Food proteins can sensitize the infants via different sources. A 5-month-old boy suffered three episodes of generalized urticaria 20 min after the ingestion of a fruit purée containing apple, banana and orange. Skin testing showed positive results to banana and chestnut. Other tests were negative. The value of specific immunoglobulin E (Pharmacia CAP-FEIA, Uppsala, Sweden) to banana was 58 KU/l, to orange was 9.7 KU/l, to chestnut was 5.6 KU/l and to latex was 1.6 KU/l. Orange, apple and latex products were well tolerated. He never had eaten chestnut. The parents rejected a banana challenge test. The route of sensitization in our case might be via placenta, breast-milk, and inadvertent oral intake of food or even via inhalation. An early frequent exposure to banana allergens was considered a possibility factor for the development of banana sensitization. We found that the banana consumption during pregnancy and lactation by the mother of our patient was greater than usual. It is not frequent to find so high levels of sensitization to any fruit in first year of life. In our case, latex, chestnut and orange sensitizations did not seem to be clinically relevant. However, latex and foods known to cross-react with banana antigens should be given to banana-sensitive individuals with great caution.
Positive skin prick test (SPT) reactions to carmine red (E120) have been reported to occur concurrently with reactions to mites. The relationships between positive SPT reactions to carmine, carmine allergy and concurrent mite reactions are unknown. The aim of this study was to analyse the prevalence of carmine sensitization and its clinical importance among patients with suspected allergy to food additives.
The occurrence of positive SPT reactions to mites was studied in 6,464 patients: 3,164 were tested with carmine and 2,837 with shrimp. Carmine ingestion-associated symptoms were registered at the time of testing. Patients with positive SPT to carmine received a follow-up questionnaire on their symptoms 1-5 years later.
Positive SPT reactions to carmine were seen in 94 patients (3.0%) of whom 74% also had positive SPT reactions to mites and 22% to shrimp. Carmine ingestion-associated symptoms were not dependent on concurrent mite reactivity in 39/94 (42%) patients.
Carmine sensitization without sensitization to mites is seen in one fourth of the patients. Allergic reactions to carmine are not dependent on concurrent reactivity to mites.
We developed an oral sensitization protocol for food proteins for the rat. Young Brown Norway (BN) rats were exposed to 1 mg ovalbumin (OVA) by daily gavage dosing for 42 days without the use of an adjuvant. OVA-specific IgE and IgG responses were determined by ELISA. On an oral challenge with OVA some clinical symptoms of food allergy-like effects on the respiratory system, blood pressure, and permeability of the gastrointestinal barrier were studied. In addition, BN rats were orally exposed to a total hen egg white protein (HEW) extract and cow's milk (CM) and the specificities of induced antibody responses were compared with the specificities of antibodies in sera from egg- and milk-allergic patients using immunoblotting. Animals orally exposed to the allergens developed specific IgE and IgG antibodies which recognized the same proteins compared with antibodies from egg- or CM-allergic patients. Among the various clinical symptoms of food allergy, gut permeability was increased after an oral challenge. In addition, some animals demonstrated a temporary decrease in breathing frequency or systolic blood pressure. The results obtained show that the Brown Norway rat is a suitable animal model for inducing specific IgG and IgE responses on daily intragastric dosing of OVA without the use of an adjuvant. Moreover, local immune-mediated effects on oral challenge are observed. The observation that enterally exposed BN rats and food-allergic patients demonstrate antibody responses to a comparable selection of proteins on exposure to different protein mixtures (HEW and CM) further supports the suitability of the BN rat as an animal model for food allergy research and for the study of the allergenicity of (novel) food proteins.
Few models have described a chronic food allergy with morphological changes in the intestinal mucosa. Here we established an ovalbumin (OVA)-induced, cell-mediated, allergic rat model and examined lymphocyte migration in the gut. Brown Norway rats were intraperitoneally sensitized to OVA and then given 10 mg OVA/day by gastric intubation for 6 wk. Lymphocyte subsets and adhesion molecules were examined immunohistochemically, and the migration of T lymphocytes to microvessels of Peyer's patches and villus mucosa was observed by using an intravital microscope. Serum OVA-specific IgG and IgE levels were increased in animals repeatedly exposed to OVA. Significant villus atrophy and increased crypt depth was accompanied by increased infiltration of T lymphocytes in the small intestinal mucosa of the group given OVA. Expression of rat mast cell protease II and of mucosal addressin cell adhesion molecule-1 (MAdCAM-1) was also increased in these groups. The administration of anti-MAdCAM-1 antibody significantly attenuated the OVA-induced changes in the mucosal architecture and in CD4 T lymphocyte infiltration. Intravital observation demonstrated that in rats with a chronic allergy, T lymphocytes significantly accumulated in villus microvessels as well as in Peyer's patches via a MAdCAM-1-dependent process. Our model of chronic food allergy revealed that lymphocyte migration was increased with MAdCAM-1 upregulation.
