Food Allergy

Methods of Detection and Clinical Studies

Anas M. Abdel Rahman

• Publisher: CRC Press
• Year: 2017
• Print ISBN:
  9781498743570
• eBook ISBN:
  9781351647823
• Topic: Medicine
• Subtopic: Biotechnology in Medicine

This book explores the recent advances and integrations in molecular technology in food research platforms, which have revolutionized the way we discover and trace potential allergens in our food and drugs and how we utilize that for diagnosis and management. These different technologies for global allergenomic profiling in different kinds of food are discussed, including mass spectrometry, chromatography, and nuclear magnetic resonance. The book also addresses multiomics research with bioinformatics strategies in food allergy in terms of allergen characterization and quantitation, and covers applications in food allergy research from discovery to routine analysis.

Contents

Preface

1. Food Allergy Nomenclature

Sten Dreborg

2. Food Allergy in Children

Sophia Tsabouri, Gavriela Feketea and Nicolaos Nicolaou

3. Peanut Allergy: Clinical Relevance and Allergen Characterisation

Joana Costa, Caterina Villa, Telmo J.R. Fernandes, M. Beatriz P.P. Oliveira and Isabel Mafra

4. The Pollen-Food Syndrome: An Update on Diagnostic and Therapeutic Approaches

Sara Huber, Claudia Asam, Anargyros Roulias, Fatima Ferreira and Lorenz Aglas

5. Advances in Seafood Allergy Research: Allergen Detection and Allergen-Specific Immunotherapy

Nicki Y.H. Leung, Christine Y.Y. Wai, Ka Hou Chu and Patrick S.C. Leung

6. Skin Prick/Puncture Testing in Food Allergy

Sten Dreborg

7. Immunotherapy for Food Allergy

Bright I. Nwaru and Aziz Sheikh

8. Allergenomics-A Strategy for Food Allergen Discovery

Anas M. Abdel Rahman

9. Proteomics in Food Allergy

Pasquale Ferranti, Anas M. Abdel Rhaman, Maria Adalgisa Nicolai and Monica Gallo

10. Allergen Quantitation for Food Labeling

Martina Koeberl, Dean Clarke and Andreas L. Lopata

11. Shellfish Allergy Taking the Allergenomics Approach towards Improved Allergen Detection and Diagnostics

Sandip D. Kamath and Andreas L. Lopata

12. Bioinformatics Approaches toIdentifying the Cross-Reactive Allergenic Risk of NovelFood Proteins

Ping Song, Rod A. Herman and Siva Kumpatla

13. The Pollen-Food Syndrome A Molecular Perspective

Claudia Asam, Lorenz Aglas, Sara Huber, Fatima Ferreira and Anargyros Roulias

14. Biotechnology Methods for Assessing Potential Allergenicity of Novel Proteins According to Global Regulations

Christal C. Bowman and Scott McClain

15. Advances in Biosensor Technologies for Food Allergen Monitoring and Diagnosis

Shimaa Eissa, Raja Chinnappan and Mohammed Zourob

Index

Preface

Bridging the gap between the clinicians and basic science researchers in food allergy was the idea of writing this book. A few dozen of authors from around the world were invited to share their bedside and bench top research experience in the field of food allergy. We tried to cover all the clinical updates in the first seven chapters starting from nomenclature to immunotherapy. The other half of the book includes state of the art technology role in enhancing the molecular knowledge in food allergy research and the updated experience of the authors’ laboratories. The authors of these chapters introduced their expertise in the novel technologies such as mass spectrometry and biosensors, bioinformatics and databases, and the food labeling regulations. This book will be a useful reading material for the young and expert scientists in food allergy with the theme of introductory to the basic knowledge and literature updates, respectively.

CHAPTER 1

Food Allergy Nomenclature

Sten Dreborg

Introduction

Nomenclature is the basis for appropriate communication between scientists and clinicians. Studies should be performed using defined methods, grouping populations of patients with given characteristics, using words which describe patients clearly enough to be understood by others. Results can be applied to similar patients using the same methodology and patient characteristics using established nomenclature. This makes nomenclature crucial to both investigators as well as to clinicians to convey the message from research to the clinic. Allergists as well as other scientists interested in allergy, and not least lay persons and lay organizations must have a common language when communicating.

