), employing multivariate statistical principal component analysis (PCA), techno-functional properties, and the microbial competitiveness (MALDI-TOF-MS) have been evaluated. SDS-PAGE profiles evidenced that the enzyme preparations degraded most of major soy allergens (ß-conglycinin, glycinin), while subsequent fermentation did not further change the profiles. All strains investigated effectively reduced bitterness to a minimum of 0.7 on a 10-cm continuous scale (0 = no perception; 10 = strong perception) compared to non-fermented hydrolysates (2.8 – 8.0) and untreated soy protein isolate (2.8). Protein solubility, emulsifying and oil-binding capacity as well as foaming activity and gelation behaviour were enhanced depending on the protease used; subsequent fermentation further improved foaming stability and gelation concentration. PCA of descriptive sensory data revealed that fermentation apparently upgrade the organoleptic perception by effectively decreasing the bitter taste, simultaneously reducing the beany off-flavor of soy. Consequently, enzymatic hydrolysis combined with subsequent fermentation represents a promising method for the production of hypoallergenic soy hydrolysates with pleasant taste and great technofunctionality.
... Immunological food reactions are the most common, including IgE-mediated and non-IgEmediated food allergies, and coeliac disease. Nevertheless, non-immunological food reactions, such as secondary food sensitivities and food intolerances, may also play an important role [2][3][4]. ...
... Adverse food reactions due to secondary food sensitivities occur with or after the effects of other conditions (e.g., secondary to gastrointestinal disorders or secondary to drug treatment) [4]. ...
Article
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Several disorders should be considered in the case of newborns and infants experiencing acute or recurrent symptoms after food ingestion. Immune-mediated adverse food reactions are the most frequent and always to be considered. Nevertheless, in the extensive differential diagnosis, clinicians should also include inherited metabolic disorders (IMDs). This review reports clinical features and diagnostic aspects of the most common IMDs that may present with acute manifestations triggered by food intake. Major focus will be amino acid and protein metabolism defects and carbohydrate disorders. Nowadays, for many of these disorders the risk of an acute presentation triggered by food has been decreased by the introduction of expanded newborn screening (NBS). Nevertheless, clinical suspicion remains essential because some IMDs do not have still reliable markers for NBS and a false negative screening result may occur. The aim of this review is to help pediatricians to take these rare inherited disorders into account in the differential diagnosis of acute or recurrent gastrointestinal symptoms related to food intake, which may avoid delayed diagnosis and potentially life-threatening consequences.
... Bizim çalışmamızda besin duyarlılığı 3 yaş altında %31.9 oranında daha sık olmasına rağmen, 3 yaş üstünde de %19.3 oranında besin duyarlılığının devam ettiği gözlenmiştir. Günlük yaşamda solunum sistemi (astım, rinit, larinks ödemi), gastrointestinal sistem (bulantı, kusma, ishal, karın ağrısı) ve cilt (kaşıntı, ürtiker, dermatit, egzema, anjiyoödem) gibi farklı sistemleri etkileyerek farklı klinik tablolarla karşımıza gelebilmektedir [11]. Choi ve arkadaşlarının yaptığı bir çalışmada besin allerjisi olan çocuklar arasında en sık (%26.7) ...
... semptom ürtiker olarak bildirilmiştir [12]. Çocuklar arasında önemli besin allerjenleri yumurta, inek sütü, balık ve diğer deniz ürünleri iken yetişkinler arasında fıstık, fındık, balık ve kabuklu deniz ürünleri (karides, yengeç, ıstakoz) gelmektedir [11,13]. Bizim çalışmamızda tüm grupta sıklık sırasına göre yumurta akı %7.3; buğday %3.3, inek sütü %2.7, 3 yaş altındaki-Resim 1. Tüm yaş gruplarında akut ürtiker ve besin allerjisi şüphesi ile getirilen çocuklarda epidermal prik testi duyarlılıkları. ...
Article
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Aim: Families of children with acute urticaria often think that there is food allergy in children with urticaria and insist for skin tests. In this study, it was aimed to determine whether skin prick tests are necessary in cases presented with acute urticaria, in whom other causes of acute urticaria are excluded. Material and Method: A test panel involving cow milk, egg white, wheat, hazelnut, peanut, soybean, walnut, sesame, and tuna fish antigens was applied to the children presented with acute urticaria between 1 August 2013 and 1 August 2014, in whom other causes of acute urticaria were excluded and suspected food allergy was reported by parents. Results: Overall, 574 children aged 1-14 years were included to the study. Of the patients, sensitization against at least one food antigen was detected in 22.3% (128/574) of the patients. This rate was found to be 31.9% among those younger than 3 years, while 19.3% in those older than 3 years. Overall, sensitization rates against food allergen in panel were as follows: egg white, 7.3%; wheat, 3.3%; cow milk, 2.7%,; sesame, 2.8%; hazelnut, 2.4%; soybean, 2.3%; peanut, 1.9%, walnut, 1.6%; tuna fish, 1.6%. In general, the history of patients wasn%u2019t compatible with food sensitization detected. Discussion: Sensitization to food allergens is infrequent in children presented with acute urticaria, particularly among those older than 3 years despite expressions of parent and skin prick tests seems to be unnecessary unless strongly suggestive history is present.
... Слід зазначити, що майже всі харчові алергени є протеїнами, стійкими до високих температур, протеолізу й кислотного гідролізу. Найпоширенішими алергенними продуктами є арахіс, молоко, яйця, горіхи, пшениця, ракоподібні, риба, соя [106]. Симптоми алергії на пшеницю охоплюють такі патології, як астма мірошника і риніти, що виникають унаслідок вдихання борошна. ...
... However, food intolerance is more prevalent in adults. In general, adults have more compromised digestive function due to stress, the intake of alcohol and the use of drugs like NSAIDS such as aspirin [10] . The major food allergens identified among the age group of 5-15 yrs were Cow's milk, semolina, and wheat followed by peanut. ...
Article
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A survey on self-reported food allergy has been carried out from data collected through diagnostic laboratories in Banglore during 2013-2015. Blood samples of a total of 168 individuals are screened using the Food Detective TM IS Professional (Product code: CNSFDIS/CNSFD5IS) kit. The individuals are divided into three categories for the purpose of evaluation, such as 5-15 yrs, 16-45 yrs and ˃ 45 yrs. Among these, the age group of 16-45 yrs was found to be the most affected group, followed by the group of 5-15 yrs and the 45 yrs. Major food items eliciting allergic response varied among different categories.
... Nearly all food allergens are proteins that tend to resist degradation from heat, proteases, or acid hydrolysis. Peanut, milk, egg, tree nuts, wheat, crustaceans, fish, and soybeans are the most common allergenic foods (Taylor and Hefle 2001). Symptoms of wheat allergy encompass baker's asthma and rhinitis, which results from inhaled flour; atopic dermatitis, which relates to skin exposure; urticaria, which forms hives after contact with wheat; and anaphylaxis, which is the most lifethreatening type of wheat allergy and affects many body systems (Battais and others 2008). ...
Article
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The role of wheat, and particularly of gluten protein, in our diet has recently been scrutinized. This article provides a summary of the main pathologies related to wheat in the human body, including celiac disease, wheat allergy, nonceliac wheat sensitivity, fructose malabsorption, and irritable bowel syndrome. Differences in reactivity are discussed for ancient, heritage, and modern wheats. Due to large variability among species and genotypes, it might be feasible to select wheat varieties with lower amounts and fewer types of reactive prolamins and fructans. Einkorn is promising for producing fewer immunotoxic effects in a number of celiac research studies. Additionally, the impact of wheat processing methods on wheat sensitivity is reviewed. Research indicates that germination and fermentation technologies can effectively alter certain immunoreactive components. For individuals with wheat sensitivity, less-reactive wheat products can slow down disease development and improve quality of life. While research has not proven causation in the increase in wheat sensitivity over the last decades, modern wheat processing may have increased exposure to immunoreactive compounds. More research is necessary to understand the influence of modern wheat cultivars on epidemiological change.
... concentration of IgE in their blood which is caused by Th2 helper Tcell overactivation against the antigen (Burks and Ballmer-Weber, 2006;Taylor and Hefle, 2001). The IgE mediated reactions result in the clinical symptoms, such as skin, respiratory tract, gastrointestinal tract, and systemic anaphylactic reactions (van Esch et al., 2011;Furrie, 2005;Kalach et al., 2001). ...
... For instance, in the USA, it is estimated that between 4.5 and 8% of the children aged below 2 years old are suffering from food allergies[4]. Food allergy happens when a person exhibits a high level of IgE directed against any ingested food antigen[5,6]. Among food-induced allergies, milk allergy is one of the most prevalent hypersensitivities in young infants, with an estimated prevalence approximately 2–6%[7,8]. ...
... Food allergy is the abnormal response of the body's immune system to certain food or food components, usually food proteins (Li, Offengenden, Fentabil, Gänzle, & Wu, 2013;Taylor & Hefle, 2001). Food allergy can cause urticaria, angioedema, atopic dermatitis, asthma, and even can be life threatening (Novembre et al., 1998). ...
Article
Egg is the second most common food allergen among infants and young children. This work investigated the influence of plastein reaction on immunoglobulin E (IgE)-binding activities of egg white protein hydrolysates after simulated gastrointestinal (GIT) digestion. Compared to hydrolysate precursors, the IgE-binding activity of Pepsin-Plastein significantly decreased from 35 ± 7% to 8 ± 2% (P < 0.05), and Papain-Plastein from 70 ± 5% to 59 ± 4%. Further GIT hydrolysis of Pepsin-Plastein maintained the reduced IgE-binding activity (7 ± 3%) whereas Papain-Plastein digestion restored the IgE-binding reactivity to 66 ± 7%. This discrepancy is related to the different mechanisms of plastein formation. Covalent modifications (decreased free amino nitrogen and sulfhydryl contents) provided biostability for Pepsin-Plastein, whereas hydrophobic interactions (increased surface hydrophobicity) mainly contributed to Papain-Plastein formation. The latter can be destroyed during GIT digestion leading to re-exposure of hidden IgE-binding epitopes. Taken together, plastein reaction is a promising strategy for inducing structural modifications that reduce the immune reactivity of allergenic proteins.
