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Food Challenge (food + challenge)

Distribution by Scientific Domains

Medical Sciences	93%
2 Other Domains	7%

Kinds of Food Challenge

oral food challenge

placebo-controlled food challenge

Selected Abstracts

Lupin sensitization and clinical allergy in food allergic children in Norway

ACTA PAEDIATRICA, Issue 1 2008
Helene Lindvik
Abstract Aim: The aim of the present pilot study was to investigate to what extent children in Norway sensitized to lupin had clinical lupin allergy, and to compare sensitization to lupin with sensitization to other legumes. Methods: Thirty-five children with food allergy referred to a national referral hospital were evaluated with skin prick test (SPT) and analysis of serum-specific IgE to lupin, peanut, pea and soy. The children with positive SPTs to lupin were offered oral food challenges with lupin flour. Results: Fifteen children (43%) had positive SPT and 17 children (49%) had serum-specific IgE to lupin. Ten SPT-positive children underwent oral food challenges and one experienced an allergic reaction to lupin flour. This child was one of six challenged children with IgE antibodies to peanut >15 kUA/L. There was a strong relationship between positive SPT to lupin flour and positive SPT to soy and between positive SPT to lupin and specific IgE to soy, pea and peanut. Conclusions: Children with sensitization to lupin are not likely to have a clinical lupin allergy. Avoidance of lupin on the basis of lupin sensitization or peanut allergy would lead to unnecessarily strict diets. Food challenge is currently necessary to diagnose lupin allergy. [source]

Does food allergy cause atopic dermatitis?

DERMATOLOGIC THERAPY, Issue 2 2006
Food challenge testing to dissociate eczematous from immediate reactions
ABSTRACT:, The objective is to evaluate and diagnose, in a controlled setting, suspected food allergy causation in patients hospitalized for management of severe, unremitting atopic dermatitis (AD). Nineteen children were hospitalized at Oregon Health and Science University with atopic dermatitis from 1986 to 2003 for food restriction, then challenge, following standard recommendations. Challenges were prioritized by categories of (a) critical foods (e.g., milk, wheat, egg, soy); (b) important foods; and (c) other suspected foods. Patients were closely observed for evidence of pruritus, eczematous responses, or IgE-mediated reactions. If results were inconsistent, double-blind, placebo-controlled food challenge was performed. A total of 17 children with atopic dermatitis were assessed. Two could not be fully evaluated, thus were excluded from data tabulations. Only one positive eczematous food response was observed of 58 challenges. Three children had well-documented histories of food-induced IgE-mediated anaphylactoid or urticaria reactions to seafood and/or nuts and were not challenged with those foods. Atopic dermatitis, even in the highest-risk patients, is rarely induced by foods. Undocumented assumptions of food causation detract from proper anti-inflammatory management and should be discouraged. Immediate IgE-mediated food reactions are common in atopic dermatitis patients; such reactions are rapid onset, typically detected outside the clinic, and must be distinguished from eczematous reactions. Diagnosis of food-induced eczema cannot be made without food challenge testing. Such tests can be practical and useful for dispelling unrealistic assumptions about food allergy causation of atopic dermatitis. [source]

Changes in diet and life of children with food allergies after a negative food challenge

ALLERGY, Issue 6 2010
S. Flammarion
No abstract is available for this article. [source]

Thresholds for food allergens and their value to different stakeholders

ALLERGY, Issue 5 2008
R. W. R Crevel
Thresholds constitute a critical piece of information in assessing the risk from allergenic foods at both the individual and population levels. Knowledge of the minimum dose that can elicit a reaction is of great interest to all food allergy stakeholders. For allergic individuals and health professionals, individual threshold data can inform allergy management. Population thresholds can help both the food industry and regulatory authorities assess the public health risk and design appropriate food safety objectives to guide risk management. Considerable experience has been gained with the double-blind placebo-controlled food challenge (DBPCFC), but only recently has the technique been adapted to provide data on thresholds. Available data thus vary greatly in quality, with relatively few studies providing the best quality individual data, using the low-dose DBPCFC. Such high quality individual data also form the foundation for population thresholds, but these also require, in addition to an adequate sample size, a good characterization of the tested population in relation to the whole allergic population. Determination of thresholds at both an individual level and at a population level is influenced by many factors. This review describes a low-dose challenge protocol developed as part of the European Community-funded Integrated Project Europrevall, and strongly recommends its wider use so that data are generated that can readily increase the power of existing studies. [source]

