- Nut allergy is commonly caused by peanuts and tree nuts and can cause anaphylaxis. Peanut allergy prevalence is 0.5-2.5% in children in the UK and tree nut allergy prevalence is 0.2-2.2%.
- Diagnosis involves taking a history, skin prick tests, nut-specific IgE levels, and oral food challenges. Skin prick tests ≥3mm or nut-specific IgE levels ≥15kU/L suggest allergy.
- Cross-reactivity between peanuts and tree nuts is common, so testing for multiple nuts is often recommended for those allergic to one type of nut. Component resolved testing for Ara h 2
This document discusses molecular-based allergy diagnostics and provides definitions and concepts. It outlines how molecular allergy diagnostics can increase the accuracy of allergy diagnosis by helping to resolve cross-reactivity between allergens and distinguish primary sensitizations. It also describes how molecular diagnostics can help assess the risk and type of allergic reaction, and identify specific allergens relevant for immunotherapy. A wide range of purified and recombinant food, aeroallergen, and other allergens are available to facilitate these applications.
This document provides an overview of peanut allergy, including its prevalence, genetics, environmental risk factors, allergens, effects of processing, clinical manifestations, environmental exposure, diagnosis, cross-reactivity, natural history, treatment, and prevention. Some key points include:
- Peanut allergy prevalence is approximately 2% in US children and 1.8% in US adults. Rates are highest in English-speaking countries.
- Genetics play a strong role, with 64% concordance in identical twins. Several loci have been identified that increase risk.
- Major allergens include Ara h 1, Ara h 2, Ara h 3, and Ara h 6, which are resistant to heat and digestion
This document provides an overview of food allergies for dietitians, including distinguishing allergies from intolerances, common food allergens, symptoms of allergic reactions, diagnosis, and management. It discusses the immune system response to allergens and introduces concepts such as oral tolerance. Statistics on the prevalence of food allergies in children and adults are presented. The roles of dietitians in supporting diagnosis and managing allergies through dietary avoidance and ensuring nutrition are also summarized.
This document discusses food allergies in children. It notes that the most common food allergens in children are milk, eggs, peanuts, tree nuts, soy, and wheat. Symptoms of food allergies can include anaphylaxis, skin issues like urticaria and atopic dermatitis, gastrointestinal problems, and respiratory symptoms. Diagnosis involves elimination diets and food challenges. Treatment is elimination of the offending foods from the diet.
The document discusses food allergies and immunology. It defines the immune system and how it responds to antigens through antibody production. Food allergies occur when the immune system mistakenly reacts to certain foods. The main types of food allergies are IgE-mediated and non-IgE mediated. Common symptoms include hives, difficulty breathing, and anaphylaxis in severe cases. Treatment involves strictly avoiding the allergenic foods and carrying an epinephrine auto-injector in case of anaphylaxis.
This document provides information on addressing food allergies in schools. It begins with session objectives on developing awareness of food allergy basics, why schools should address food allergies, components of a food allergy policy, and available resources. It then defines food allergy and anaphylaxis, compares food allergy to intolerance, lists common symptoms, and outlines treatment for anaphylaxis. The document discusses why schools need food allergy policies given their responsibility for student safety and laws regarding disabilities. It provides guidance on 10 components of a comprehensive food allergy policy around identification of students, individual plans, medication protocols, healthy environments, communication, emergency response, training, awareness education, and monitoring.
This document summarizes recent research on peanut allergy. It discusses the rising prevalence of peanut allergy in western countries. It also examines factors that may be associated with the development of peanut allergy such as delayed introduction of peanuts in infancy, maternal diet during pregnancy/lactation, and environmental peanut exposure. The document also reviews research on diagnosing peanut allergy and the natural history of peanut allergy. It briefly discusses a new immunotherapy treatment approach called oral immunotherapy.
- Nut allergy is commonly caused by peanuts and tree nuts and can cause anaphylaxis. Peanut allergy prevalence is 0.5-2.5% in children in the UK and tree nut allergy prevalence is 0.2-2.2%.
- Diagnosis involves taking a history, skin prick tests, nut-specific IgE levels, and oral food challenges. Skin prick tests ≥3mm or nut-specific IgE levels ≥15kU/L suggest allergy.