... Despite its many positive functions, SD 2 intake can cause some adverse effects in sensitive individuals, such as breathing difficulties, gastric irritation and the induction of asthmatic reactions (Fazio & Warner, 1990;Taylor & Hefle, 2001;Vally et al., 2009). In 1974, the Joint FAD/WHD Expert Committee on Food Additives (JECFA) established an acceptable daily intake (ADI) for sulfites of 0-0.7 mg/kg body weight, expressed as SD 2 (World Health Drganization, 1974). ...
Article
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This study aimed to evaluate the effect of the distillation time and the sample mass on the total SO2 content in integral passion fruit juice (Passiflora sp). For the SO2 analysis, a modified version of the Monier-Williams method was used. In this experiment, the distillation time and the sample mass were reduced to half of the values proposed in the original method. The analyses were performed in triplicate for each distilling time x sample mass binomial, making a total of 12 tests, which were performed on the same day. The significance of the effects of the different distillation times and sample mass were evaluated by applying one‑factor analysis of variance (ANOVA). For a 95% confidence limit, it was found that the proposed amendments to the distillation time, sample mass, and the interaction between distilling time x sample mass were not significant (p > 0.05) in determining the SO2 content in passion fruit juice. In view of the results that were obtained it was concluded that for integral passion fruit juice it was possible to reduce the distillation time and the sample mass in determining the SO2 content by the Monier-Williams method without affecting the result. © 2015, Sociedade Brasileira de Ciencia e Tecnologia de Alimentos, SBCTA. All rights reserved.
... The parts of the protein that are recognized by the antibodies are called epitopes. To set off an allergic reaction, two antibodies must generally bind to two epitopes of the protein, which then trigger the allergic reaction via cross-linking ( Fig. 4.3) [47,80]. Strictly speaking, any food protein could trigger an allergic reaction. ...
Chapter
The expected increase of the global population to over 9.5 billion by the middle of this century and the rising consumption of animal food products present one of the greatest global challenges—securing humanity’s food supply. The use of new plant‐based protein ingredients instead of animal protein preparations can be an important part of the solution, as the production of animal proteins requires around five times the area of plant protein production. The following article provides an overview of the state of the art production, processing and application of plant‐based proteins in the European food industry. Not only are the opportunities and advantages presented, but also the shortcomings that plant‐based proteins have had until now, and strategies for optimization. Furthermore, current project results (Fraunhofer Future Foundation) are reported, in the scope of which new methods for the reduction of the allergenic potential of plant proteins have been developed. The article is rounded off with a discussion of technical approaches to the optimization of the taste, texture and mouthfeel of plant‐based foods and examples of the successful implementation of research results by Fraunhofer spin‐offs.
... Some adverse reactions do not involve the immune system as seen with disorders such as coeliac disease (Troncone et al. 2008). These sensitivities may be attributed to the existence of metabolic disorders or the occurrence of reactions with unknown mechanism (Taylor and Hefle, 2001). Both IgE and non-IgE mediated food allergy is frequently seen during this period. ...
... Food allergens are naturally occurring proteins of the allergenic foods. Small and specific regions of the protein molecule, called epitopes, are responsible for the immunoglobulin E (IgE)-mediated allergic response by acting as an antigen 9 . ...
Article
The addition of soy proteins, currently classified as a food allergen, into meat products is a commonly used practice due to its functional properties and low cost. Its addition to meat products can cause health problems for individuals allergic to these proteins. Allergic individuals can be affected by the ingestion of low amounts of the allergen. In Brazil, limits are set for the addition of soy proteins in meat products in order to avoide fraud. Starting in 2015 reporting the name of the added component became mandatory for all food labelling. Some studies have reported that food processing can reduce the allergenicity, either by irreversible removal of allergens or by modifying the allergen structure. However, the technological approach to decrease allergenicity has largely been empirical. This review describes the use of soy protein in meat products and the health risk for allergic individuals and consumers of these products. Finally, appropriate methodologies for the detection and quantification of these proteins must be further explored and established to avoid fraud and to preserve consumer health.
... Food allergy results from an adverse immunoglobulin E (IgE)-mediated reaction of the immune system towards dietary antigens, commonly proteins. The antigenic determinant of allergenic proteins is called epitope, which can be classified into linear and conformational epitopes (Taylor & Hefle, 2001). Although nearly any food is capable of causing an allergic reaction, it was found that nearly 90% of all allergic reactions in the U.S. are triggered by eight main protein sources, which compromise milk, eggs, fish, crustacean/shellfish, tree nuts, peanuts, wheat, and soy. ...
Article
This study investigates the effect of nonthermal processing technologies on soy immunoreactivity. Soy protein isolate was treated with pulsed ultraviolet (PUV) light, direct and remote cold atmospheric pressure plasma (CAPP), and gamma-irradiation (3–100 kGy). Sample weight, surface temperature, hydrogen peroxide content, and pH value have been measured. SDS-PAGE analysis revealed reduced protein intensity bands corresponding to major soy allergens β-conglycinin (Gly m5) and glycinin (Gly m6). Sandwich ELISA using specific mouse monoclonal anti-Gly m5 antibodies (mAbs) confirmed a loss of soy immunoreactivity following PUV light, direct CAPP, and gamma-irradiation with increasing dose and time. The maximum reduction in immunoreactivity (91–100%) in the soluble protein fraction was achieved by direct CAPP as well as PUV light and gamma-irradiation treatment. A decreased immunoreactivity up to 89% was observed for samples treated with remote CAPP. These innovative technologies might have great potential for industrial application due to their effectiveness in reduction of soy immunoreactivity.
... Soybean (Glycine max) is an attractive ingredient for the production of a variety of foods due to its high functionality as well as nutritional Innovative Food Science and Emerging Technologies xxx (2016) value. However, soy belongs to the eight priority food allergens ("big 8") that are believed to be responsible for 90% of all IgE-mediated allergic reactions in the U.S. (Taylor & Hefle, 2001). The European Food Safety Authority (EFSA) reported that soy allergy prevails among 2.7% of the population. ...
Article
Soybean (Glycine max (L.) MERR.) is recognized as a potent food allergen causing one of the most frequent food allergies worldwide. The effect of high pressure processing (HPP) prior to and during enzymatic hydrolysis using the enzyme preparation Flavourzyme® on the degree of hydrolysis (DH), molecular weight distribution (SDS-PAGE) and β-conglycinin (Gly m5) immunoreactivity of soy protein isolate (SPI) was studied. Enzymatic hydrolysis was carried out at atmospheric pressure (0.1 MPa) and HPP (100–600 MPa) at 50 °C for 15 min. Pressures higher than 300 MPa enhanced the degradation of Gly m5, which was confirmed by SDS-PAGE and LC-MS/MS analyses. The immunoreactivity of the samples was assessed by in vitro sandwich ELISA using mouse monoclonal anti-Gly m5 antibodies. Depending on the antibody tested, the residual immunoreactivity was completely inhibited or significantly impaired up to 99.5% applying HPP during hydrolysis at 400 and 500 MPa. By means of principal component analysis, the beany and green off-flavors characteristic for unprocessed SPI could be reduced by pressure enhanced hydrolysis at 400–500 MPa. The resulting hydrolysates possessed improved protein solubility, foaming activities and oil-binding capacities, which were improved by 45%, 66%, and 210%, respectively. HPP prior to and during enzymatic hydrolysis at 400–500 MPa constitutes an innovative approach for the production of low-allergen food ingredients that combine good taste and enhanced functional properties.
... Food additives such as MSG (monosodium glutamate) and dyes may cause allergies, but are uncommon (less than 1 in 100, or 1%, in children and less than 1 in 500, or 0.2%, in adults). Some studies suggest these reactions may not be allergic in nature, but mediate by some other mechanism (Taylor & Hefle, 2001;US Dept. of Health, 1995). ...
Article
A food allergy is an acquired hypersensitivity reaction to what is normally considered a safe food. Food allergies occur more often in children than in adults: 5-8% of those age 4 or under and about 1-4% of adults are affected. Together, about 11 million Americans suffer from some degree of food allergy. Those with severe reactions may experience what is known as anaphylaxis or anaphylactic shock. Annually, around 30,000 people receive life-saving emergency treatment and 150 fatalities occur. This document is FSHN05-13, one of a series of the Food Science and Human Nutrition Department, UF/IFAS Extension. Original publication date August 2005. FSHN0513/FS123: Food Allergies (ufl.edu)
... Food allergic reactions are described as adverse reactions to health (from local and transient effects to systemic anaphylaxis) that induce specific immune response in susceptible subjects following dietary exposure to relevant allergens in food (Verhoeckx et al., 2015). In a broad sense, allergic food reactions can include immunoglobulins (IgE) and non-IgEmediated primary immunological sensitivities, non-immunological food intolerances, and secondary sensitivities (Taylor & Hefle, 2001). The main form of immune-mediated allergic reactions to foods is linked to IgE formation against food allergens (Type I reactions). ...
