Management of IgE‐mediated food allergy in the 21st century

Cafarotti, Arianna; Giovannini, Mattia; Bégin, Philippe; Brough, Helen A.; Arasi, Stefania

doi:10.1111/cea.14241

Cited by 21 publications

(8 citation statements)

References 132 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Avoiding foods containing HEW is crucial for managing HE allergy; however, overly strict elimination diets may harm nutrition and quality of life. 9 10 Furthermore, some children with HEW allergy can tolerate baked or extensively heated eggs. 16 However, most patients with HEW allergy avoid all HEW-containing dishes and products out of fear of clinical reactions, miseducation, or misunderstanding.…”

Section: Discussionmentioning

confidence: 99%

“…However, there is a lack of pharmacological treatment for food allergy, and the most effective management is an elimination diet and careful planning to avoid accidental ingestion of causative food. 9 Nevertheless, a strict elimination diet can lead to malnutrition and impaired growth, further affecting the quality of life of children with food allergies. 10 …”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Variation in the Allergenicity of Scrambled, Boiled, Short-Baked and Long-Baked Egg White Proteins

Gantulga,

Lee,

Jeong

et al. 2024

J Korean Med Sci

View full text Add to dashboard Cite

Background Hen’s egg white (HEW) is the most common cause of food allergy in children which induces mild to fatal reactions. The consultation for a proper restriction is important in HEW allergy. We aimed to identify the changes in HEW allergenicity using diverse cooking methods commonly used in Korean dishes. Methods Crude extract of raw and 4 types of cooked HEW extracts were produced and used for sodium dodecyl-sulfate polyacrylamide gel electrophoresis (SDS-PAGE), enzyme-linked immunosorbent assay (ELISA), and ELISA inhibition assays using 45 serum samples from HEW allergic and tolerant children. Extracts were prepared; scrambled without oil for 20–30 seconds in frying pan without oil, boiled at 100°C for 15 minutes, short-baked at 180°C for 20 minutes, and long-baked at 45°C for 12 hours with a gradual increase in temperature up to 110°C for additional 12 hours, respectively. Results In SDS-PAGE, the intensity of bands of 50–54 kDa decreased by boiling and baking. All bands almost disappeared in long-baked eggs. The intensity of the ovalbumin (OVA) immunoglobulin E (IgE) bands did not change after scrambling; however, an evident decrease was observed in boiled egg white (EW). In contrast, ovomucoid (OM) IgE bands were darker and wider after scrambling and boiling. The IgE binding reactivity to all EW allergens were weakened in short-baked EW and considerably diminished in long-baked EW. In individual ELISA analysis using OVA + OM + serum samples, the median of specific IgE optical density values was 0.435 in raw EW, 0.476 in scrambled EW, and 0.487 in boiled EW. Conversely, it was significantly decreased in short-baked (0.406) and long-baked EW (0.012). Significant inhibition was observed by four inhibitors such as raw, scrambled, boiled and short-baked HEW, but there was no significant inhibition by long-baked HEW (IC 50 > 100 mg/mL). Conclusion We identified minimally reduced allergenicity in scrambled EW and extensively decreased allergenicity in long-baked EW comparing to boiled and short-baked EW as well as raw EW. By applying the results of this study, we would be able to provide safer dietary guidence with higher quality to egg allergic children.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Variation in the Allergenicity of Scrambled, Boiled, Short-Baked and Long-Baked Egg White Proteins

Gantulga,

Lee,

Jeong

et al. 2024

J Korean Med Sci

View full text Add to dashboard Cite

show abstract

“…The clinical manifestations of food allergies include skin, GI, respiratory and systemic manifestations with varying severity [ 18 , 19 , 20 ]. The diagnostic approach begins with a careful medical history collection to identify the culprit food, and a physical examination [ 21 ]. Oral food challenge (OFC) currently represents the diagnostic gold standard [ 22 ].…”

Section: Introductionmentioning

confidence: 99%

Dietary Intervention during Weaning and Development of Food Allergy: What Is the State of the Art?