Eczematous reactions to food in atopic eczema: position paper of the EAACI and GA2LEN

ALLERGY, Issue 7 2007
T. Werfel
Food allergy and atopic eczema (AE) may occur in the same patient. Besides typical immediate types of allergic reactions (i.e. noneczematous reactions) which are observed in patients suffering from AE, it is clear that foods, such as cow's milk and hen's eggs, can directly provoke flares of AE, particularly in sensitized infants. In general, inhaled allergens and pollen-related foods are of greater importance in older children, adolescents and adults. Clinical studies have revealed that more than 50% of affected children with AE that can be exacerbated by certain foods will react with a worsening of skin eczema either alone or in addition to immediate symptoms. Adolescents and adults may also react to foods, but reactions to ,classical' food allergens, such as hen's eggs and cow's milk, are not as common as in childhood. Some patients with AE do react to pollen-associated foods. Food-induced eczema should not be neglected by the allergologist: On the one hand, food can be a relevant trigger factor of persistent moderate-to-severe AE; on the other hand, unnecessary diets which are not based on a proper diagnosis may lead to malnutrition and additional psychological stress on patients suffering from AE. Eczematous reactions to food can only be diagnosed by a thorough diagnostic procedure, taking into account the patient's history, the degree of sensitization and the clinical relevance of the sensitization. The latter has often to be proven by oral food challenges. Upon oral food challenge it is most important to evaluate the status of the skin with an established score (e.g. SCORAD, EASI) after 24 h and later because otherwise worsening of eczema will be missed. [source]

Screening the allergenic repertoires of wheat and maize with sera from double-blind, placebo-controlled food challenge positive patients

ALLERGY, Issue 1 2006
M. Weichel
Background:, Food allergy to wheat and maize is an increasing factor of deterioration of life quality, especially childhood and can, in rare cases, even induce anaphylaxis. Although omega-5 gliadin from wheat and maize lipid transfer protein have been characterized as major cereal allergens on the molecular level, the list of food allergens is far to be complete. Methods:, To identify the IgE-binding repertoires of wheat and maize we screened respective cDNA libraries displayed on phage surface with sera from patients with a confirmed food allergy. The study included six patients with a positive double-blind, placebo-controlled food challenge (DBPCFC) to wheat, nine patients with a positive DBPCFC to maize, and six patients with anaphylactic reactions after ingestion of wheat. Results:, The enriched sequences encoding IgE-binding proteins showed heterogeneous repertoires for both, wheat and maize. The selected wheat repertoire yielded 12, the maize repertoire 11 open reading frames. Among these we identified allergens belonging to already characterized allergens families, such as gliadin, profilin and beta-expansin. Besides, we found novel proteins with high cross-reactive potential, such as thioredoxins, as well as sequences that had so far not been related to cereal allergy at all. The IgE-binding capacity of some selected proteins was evaluated in vitro and cross-reactivity was demonstrated by competition ELISA. Conclusion:, With regard to the heterogeneity of the characterized sequences as well as to the biochemical nature of the new allergens detected we conclude that wheat and maize-related food allergy is more complex than so far anticipated. [source]

Characterization of Bet v 1-related allergens from kiwifruit relevant for patients with combined kiwifruit and birch pollen allergy