For the safety evaluation of genetically engineered crops the potential allergenicity of the newly introduced protein(s) has become an important issue. There is, however, no universal and reliable test system for the evaluation of the allergenic potency of food products. The best known allergy assessment proposal is the careful stepwise process using the IFBC/ILSI decision tree. Unfortunately, the described tests are not always conclusive, especially if the gene source coding for the protein has no history of dietary use and/or an unknown history in terms of allergenicity. The further testing warranted should in particular be focused on the prediction of the sensitizing potential of the novel protein, for which animal models are considered to be needed. In this paper the results are summarized of a promising food allergy model developed in Brown Norway (BN) rats. The results demonstrate that BN rats can be sensitized orally to the various allergenic food proteins tested, resulting in significant antigen-specific IgE responses, without the use of adjuvants. Upon oral challenge of previously sensitized animals, local and systemic immune-mediated effects, such as increased gastrointestinal permeability and decreased breathing frequency and blood pressure, could also be observed.
BACKGROUND: Early vitamin supplementation is given routinely to infants in many countries, but it is unclear whether this affects the risk of allergic diseases. OBJECTIVES: We sought to study the association between early-life supplementation of vitamins A and D in water-soluble form or in peanut oil and allergic diseases up to 4 years of age. METHODS: A prospective birth cohort of 4089 newborn infants was followed for 4 years using parental questionnaires repeatedly to collect information on exposure and health. At 4 years, the response rate was 90%, and allergen-specific IgE levels to food and airborne allergens were measured in 2614 of the participating children. RESULTS: Vitamins A and D were given to 98% of the children in infancy, and vitamins based in peanut oil dominated (90%). Children supplemented with vitamins A and D in water-soluble form during the first year of life had an almost 2-fold increased risk of asthma (adjusted odds ratio [OD], 2.18; 95% CI, 1.45-3.28), food hypersensitivity (adjusted OR, 1.89; 95% CI, 1.33-2.65), and sensitization to common food and airborne allergens (adjusted OR, 1.88; 95% CI, 1.34-2.64) at age 4 years compared with those receiving vitamins in peanut oil. No increased risk of IgE antibodies to peanut was seen in children receiving vitamins in peanut oil. CONCLUSION: Supplementation of vitamins A and D in water-soluble form seems to increase the risk of allergic disease up to the age of 4 years compared with supplementation with the same vitamins given in peanut oil. CLINICAL IMPLICATIONS: Vitamins A and D in oil does not seem to increase the risk of allergic disease during childhood.
Research Institute for Occupational Medicine of the Berufsgenossenschaften, Ruhr University, Department of Allergology/Immunology, Bochum, Germany. nsmis@neuro.hfh.edu
BACKGROUND: Potential cross-reactions between natural rubber latex and fruit/vegetable specific immunoglobulin (Ig)E antibodies have been reported for many years. This study was designed to investigate the molecular basis of acquired food sensitization focusing on the storage protein patatin and the patatin-like latex protein Hev b 7. OBJECTIVE: The amount of potato-specific IgE in the serum of latex-allergic health care workers and children with atopic dermatitis was determined to evaluate cross-reactivity between Hev b 7 and patatin. Additionally, the stability of potato patatin to digestion was investigated. METHODS: Human serum was tested on its reactivity to latex and potato proteins by IgE immunoblotting after one-dimensional (1-D) and 2-D electrophoresis. Latex- and potato-specific IgE concentrations were measured in fluorescence enzyme immunoassays (CAP, Pharmacia, Uppsala, Sweden). Further, potato patatin was chromatographically isolated to perform auto-inhibition tests. Stability of patatin to degradation was determined by digestion in vitro. RESULTS: Patatin was identified as major cross-reactive potato allergen by N-terminal sequencing. Seventy-five percent of the potato-sensitized people reacted with patatin in 1-D immunoblots, and 25% of the positive reactions to Hev b 7 could be blocked by preincubation of the patients' sera with purified potato patatin. Examination of children with atopic dermatitis showed that most sera contained patatin-specific IgE, whereas no Hev b 7-specific IgE was detected. Finally, patatin has been found partially stable to digestion in vitro. CONCLUSIONS: Patatin was identified as a major cross-reactive protein in latex-associated potato allergy and appears to be relevant for atopic dermatitis. Therefore, patatin could be a suitable marker for the determination of potato sensitization, and it may also constitute an important food allergen. Cross-reactivity between Hev b 7 and patatin was restricted to primarily latex-sensitized adults, suggesting a different mechanism of sensitization in children with atopic dermatitis.