Article
There is an increasing demand for alternative and sustainable protein sources, such as vegetables, insects and microorganisms, that can meet the nutritional and sensory pleasantness needs of consumers. This emergent interest for novel protein sources, allied with "green" and cost-effective processing technologies, such as high hydrostatic pressure, ohmic heating and pulsed electric fields, can be used as strategies to improve the consumption of proteins from sustainable sources without compromising food security. In addition to their nutritional value, these novel proteins present several technological-functional properties that can be used to create various protein systems in different scales (i.e., macro, micro and nano scale), which can be tailored for a specific application in innovative food products. However, in order for these novel protein sources to be broadly used in future food products, their fate in the human gastrointestinal tract (e.g., digestion and bioavailability) must be assessed, as well as their safety for consumers must be clearly demonstrated. In particular, these proteins may become novel allergens triggering adverse reactions and, therefore, a comprehensive allergenicity risk assessment is needed. This review presents an overview of the most promising alternative protein sources, their application in the production of innovative food systems, as well as their potential effects on human health. In addition, new insights on sustainable processing strategies are given.
... Some adverse reactions do not involve the immune system as seen with disorders such as coeliac disease (Troncone et al. 2008). These sensitivities may be attributed to the existence of metabolic disorders or the occurrence of reactions with unknown mechanism (Taylor and Hefle, 2001). Both IgE and non-IgE mediated food allergy is frequently seen during this period. ...
... Metabolic food intolerances are adverse reactions to a food or food component resulting from a defect in the metabolism of these foods or some substance therein, or from an effect of the food or food component on the body's normal metabolic processes (Taylor & Hefle 2001). Most food intolerance reactions would be expected to fall into this category, and many examples have been reported in humans. ...
Article
Food intolerance refers to any abnormal physiological response to a food or food additive, believed not to be immunological in nature. Mechanisms include food toxicity, pharmacological reactions, metabolic reactions, dysmotility, dysbiosis, physical effects and non‐specific dietary sensitivity. Food intolerance reactions are variable, typically dose‐dependent, and can occur at any age. Signs may arise at any time, sometimes several hours or days after consumption of the offending food item, and can last for hours or days. Dietary indiscretion and non‐immunological food intolerance are probably more common in dogs than true dietary hypersensitivity. Hopefully, with a greater knowledge of the different pathophysiological mechanisms involved, we will become better at recognising, preventing and managing adverse food reactions.
... Fish is one of the ''Big Eight" food allergens identified to cause more than ninety percent of IgE-mediated food allergies (Taylor & Hefle, 2001). Compared to other food allergies, fish allergy tends to show a high proportion of severe anaphylactic reactions, and has shown to be the primary cause of death related food allergy in emergency rooms in Australia (Schulkes et al., 2014;. ...
Article
This study aimed to develop a novel approach to determine the correlation between the parvalbumin (PAV) contents and their corresponding immunoreactivity (detectability) in southern hemisphere fish species. The immuno-detected PAV contents of the test fish species were estimated by a quantitative SDS-PAGE. A quantitative Enzyme-Linked ImmunoSorbent Assay (ELISA) was formatted to assess relative immunoreactivity of PAV. Sixteen species (forty-three percent) displayed a positive correlation with the anti-cod PAV polyclonal antibody, but no correlation with the anti-carp PAV monoclonal antibody. There was a strong phylogenetic association of the PAV immunoreactivity. Species from the order of Perciformes showed strong binding with both antibodies; whereas species from Salmoniformes, Ophidiiformes, Scombriformes, Scorpaeniformes, and Tetraodontiformes showed weak or no binding. This approach showed for the first time a statistical correlation between the PAV content and the immunoreactivity and allowed to rank the relative species/order specificity of the two antibodies for the southern hemisphere fish PAV.
... However, there are examples of allergies to other foods, whose prevalence has a particular distribution in different Countries. This is the case of celery in Switzerland/Austria, and of rice and buckwheat mainly in Japan (Cochrane et al. 2009;Mills et al. 2007;Eriksson et al. 2004;Taylor and Hefle 2001;EFSA 2004). This implies that the requirements for mandatory food allergen declarations are different across the different Countries, where the allergen labelling lists are focused on the local prevalence patterns of sensitization (Gendel 2012). ...
Article
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Food allergy represents an increasing public health issue, and a large number of food control authorities have provided regulations aimed to minimize the risk of allergic reaction for sensitized consumers. The Food and Agriculture Organization of the United Nations together with the World Health Organization established the Codex Alimentarius Commission whose main goal is to protect the consumers’ health. To purse this task the Commission listed the foods and ingredients causing the most severe allergic reactions that should be labelled. It has been reported that some cases of specific foods hypersensitivity display a different prevalence among different Countries. Thus, the European Union drew up a list of mandatory allergens (that must be labelled) longer than that provided by Codex Alimentarius. As a consequence of the complexity of the legal phraseology of the European Union (EU) and/or European Community (EC) the Regulations and/or Directives were differently translated in all EC/EU official languages determining possible misinterpretations of the legislation. Moreover, food labelling regulations were also established with the goal to promote the consumers’ conscious choice about what they eat. Starting from the case of the fermented beverages, we analysed the European legislative scenario concerning the allergen labelling of the last fifteen years, highlighting that mistranslations, misinterpretations and lack of information in the EU Regulations might lead to health and ethical issues.
... In recent years, the analyses on the binding interactions of biologically potential organic/inorganic molecules with different biomolecules (protein and DNA) obtain significant attention in the area of biophysical chemistry, clinical medicine and life sciences (Naveenraj & Anandan, 2013). Food allergy is a major concern of health for people (particularly children), and there is therefore a critical subject to recognize and describe the sensitizing potential of food proteins and to find a way to prevent such hypersensitivity (Taylor & Hefle, 2001). Herein, we choose low-cost, readily available and model food protein, ovalbumin (OVA). ...
... Sensorik und die Verdaubarkeit [7], [9], [21], [43], [45], [49], [50], [51], [56], [77] Modifikation [47], [80]. Grundsätzlich kann jedes Lebensmittelprotein eine allergische Reaktion auslösen. ...
Chapter
Der bis Mitte des Jahrhunderts erwartete Anstieg der Weltbevölkerung auf über 9,5 Milliarden Menschen und der zunehmende Verzehr tierischer Lebensmittel sind eine der größten globalen Herausforderung zur Sicherung der Versorgung der Menschheit. Die Nutzung neuer pflanzlicher Proteinzutaten anstelle von tierischen Eiweißpräparaten kann ein wichtiger Teil der Lösung sein, da die Produktion tierischer Eiweiße rund fünfmal so viel Fläche benötigt wie die Gewinnung von Pflanzenproteinen. Der folgende Beitrag gibt einen Überblick über den Stand der Technik der Gewinnung, Verarbeitung und Applikation pflanzlicher Proteine in der europäischen Lebensmittelindustrie. Dabei werden neben den Chancen und Vorteilen auch bisherige Schwächen pflanzlicher Proteine vorgestellt und Strategien zur Optimierung aufgezeigt. Weiterhin wird über aktuelle Ergebnisse eines Projekts der Fraunhofer-Zukunftsstiftung berichtet, in dessen Rahmen neue Verfahren zur Reduktion des allergenen Potenzials pflanzlicher Proteine entwickelt wurden. Technische Ansätze zur Optimierung von Geschmack, Textur und Mundgefühl pflanzlicher Lebensmittel und Beispiele zur erfolgreichen Umsetzung der Forschungsergebnisse durch Fraunhofer-Ausgründungen schließen den Beitrag ab.
... To date, it is estimated that 1-2% of adults and up to 5-7% of children suffer from some type of food allergy such as peanuts and tree nuts. 1 Different symptoms may appear in these patients, on the skin (urticaria, dermatitis, eczema, angioedema, itching), in the gastrointestinal tract (nausea, vomiting, diarrhoea, abdominal cramping) and in the respiratory system (rhinitis, asthma, laryngeal oedema). 2 Food-induced anaphylactic shock is a more severe reaction, occurring within minutes or hours, and may lead to death without prompt medical treatment. 3 Oral food challenge (OFC) remains the gold-standard diagnostic test for food allergy but there is the possibility of inducing a systemic reaction. ...
Article
BACKGROUND Peanuts and tree nut allergies pose an increasing food safety problem. The aim of our study was to test the accuracy of different commercial ELISA kits in the detection of the presence of walnuts in untreated and heat exposed food samples. The evaluation of the effects of thermal treatment in samples was tested exposing walnuts to different heat treatments. All samples were firstly analyzed by two different commercial ELISA assays. Then, we performed Skin Prick test (SPT) on nine patients with proven nuts allergy using small walnut pieces from raw and treated samples. RESULTS The presence of nuts proteins in thermally processed foods was not accurately detected by ELISA kits. All patients had a positive SPT reaction with raw walnut, while thermal treatments affected walnut allergenicity. ELISA test gives a negative result in case of strong thermal treatment, but at the same time allergic subjects react positive at the stimulation with the same sample. CONCLUSION This study suggest that commercial ELISA kits may not be able to accurately determine the amount of proteins present in thermally processed foods due to changes in the solubility and immunoreactivity of the target proteins. Finally, the clinical results highlight that thermal treatment might induce a reduction in walnut allergenicity. This article is protected by copyright. All rights reserved.
... Food sensitivities are divided into two groups: primary food sensitivities and secondary ones. IgE-mediated food allergy is in the primary food sensitivity group and can cause anaphylaxis in the high level and lead to immunologic disturbances [6]. Allergens causes some symptoms as all asthma, allergic conjunctivitis, and allergic rhinitis [7]. ...