Gravina,

Olivero,

Brindisi

et al. 2024

IJMS

View full text Add to dashboard Cite

Food allergy (FA) affects approximately 6–8% of children worldwide causing a significant impact on the quality of life of children and their families. In past years, the possible role of weaning in the development of FA has been studied. According to recent studies, this is still controversial and influenced by several factors, such as the type of food, the age at food introduction and family history. In this narrative review, we aimed to collect the most recent evidence about weaning and its role in FA development, organizing the gathered data based on both the type of study and the food. As shown in most of the studies included in this review, early food introduction did not show a potential protective role against FA development, and we conclude that further evidence is needed from future clinical trials.

show abstract

“…Food allergy is an important public health concern due to significant quality-of-life and economic impact. Food allergy incidence varies between populations, and the discovery that earlier introduction of egg and peanut to the infant diet probably reduces risk of egg and peanut allergy, respectively, has galvanized primary prevention efforts. Clinical practice guidelines now recommend earlier introduction of allergenic foods, and infant feeding practice has changed substantially in some regions.…”

Section: Introductionmentioning

confidence: 99%

Timing of Allergenic Food Introduction and Risk of Immunoglobulin E–Mediated Food Allergy

et al. 2023

View full text Add to dashboard Cite

ImportanceEarlier egg and peanut introduction probably reduces risk of egg and peanut allergy, respectively, but it is uncertain whether food allergy as a whole can be prevented using earlier allergenic food introduction.ObjectiveTo investigate associations between timing of allergenic food introduction to the infant diet and risk of food allergy.Data SourcesIn this systematic review and meta-analysis, Medline, Embase, and CENTRAL databases were searched for articles from database inception to December 29, 2022. Search terms included infant, randomized controlled trial, and terms for common allergenic foods and allergic outcomes.Study SelectionRandomized clinical trials evaluating age at allergenic food introduction (milk, egg, fish, shellfish, tree nuts, wheat, peanuts, and soya) during infancy and immunoglobulin E (IgE)–mediated food allergy from 1 to 5 years of age were included. Screening was conducted independently by multiple authors.Data Extraction and SynthesisThe Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline was used. Data were extracted in duplicate and synthesized using a random-effects model. The Grading of Recommendations, Assessment, Development, and Evaluation framework was used to assess certainty of evidence.Main Outcomes and MeasuresPrimary outcomes were risk of IgE-mediated allergy to any food from 1 to 5 years of age and withdrawal from the intervention. Secondary outcomes included allergy to specific foods.ResultsOf 9283 titles screened, data were extracted from 23 eligible trials (56 articles, 13 794 randomized participants). There was moderate-certainty evidence from 4 trials (3295 participants) that introduction of multiple allergenic foods from 2 to 12 months of age (median age, 3-4 months) was associated with reduced risk of food allergy (risk ratio [RR], 0.49; 95% CI, 0.33-0.74; I2 = 49%). Absolute risk difference for a population with 5% incidence of food allergy was −26 cases (95% CI, −34 to −13 cases) per 1000 population. There was moderate-certainty evidence from 5 trials (4703 participants) that introduction of multiple allergenic foods from 2 to 12 months of age was associated with increased withdrawal from the intervention (RR, 2.29; 95% CI, 1.45-3.63; I2 = 89%). Absolute risk difference for a population with 20% withdrawal from the intervention was 258 cases (95% CI, 90-526 cases) per 1000 population. There was high-certainty evidence from 9 trials (4811 participants) that introduction of egg from 3 to 6 months of age was associated with reduced risk of egg allergy (RR, 0.60; 95% CI, 0.46-0.77; I2 = 0%) and high-certainty evidence from 4 trials (3796 participants) that introduction of peanut from 3 to 10 months of age was associated with reduced risk of peanut allergy (RR, 0.31; 95% CI, 0.19-0.51; I2 = 21%). Evidence for timing of introduction of cow’s milk and risk of cow’s milk allergy was very low certainty.Conclusions and RelevanceIn this systematic review and meta-analysis, earlier introduction of multiple allergenic foods in the first year of life was associated with lower risk of developing food allergy but a high rate of withdrawal from the intervention. Further work is needed to develop allergenic food interventions that are safe and acceptable for infants and their families.

show abstract

Management of IgE‐mediated food allergy in the 21st century

Cited by 21 publications

References 132 publications

Variation in the Allergenicity of Scrambled, Boiled, Short-Baked and Long-Baked Egg White Proteins

Variation in the Allergenicity of Scrambled, Boiled, Short-Baked and Long-Baked Egg White Proteins

Dietary Intervention during Weaning and Development of Food Allergy: What Is the State of the Art?

Timing of Allergenic Food Introduction and Risk of Immunoglobulin E–Mediated Food Allergy

Contact Info

Product

Resources

About