MOLECULAR NUTRITION & FOOD RESEARCH (FORMERLY NAHRUNG/FOOD), Issue S2 2008
Christina Oberhuber
Abstract Allergy to kiwifruit appears to have become more common in Europe and elsewhere during the past several years. Seven allergens have been identified from kiwifruit so far, with actinidin, kiwellin and the thaumatin-like protein as the most relevant ones. In contrast to other fruits, no Bet v 1 homologues were characterized from kiwifruit so far. We cloned, purified, and characterized recombinant Bet v 1-homologous allergens from green (Actinidia deliciosa, Act d 8) and gold (Actinidia chinensis, Act c 8) kiwifruit, and confirmed the presence of its natural counterpart by inhibition assays. Well-characterized recombinant Act d 8 and Act c 8 were recognized by birch pollen/kiwifruit (confirmed by double-blind placebo-controlled food challenge) allergic patients in IgE immunoblots and ELISA experiments. The present data point out that Bet v 1 homologues are allergens in kiwifruit and of relevance for patients sensitized to tree pollen and kiwifruit, and might have been neglected so far due to low abundance in the conventional extracts used for diagnosis. [source]

Parental anxiety before and after food challenges in children with suspected peanut and hazelnut allergy

PEDIATRIC ALLERGY AND IMMUNOLOGY, Issue 2p2 2010
Wieneke T. Zijlstra
Zijlstra WT, Flinterman AE, Soeters L, Knulst AC, Sinnema G, L'Hoir MP, Pasmans SG. Parental anxiety before and after food challenges in children with suspected peanut and hazelnut allergy. Pediatr Allergy Immunol 2010: 21: e439,e445. © 2009 John Wiley & Sons A/S As ingestion of peanut and hazelnut by allergic children is potentially life threatening, parents of these children need to be vigilant about their child's dietary intake. This may cause high levels of anxiety. To assess parental anxiety about food-allergic reaction in their child (state anxiety) and their personal disposition to anxiety (trait anxiety). Parental anxiety was investigated again after food challenges. Fifty-seven children (3,16 yr, mean age 7.2) with suspected peanut or hazelnut allergy (mean specific IgE 20.9) were evaluated by double-blind, placebo-controlled food challenge (DBPCFC). Thirty-two children (56%) developed an allergic reaction. All parents completed the Spielberger State-Trait Anxiety Inventory (STAI) prior to DBPCFC and 2 wk, 3 months and 1 yr thereafter. The mean anxiety scores on these moments were compared with each other and with general Dutch norms. The STAI was also investigated in a group that refused DBPCFC. Prior to DBPCFC, parents had high levels of state anxiety in contrast to a lower trait anxiety compared to the norm group. After DBPCFC, the state anxiety was significantly lower, regardless of a positive or negative outcome (p , 0.05). The state anxiety was still significant lower after 1 yr (p , 0.03). The trait anxiety remained unchanged in mothers and slightly decreased in fathers. The state anxiety in the group that refused DBPCFC was comparable to the challenge group, but the trait anxiety was significantly higher (p = 0.038). Parents of children with suspected peanut or hazelnut allergy show high levels of anxiety about a food-allergic reaction. After DBPCFC, the anxiety was significantly lower, even in the group with a positive outcome. [source]

Safety and efficacy of a new extensively hydrolyzed formula for infants with cow's milk protein allergy

PEDIATRIC ALLERGY AND IMMUNOLOGY, Issue 4 2008
B. Niggemann
Cow's milk protein allergy (CMPA) is best treated by complete elimination of cow's milk from the diet. For infants with CMPA who cannot be breast-fed, formulas based on extensively hydrolyzed proteins or on amino acids are the preferred substitutes for cow's milk-based formulas. In this study, we compared the tolerance and growth of infants with CMPA who were fed a new extensively hydrolyzed formula containing lactose (eHF) with those who were fed an amino acid formula (AAF). This was a prospective, multi-center, randomized, reference-controlled study. Seventy-seven infants <12 months old with suspected CMPA were enrolled. In 66 of these, CMPA was confirmed by oral challenge in a double-blind, placebo-controlled food challenge (DBPCFC) or by a medical history of severe allergic reaction to cow's milk and a positive skin prick test. These infants were then tested for their reaction to eHF and AAF in a DBPCFC. All infants tolerated both formulas and were randomized to receive either eHF (n = 34) or AAF (n = 32) for 180 days. Growth (weight, length, and head circumference) and tolerance [skin, gastro-intestinal, and respiratory tract symptoms of allergy] were evaluated after 30, 60, 90, and 180 days. There were no significant differences between the two groups in any of the growth measurements. Length and head circumference were similar to Euro-growth standards, but weight was slightly lower. Gastro-intestinal and respiratory tract symptoms of allergy were also similar in the two groups. However, whereas SCORAD scores for atopic dermatitis remained constant throughout the study in infants-fed eHF, there was a slight decrease in those fed AAF. Infants-fed eHF had significantly fewer incidents of vomiting than infants-fed AAF and a significantly higher frequency of soft stools. The new eHF is safe and well tolerated in infants diagnosed with CMPA. [source]