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Allergens causes some symptoms as all asthma, allergic conjunctivitis, and allergic rhinitis. These symptoms are seen twice as many in women than in men. The major wine allergens reported in wines are endochitinase 4A and lipid-transfer protein (LTP). This review deal with possibilities of using lactic acid bacteria as suppressors of wine allergies. Phenolic compounds present in wines have not only antioxidant properties causing radical scavenging but also some special properties reported in many in vitro studies as regulating functions in inflammatory cells as mast cells. So what is the role of lactic acid bacteria in these cases? Lactic acid bacteria are used during malolactic fermentation step of wine production with purpose of malic acid reduction. During this bioconversion complex phenolic compounds could be hydrolysed by bacterial enzymes to their aglycone forms. Obtained aglycons could pass through the intestinal epithelium of human and allowed reduction of IgE antibody production by affecting Th1/ Th2 ratio. Considering different contents and quantities of phenols in different grape varieties and consequently in different wines more studies are required in order to determine which lactic acid bacteria and strains could be effective in suppressing wine allergens.
... However, soybean is recognized as one of the common allergenic food sources requiring food allergen labeling ("Big Eight" in the U.S. and among the top 14 in the European Union). Eight foods and food groups are thought to account for up to 90% of IgE mediated food allergic reactions in the U.S. (Taylor and Hefle, 2001). Soybean food allergy is relatively common in infants and young children in the U.S. due to the exposure to soy-based formula for those with cow's milk allergy (Zeiger et al., 1999). ...
Article
Full-text available
Soybean is recognized as a commonly allergenic food, but the identity of important allergens is not well studied. Recently, some global regulatory agencies started requiring quantitative analysis of individual allergens, including unproven allergens, as part of the risk assessment for genetically engineered (GE) soybeans. We sought to identify soybean proteins that bind IgE from any of 10 individual soybean-sensitized subjects. Soybean IgE binding proteins were identified by 2-DE immunoblots using sera from four soy-allergic and plasma from six soy-sensitized human subjects. Corresponding spots were excised from stained gels, digested, and analyzed using a quadrupole TOF Synapt G2-S tandem mass spectrometer. Results showed the major IgE binding proteins were subunits of either β-conglycinin (Gly m 5) or glycinin (Gly m 6). Soybean Kunitz trypsin inhibitor (SKTI) was a significant IgE binding protein for four subjects. Soybean agglutinin, seed biotinylated protein (SBP) of 65 kDa, late embryogenesis protein (LEP), and sucrose-binding protein were identified as IgE binding only for soy-sensitized subjects. We conclude that the major soybean allergens are isoforms of Gly m 5, Gly m 6, and possibly SKTI and that requirements for quantitative measurement of proteins that are not clear allergens is not relevant to safety.
Article
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Milk allergy is known to cause severe allergic reactions in hypersensitive patients, especially in infants and children. β‐Lactoglobulin is one of the major allergens in bovine milk. The influence of thermal and microwave processing on the structural deviations of β‐lactoglobulin protein have been studied using molecular modeling techniques. The structural deviations are studied using root mean square deviations, radius of gyration, dipole moment, and solvent accessible surface area. STRIDE analysis showed significant changes in the β‐lactoglobulin, especially when oscillating electric fields were applied along with heat. Root mean square fluctuations (RMSF) has been assessed for known epitopes in the β‐lactoglobulin molecule. This showed that when the protein is exposed to certain thermal stress, it compacts by burying hydrophobic residues in the core. However, few allergic epitope residues also exhibit increased RMSF leading to higher reactive sites on the surface of the protein molecule. Practical applications This study showed that molecular modeling can be used to gain valuable insights regarding the structural changes during processing. In the future, with more computational capacity, it can be used to make comparison between results obtained from simulations and real‐time experiments. The current techniques used in food industries such as Nuclear Magnetic Resonance Imaging, Fourier Transformation Infrared Spectroscopy, X‐ray diffraction can analyze pre‐ and post‐processing effects. Hence, it become necessary to understand the changes that takes place during the processing techniques. Molecular dynamic simulation could be a useful technique in analyzing the changes occurring during the processing.
Article
In order to support patients’ safety, the analytical methods should be able to quantify the allergenic proteins in food products. Analytical performance of the currently used ELISA methods is not always appropriate, particularly in case of processed foods. A possible way to investigate the sources of analytical errors is the utilisation of model food matrices that mimic the technology and behaviour of real food products. Consequently, factors affecting the analytical results were identified, their contribution to the whole analytical error was determined, and the underlying phenomena were interpreted in this study. Heat-treated model matrices incurred with gliadin, milk, egg, or soy proteins were produced and analysed with commercially available ELISA test kits. The data were evaluated with statistical tools. Results clearly show that the type of the food matrix, the level of processing, and the analytical methods (i.e. the type of the ELISA kit) are the three main factors that play a significant role in the uncertainty. The developed laboratory methodology seems to be suitable for generalising the investigation of other allergens, methods, matrices, and the scientific background of the phenomena.
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This chapter focuses on the chemical composition of amaranth, quinoa, and buckwheat. The excellent protein quality of amaranth and quinoa has to be pointed out, while buckwheat is characterized by a unique concentration of phythochemicals. As amaranth and quinoa have long been neglected within food production and nutrition, mainly on account of wheat, the current knowledge is still very limited. This is one reason why only few food products based on or including pseudocereals are available, in particular Western-type foods like bakery products and pasta. Increased and thorough research should thus be pursued on physico-chemical and functional properties of all three plants to enable future product development. All three pseudocereals do not contain any prolamins toxic to celiac disease and can be integrated into gluten-free diets. The available research data is yet not sufficient to clearly state that all people with celiac disease can tolerate these three plants. Further research is necessary to give detailed recommendations. Celiac disease is often accomplished by malabsorption and subsequent vitamin or mineral deficiencies, which make high-quality nutrition even more important. As amaranth, quinoa, and buckwheat are highly nutritious, their integration into the gluten-free diet could be a valuable contribution.
Chapter
Food allergens are proteins that are well tolerated by most, but can cause severe reactions in sensitive individuals. Since there is no cure for food allergy, strict adherence to an allergen-free diet is the only safe choice currently available for allergic consumers. Accurate food labeling can help consumers avoid foods containing an allergenic ingredient. Regulatory agencies have mandated the labeling of major food allergens on packaged foods to help with safe food choices. However, the inadvertent presence of an allergen in food due to cross-contact and labeling error can jeopardize consumer health. Analytical methods are developed for allergen detection and quantitation to ensure food safety and labeling compliance. These methods are mostly based on immunochemistry, mass spectrometry and genomic amplififi cation. Th is chapter details the general principles and advances in the development of allergen detection methods. Th e validation of these analytical methods and challenges associated with accurate allergen quantitation is also discussed.
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Fruits and vegetable are part of our daily diet and it is important to understand the role of postharvest treatment effects on functional components including organoleptic characteristics. Irradiation has multiple benefits in food preservation through several processes such as disinfestations, delaying maturation, sprout inhibition, decontamination, and sterilization. Sensory evaluation studies in different commodities indicate that irradiation treatment does not affect quality and flavor. Quality retention, along with efficacy and efficiency, is critical for many postharvest treatments. Although irradiated fruit retained quality compared to control, very little information is available on the effects of irradiation on functional components. Accumulative evidences from epidemiological, case and cohort studies have shown that functional components such as flavonones, flavonols may prevent chronic diseases such as cancer and cardiovascular diseases. In this chapter, emphasis is given to onion and grapefruit to illustrate the effects of irradiation on functional components. In onion, our results have demonstrated that irradiation at 0.8 and 1.2 kGy doses significantly increased both free and total quercetin concentrations. During the last four decades, ionizing radiation has been used as a quarantine treatment for eight fruit hosts that are shipped from Hawaii to the USA mainland. Flexibility and effectiveness of irradiation as a quarantine treatment have been demonstrated and proven to be appropriate for tropical fruits crops. However, several recent studies indicated the need of irradiation as an alternative for quarantine treatment in citrus to prevent infestation of Mediterranean (Ceratitis capitata (Weid), Mexican (Anastrepha ludens (Loew), and Carribbean (A. suspensa (Loew)) fruit flies. Our studies, in citrus, showed that low doses of ionizing radiation significantly increased flavonone concentrations. Potential use of irradiation to enhance the levels of functional components is discussed. To remain competitive in international and national markets, optimization of these components may be important for the processing industry.
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High oleic acid is one of the main breeding objectives of peanut in China. Twelve peanut cultivars with high oleic acid have been developed at the Biotech Division, Shandong Peanut Research Institute. All of these cultivars contained over 80% oleic acid. Their oleic acid to linoleic acid ratios were greater than 23. The cultivars performed well in evaluation tests, showing yield superiority over local controls. Studies using some of the cultivars indicated that high oleic acid seed peanuts had good storability.
Article
Food allergy has emerged as a serious health problem and is estimated to affect up to 8% of children and up to 2% of the adult population. Food allergies involve abnormal immunological responses to specific components of certain foods. Naturally occurring proteins in certain foods are the typical instigators of allergic sensitization. The availability of accurate and sensitive detection methods for food allergens is crucial for the food industry to inspect and control their production processes, and to ensure the correct labeling of their products that can prevent costly product recalls. Radio-allergosorbent (RAST) or enzyme-allergosorbent (EAST) assays are designed for the detection of allergen-specific IgE. These in vitro assays are mainly used in the diagnosis of food allergy. Two types of ELISA systems are employed for the detection of food allergens: competitive ELISA and sandwich ELISA. Lateral flow immunochromatographic assays, commonly known as dipsticks, can serve as extremely fast methods for the detection of food allergens. This method is also based on an immunological detection of proteins from an allergenic food.
