Food Allergy: Expert Consult Basic

Cover......Page 1
Front Matter......Page 2
ISBN:   9781437719925......Page 4
Copyright......Page 5
Preface......Page 8
List of contributors......Page 10
Acknowledgments......Page 14
Introduction......Page 15
Trafficking of antigen across the epithelium......Page 16
Initial contact with the mucosal immune system......Page 18
Regulatory T cells......Page 19
Developmental stage......Page 22
Nutritional factors......Page 24
Genetics......Page 25
Opportunities for prevention......Page 26
References......Page 27
Introduction......Page 29
Common properties and structural attributes of food allergens......Page 30
Parvalbumins (Fig. 2.2)......Page 31
Minor animal food allergen families......Page 32
Prolamins (Fig. 2.4)......Page 33
Bet v 1 homologs (see Fig. 2.7)......Page 34
Minor plant food allergen families......Page 35
Common properties and predicting allergens......Page 36
Cows’ milk......Page 37
Fish......Page 38
Fresh fruits and vegetables......Page 39
Tree nuts and seeds......Page 41
Legumes, including peanut......Page 42
Allergens in diagnosis and treatment of food allergies......Page 43
Conclusion......Page 44
Wheat:......Page 45
Further reading......Page 46
Introduction......Page 47
How do we define and measure food allergy?......Page 48
What is the current prevalence of food allergy?......Page 50
Estimates of the prevalence of anaphylaxis......Page 52
Is the incidence of food allergy increasing?......Page 54
The ‘old friends’ hypothesis......Page 55
Evidence for change in the timing of introduction of solids and the impact on food allergy prevalence......Page 57
Food allergy and the ‘atopic march’......Page 58
Non-IgE-mediated food allergies......Page 59
References......Page 60
Urticarial/anaphylactic......Page 63
Reproducibility......Page 64
Skin test vs RAST......Page 65
False negatives......Page 66
Emergency treatment......Page 67
One dose or two......Page 68
Food-dependent, exercise-induced anaphylaxis......Page 69
Eosinophilic esophagitis......Page 70
Food protein-induced enterocolitis syndrome......Page 71
References......Page 72
Introduction......Page 75
Pathogenesis......Page 76
Clinical features......Page 78
Clinical evidence supporting the relationship between AD and food allergy......Page 79
Immunologic evidence supporting the relationship between AD and food allergy......Page 80
Environmental and dietary exposures important in the development of AD and food allergy......Page 81
Diagnosis......Page 82
Natural history......Page 84
References......Page 85
Introduction......Page 89
Epidemiology......Page 90
Pathogenesis......Page 91
Diagnosis......Page 92
Treatment......Page 94
References......Page 95
Introduction......Page 97
Oral allergy syndrome: also known as pollen–food syndrome......Page 98
The prolamin superfamily......Page 99
Lipid transfer proteins......Page 100
Pathogenesis-related proteins......Page 102
Thaumatin-like proteins (TLPs)......Page 103
Cross-reactive carbohydrate determinants (CCDs)......Page 104
Prick test......Page 105
In vitro tests......Page 107
Basophil activation test......Page 108
Management......Page 109
References......Page 110
Introduction......Page 113
Prevalence......Page 114
Allergens......Page 116
Differential diagnosis of food-induced respiratory syndromes (Table 8.1)......Page 117
Eczema within the first 2 years of life and risk of developing asthma and allergic rhinitis......Page 118
Acute asthma induced by food allergy......Page 119
Food allergy and predisposition to bronchial hyperreactivity (BHR)......Page 120
Patients with recurrent or chronic asthma: routine testing for food allergy......Page 121
Testing for food allergy......Page 122
Summary and conclusions......Page 123
References......Page 124
Definition of anaphylaxis......Page 127
Reports on children......Page 129
Reports on fatal cases of anaphylaxis......Page 130
Pathogenesis......Page 132
Food-dependent exercise-induced anaphylaxis......Page 134
Associated condition worsening food-induced anaphylaxis or food-dependent exercise-induced anaphylaxis......Page 135
Food-dependent exercise-induced anaphylaxis......Page 136
Epinephrine (adrenaline)......Page 137
Inhaled β2-agonist......Page 138
Acknowledgement......Page 139
References......Page 141
Eosinophilic gastrointestinal diseases (EGIDs)......Page 143
Clinical features/diagnosis......Page 144