Sensitization and allergy to turnip rape: a comparison between the Finnish and French children with atopic dermatitis

ACTA PAEDIATRICA, Issue 2 2009
S Poikonen
Abstract Aim: Finnish children with atopic dermatitis (AD) are frequently sensitized and show positive food challenge to turnip rape. We examined whether French children are also allergic to this oilseed plant and whether mustard could be the cross-reacting allergen. Methods: Turnip rape and mustard challenge was performed to 14 Finnish and 14 French children with atopic dermatitis and positive skin prick test to turnip rape. Specific IgE antibodies were measured by ImmunoCAP and enzyme-linked immunosorbent assay (ELISA). Results: Open labial or oral challenge to turnip rape was positive in 14 (100%) Finnish and five (36%) French children and mustard challenge in five Finnish and five French children. IgE antibodies to oilseed rape and mustard were slightly more frequent in the Finnish (100% and 93%) than in the French (93% and 71%) children but rare (4%) in the 28 matched controls. The same findings were true for IgE antibodies to purified 2S albumin allergens, which showed similar cross-wise IgE inhibition patterns. Conclusion: French children with atopic dermatitis show IgE antibodies to turnip rape, oilseed rape and mustard similarly to the Finnish children. 2S albumin allergens in the seeds of these plants are highly cross-reactive and therefore, they all could be important sensitizers in children with atopic dermatitis. [source]

Longitudinal validity and responsiveness of the Food Allergy Quality of Life Questionnaire , Parent Form in children 0,12 years following positive and negative food challenges

CLINICAL & EXPERIMENTAL ALLERGY, Issue 3 2010
A. DunnGalvin
Summary Background There are no published studies of longitudinal health-related quality of life (HRQL) assessments of food-allergic children using a disease-specific measure. Objective This study assessed the longitudinal measurement properties of the Food Allergy Quality of Life Questionnaire , Parent Form (FAQLQ-PF) in a sample of children undergoing food challenge. Methods Parents of children 0,12 years completed the FAQLQ-PF and the Food Allergy Independent Measure (FAIM) pre-challenge and at 2 and 6 months post food challenge. In order to evaluate longitudinal validity, differences between Group A (positive challenge) and Group B (negative challenge) were expected over time. We computed correlation coefficients between change scores in the FAQLQ-PF and change scores in the FAIM. To determine the minimally important difference (MID), we used distributional criterion and effect size approaches. A logistic regression model profiled those children falling below this point. Results Eighty-two children underwent a challenge (42 positive; 40 negative). Domains and total score improved significantly at pos-challenge time-points for both groups (all P<0.05). Sensitivity was demonstrated by significant differences between positive and negative groups at 6 months [F(2, 59)=6.221, P<0.003] and by differing improvement on relevant subscales (P<0.05). MID was 0.45 on a seven-point response scale. Poorer quality of life at baseline increased the odds by over 2.0 of no improvement in HRQL scores 6-month time-point. General maternal health (OR 1.252), number of foods avoided (OR 1.369) and children >9 years (OR 1.173) were also predictors. The model correctly identified 84% of cases below MID. Conclusion The FAQLQ-PF is sensitive to change, and has excellent longitudinal reliability and validity in a food-allergic patient population. The standard error of measurement value of 0.5 points as a threshold for meaningful change in HRQL questionnaires was confirmed. The FAQLQ-PF may be used to identify problems in children, to assess the effectiveness of clinical trials or interventions, and to guide the development of regulatory policies. Cite this as: A. DunnGalvin, C. Cullinane, D. A. Daly, B. M. J. Flokstra-de Blok, A. E. J. Dubois and J. O'B. Hourihane, Clinical & Experimental Allergy, 2010 (40) 476,485. [source]

Should children with a history of anaphylaxis to foods undergo challenge testing?