Article
Introduction Nature of chemical hazards in foods Food safety engineering and control of chemical hazards Food allergen control Conclusions
Article
Adverse reactions to dairy products are predominantly caused either by intolerance to lactose or by allergic reactions to cow's milk proteins. These are distinct disorders that have separate mechanisms of action and require different methods for diagnosis and strategies for avoidance. Cow's milk allergy (CMA) affects approximately 1-3% of infants and 0.1-0.5% of adults, with symptoms ranging from mild irritations to life-threatening anaphylaxis. Fortunately, most infants with CMA spontaneously recover during early childhood. For infants and adults with active CMA, avoidance of milk proteins remains the only effective management strategy. Hypoallergenic cow's milk formulas, in which the milk proteins are extensively hydrolysed, are available for allergic infants. However, there remains a dearth of alternative dairy products suitable for adults with CMA. Attaining a better understanding of the immunological mechanisms of CMA is crucial to developing strategies to prevent allergic sensitization, treatments to induce immune tolerance, improved diagnostics and hypoallergenic products. To date, much has been learned about the complexity of CMA, including the diversity of allergenic epitopes within various milk proteins and the heterogeneity of allergic responses among individuals. At a population level, the dominant immunological mechanisms driving CMA appear to change with age. While the antibody class IgE often mediates reactions in infants, CMA in adults is predominately non-IgE-mediated and, the precise immunological mechanisms remain poorly understood. We have been examining differences between the immune responses of milktolerant and milk-allergic adults in order to better understand non-IgE-mediated CMA. Preliminary indications are that serum titres of milk protein-specific antibodies IgA1,2, IgE and IgG1-4 are not related to allergy symptoms, and that allergic adults may have increased T-helper cell Type 1 (Th1) reactivity to milk proteins. We are using these findings to develop new cell-based assays to measure the allergenic potency of modified milk proteins.
Article
Hypersensitivity reactions (allergy and intolerance) triggered by certain food proteins affect an increasing rate of population. The only effective treatment of these illnesses is the total avoidance of the problematic proteins from patient's diet. At the moment the labeling regulations of European Union defines 14 foodstuffs or components which are responsible for the highest number of these cases. In order to comply the regulation, right technological solutions and validated analytical methods are needed. At present, the most commonly used methods in allergen analysis are immune-analytical based ELISA or LFD kits. The development and validation of these methods cause many challenges. The compositions of allergenic proteins are not well-defined, furthermore neither reference materials nor reference methods exist. Finally the effects of food processing steps on the allergenic proteins and the results of the analytical methods are not described well. One direction towards overtaking the problems is the development of incurred real food matrices which contains dedicated amount of allergenic protein, which was the main goal of this work. These model matrices can be used as incurred reference material (IRM) and opened the door to investigate the influence of food processing. Reference material also give the opportunity to make a comparative study of ELISA kits and other analytical methods.
Article
Whey proteins, due to their high nutritional value, are generally hydrolyzed to reduce the allergenicity and used as ingredients in many special products, such as infant formulae, geriatric products, highly energetic supplements or dietetic foods or in foods produced to prevent nutrition related diseases, like food intolerances and allergies.The aim of this work was to assess the applicability of innovative technologies, such as high hydrostatic pressure (HHP) processes, to assist the enzymatic hydrolysis of target proteins, namely whey protein concentrate (WPC-80), in order to modify their antigenicity. Experiments were carried out to verify the effectiveness of HHP technology to accelerate whey protein hydrolysis reaction with selected enzymes (α-chymotrypsin, bromelain), and to affect the protein allergenic power. To this purpose, different HHP treatments were carried out at several pressure levels (100, 200, 300 and 400. MPa) and the untreated whey protein samples were used as control. A defined enzyme/substrate ratio of 1/10 w/w was used in the experiments, while the treatment time was changed from 0 to 30. min (0, 5, 15, or 30. min).The experimental data demonstrated that High Hydrostatic Pressure (HHP) induced WPC-80 unfolding at the highest value of the pressure applied (400. MPa) as indicated by the higher exposure of free sulfhydryl groups. When HHP was used in combination with enzymatic hydrolysis, the degree of hydrolysis increased not only with the pressure level applied but also with the processing time. These results suggested that, even if the exposure of hidden epitopes upon protein unfolding increased the antigenicity of whey proteins, further peptide bonds cleavage also took place after hydrolysis. This effect could modify whey proteins antigenic sequences, and thus their antigenic power.
Chapter
The most common food allergies in adults are to plant foods (nuts, legumes, fruits, and vegetables) and a few animal products (milk, eggs, crustacean shellfish, and fish muscle). Eliminating relevant allergens (specific proteins) in specific plants represents a new approach to allergen avoidance for the prevention of sensitization and elicitation of food allergies. A variety of methods have been used to date with varying success in proof-of-concept investigations to develop hypoallergenic foods. This chapter provides an overview of the current status of hypoallergenic foods produced in model allergenic plants (rice, soy, apple, tomato, carrot, peanut). Perspectives and challenges are discussed. However, marketing of hypoallergenic foods produced from genetically modified crops is currently not feasible as these varieties would have to be accurately differentiated from unmodified, fully allergenic varieties.
Article
Macadamia nut is considered a priority food allergen and undeclared macadamia nut residues pose a potential food safety risk to individuals with macadamia nut allergies. To date, there are a limited number of immunochemical methods that are available for detection of processed macadamia nut residues. Therefore, the aim of this study was to develop a reliable and robust sandwich ELISA for detection of macadamia nut residues. Raw and roasted macadamia nuts were used for immunization in three different species of animals (sheep, goat, and rabbits). Macadamia nut specific IgG antibodies produced by each animal were tested for their specificity and monitored by determining their titer values. Rabbit antiserum was used as the capture reagent while goat antiserum was used as the detector reagent in the optimized sandwich ELISA. These antisera recognized both raw and roasted macadamia protein equivalently. Potential matrix interference was evaluated in sugar cookies, vanilla ice cream, and dark chocolate to assess the overall sensitivity of the ELISA. The cookie and ice cream matrices did not significantly affect the sensitivity of the developed ELISA (p<0.05). The dark chocolate matrix decreased macadamia nut protein extraction and overall ELISA sensitivity; however, the addition of NFDM or fish gelatin into the extraction buffer enhanced the extraction efficiency which allowed for an estimated limit of quantification of 1 ppm macadamia nut in three matrices. Potential cross-reactivity was assessed in 86 food ingredients. Pure extracts from a few ingredients (all-spice, cinnamon, cloves, paprika, Brazil nut, poppy seeds, oregano, nutmeg, and cherries) showed low level binding but would not significantly affect the accuracy of the ELISA. The sensitivity and efficiency of the developed ELISA was evaluated further through macadamia incurred sugar cookies and vanilla ice cream. The overall high percentage recovery of macadamia nut residues in both model foods shows that the developed ELISA can sufficiently and reliably detect macadamia nut proteins in processed foods, and will provide a useful tool to support the validation of allergen control procedures within food companies or regulatory compliance. Advisor: Joseph L. Baumert
Article
Nahrungsmittelallergien im Erwachsenenalter richten sich am häufigsten gegen pflanzliche Nahrungsmittel (Nüsse, Leguminosen, Früchte und Gemüse). Eine Ausschaltung relevanter Allergene in der Pflanze selbst stellt einen neuen Ansatz der Allergenkarenz zur Primär-, Sekundär- und Tertiärprävention von Nahrungsmittelallergien dar. Verschiedene Methoden wurden in den bisherigen „Proof-of-concept“-Untersuchungen zum Design hypoallergener Nahrungsmittel mit unterschiedlichem Erfolg eingesetzt. Diese Arbeit gibt einen Überblick über den aktuellen Stand der in verschiedenen Modellallergenpflanzen (Reis, Soja, Apfel, Tomate, Karotte, Erdnuss) generierten hypoallergenen Nahrungsmittel. Perspektiven und Herausforderungen werden aufgezeigt. Zum aktuellen Zeitpunkt ist eine Vermarktung der generierten genmodifizierten hypoallergenen Nahrungsmittel nicht absehbar.
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Lactose intolerance is being reported in many populations. Yet, milk is highly nutritious and methods are being explored to use milk while limiting the lactose content. Thirty-two blacks 13-19 years of age were studied to determine a blood sugar rise with 8 ounces of the following test milks: 1) untreated whole milk (12 g/lactose); 2) 90% lactose hydrolyzed milk (1.2 g/lactose); and 3) 50% lactose hydrolyzed milk (6 g/lactose). In the 22 lactose malabsorbers, the peak blood sugars were: 1) untreated whole milk--4.4 mg/100 ml, 2) 90% lactose hydrolyzed milk--14.5 mg/100 ml, and 3) 50% lactose hydrolyzed milk--8.8 mg/100 ml. The 10 blacks with normal lactose absorption had a comparably high peak blood sugar on all three test milks. Differences between the blood sugar in the lactose absorbing and malabsorbing subjects when drinking untreated whole milk are significant (P less than 0.001); so are differences in the lactose malabsorbing subjects consuming untreated whole milk and 90% lactose hydrolyzed milk (P less than 0.001) as well as 50 and 90% lactose hydrolyzed milk. Symptoms were reported by three lactose malabsorbing subjects with untreated whole milk with two of the three symptomatic with 90% lactose hydrolyzed milk and none with 50% lactose hydrolyzed milk. No symptoms were reported by the lactose absorbers. Significant improvement in absorption with 90% lactose hydrolyzed milk is seen in low lactase subjects. Lactose hydrolyzed milk may serve as an important alternative for food planners wanting to provide milk to high risk populations with low lactase levels.