The nomenclature of allergy and allergic diseases has varied from time to time. However, within some areas confusing terms have been used such as “non-atopic atopic dermatitis”, i.e., a dermatitis, clinically resembling that of so called “atopic dermatitis” (with allergen specific IgE antibodies also called eczema (Johansson et al., 2004)), but without allergen specific IgE antibodies. That was, and still is, confusing. Accordingly, Gunnar O. Johansson formed a task force within the European Academy of Allergy and Clinical Immunology, EAACI, to write a position paper expressing the meaning of the Academy of allergy nomenclature (Johansson et al., 2001). To make the message general he later formed a group within the World Allergy Organization, WAO to discuss the EAACI position paper (Johansson et al., 2001), adding views from other continents and to agree on a common nomenclature for the worldwide allergy community (Johansson et al., 2004). One of the main achievements was to start using “eczema” instead of “atopic dermatitis”. However, as often happens, conservatives maintained atopic dermatitis as a parallel option to eczema, why “non-atopic atopic dermatitis” could not be eradicated. Since then, many people have tried to implement the new nomenclature. However, allergy and thereby allergy nomenclature, concerns not only allergists, but even specialists within adult and pediatric gastroenterology, dermatology, Ear, Nose and Throat (ENT), and respiratory medicine, who therefore have an interest in allergy nomenclature. All these related specialists and even lay persons and lay organizations must be involved to implement the allergy nomenclature to achieve global mutual understanding.

Recently, a Nomenclature Review Committee was set up by the WAO Board of Directors (Rosenwasser et al., in prep.) for the purpose of updating the present nomenclature (Johansson et al., 2004).

This chapter presents the existent nomenclature (Johansson et al., 2004) discussing possible changes of the Food Allergy Nomenclature (Johansson et al., 2001; Johansson et al., 2004).

General considerations

Hypersensitivity is the global term describing not tolerating an environmental factor tolerated by the majority. Hypersensitivity can be mediated either by an immunological mechanism, i.e., allergy, or by non-immunological mechanisms. It does not include infection, autoimmunity or toxic reactions (Johansson et al., 2004).

The WAO nomenclature 2004

The WAO nomenclature describes hypersensitivity as “objectively reproducible symptoms or signs initiated by exposure to a defined stimulus at a dose tolerated by normal persons”.

Hypersensitivity is either mediated by an immunological mechanism or not, dividing hypersensitivity into immunologically mediated hypersensitivity or allergy and non-immunologically mediated hypersensitivity, Fig. 1.1.

Immunologically mediated food hypersensitivity or allergy

Originally, allergy was defined by Clemens von Pirquet in 1906 as “changed reactivity”, based on the old Greek words “allos” (different or changed) and “ergos” (work or effect) (von Pirquet, 1906). The WAO nomenclature defines allergy as “an immunologically mediated specific hypersensitivity” and this definition is still accepted by the allergy community (Fig. 1.1) (Johansson et al., 2004).

Immunologically mediated symptoms and diseases are named allergic. The WAO definition is: “Allergy is a hypersensitivity reaction initiated by specific immunologic mechanisms” (Johansson et al., 2004). Allergy includes many mechanisms caused by environmental influences. “Allergy can be antibody-mediated or cell-mediated. In most patients with allergic symptoms from mucosal membranes in the airways and gastrointestinal tract, the antibody belongs to the IgE isotype, and these patients may be said to have an IgE-mediated allergy or atopic allergy” (Johansson et al., 2004). Even diseases/symptoms with obvious inflammatory components but without known mechanism should be classified as allergic.

Fig. 1.1: Principles of Allergy nomenclature. Modified after (Johansson et al., 2001; Johansson et al, 2004).

The WAO position paper classifies allergies mediated by IgE antibodies as IgE-mediated allergy (previous paragraph). Atopic allergy is caused by low dose of allergen exposure to mucosal membranes in genetically predisposed individuals causing long standing sensitization. IgE-mediated allergy consists of atopic allergy and high dose dependent IgE-mediated allergies. Doses are discussed later.

Atopic allergy

Atopic allergy is due to an immunological response induced by very low doses of seemingly harmless proteins (mainly) in the environment, stimulating the immune system to respond with a humoral response of Th2 type with production by B-cells of allergen specific IgE antibodies.

High antigen dose IgE-mediated allergy

To this category belong, e.g., IgE mediated reactions to Hymenoptera venoms and IgE reactions against helminths (Fig. 1.1).

Comments

According to the WAO nomenclature (Johansson et al., 2001; Johansson et al., 2004), there are two types of IgE-mediated allergy, low dose sensitization (atopic) and reactivity and high dose sensitization and reactivity.

Low doses of allergen sensitizing via the mucous membranes is typical for atopic sensitization. Atopy was introduced by Cooke and Coca in 1923 (Coca and Cooke, 1923). Individuals with a predisposition to develop diseases like asthma, rhino-conjunctivitis, eczema and urticaria, combined with a hereditary predisposition to be sensitized to proteins that they were exposed to, were classified as atopic. In 1975, Pepys defined atopy as a tendency to develop IgE antibodies when exposed to low concentrations of environmental, normally harmless, proteins called allergens (Pepys, 1975). The diseases caused by sensitization were called atopic diseases. The WAO position paper (Johansson et al., 2004) states: “The term atopy should be reserved to describe the genetic predisposition to become IgE-sensitized to allergens commonly occurring in the environment and to which everyone is exposed but to which the majority do not produce a prolonged IgE antibody response. Thus, atopy is a clinical definition of an IgE-antibody high-responder. The term atopy cannot be us...

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