CLINICAL & EXPERIMENTAL ALLERGY, Issue 12 2008
B. J. Vlieg-Boerstra
Summary Background Data on the frequency of resolution of anaphylaxis to foods are not available, but such resolution is generally assumed to be rare. Objective To determine whether the frequency of negative challenge tests in children with a history of anaphylaxis to foods is frequent enough to warrant challenge testing to re-evaluate the diagnosis of anaphylaxis, and to document the safety of this procedure. Methods All children (n=441) who underwent a double-blind, placebo-controlled food challenge (DBPCFC) between January 2003 and March 2007 were screened for symptoms of anaphylaxis to food by history. Anaphylaxis was defined as symptoms and signs of cardiovascular instability, occurring within 2 h after ingestion of the suspected food. Results Twenty-one children were enrolled (median age 6.1 years, range 0.8,14.4). The median time interval between the most recent anaphylactic reaction and the DBPCFC was 4.25 years, range 0.3,12.8. Twenty-one DBPCFCs were performed in 21 children. Eighteen of 21 children were sensitized to the food in question. Six DBPCFCs were negative (29%): three for cows milk, one for egg, one for peanut, and one for wheat. In the positive DBPCFCs, no severe reactions occurred, and epinephrine administration was not required. Conclusions This is the first study using DBPCFCs in a consecutive series of children with a history of anaphylaxis to foods, and no indications in dietary history that the food allergy had been resolved. Our study shows that in such children having specific IgE levels below established cut-off levels reported in other studies predicting positive challenge outcomes, re-evaluation of clinical reactivity to food by DBPCFC should be considered, even when there are no indications in history that anaphylaxis has resolved. DBPCFCs can be performed safely in these children, although there is a potential risk for severe reactions. [source]

Asthma induced by inhalation of flour in adults with food allergy to wheat

CLINICAL & EXPERIMENTAL ALLERGY, Issue 8 2008
N. Salvatori
Summary Background Wheat is one of the major food allergens and it is also an inhalant allergen in workers exposed to flour dusts. Food allergy to wheat in adulthood seems to be rare and has never been reported to be associated with asthma induced by flour inhalation. Objective The study aimed at detecting adults with food allergy to wheat and screening them for the presence of specific bronchial reactivity to inhaled wheat proteins. Methods Adults with a history of adverse reactions to ingestion of wheat underwent skin prick test with commercial wheat extract and were assessed for the presence of specific wheat IgE in the sera. Food sensitivity to wheat was confirmed by double-blind, placebo-controlled food challenge (DBPCFC). Specific bronchial reactivity was investigated through a specific bronchial challenge with wheat proteins. Results In nine patients with evidence of specific IgE response to wheat, a diagnosis of food allergy was made by DBPCFC. Only two subjects had asthma as disease induced by ingestion of wheat. Seven subjects reported a history of respiratory symptoms when exposed to flour dusts. A significant reduction of forced expiratory volume in 1 s (FEV1) was detected in these seven patients when a specific bronchial challenge with flour proteins was performed. Only three out of seven subjects with asthma induced by flour could be considered occupationally exposed to flour dusts. Conclusion For the first time, it has been shown that specific bronchial reactivity to wheat proteins can be detected in patients with different disorders associated with food allergy to wheat. The presence of asthma induced by inhaled flour is not strictly related to occupational exposure and it may also occur in subjects not displaying asthma among symptoms induced by wheat ingestion. [source]