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We examined the efficiency of two beta-galactosidase preparations--one derived from the yeast, Kluyveromyces lactis (Lactaid), the other derived from the fungus, Aspergillus oryzae (Takamine)--to assist the in vivo digestion of lactose consumed by healthy Guatemalan preschool children. Milk prehydrolyzed by in vitro incubation with enzymes was used as the standard of reference, and the degree of incomplete digestion of lactose from 240 mL of milk was determined using the hydrogen breath test. In in vivo dose-response studies, both 3,250 neutral lactose units of Lactaid and 6,635 food and chemical codex lactose units of Takamine completely eliminated excess H2 excretion in a small sample of lactose-maldigesting subjects. When evaluated in a controlled, clinical trial setting, the same dose of Lactaid added directly to the milk at consumption produced an 82% relative reduction in H2 excretion, whereas Takamine was equally as effective as the prehydrolyzed milk. Thus, intraluminal conditions and gastrointestinal transit in the preschool child support the effective assisted digestion of milk lactose in an efficient manner and with the same enzyme to milk ratios as observed previously in adults.
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Eight individuals with asthma who had been diagnosed as sulfite sensitive on the basis of double-blind capsule-beverage challenges were subjected to challenges with various sulfited foods, including lettuce, shrimp, dried apricots, white grape juice, dehydrated potatoes (as mashed potatoes), and mushrooms. Four of these patients failed to respond to challenges with any of the sulfited foods. The other four patients experienced a decrease in pulmonary function on double-blind challenges with sulfited lettuce. Two of three of these patients reacted to challenges with dried apricots and white grape juice; the fourth patient has not yet been challenged with these products. Only one of these four patients reacted to challenges with dehydrated potatoes and mushrooms, and, in this case, the response to double-blind challenges with dehydrated potatoes was not consistent. None of the sulfite-sensitive subjects with asthma responded to challenges with sulfited shrimp. It is concluded that sulfite-sensitive subjects with asthma will not necessarily react after ingestion of sulfited foods. The likelihood of a reaction is dependent on the nature of the food, the level of residual sulfite, the sensitivity of the patient, and perhaps on the form of residual sulfite and the mechanism of the sulfite-induced reaction.
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Histamine poisoning can result from the ingestion of food containing unusually high levels of histamine. Fish are most commonly involved in incidents of histamine poisoning, although cheese has also been implicated on occasion. The historic involvement of tuna and mackerel in histamine poisoning led to the longtime usage of the term, scombroid fish poisoning, to describe this food-borne illness. Histamine poisoning is characterized by a short incubation period, a short duration, and symptoms resembling those associated with allergic reactions. The evidence supporting the role of histamine as the causative agent is compelling. The efficacy of antihistamine therapy, the allergic-like symptomology, and the finding of high levels of histamine in the implicated food suggest strongly that histamine is the causative agent. However, histamine ingested with spoiled fish appears to be much more toxic than histamine ingested in an aqueous solution. The presence of potentiators of histamine toxicity in the spoiled fish may account for this difference in toxicity. Several potentiators including other putrefactive amines such as putrescine and cadaverine have been identified. Pharmacologic potentiators may also exist; aminoguanidine and isoniazid are examples. The mechanism of action of these potentiators appears to be the inhibition of intestinal histamine-metabolizing enzymes. This enzyme inhibition causes a decrease in histamine detoxification in the intestinal mucosa and results in increased intestinal uptake and urinary excretion of unmetabolized histamine.
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The manifestations of gastrointestinal milk allergy in infants and children are protean and include vomiting, diarrhea, malabsorption, and even gastrointestinal hemorrhage. Diagnosis is extremely difficult, for RASTs may be negative, and food-specific serum antibodies may be absent.
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Seventy percent of the world's population are lactose maldigesters, but even those maldigesters who believe they are lactose intolerant can consume dairy products such as yogurt and lactose-hydrolyzed milk.
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A cohort of 1749 newborns from the municipality of Odense born during 1985 at the University Hospital were followed prospectively for the development of IgE-mediated and non-igE-mediated cow milk allergy (CMA) during their first year. The diagnosis of CMA was based on the results of strict elimination/milk challenge procedures in a hospital setting, and continued clinical sensitivity to cow milk (CM) was assessed by rechallenging every 6–12 months until the age of3 years. Further, in infants with CMA, the Clinical course of adverse reactions to other foods and the development of allergy to inhalant allergens In 3 years were investigated. Of 117 (6.7 %) with symptoms suggestive of CMA, the diagnosis of CMA was proven m 39 infants (2.2%), 64% showed cutaneous symptoms. 59% gastrointestinal symptoms, and 33% had respiratory symptoms. 92% had two or more symptoms and 72 % symptoms from 2 organ systems. Based on a positive skin prick test ( 2 +) and/or AL-RAST class 2 to CM 16 infants at the time of diagnosis, and at reinvestigation at 1 year, a further five infants giving a total of 21, were classified as having IgE-mediated CMA, 19 infants showed “immediate reactions to CM (within 1 h after intake of 2.3 g milk protein) and 20 infants were “late reactors”, No significant correlation between IgE-mediated CMA and “immediate reactions” to CM was demonstrated, The overall prognosis of CMA was good with a total recovery of 22/39 (56%) at 1 year. 30/39 (77%) at 2 years, and 34/39 (87%) at 3 years. Adverse reactions to other foods, particularly egg, citrus, tomato, developed in a total of 21/39 (54%) with the maximum point prevalence of 15/39 (38%) at 18 months, and 9/39 (23%) were still intolerant to other foods at 36 months. Inhalant allergy before 3 years developed in 11/39 (28%), particularly against dog and cat to which the infants had been exposed. Infants with CMA and early IgE, sensitization to CM had an increased risk of persisting CMA (24%) development of persistent adverse reactions to other foods (38%), particularly egg white (29%), and finally, inhalant allergy (48%) before 3 years of age.
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Ingestion of sulfiting agents can induce wheezing in some asthmatic patients. However, neither the prevalence of sulfite sensitivity nor the clinical characteristics of the affected asthmatic population are known. In a prospective single-blind screening study, 120 non-steroid-dependent and 83 steroid-dependent asthmatic patients underwent challenge with oral capsules of potassium metabisulfite. Five non-steroid-dependent and 16 steroid-dependent asthmatic patients experienced a greater than 20 percent reduction in their one-second forced expiratory volume within 30 minutes following the oral challenge. Twelve of these sulfite reactors were rechallenged with metabisulfite capsules in a double-blind protocol. Under these conditions, only three of seven steroid-dependent patients had a positive response. Moreover, only one of five non-steroid-dependent patients had a response to double-blind challenge. On the basis of this challenge study, the best estimate of the prevalence of sulfite sensitivity in the asthmatic patients studied is 3.9 percent. This population, however, contained a larger number of steroid-dependent asthmatic patients than would be found in the general asthmatic population. It is concluded, therefore, that the prevalence of sulfite sensitivity in the asthmatic population as a whole would be less than 3.9 percent and that steroid-dependent asthmatic patients are most at risk.
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In continuation of pharmacological investigations on polyphenolic compounds from the aerial parts of Galphimia glauca, flavonol acyl glycosides and gallic acid derivatives were screened in the classical and alternative complement assay. A reduction of complement-induced hemolysis was measured for quercetin-3-O-(2″-galloyl)-β-D-glucoside by 91.3 ± 1.76% (100 μM) and by 76.69 ± 4.43% (50 μM), respectively, and for quercetin-3-O-(6″-galloyl)-β-D-glucoside by 74.3 ± 6.77% (50 μM). Isoquercitrin, hyperoside, gallic acid, and ellagic acid inhibited the hemolysis to a much lower extent. In the alternative pathway quercetin-3-O-(2″-galloyl)-β-D-glucoside and quercetin-3-O-(2″-galloyl)-β-D-glucoside exhibited weaker inhibitory effects than in the classical pathway.
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This study was undertaken to determine the proper use of skin tests with food extracts in diagnosis of hypersensitivity to food in children. Cutaneous reactions evoked by graded amounts of food extracts were compared with results of double-blind food challenge and in vitro release of histamine from leucocytes. A 3 mm or greater weal reaction in skin tests by puncture technique using food extracts of 1:20 w/v concentration was found to indicate the degree of hypersensitivity likely to be associated with clinically significant hypersensitivity reactions to food. Proper use of this simple technique will facilitate accurate diagnosis of food hypersensitivity in children by identifying the group among whom all positive reactions to food challenges will be found. Nevertheless, double-blind food challenge is essential to establish a diagnosis of symptomatic hypersensitivity to food.
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 Soybeans are known to be allergenic for adults as well as for infants. Processed products derived from soybeans are used in a wide spectrum of foods, drugs and other industrial products. In particular, soybean lecithins are used as stabilizers and emulsifiers and may not be suspected as possible source of allergens. To test this hypothesis, six commercial soy lecithins were investigated for residual allergenicity and compared with extracts from raw and heat-treated soybeans. They were characterized, the protein content was determined by enzyme-linked immunosorbent assay (ELISA) and allergens were analyzed with specific IgE from patients' sera using the enzyme allergosorbent test (EAST), EAST inhibition and protein blotting followed by immunodetection. For further characterization a polyclonal antiserum directed against soybean extract and a monoclonal antibody (mAb 025) directed against the acidic subunit of the soybean storage protein glycinin were used. The EAST studies revealed that three of six sera from patients with allergy to soybeans contained IgE to four soy lecithins (Topcithin 50, Topcithin 300, Emulfluid FD 12, Epikuron 100 P), the same lecithins which were found to contain residual proteins. Two lecithins with a protein content of less than 20 ppb did not bind IgE. EAST inhibition showed that the allergens from soy lecithin were immunologically more closely related to allergens from heat-treated soybeans than to those from raw soybeans. Protein blotting and immunodetection of the protein extract from the lecithins resulted in various allergen bands between 14 kDa and 94 kDa. A heat-stable allergen of 39 kDa was recognized by the monoclonal antibody and thus identified as a subunit of glycinin. The results obtained were confirmed by a mediator release assay based on a rat basophil leukemia cell line. Lecithins that contained residual proteins caused a specific mediator release, suggesting that these products may induce allergic symptoms. Our results show that soybean lecithins are capable of introducing hidden allergens to processed foods and that the IgE binding potential corresponds to the total protein determined by ELISA. Furthermore, it appears to be possible that by monitoring the protein content soy lecithins can be applied which may be safe for the allergic consumer.
