Artificial Food Additive Intolerance in Patients With Angio-Oedema and Urticaria

Supramaniam, G; Warner, John O.

doi:10.1016/s0140-6736(86)90423-x

Cited by 121 publications

(80 citation statements)

References 10 publications

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“…One week later, the patients started a food-additive-free diet (FAFD) [3, 13,18,19,20,21,22]. Table 2 presents the foods excluded from the 4-week diet [19, 20, 35].…”

Section: Methodsmentioning

confidence: 99%

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Food-Additive-Induced Urticaria: A Survey of 838 Patients with Recurrent Chronic Idiopathic Urticaria

Lorenzo

Pacor

Mansueto

et al. 2005

Int Arch Allergy Immunol

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Background: Recurrent chronic idiopathic urticaria (RCIU) is a common skin condition that affects 0.1–3% of the population in the USA and Europe and accounts for nearly 75% of all ‘ordinary’ chronic urticaria (CU) cases. Methods: We studied 838 consecutive patients with RCIU referred to hospital between 1998 and 2003. Patients with known causes of CU were excluded. Clinical history, physical examination, and symptom diaries were evaluated during two periods, a diet-free period (1 week) and a food-additive-free diet (FAFD) period (4 weeks), respectively, and two double-blind placebo-controlled (DBPC) challenges of six food additives were administered. The first DBPC challenge included a mixture of the six food additives (DBPC_mixed) given to all patients. The second DBPC challenge comprised the single food additives, administered at increasing doses (DBPC_single) to patients with a positive DBPC_mixed test and 105 patients with a negative DBPC_mixed test, as a control. Results: The DBPC_mixed challenge was positive in 116 patients. None of the 105 control patients had a positive DBPC_single test. Only 31 DBPC_single tests were positive in patients with positive DBPC_mixed challenge. Twenty-four of the 116 patients showing a positive DBPC_mixed challenge also had a positive DBPC_single result. Conclusions: Our results confirmed that food additive hypersensitivity reactions occurred in few RCIU patients using DBPC_single challenge. The combination of the results of FAFD and DBPC_mixed challenge seems to be of considerable practical interest for allergists, internists and dermatologists, rather than the data of clinical history and the results of DBPC_single challenge, in patients with RCIU.

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“…One week later, the patients started a food-additive-free diet (FAFD) [3, 13,18,19,20,21,22]. Table 2 presents the foods excluded from the 4-week diet [19, 20, 35].…”

Section: Methodsmentioning

confidence: 99%

“…Acute urticaria is much more likely to be caused by food allergy than CU. However, there is a subgroup of patients with RCIU with food-additive-evoked urticaria [7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22]. …”

Section: Introductionmentioning

confidence: 99%

Food-Additive-Induced Urticaria: A Survey of 838 Patients with Recurrent Chronic Idiopathic Urticaria

Lorenzo

Pacor

Mansueto

et al. 2005

Int Arch Allergy Immunol

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“…Reports are often characterised by poorly controlled challenge procedures. Recent studies performed under properly controlled conditions imply that sensitivity to food additives in patients with chronic urticaria/angioedema or asthma is uncommon (Supramaniam and Warner, 1986;Simon, 2003) Novembre et al (1992) reported two cases of unusual reactions to food additives (Tartrazine and benzoates) involving mainly the central nervous system (headache, migraine, overactivity, concentration and learning difficulties, depression) and joints (arthralgias), confirmed with diet and double-blind challenge.…”

Section: Hypersensitivity and Intolerancementioning

confidence: 99%

Scientific Opinion on the re-evaluation Tartrazine (E 102)