Kiwifruit allergy: actinidin is not a major allergen in the United Kingdom

CLINICAL & EXPERIMENTAL ALLERGY, Issue 9 2007
J. S. A. Lucas
Summary Background Actinidin has previously been reported as the major allergen in kiwifruit. Objectives To investigate the relevance of actinidin in a well-characterized population of UK patients with kiwifruit allergy. Methods To identify the allergens in kiwifruit, using Western blots, we examined the IgE-binding patterns of 76 patients with a history of kiwifruit allergy, 23 of who had had a positive double-blind, placebo-controlled food challenge. In addition, IgE binding to purified native actinidin was studied in 30 patients, and to acidic and basic isoforms of recombinant actinidin in five patients. Inhibition of IgE binding to kiwifruit protein extract by purified native actinidin was investigated by both inhibition immunoblots and inhibition ELISAs using pooled sera. Results Twelve protein bands in kiwifruit protein extract were bound by IgE. A protein band with a molecular weight of 38 kDa was the major allergen recognized by 59% of the population. IgE did not bind to actinidin in the kiwifruit protein extract, or to purified native or recombinant forms of actinidin during Western blotting. Pooled sera bound to kiwifruit protein extract but not purified actinidin on ELISA, and pre-incubating sera with actinidin did not inhibit IgE binding to kiwifruit protein extract on immunoblot or ELISA. Conclusion A novel 38 kDa protein, not actinidin, is the major allergen in this large study population. Identification of major allergens in one patient group is therefore not necessarily reproducible in another; therefore, major allergens should not be defined until there is a sufficient body of data from diverse geographical and cultural populations. [source]

Kiwi fruit is a significant allergen and is associated with differing patterns of reactivity in children and adults

CLINICAL & EXPERIMENTAL ALLERGY, Issue 7 2004
J. S. A. Lucas
Summary Background Allergy to kiwi fruit appears increasingly common, but few studies have evaluated its clinical characteristics, or evaluated methods of investigating the allergy. Objective To characterize the clinical characteristics of kiwi fruit allergy and to study the role of double-blind placebo-controlled food challenge (DBPCFC), skin tests and specific IgE in the diagnosis of this food allergy. Methods Two-hundred and seventy-three subjects with a history suggestive of allergy to kiwi completed a questionnaire. Forty-five were investigated by DBPCFC, prick-to-prick skin testing with fresh kiwi pulp, and specific IgE measurement. Nineteen subjects were also skin tested using a commercially available solution. Results The most frequently reported symptoms were localized to the oral mucosa (65%), but severe symptoms (wheeze, cyanosis or collapse) were reported by 18% of subjects. Young children were significantly more likely than adults to react on their first known exposure (P<0.001), and to report severe symptoms (P=0.008). Twenty-four of 45 subjects (53%) had allergy confirmed by DBPCFC. Prick-to-prick skin test with fresh kiwi was positive in 93% of subjects who had allergy confirmed by DBPCFC, and also in 55% of subjects with a negative food challenge. The commercial extract was significantly less sensitive, but with fewer false-positive reactions. CAP sIgE was only positive in 54% of subjects who had a positive challenge. Conclusions Kiwi fruit should be considered a significant food allergen, capable of causing severe reactions, particularly in young children. DBPCFC confirmed allergy to kiwi fruit in 53% of the subjects tested, who had a previous history suggestive of kiwi allergy. Skin testing with fresh fruit has good sensitivity (93%), but poor specificity (45%) in this population. CAP sIgE and a commercially available skin test solution were both much less sensitive (54%; 75%) but had better specificity (90%; 67%). [source]

Recurrent abdominal pain in school children revisited: fitting adverse food reactions into the puzzle

ACTA PAEDIATRICA, Issue 7 2004
K Størdal
The diagnostic work-up of children seeking health care because of recurrent abdominal pain is a clinical challenge. Food hypersensitivity might be one of the aetiologies behind this symptom. Neither the understanding of possible immune mechanisms nor endoscopic or histological findings have yet contributed to reliable diagnostic tests. Conclusion: The possibility of adverse food reactions should be evaluated among other abnormalities behind recurrent abdominal pain in children. Still, the diagnosis of immune-mediated food reactions depends on open or blinded food challenge. [source]

