Tags

Type your tag names separated by a space and hit enter

Food allergy: recent advances in pathophysiology and diagnosis.

Abstract

Approximately 5% of young children and 3-4% of adults exhibit adverse immune responses to foods in westernized countries, with a tendency to increase. The pathophysiology of food allergy (FA) relies on immune reactions triggered by epitopes, i.e. small amino-acid sequences able to bind to antibodies or cells. Some food allergens share specific physicochemical characteristics that allow them to resist digestion, thus enhancing allergenicity. These allergens encounter specialized dendritic cell populations in the gut, which leads to T-cell priming. In case of IgE-mediated allergy, this process triggers the production of allergen-specific IgE by B cells. Tissue-resident reactive cells, including mast cells, then bind IgE, and allergic reactions are elicited when these cells, with adjacent IgE molecules bound to their surface, are re-exposed to allergen. Allergic reactions occurring in the absence of detectable IgE are labeled non-IgE mediated. The abrogation of oral tolerance which leads to FA is likely favored by genetic disposition and environmental factors (e.g. increased hygiene or enhanced allergenicity of some foods). For an accurate diagnosis, complete medical history, laboratory tests and, in most cases, an oral food challenge are needed. Noticeably, the detection of food-specific IgE (sensitization) does not necessarily indicate clinical allergy. Novel diagnostic methods currently under study focus on the immune responses to specific food proteins or epitopes of specific proteins. Food-induced allergic reactions represent a large array of symptoms involving the skin and gastrointestinal and respiratory systems. They can be attributed to IgE-mediated and non-IgE-mediated (cellular) mechanisms and thus differ in their nature, severity and outcome. Outcome also differs according to allergens.

Links

  • FREE Publisher Full Text
  • Authors+Show Affiliations

    Gastroentérologie pédiatrique ambulatoire, Allergie alimentaire et Explorations fonctionnelles digestives, Hôpital Necker-Enfants Malades, 149 rue de Sèvres, Paris, France. christophe.dupont@nck.aphp.fr

    Source

    Annals of nutrition & metabolism 59 Suppl 1: 2011 pg 8-18

    MeSH

    Adult
    Animals
    Antibody Specificity
    Child
    Decision Trees
    Diagnosis, Differential
    Dietary Proteins
    Endoscopy, Gastrointestinal
    Food
    Food Hypersensitivity
    Health Knowledge, Attitudes, Practice
    Humans
    Immunoglobulin E
    Infant
    Parents
    Prognosis
    Skin Tests

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    22189252

    Citation

    Dupont, Christophe. "Food Allergy: Recent Advances in Pathophysiology and Diagnosis." Annals of Nutrition & Metabolism, vol. 59 Suppl 1, 2011, pp. 8-18.
    Dupont C. Food allergy: recent advances in pathophysiology and diagnosis. Ann Nutr Metab. 2011;59 Suppl 1:8-18.
    Dupont, C. (2011). Food allergy: recent advances in pathophysiology and diagnosis. Annals of Nutrition & Metabolism, 59 Suppl 1, pp. 8-18. doi:10.1159/000334145.
    Dupont C. Food Allergy: Recent Advances in Pathophysiology and Diagnosis. Ann Nutr Metab. 2011;59 Suppl 1:8-18. PubMed PMID: 22189252.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Food allergy: recent advances in pathophysiology and diagnosis. A1 - Dupont,Christophe, Y1 - 2011/12/21/ PY - 2011/12/23/entrez PY - 2012/1/4/pubmed PY - 2012/4/17/medline SP - 8 EP - 18 JF - Annals of nutrition & metabolism JO - Ann. Nutr. Metab. VL - 59 Suppl 1 N2 - Approximately 5% of young children and 3-4% of adults exhibit adverse immune responses to foods in westernized countries, with a tendency to increase. The pathophysiology of food allergy (FA) relies on immune reactions triggered by epitopes, i.e. small amino-acid sequences able to bind to antibodies or cells. Some food allergens share specific physicochemical characteristics that allow them to resist digestion, thus enhancing allergenicity. These allergens encounter specialized dendritic cell populations in the gut, which leads to T-cell priming. In case of IgE-mediated allergy, this process triggers the production of allergen-specific IgE by B cells. Tissue-resident reactive cells, including mast cells, then bind IgE, and allergic reactions are elicited when these cells, with adjacent IgE molecules bound to their surface, are re-exposed to allergen. Allergic reactions occurring in the absence of detectable IgE are labeled non-IgE mediated. The abrogation of oral tolerance which leads to FA is likely favored by genetic disposition and environmental factors (e.g. increased hygiene or enhanced allergenicity of some foods). For an accurate diagnosis, complete medical history, laboratory tests and, in most cases, an oral food challenge are needed. Noticeably, the detection of food-specific IgE (sensitization) does not necessarily indicate clinical allergy. Novel diagnostic methods currently under study focus on the immune responses to specific food proteins or epitopes of specific proteins. Food-induced allergic reactions represent a large array of symptoms involving the skin and gastrointestinal and respiratory systems. They can be attributed to IgE-mediated and non-IgE-mediated (cellular) mechanisms and thus differ in their nature, severity and outcome. Outcome also differs according to allergens. SN - 1421-9697 UR - https://www.unboundmedicine.com/medline/citation/22189252/Food_allergy:_recent_advances_in_pathophysiology_and_diagnosis_ L2 - https://www.karger.com?DOI=10.1159/000334145 DB - PRIME DP - Unbound Medicine ER -