Aguilar¹,

Charrondière²,

Dusemund³

et al. 2009

EFSA Journal

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The Panel on Food Additives and Nutrient Sources added to Food provides a scientific opinion re-evaluating the safety of Tartrazine (E 102). Tartrazine has been previously evaluated by the Joint FAO/WHO Expert Committee on Food Additives (JECFA) in 1966 and the EU Scientific Committee for Food (SCF) in 1975 and. Both committees established an Acceptable Daily Intake (ADI) of 0-7.5 mg/kg bw/day. The Panel was not provided with a newly submitted dossier and based its evaluation on previous evaluations, additional literature that became available since then and the data available following a public call for data. New studies included a study by Sasaki et al. from 2002 reporting effects on nuclear DNA migration in the mouse in vivo Comet assay, a study by McCann et al. from 2007 that concluded that exposure to a mixture including Tartrazine resulted in increased hyperactivity in 3-year old and 8-to 9-year old children and studies on neurodevelopment by Tanaka. The Panel notes that Tartrazine was negative in long-term carcinogenicity studies and that the effects on nuclear DNA migration observed in the mouse in vivo Comet assay are not expected to result in carcinogenicity. The Panel also concurrs with the conclusion from a previous EFSA opinion on the McCann et al. study that the findings of the study cannot be used as a basis for altering the ADI, and additionally considered that the Tanaka study can also not be used as a basis for altering the ADI. The Panel concludes that the present database does not give reason to revise the ADI of 7.5 mg/kg bw/day. The Panel also concludes that at the maximum reported levels of use, refined intake estimates are below the ADI. The Panel concludes that Tartrazine appears to be able to elicit intolerance reactions in a small fraction of the exposed population.The Panel also notes that sensitive individuals may react to Tartrazine at dose levels within the ADI. Tartrazine, FD&C Yellow No. 5, E 102, CAS 1934-21-0, 3-carboxy-5-hydroxy-1-(4'-sulphophenyl Tartrazine consists essentially of 3-carboxy-5-hydroxy-1-(4'-sulphophenyl)-4-(4'-sulphophenylazo) pyrazole trisodium salt and subsidiary colouring matters together with sodium chloride and/or sodium sulphate as the principal uncoloured components. Tartrazine is described as the sodium salt. The calcium and the potassium salts are also permitted (Directive 2008/128/EC). KEY WORDSThe purity is specified as not less than 85 % total colouring matters, calculated as the sodium salt. The remaining 15 % may be accounted for by sodium chloride or sodium sulphate (but this is never mentioned explicitly), water insoluble matter not more than 0.2 %, subsidiary colouring matters not more than 1.0 % and organic compounds other than colouring matters with a total not more than 0.5 % (4-hydrazinobenzene sulphonic acid, 4-aminobenzene-1-sulphonic acid, 5-oxo-1-(4-sulphophenyl)-2-pyrazoline-3-carboxylic acid, 4,4′-diazoaminodi(benzene sulphonic acid), tetrahydroxysuccinic acid).The absorption, distribution, metabolism and excretion of Tar...

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Section: Hypersensitivitymentioning

confidence: 99%

Scientific Opinion on the re-evaluation of Azorubine/Carmoisine (E 122) as a food additive

Aguilar¹,

Charrondière²,

Dusemund³

et al. 2009

EFSA Journal

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The Panel on Food Additives and Nutrient Sources added to Food provides a scientific opinion re-evaluating the safety of Azorubine/Carmoisine (E 122). Azorubine/Carmoisine has previously been evaluated by JECFA in 1983 and the SCF in 1984. Both committees established an Acceptable Daily Intake (ADI) of 0-4 mg/kg bw/day. The Panel was not provided with a newly submitted dossier and based its evaluation on previous evaluations, additional literature that became available since then and the data available following a public call for data. New studies included a study reporting alterations in the morphology of somatic chromosomes in Secale cereale (rye), and a study by McCann et al. that concluded that exposure to mixtures including Azorubine/Carmoisine, resulted in increased hyperactivity in 3-years old and 8-to 9-years old children. The Panel notes that the study in rye was not a standard genotoxicity assay, and concluded, given that all other genotoxicity tests were negative and that Azorubine/Carmoisine does not contain a structural alert, that there is no concern with respect to genotoxicity. The Panel also concurs with the conclusion from a previous EFSA opinion on the McCann et al. study that the findings of the study cannot be used as a basis for altering the ADI. The Panel concludes that the present database does not give reason to revise the ADI of 4 mg/kg bw/day. The Panel also concludes that at the maximum reported levels of use, refined intake estimates are below the ADI, although in 1-to 10-year old children the high percentile of exposure (95 th ) can be slightly higher than the ADI at the upper end of the range. KEY WORDSAzorubine, Carmoisine, E 122, CAS 3567-69-9, CI Acid Red 14, CI Food Red 3, food colouring substance, EINECS number 222-657-4. The Panel noted that the specifications on the purity of Azorubine/Carmoisine permit concentrations of unidentified unsulphonated aromatic amines to be present in concentrations of up to 100 mg/kg Azorubine/Carmoisine. Although some aromatic amines may be associated with genotoxicity or even carcinogenicity, the Panel notes that Azorubine/Carmoisine was negative in in vitro genotoxicity studies and an in vivo genotoxicity study as well as in long-term carcinogenicity studies.The Panel concurs with the view expressed in previous evaluations by JECFA and TemaNord that the absorption of Azorubine/Carmoisine is limited, but that after reduction in the gastrointestinal tract, free sulphonated aromatic amines may reach the systemic circulation.The SCF and also the JECFA and TemaNord evaluations concluded, based on in vivo and in vitro studies available at that time, that Azorubine/Carmoisine does not show any genotoxic activity.In a more recent study, Zaharia and Pavel have tested four colourings, Tartrazine (E 102), Azorubine/Carmoisine (E 122), Patent Blue (E 131) and Acid Green 50 (E 142), on the frequency of divisional cells, mitotic index, mutagenic process, and the potential of these synthetic colourings to induce chromosomal modifications. Using cyt...

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Artificial Food Additive Intolerance in Patients With Angio-Oedema and Urticaria

Cited by 121 publications

References 10 publications

Food-Additive-Induced Urticaria: A Survey of 838 Patients with Recurrent Chronic Idiopathic Urticaria

Food-Additive-Induced Urticaria: A Survey of 838 Patients with Recurrent Chronic Idiopathic Urticaria

Scientific Opinion on the re-evaluation Tartrazine (E 102)

Scientific Opinion on the re-evaluation of Azorubine/Carmoisine (E 122) as a food additive

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