Recurrent abdominal pain, food allergy and endoscopy

ACTA PAEDIATRICA, Issue 1 2001
Steffen Husby
Gastrointestinal food allergy, a well-recognized clinical entity, has a wide spectrum of clinical features, including cutaneous, respiratory and gastrointestinal symptoms and objective abnormalities. The gastrointestinal alterations in food allergy have been described throughout the gastrointestinal tract. Recurrent abdominal pain (RAP) is a common complaint in school-age children. The findings among children with RAP of an underlying food allergy associated with mucosal pathology of the foregut may support a causal relationship between food allergy and RAP. Further studies are needed to elucidate whether well-documented food allergy (based on double-blind placebo-controlled food challenges) is a major cause of RAP. [source]

Globalization vs. localization: global food challenges and local solutions

INTERNATIONAL JOURNAL OF CONSUMER STUDIES, Issue 3 2010
Quaye Wilhelmina
Abstract The objective of this study was to examine the effect of global,local interactions on food production and consumption in Ghana, and identify possible local solutions. Primary data were collected using a combination of quantitative-qualitative methods, which included focus group discussions and one-on-one interviews. Approximately 450 household heads were randomly selected and interviewed between August 2007 and August 2008 in Eastern, Central, Upper East and Northern Regions of Ghana. Findings revealed increasing consumption of foreign rice as opposed to decreasing consumption of local rice and other staples like millet, sorghum and yam because of global,local interactions. However, opportunities exist to re-localize production-consumption patterns through the use of ,glocal foods' like improved ,koose and waakye'. Referencing the situation in Ghana, the study recommends improved production and processing practices backed with appropriate technologies that reflect changing consumption dynamics in order to take full advantage of opportunities created as a result of global,local interactions. [source]

Evaluation and standardisation of different matrices used for double-blind placebo-controlled food challenges to fish

JOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 5 2010
E. Vassilopoulou
Abstract Background:, Fish allergens represent one of the most common causes of adverse reactions to food worldwide. Double-blind placebo-controlled food challenges (DBPCFC) are the gold standard for food allergy diagnosis. However, no standardised recipes are available for common food allergens such as fish, and a well trained dietitian is essential for creating and standardising them. The present study aimed to create and standardise recipes for use in DBPCFCs to fish. Methods:, Three recipes were prepared. Employing a standardised procedure, a total of 35 panelists evaluated the different matrices using an evaluation form. A paired comparison test was used to estimate total evaluation's outcome. Fish allergic patients were challenged with different fish species blinded with the selected matrix and evaluated the recipe using the same form. Results:, From a base recipe and step-by-step modifications, a low fat recipe was selected among other recipes tested, which proved to be appropriate for fish blinding, in terms of taste, odour, appearance and blinding. Patients challenged with the final matrix found it acceptable, no matter which fish type was used. Conclusions:, In this pilot study, a recipe with satisfactory organoleptic characteristics was developed and validated for DBPCFC to fish. [source]

Oropharyngeal symptoms predict objective symptoms in double-blind, placebo-controlled food challenges to cow's milk

ALLERGY, Issue 8 2009
E. E. Kok
First page of article [source]

Eczematous reactions to food in atopic eczema: position paper of the EAACI and GA2LEN

Unproven diagnostic procedures in IgE-mediated allergic diseases

ALLERGY, Issue 8 2004
B. Niggemann
A considerable body of literature on therapeutic aspects of complementary and alternative medicine has been published in recent years, but little is known on diagnostic procedures. This short review lists complementary and alternative diagnostic procedures for the diagnosis of allergic diseases and presents an assessment of their usefulness for the daily practice. The review of the literature revealed that neither the determination of specific immunoglobulin G-antibodies in serum, the hair-analysis, the cytotoxic test, kinesiology, iridology, or electrodermal testing represent useful tests for the daily practice. To date, no complementary or alternative diagnostic procedure can be recommended as a meaningful element in the diagnostic work-up of allergic diseases. This is especially true for food allergy: properly performed oral food challenges still represent the gold standard for implementing specific diets in food allergic individuals. Ineffective diagnostic approaches may be costly for the consumer and delay appropriate therapy. [source]

Dysregulated Th1 and Th2 responses in food-allergic children , Does elimination diet contribute to the dysregulation?