Article
The Chinese Restaurant Syndrome arose from an anecdote of discomfort experienced after eating Chinese cuisine. Monosodium glutamate has been implicated as the causative agent. Work over the past 17 years has consistently failed to reveal any objective sign accompanying the transient sensations that some individuals experience after the experimental ingestion of monosodium glutamate and it is questionable whether the term 'Chinese Restaurant Syndrome' has any validity. When some common food materials are used in the same experimental setting, similar symptoms can be produced in a limited number of people. Double-blind testing of individuals who identify themselves as suffering the 'syndrome' has failed to confirm the role of monosodium glutamate as the provocative agent.
Article
Cow milk allergy (CMA) is a common clinical problem. Three groups of patients can be identified on the basis of history, clinical features, and effect of milk challenge. This diagnostic value of IgE antibodies and lymphokine production is discussed. Skin tests are more helpful than these tests. Clinical features included anaphylaxis, gastrointestinal reactions, eczema, colic, and failure to thrive. Over 80 percent of children become tolerant to cow milk by the age of 5 years. Management of CMA consists of maternal dietary precautions in the case of breast-fed infants and soy or hydrolysate formulas in the case of bottle-fed infants.
Article
A review of the development of food allergy in a birth cohort of 620 Australian infants at high risk for development of atopic disease has recently been completed. Extrapolating to a random community population showed that at the age of two, egg appears the most frequent food allergen (3.2%), while cow milk (2.0%), and peanut are of similar frequency (1.9%). The prevalence of hypersensitivity to wheat and soy appears similar to sesame seed, cashew nut, hazelnut and walnut, but allergy to fish, brazil nut and shell fish are uncommon. Despite a different methodology, reports from several Asian centres suggest a similar frequency of hypersensitivity to these foods in young children although hypersensitivity to shellfish and seafood was more common than for nuts, peanut and wheat, if seafoods are part of the staple infant diet. Rice hypersensitivity was rare in both Australia and Asian countries.
Article
In order to extend previous investigations of adverse reactions to foods performed at this institution, 68 children, aged 5 mo to 15 yr, were studied. All subjects reported a history of adverse reaction to ingestion of one or more of the 14 foods under study. Sixteen of 43 subjects, 3 yr of age or older, had 22 adverse reactions during 94 food challenges with one or more of the 14 foods. All reactions confirmed were to peanut or other nuts, milk, egg, and soy. Skin testing with 1:20 weight/volume concentrations of food extracts applied by the puncture technique produced a net wheal reaction 3 mm or greater in all subjects 3 yr of age or older in whom double-blind food challenges confirmed the history of adverse reaction. Thirteen of 25 children less than 3 yr of age manifested adverse reactions during 49 food challenges. Skin testing by puncture technique produced a net wheal 3 mm or greater in 9 children less than 3 yr of age in whom food challenge elicited a clinical response within 2 hr. One of 4 subjects less than 3 yr of age in whom the adverse reaction occurred more than 4 hr after food challenge exhibited a wheal to puncture skin test of 3 mm or greater. These studies suggest that at present double-blind food challenge is an indispensible tool for the unequivocal evaluation of adverse reactions to foods.
Article
The clinical and immunological investigation of three patients with an acute anaphylaxis after ingesting commercial varieties of sunflower seeds is presented. Specific IgE-mediated hypersensitivity has been demonstrated in all three patients to sunflower seed extract by history, direct skin tests, and positive radioallergosorbent test (RAST) titers. RAST inhibition was positive in two patients tested. Similar tests on controls were negative.
Article
We studied 166 hospitalized male patients to determine the clinical importance of tolerance-test-determined "lactose intolerance," assumed to affect most of the world's adults. Abnormal lactose tolerance tests were found in 81% of 98 blacks, 12% of 59 whites of Scandinavian or Northwestern European extraction, and three of nine non-European whites. Seventy-two per cent of the "lactose-intolerant" subjects had previously realized that milk drinking could induce abdominal and bowel symptoms. Two hundred and forty milliliters of low-fat milk produced gaseousness or cramps in 59% of 44 "lactose-intolerant" men, and 68% were symptomatic with the equivalent amount of lactose. None of 18 "lactose-tolerant" men noted symptoms with milk or lactose. Refusal to drink 240 ml of low-fat milk served with meals correlated significantly with "lactose-intolerance": 31.4% versus 12.9% among "lactose-tolerant" patients. "Lactose intolerance" is common in adults and is a clinically relevant problem.
Article
Reports of fatal or near-fatal anaphylactic reactions to foods in children and adolescents are rare. We identified six children and adolescents who died of anaphylactic reactions to foods and seven others who nearly died and required intubation. All the cases but one occurred in one of three metropolitan areas over a period of 14 months. Our investigations included a review of emergency medical care reports, medical records, and depositions by witnesses to the events, as well as interviews with parents (and some patients). Of the 13 children and adolescents (age range, 2 to 17 years), 12 had asthma that was well controlled. All had known food allergies, but had unknowingly ingested the foods responsible for the reactions. The reactions were to peanuts (four patients), nuts (six patients), eggs (one patient), and milk (two patients), all of which were contained in foods such as candy, cookies, and pastry. The six patients who died had symptoms within 3 to 30 minutes of the ingestion of the allergen, but only two received epinephrine in the first hour. All the patients who survived had symptoms within 5 minutes of allergen ingestion, and all but one received epinephrine within 30 minutes. The course of anaphylaxis was rapidly progressive and uniphasic in seven patients; biphasic, with a relatively symptom-free interval in three; and protracted in three, requiring intubation for 3 to 21 days. Dangerous anaphylactic reactions to food occur in children and adolescents. The failure to recognize the severity of these reactions and to administer epinephrine promptly increases the risk of a fatal outcome.
Article
Martin JA, Compaired JA, dc la Hoz B, Quirce S, Alonso MD, Igca JM, Losada E. Bronchial asthma induced by chick pea and lentil. Allergic reactions to legumes through inhalation have rarely been described. We report the case of a 20-year-old man who experienced asthmatic attacks when exposed to the steam from cooking either chick pea or lentil. Type I hypersensitivity to the antigens in these legumes was demonstrated by means of immediate skin reactivity, histamine release tests, RAST and RAST inhibition. Specific bronchial challenges with the heated (75° for 30 min) extracts of chick pea and lentil elicited isolated immediate responses.
Article
The purpose of this study was to determine whether patients allergic to one fish species can safely eat other fish species. Eleven atopic, food-allergic children and young adults with histories consistent with IgE-mediated fish hypersensitivity were skin prick tested to 10 fish species. Skin prick tests (SPTs) were positive to all 10 fish in eight of the 11 patients, and the remaining three patients had at least two positive fish SPTs. Positive oral challenges occurred to only one fish in seven of the patients, to two fish species in one patient, and to three fish species in two patients. One patient did not react to any of the fish tested. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis and immunoblot analyses were performed on raw and cooked protein extracts from nine of the 10 fish species used in SPTs. Several protein bands in the raw-fish extracts appeared to denature with cooking and form high molecular weight conglomerates. Immunoblot analyses with sera from documented fish-allergic patients demonstrated specific IgE binding to protein bands from fish to which patients were not clinically allergic, as determined by oral challenge. In ELISA-inhibition assays, the concentration of fish antigen required to achieve 50% inhibition was similar for fish to which the patients were clinically allergic as compared to fish to which they were clinically tolerant. SPT and in vitro evidence of IgE-specific cross-reactivity does not necessarily correlate with symptomatic fish allergy. In addition, these fish-hypersensitive patients were able to consume one or more other fish species without adverse allergic reactions.
Article
We reported 11 cases of patients who developed moderate to severe anaphylactic reactions induced by the ingestion of grand keyhole limpet (GKL) and abalone. Specific IgE-mediated hypersensitivity to these shellfish was demonstrated by history, skin prick test, RAST and immunoblotting. The RAST inhibition technique revealed cross antigenicity between GKL, abalone and keyhole limpet hemocyanin. By immunoblotting analysis, the major antigens of GKL are shown in the MW range of about 38 Kd and 80 Kd.
Article
For 16 years the double-blind, placebo-controlled food challenge (DBPCFC) has been used at the National Jewish Center for Immunology and Respiratory Medicine to determine whether adverse reactions to foods do occur in children. The objective of these studies was to explore these reproducible adverse reactions and to characterize them. Although skin testing was performed on all subjects, a history of an adverse reaction to food and to subsequent DBPCFC were the only criteria for entry into this study. Of 480 children studied, 185 (39%) have had positive DBPCFC results. In these 480 children, 245 (24%) of 1014 DBPCFCs showed positive results. Egg, peanut, and cow milk accounted for 73% of the positive DBPCFC reactions, but many foods produced reactions. Skin test results were positive in most children with a positive DBPCFC reaction, but the large number of patients with asymptomatic hypersensitivity limited the accuracy of a positive skin test result alone as a predictor of clinical symptoms during food ingestion. Evaluation of results in this large number of children for a prolonged period revealed reproducible patterns of symptoms, timing, and incriminated foods. Placebo reactions were rare. The procedure was safe. Twelve youngsters with a negative DBPCFC result subsequently had positive reactions to open challenges when large amounts of the challenge food were used. In each of these cases the reactions were limited to areas of direct contact with the food or could be explained by the larger amount of food ingested during the open challenge. Multiple food hypersensitivity has been a rare finding. The DBPCFC should be the "gold standard" for both research and clinical diagnostic evaluations until it is superseded by methods that have yet to be developed.