Radiology......Page 146
Histology......Page 147
Allergic manifestations......Page 148
Corticosteroids......Page 150
Eosinophilic gastroenteritis......Page 151
References......Page 152
Pathogenesis......Page 157
Clinical features......Page 159
Diagnosis......Page 161
Oral food challenge......Page 162
Food protein-induced proctocolitis......Page 163
Clinical features......Page 164
Management......Page 165
Pathogenesis......Page 166
Diagnosis......Page 167
Epidemiology......Page 168
Colic–food hypersensitivity association......Page 169
Management......Page 172
References......Page 174
First consultation......Page 179
What immune mechanism is causing the problem in this child?......Page 181
Suspected allergic reactions under 6 months of age......Page 182
Suspected allergic reactions to foods 6–18 months......Page 183
New food allergies after infancy......Page 184
Diagnosis of new allergies in adolescents......Page 185
References......Page 186
Skin testing......Page 189
In vitro testing......Page 193
References......Page 197
Indications for an oral food challenge......Page 199
Oral food challenges: design and methodology......Page 201
Open vs blinded challenges......Page 202
Form of challenge food......Page 204
Choice of food vehicle......Page 205
Challenge foods for DBPCFC......Page 206
Doses......Page 207
Number of doses and interval between doses......Page 208
Logistics......Page 209
Scoring of immediate-onset IgE-mediated allergic reactions......Page 210
After the challenge......Page 211
Oral food challenges for the assessment of non-IgE-mediated (delayed-onset) food hypersensitivity......Page 212
Atopic eczema......Page 213
Food–exercise challenges......Page 214
Assessment on arrival for challenge......Page 215
Following a negative challenge......Page 216
References......Page 217
Introduction......Page 219
Epinephrine administration......Page 220
Inhaled β2-agonists......Page 221
Identifying the causal factor......Page 222
Management of specific conditions (Table 15.3)......Page 224
Which device should be prescribed?......Page 225
Patient and family education......Page 226
Involving the community in management (Fig. 15.3)......Page 227
Future perspectives......Page 230
References......Page 231
Label reading......Page 233
Cross-contamination......Page 235
Avoiding contact......Page 236
Symptom recognition and treatment......Page 239
Plans and paperwork......Page 241
Empowerment......Page 243
References......Page 247
Identifying subjects for novel food allergy therapies......Page 249
Humanized monoclonal anti-IgE......Page 250
Traditional Chinese medicine (TCM)......Page 253
Diet containing extensively heated cows’ milk and egg......Page 254
Birch pollen immunotherapy for the pollen–food allergy syndrome......Page 256
Oral immunotherapy trials......Page 257
Peanut oral immunotherapy......Page 258
Sublingual immunotherapy......Page 259
Epicutaneous immunotherapy (EPIT)......Page 260
Other approaches......Page 261
References......Page 262
Introduction and pathogenesis......Page 265
Hen’s egg (Table 18.1)......Page 266
Cows’ milk (Table 18.1)......Page 267
Peanut (Table 18.2)......Page 268
Fish and crustacean shellfish......Page 269
Pathogenesis......Page 270
Breastfeeding......Page 272
Complementary foods......Page 273
Recommendations......Page 274
References......Page 275
Cows’ milk......Page 279
Soy products......Page 280
Practical acceptance of specialized formula......Page 282
Peanuts......Page 283
Soy......Page 284
Other legumes......Page 285
Seeds......Page 286
Avoiding wheat......Page 287
Egg......Page 288
Fruits and vegetables......Page 291
Food labeling laws......Page 292
Precautionary labeling......Page 293
Ensuring adequate calcium......Page 294
Elimination/exclusion diets for diagnosis of food allergy and intolerance......Page 295
References......Page 296
Classification of reactions to foods......Page 299
Food additives......Page 301
Additives and asthma......Page 302
Additives and behavior......Page 303
Additive challenge and behavior......Page 304
Putative mechanisms of food additive effects on behavior......Page 306
Summary......Page 307
References......Page 308
A......Page 311
C......Page 312
E......Page 314
F......Page 315
G......Page 316
I......Page 317
M......Page 318
O......Page 319
P......Page 320
S......Page 321
V......Page 322
Y......Page 323