PEDIATRIC ALLERGY AND IMMUNOLOGY, Issue 4p1 2010
Sara Tomi
Tomi,i, S, Fälth-Magnusson K, Fagerås Böttcher M. Dysregulated Th1 and Th2 responses in food-allergic children , does elimination diet contribute to the dysregulation? Pediatr Allergy Immunol 2010: 21: 649,655. © 2010 John Wiley & Sons A/S Infants with eczema and sensitization to foods are recommended skin care and, if food allergy is proven, an elimination diet. Although most of these children tolerate foods before 3 yr of age, some children experience prolonged food allergy. To our knowledge, no prospective study has investigated the cytokine profile in food-sensitized eczematous children with prolonged food intolerance. The aim of the study was to prospectively investigate the development of cytokine production induced by food allergen in food-sensitized eczematous children who, at 4½ yr of age, were allergic or tolerant to egg or milk. Twenty-one eczematous infants, [age 5 (3,10) months; median and range], sensitized to egg and/or milk were included, put on elimination diet and followed prospectively. At 4½ yr of age, the children were defined as tolerant or allergic to egg and/or milk based on open or double-blind placebo-controlled food challenges. Peripheral blood mononuclear cells (PBMC) were isolated from the children on inclusion, after 6 wk of elimination diet, and at 3 and 4½ yr of age. Ovalbumin, ,-lactoglobulin and tetanus toxoid-induced IL-4, -5, -10, -13 and IFN-, production from PBMC were analyzed with enzyme-linked immunosorbent assay. The IFN-, and IL-5 secretion induced by food allergen at 4½ yr was higher in cell cultures from children who were allergic to egg or milk than in tolerant children. In food-allergic children, the levels of IFN-, and IL-5 were higher at 4½ yr compared with inclusion levels, but this increase was generally not observed in the tolerant children who consumed milk and egg. In conclusion, immune cells from food-allergic children on an elimination diet respond with up-regulated T helper 1 and T helper 2 cytokine secretion induced by food allergen. We hypothesize that allergen elimination may influence the regulatory mechanisms maintaining balanced immune responses to innocuous food antigens. [source]

Parental anxiety before and after food challenges in children with suspected peanut and hazelnut allergy

Longitudinal validity and responsiveness of the Food Allergy Quality of Life Questionnaire , Parent Form in children 0,12 years following positive and negative food challenges

Peanut cross-reacting allergens in seeds and sprouts of a range of legumes

CLINICAL & EXPERIMENTAL ALLERGY, Issue 12 2008
L. B. Jensen
Summary Background Recently, peanut-allergic patients have reported symptoms upon ingestion of bean sprouts produced from various legumes. Objective This study was designed to identify immunoreactivity to seeds and sprouts of legumes other than peanut in sera from peanut-allergic patients. Methods Crude protein extracts of seeds and sprouts (comprising cotelydons and hypocotyls/epicotyls) of peanut, soybean, green pea, blue lupine, mung bean, alfalfa, broad bean, and azuki bean were prepared. The reactivity of sera from 10 peanut-allergic patients to these extracts was analysed by indirect histamine release (HR), enzyme-allergosorbent test (EAST), EAST inhibition, and Western blots. Skin prick tests (SPTs) were performed on the patients with fresh legume seeds as well as four commercial legume sprouts, and food challenges with soybean, pea, and lupine were performed on a subgroup of the patients. Results All legume seeds and commercial sprouts induced positive SPTs in some of the patients. Indirect HR experiments indicated an extensive co-reactivity between peanut and the legumes, and cross-reactivity was observed for soybean, pea, and lupine seeds as well as lupine hypocotyls in EAST inhibition experiments. Of the 16 protein extracts, soybean, pea, and lupine seed extracts produced visible bands in Western blots. Conclusion The symptoms reported by peanut-allergic patients after legume sprout intake might be caused by cross-reactivity of peanut-specific antibodies. The intake of raw legume sprouts might cause symptoms in peanut-allergic patients. [source]