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Bronchial challenges with aerosolized food in asthmatic, food-allergic children.

Abstract

BACKGROUND

Allergic asthma is usually considered to be provoked by aeroallergens. However, we have recently recognized a group of children with food allergies who also develop asthma when exposed to the aerosolized form of the food.

METHODS

Between 1997 and 1999 we prospectively identified children with an immunoglobulin (Ig)E-mediated food allergy who develop asthma on inhalational exposure to the relevant food allergen while it is being cooked. Subjects were exposed for 20 min to the aerosolized form of the allergen and the symptoms and the lung function were monitored. Aerosolization was achieved by cooking the food in a small room. Where possible challenges were double-blinded.

RESULTS

We identified 12 children with an IgE-mediated food allergy who developed asthma on inhalational exposure to food. The implicated foods were fish, chickpea, milk, egg or buckwheat. Nine out of the 12 children consented to undergo a bronchial food challenge. Five challenges were positive with objective clinical features of asthma. Additionally, two children developed late-phase symptoms with a decrease in lung function. Positive reactions were seen with fish, chickpea and buckwheat. There were no reactions to the seven placebo challenges.

CONCLUSIONS

We have presented a prospective series of children with food allergy who developed symptoms of asthma with exposure to aerosolized food allergens. Our data demonstrates that, as in the case of other aeroallergens, inhaled food allergens can produce both early- and late-phase asthmatic responses. This highlights the importance of considering foods as aeroallergens in children with coexistent food allergy and allergic asthma. For these children, dietary avoidance alone may not be sufficient and further environmental measures may be required to limit exposure to aerosolized food.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Paediatric Allergy, Asthma, and Immunology, Imperial College School of Medicine at St Mary's, London, UK.

    ,

    Source

    Allergy 57:8 2002 Aug pg 713-7

    MeSH

    Aerosols
    Asthma
    Bronchial Provocation Tests
    Child
    Child, Preschool
    Double-Blind Method
    Food
    Food Hypersensitivity
    Humans
    Hypersensitivity, Delayed
    Immunoglobulin E
    Lung
    Prospective Studies

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    12121190

    Citation

    Roberts, G, et al. "Bronchial Challenges With Aerosolized Food in Asthmatic, Food-allergic Children." Allergy, vol. 57, no. 8, 2002, pp. 713-7.
    Roberts G, Golder N, Lack G. Bronchial challenges with aerosolized food in asthmatic, food-allergic children. Allergy. 2002;57(8):713-7.
    Roberts, G., Golder, N., & Lack, G. (2002). Bronchial challenges with aerosolized food in asthmatic, food-allergic children. Allergy, 57(8), pp. 713-7.
    Roberts G, Golder N, Lack G. Bronchial Challenges With Aerosolized Food in Asthmatic, Food-allergic Children. Allergy. 2002;57(8):713-7. PubMed PMID: 12121190.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Bronchial challenges with aerosolized food in asthmatic, food-allergic children. AU - Roberts,G, AU - Golder,N, AU - Lack,G, PY - 2002/7/18/pubmed PY - 2002/9/13/medline PY - 2002/7/18/entrez SP - 713 EP - 7 JF - Allergy JO - Allergy VL - 57 IS - 8 N2 - BACKGROUND: Allergic asthma is usually considered to be provoked by aeroallergens. However, we have recently recognized a group of children with food allergies who also develop asthma when exposed to the aerosolized form of the food. METHODS: Between 1997 and 1999 we prospectively identified children with an immunoglobulin (Ig)E-mediated food allergy who develop asthma on inhalational exposure to the relevant food allergen while it is being cooked. Subjects were exposed for 20 min to the aerosolized form of the allergen and the symptoms and the lung function were monitored. Aerosolization was achieved by cooking the food in a small room. Where possible challenges were double-blinded. RESULTS: We identified 12 children with an IgE-mediated food allergy who developed asthma on inhalational exposure to food. The implicated foods were fish, chickpea, milk, egg or buckwheat. Nine out of the 12 children consented to undergo a bronchial food challenge. Five challenges were positive with objective clinical features of asthma. Additionally, two children developed late-phase symptoms with a decrease in lung function. Positive reactions were seen with fish, chickpea and buckwheat. There were no reactions to the seven placebo challenges. CONCLUSIONS: We have presented a prospective series of children with food allergy who developed symptoms of asthma with exposure to aerosolized food allergens. Our data demonstrates that, as in the case of other aeroallergens, inhaled food allergens can produce both early- and late-phase asthmatic responses. This highlights the importance of considering foods as aeroallergens in children with coexistent food allergy and allergic asthma. For these children, dietary avoidance alone may not be sufficient and further environmental measures may be required to limit exposure to aerosolized food. SN - 0105-4538 UR - https://www.unboundmedicine.com/medline/citation/12121190/Bronchial_challenges_with_aerosolized_food_in_asthmatic_food_allergic_children_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0105-4538&date=2002&volume=57&issue=8&spage=713 DB - PRIME DP - Unbound Medicine ER -