Food allergy and hypersensitivity reactions in children and adults—A review

Abstract

Adverse reactions after food intake are commonly reported and a cause of concern and anxiety that can lead to a very strict diet. The severity of the reaction can vary depending on the type of food and mechanism, and it is not always easy to disentangle different hypersensitivity diagnoses, which sometimes can exist simultaneously. After a carefully taken medical history, hypersensitivity to food can often be ruled out or suspected. The most common type of allergic reaction is immunoglobulin E (IgE)–mediated food allergy (prevalence 5–10%). Symptoms vary from mild itching, stomach pain, and rash to severe anaphylaxis. The definition of IgE‐mediated food allergy is allergic symptoms combined with specific IgE‐antibodies, and therefore only IgE‐antibodies to suspected allergens should be analyzed. Nowadays, methods of molecular allergology can help with the diagnostic process. The most common allergens are milk and egg in infants, peanut and tree nuts in children, and fish and shellfish in adults. In young children, milk/egg allergy has a good chance to remit, making it important to follow up and reintroduce the food when possible. Other diseases triggered by food are non‐IgE‐mediated food allergy, for example, eosinophilic esophagitis, celiac disease, food protein‐induced enterocolitis syndrome, and hypersensitivity to milk and biogenic amines. Some of the food hypersensitivities dominate in childhood, others are more common in adults. Interesting studies are ongoing regarding the possibilities of treating food hypersensitivity, such as through oral immunotherapy. The purpose of this review was to provide an overview of the most common types of food hypersensitivity reactions.

New Mechanistic Advances in FcεRI-Mast Cell–Mediated Allergic Signaling

“…In recent studies, various chemical modifications were used to reduce allergenicity and generate "hypoallergens" [20,21]. Currently, allergen-specific immunotherapy is the most effective approach for allergic diseases [22,23]; this approach requires an eligible allergoid with weakened allergenicity, but retained immunogenicity, which can prompt signaling internalization but provoke no degranulation. In this regard, artificial modifications of allergen is actively pursued for allergoid preparation [24].…”

Adult anaphylaxis: A state-of-the-art review

“…In the last decades, an epidemiologic increase of anaphylaxis, mainly in terms of hospitalization, has been observed [2]. This is particularly the case of food allergy [3] [4]. The overall incidence of anaphylaxis varies between 50 and 112 episodes per 100.000 person-years while its prevalence is 0.3-5.1% according to various epidemiological and classification factors [5].…”

Fish Allergenicity Modulation Using Tailored Enriched Diets—Where Are We?

“…The clinical management of fish-allergic patients refers mainly to a strict avoidance of all kinds of fish ( Figure 1 ). When accidental consumption occurs, allergic symptoms are treated with rescue medication, including antihistamines, β -2 sympathomimetic, inhaled corticosteroids and in severe cases, adrenaline ( Tedner et al, 2022 ). Often, fish-allergic patients demand to consume this food because of its nutritional benefits on health, such as via minerals, vitamins, and polyunsaturated fatty acids ( Kalic et al, 2021 ).…”