Article
The presence of a positive clinical history and skin test (ST) results for 17 fish species (anchovy, bass, carp, dogfish, eel, gilthead, mackerel, mullet, perch, red mullet, salmon, sardine, sole, tench, toothed gilthead, trout, and tuna) were investigated in 20 children with cod-positive clinical history, ST, and RAST, and in 40 children positive to one or more foods different from cod (cow's milk, chicken egg white, peanut, and tomato). In cod-positive children, positive clinical history (60%) and ST (85%) to fish species were more frequent than in cod-negative children (7.5% and 10% respectively). In cod-positive children, a high frequency of positive STs to eel (85%) and to bass, dentex, sole, and tuna (55%) was observed. Positivity to dogfish (10%) was the least frequent. RAST-inhibition experiments suggested the presence of cross-reacting antigen(s) in cod, bass, dentex, eel, sole, and tuna. Results of this study demonstrate that cod allergy might be, on the whole, a reliable index of fish allergy, but cod-positive children may perhaps tolerate some other species, which will have to be tested for possible inclusion in their diet.
Article
Sera of patients suffering from birch pollinosis were studied in the radio-allergo-sorbent test (RAST) for the presence of IgE antibodies to various allergens of vegetable origin. The sera selected were positive in the RAST for both birch pollen and fruits. IgE antibodies directed against at least three different cross-reacting determinants in birch pollen were detected. In addition to periodate-susceptible cross-reacting determinants, which are found on a number of glycoproteins, two non-related periodate-resistant determinants were found in birch pollen, with molecular weights of 20 and 18 kD, respectively. The 20-kD component appears to be responsible for the co-occurrence of the binding of IgE to allergens of fresh fruits, whereas the 18-kD component appears to cause the cross-reactivity among grass pollen, potato and fruits.
Article
Atopic/allergic manifestations and skin-prick tests (SPT) to egg white, cow's milk (CM) and fish were evaluated during the first 18 months of life in two matched groups of infants with a family history of atopy/allergy. In one group (n = 65) the mothers had a diet free from eggs, CM and fish during the first 3 months postpartum, whereas the mothers in the other group (n = 50) consumed an ordinary diet. The diet of the infants was similar in both groups, i.e. CM was not supplied until 6 months of age, and eggs and fish not until 9 months of age. The incidence of atopic dermatitis was significantly lower in the maternal diet group during the first 6 months postpartum (10.8 and 28%, respectively) but not after that age. Other atopic/allergic manifestations did not differ and the number of positive SPT to egg white, CM or fish at 9 months of age was similar in both groups.
Article
Between 1973 and 1985, 114 children, aged 2 to 14 years, underwent double-blind, placebo-controlled, food challenge (DBPCFC) to peanut. Thirty-two of 46 children with symptoms produced by DBPCFC to peanut were included in this longitudinal evaluation. Contact was made with the 32 subjects 2 to 14 years after their positive DBPCFC to peanut. All 32 subjects had exhibited a positive puncture skin test to peanut at the time of the original evaluation. Sixteen subjects had experienced symptoms caused by accidental peanut ingestion in the year before contact. Eight subjects had reacted to accidental ingestion in more than 1 year but less than 5 years before contact. Eight subjects had completely avoided peanut since the original evaluation and positive DBPCFC. No subjects could be demonstrated to have "outgrown" their peanut reactivity. All subjects tested continued to have skin reactivity to a puncture skin test with peanut extract. It appears uncommon for peanut-sensitive patients to lose their clinical reactivity, even after many years have elapsed. In addition, data were collected concerning reactions to other legumes and other (nonlegume) nuts. Only two patients with DBPCFC to peanut reacted on DBPCFC to soy or pea (one each). None of the subjects with a positive DBPCFC to peanut reacted to nonlegume nuts.
Article
There are three primary pharmacologic modalities available for treatment of chronic asthma: beta2 agonists, methylxanthines, and cromolyn sodium, the only marketed effective mast cell stabilizer.
Article
Sixty-nine patients with one or more positive prick skin tests to legumes (peanut, soybean, green bean, pea, and lima bean) were evaluated for food hypersensitivity with in-hospital oral food challenges. Of the 280 prick skin tests to legumes performed, 130 were positive. Forty-three positive food challenges occurred in 41 patients. The prevalence of legume allergy was not statistically different in those patients (N = 36) with two or more positive legume prick skin test (64% positive) compared to those patients (N = 33) with only one positive legume prick skin test (55% positive; p greater than 0.10). Even in this selected patient population, only two patients had symptomatic hypersensitivity to two legumes. Among patients with a positive prick skin test to peanut (N = 60), the mean wheal size was larger in patients with a positive versus a negative oral food challenge to peanut (p less than 0.001). Results of oral food challenges demonstrate that clinically important cross-reactivity to legumes in children is very rare. Clinical hypersensitivity to one legume does not warrant dietary elimination of all legumes. Results of prick skin tests should not be used to determine prolonged food restriction diets.
Article
Food allergy has always been a difficult problem, especially in asthma, where some investigators deny its existence while others tend to overestimate its role. The difficulties stem not only from the concept that ingested allergens may not be able to trigger mast cells present in the airways but also from the diagnosis of food allergy, which is often less than accurate [5].
Article
Ingested chemicals, including aspirin and sulfites, are becoming increasingly recognized as provokers of acute severe asthma. In order to investigate the asthma-provoking potential of the widely used flavor enhancer, monosodium L-glutamate (MSG), we challenged 32 subjects with asthma, a number of whom gave histories of severe asthma after Chinese restaurant meals or similarly spiced meals. The subjects received an additive-free diet for 5 days before challenge and were challenged in hospital, after an overnight fast, with 500 mg capsules of MSG. They were challenged in a single-blind, placebo-controlled fashion with increasing doses of MSG from 0.5 gm to 5.0 gm. Thirteen subjects reacted. Seven subjects (group 1) developed asthma and symptoms of the Chinese restaurant syndrome 1 to 2 hours after ingestion of MSG. Six subjects (group 2) did not develop symptoms of Chinese restaurant syndrome, and their asthma developed 6 to 12 hours after ingestion of MSG. These challenge studies confirm that MSG can provoke asthma. The reaction to MSG is dose dependent and may be delayed up to 12 hours, making recognition difficult for both patient and physician.
Article
Seven subjects, who experienced systemic allergic reactions after the ingestion of a newly marketed food supplement, were evaluated to identify the responsible ingredient. Skin testing with extracts prepared from ingredients in the food supplements revealed marked sensitization of all of the subjects to cottonseed protein. Double-blind, placebo-controlled food challenges performed in two subjects with cottonseed flour produced reactions consisting of oropharyngeal pruritus, rhinitis, nausea, diaphoresis, dyspnea, cough, and a fall in pulmonary function tests of 45% or more. All placebo challenges were negative. Because of the reactions observed during these challenges, other subjects were not challenged orally with cottonseed protein but consumed without incident other ingredients in the supplement to which they were skin test positive. Our evaluation strongly incriminates cottonseed protein as the cause of the systemic allergic reactions in these subjects and is consistent with earlier articles in the literature describing the potent allergenicity of cottonseed protein.
Article
Forty-six patients with atopic dermatitis ranging from mild to severe were evaluated for food hypersensitivity with double-blind placebo-controlled food challenges. Twenty-eight (61%) patients had a positive prick skin reaction to one of the foods tested. Sixty-five food challenges were performed; 27 (42%) were interpreted as positive in 15 (33%) patients. Egg, milk, and peanut accounted for 78% of the positive reactions. As in previous studies, patients developed skin (96%), respiratory (52%), or gastrointestinal (30%) symptoms during the challenge. These studies indicate that children who have atopic dermatitis unresponsive to routine therapy or who continue to need daily treatment after several months would benefit from evaluation for food hypersensitivity.
Selective avoidance diets are the most common means of treatment for food allergies and other types of food sensitivities. With IgE-mediated food allergies, adverse reactions can occur in some patients to very small amounts of the offending food; therefore, strict avoidance of the offending food must be accomplished. With other, non-immunological types of food sensitivities, such as lactose intolerance and sulfite sensitivity, the patients are able to tolerate some, although variable, amounts of the offending substance. Thus, the degree of tolerance is an important concern in the construction of safe and effective avoidance diets. Another issue in the development of selective avoidance diets is the presence of the allergen in specific foods. For example, the peanut allergen is a protein which is not present in peanut oil. Consequently, peanut oil is safe to consume for peanut-allergic patients. Cross-reactivity is yet another concern in the development of selective avoidance diets. Cross reactions can occur between related species of legumes, crustacea, eggs, and milk for example. The construction of a safe and effective avoidance diet for food allergies and sensitivities requires consideration of several important issues and is a responsibility that should not be taken lightly.
Article
Publisher Summary Sulfiting agents have a long history of use as food ingredients. Sulfur dioxide and several forms of inorganic sulfites, which liberate sulfur dioxide under the conditions of use, are food additives, collectively known as sulfiting agents. In addition to their use as food additives, the sulfites can also occur naturally in foods. Foods contain a variety of sulfur-containing compounds, including the sulfur amino acids, sulfates, sulfites, and sulfides. The key to the understanding of sulfite toxicity may lie in elucidation of sulfite metabolism. Several researchers have proposed that defects in sulfite metabolism among certain segments of the human population may put them at greater risk to the possible toxic effects of sulfite ingestion. If the current generally recognized as safe (GRAS) review leads to some limitation on the continued use of sulfites, it will be necessary to consider alternatives. Enzymatic browning will be inhibited by any process that destroys or inactivates the enzyme. Blanching would obviously work but is impractical for using on fresh fruits and vegetables. Despite their long history of use as food additives, much remains to be learned about sulfites, which would be helpful to the present concerns about their safety.