Double-blind food challenge in the diagnosis of food sensitivity in the adult

Bernstein, Manuel; Day, James H.; Welsh, April

doi:10.1016/0091-6749(82)90043-4

Cited by 126 publications

(68 citation statements)

References 10 publications

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“…Crustaceans are highly allergenic food sources (1)(2)(3)(4)(5)(6)(7)(8). Patients with seafood-induced immediate allergic responses can develop a variety of symptoms affecting the skin, respiratory tract, gastrointestinal tract, and cardiovascular system.…”

Section: Discussionmentioning

confidence: 99%

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Proteomics and Immunological Analysis of a Novel Shrimp Allergen, Pen m 2

Yu¹,

Lin²,

Chiang

et al. 2003

The Journal of Immunology

268

186

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Shellfish are a common cause of adverse food reactions in hypersensitive individuals and shrimp is one of the most frequently reported causes of allergic reactions. A novel allergen from Penaeus monodon, designated Pen m 2, was identified by two-dimensional immunoblotting using sera from subjects with shrimp allergy, followed by matrix-assisted laser desorption ionization time-of-flight mass spectrometry analysis of the peptide digest. This novel allergen was then cloned and the amino acid sequence deduced from the cDNA sequence. The cloned cDNA encoded a 356-aa protein with an acetylated N terminus at Ala2, identified by postsource decay analysis. Comparison of the Pen m 2 sequence with known protein sequences revealed extensive similarity with arginine kinase (EC 2.7.3.3) from crustaceans. Pen m 2 was purified by anion exchange chromatography and shown to have arginine kinase activity and to react with serum IgE from shrimp allergic patients and induce immediate type skin reactions in sensitized patients. Using Pen m 2-specific antisera and polyclonal sera from shrimp-sensitive subjects in a competitive ELISA inhibition assay, Pen m 2 was identified as a novel cross-reactive Crustacea allergen. This novel allergen could be useful in allergy diagnosis and in the treatment of Crustacea-derived allergic disorders.

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Section: Discussionmentioning

confidence: 99%

“…t has long been recognized that consumption of seafood can produce allergic symptoms in susceptible individuals, and shellfish are one of the most frequently reported causes of allergic reactions (1)(2)(3)(4). Sensitized individuals can develop urticaria, angioedema, laryngospasm, asthma, and life-threatening anaphylaxis (5-7).…”

mentioning

confidence: 99%

Proteomics and Immunological Analysis of a Novel Shrimp Allergen, Pen m 2

Yu¹,

Lin²,

Chiang

et al. 2003

The Journal of Immunology

268

186

View full text Add to dashboard Cite

show abstract

“…Various reports have described the utility of HRT in the diagnosis of FA [21,22,23,24,25,26,27,28]. Norgaard et al [26] examined the utility of HRT in diagnosing hen’s egg allergy and cow’s milk allergy (CMA) in adults [28].…”

Section: Introductionmentioning

confidence: 99%

Utility of the Peripheral Blood Basophil Histamine Release Test in the Diagnosis of Hen’s Egg, Cow’s Milk, and Wheat Allergy in Children

Sato

Tachimoto²,

Shukuya³

et al. 2011

Int Arch Allergy Immunol

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Background: The diagnosis of food allergy (FA) is made by oral food challenge tests (OFCs) that occasionally produce serious symptoms in patients; therefore, whether to perform OFCs should be carefully considered. The utility of the histamine release test (HRT) in the diagnosis of childhood FA has not been fully examined. Methods: Sixty-four subjects with suspected hen’s egg allergy, cow’s milk allergy (CMA), and wheat allergy (WA) were enrolled. The diagnosis of FA was made based on the outcomes of OFCs or a convincing history of symptoms after food ingestion within 6 months before or after sample collection. HRT was performed using an HRT Shionogi kit. The threshold of histamine release (HRT threshold), which was defined as the minimum concentration of food antigen to induce a 10% net histamine release, was analyzed in association with FA diagnosis. Results: Receiver operating characteristic analysis showed that the HRT threshold was useful in the diagnosis of heated egg allergy (HEA), raw egg allergy (REA), CMA, and WA. We were able to determine the cutoff value for the HRT threshold in relation to outcomes of OFCs. The cutoff value was 6 ng/ml of egg white antigen in HEA and REA (p < 0.01), 40 ng/ml of milk antigen in CMA (p < 0.01), and 500 ng/ml of wheat antigen in WA (p < 0.05). The efficiency was 70.3% for HEA, 78.0% for REA, 77.6% for CMA, and 70.7% for WA. Conclusions: We conclude that the HRT threshold measurement for egg white, milk, and wheat antigen is related to outcomes of OFCs and is useful in determining when OFCs should be performed.

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“…It is much more frequent in children with atopic dermatitis (AD), where it is found in up to one third of cases [2]. Two of the most important allergens in food allergy are hen’s egg (HE) and cow’s milk (CM) [3, 4, 5]. The ‘gold standard’ for the diagnosis of food allergy is double-blind, placebo-controlled food challenges [2, 6, 7].…”

Section: Introductionmentioning

confidence: 99%

Changes in Blood Leukocyte Distribution during Double-Blind, Placebo-Controlled Food Challenges in Children with Atopic Dermatitis and Suspected Food Allergy

Beyer

Renz

Wahn

et al. 1998

Int Arch Allergy Immunol

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Background: The development of clinical reactions to food antigens is associated with cellular changes. The aim of this study was to determine whether the clinical outcome of double-blind, placebo-controlled food challenges would correlate with changes in blood leukocyte distribution. Methods: Double-blind, placebo-controlled food challenges were performed in 17 children with atopic dermatitis sensitized to hen’s egg or cow’s milk and in 9 children with atopic dermatitis but not sensitized to food. Blood leukocyte distribution and lymphocyte subsets were determined prior to and 24 h after challenges. Results: In food-sensitized children the numbers of leukocytes and lymphocytes decreased significantly after allergen challenge independent of the clinical outcome of the provocation (p < 0.002 in both cases). This decrease was seen in T (CD3+) and B (CD19+) cell subsets (p < 0.007 and p < 0.0005, respectively). The CD4/CD8 ratio increased (p < 0.04). The number of memory cells (CD45R0) dropped (p < 0.02 for CD4 and p < 0.004 for CD8) and there was a loss of L-selectin (p < 0.003 for CD4 and CD8). No changes in thrombocytes, neutrophils, eosinophils and basophils were observed. None of these changes were seen in the sensitized patients during placebo challenges or in the non-sensitized group of children. Conclusion: Changes in the leukocyte distribution after allergen challenge seem to be associated with sensitization, but not with the clinical outcome of the oral food challenge. They reflect important changes in the immune system in response to allergens, but are not useful in monitoring double-blind, placebo-controlled food challenges.

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Double-blind food challenge in the diagnosis of food sensitivity in the adult

Cited by 126 publications

References 10 publications

Proteomics and Immunological Analysis of a Novel Shrimp Allergen, Pen m 2

Proteomics and Immunological Analysis of a Novel Shrimp Allergen, Pen m 2

Utility of the Peripheral Blood Basophil Histamine Release Test in the Diagnosis of Hen’s Egg, Cow’s Milk, and Wheat Allergy in Children

Changes in Blood Leukocyte Distribution during Double-Blind, Placebo-Controlled Food Challenges in Children with Atopic Dermatitis and Suspected Food Allergy

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