- Cross-reactivity between peanuts and tree nuts is common, so testing for multiple nuts is often recommended for those allergic to one type of nut. Component resolved testing for Ara h 2
This document discusses molecular-based allergy diagnostics and provides definitions and concepts. It outlines how molecular allergy diagnostics can increase the accuracy of allergy diagnosis by helping to resolve cross-reactivity between allergens and distinguish primary sensitizations. It also describes how molecular diagnostics can help assess the risk and type of allergic reaction, and identify specific allergens relevant for immunotherapy. A wide range of purified and recombinant food, aeroallergen, and other allergens are available to facilitate these applications.
This document provides an overview of peanut allergy, including its prevalence, genetics, environmental risk factors, allergens, effects of processing, clinical manifestations, environmental exposure, diagnosis, cross-reactivity, natural history, treatment, and prevention. Some key points include:
- Peanut allergy prevalence is approximately 2% in US children and 1.8% in US adults. Rates are highest in English-speaking countries.
- Genetics play a strong role, with 64% concordance in identical twins. Several loci have been identified that increase risk.
- Major allergens include Ara h 1, Ara h 2, Ara h 3, and Ara h 6, which are resistant to heat and digestion
This document provides an overview of food allergies for dietitians, including distinguishing allergies from intolerances, common food allergens, symptoms of allergic reactions, diagnosis, and management. It discusses the immune system response to allergens and introduces concepts such as oral tolerance. Statistics on the prevalence of food allergies in children and adults are presented. The roles of dietitians in supporting diagnosis and managing allergies through dietary avoidance and ensuring nutrition are also summarized.
This document discusses food allergies in children. It notes that the most common food allergens in children are milk, eggs, peanuts, tree nuts, soy, and wheat. Symptoms of food allergies can include anaphylaxis, skin issues like urticaria and atopic dermatitis, gastrointestinal problems, and respiratory symptoms. Diagnosis involves elimination diets and food challenges. Treatment is elimination of the offending foods from the diet.
The document discusses food allergies and immunology. It defines the immune system and how it responds to antigens through antibody production. Food allergies occur when the immune system mistakenly reacts to certain foods. The main types of food allergies are IgE-mediated and non-IgE mediated. Common symptoms include hives, difficulty breathing, and anaphylaxis in severe cases. Treatment involves strictly avoiding the allergenic foods and carrying an epinephrine auto-injector in case of anaphylaxis.
This document provides information on addressing food allergies in schools. It begins with session objectives on developing awareness of food allergy basics, why schools should address food allergies, components of a food allergy policy, and available resources. It then defines food allergy and anaphylaxis, compares food allergy to intolerance, lists common symptoms, and outlines treatment for anaphylaxis. The document discusses why schools need food allergy policies given their responsibility for student safety and laws regarding disabilities. It provides guidance on 10 components of a comprehensive food allergy policy around identification of students, individual plans, medication protocols, healthy environments, communication, emergency response, training, awareness education, and monitoring.
This document summarizes recent research on peanut allergy. It discusses the rising prevalence of peanut allergy in western countries. It also examines factors that may be associated with the development of peanut allergy such as delayed introduction of peanuts in infancy, maternal diet during pregnancy/lactation, and environmental peanut exposure. The document also reviews research on diagnosing peanut allergy and the natural history of peanut allergy. It briefly discusses a new immunotherapy treatment approach called oral immunotherapy.
Oral allergy syndrome (OAS), also known as pollen-food allergy syndrome (PFAS), is a localized allergic reaction in the mouth that is usually caused by cross-reactivity between pollen and raw fruits or vegetables. It is estimated that 5% of the general population suffers from PFAS. The condition is caused by cross-reactivity between IgE antibodies produced in response to inhaled pollen proteins and similar proteins found in certain raw foods. Common symptoms include itching and swelling of the lips, tongue, mouth and throat. Diagnosis involves a history of symptoms, skin prick tests, and oral food challenges. Treatment focuses on avoidance of raw trigger foods and use of antihistamines
Parental migration from Asia to Australia is an important risk factor for developing tree nut allergy in children. The prevalence of tree nut allergy varies globally, with hazelnut being most common in Europe and cashew in Australia. Co-sensitization and clinical allergy to multiple tree nuts is common due to cross-reactivity between related proteins. The major tree nut allergens are stable seed storage proteins, though some conformational changes can occur during food processing that potentially impact allergenicity. Clinical reactions can be severe or systemic. Diagnosis involves clinical history, skin prick testing, nut-specific IgE levels, and oral food challenges.
This document presents information about food allergies and intolerances. It defines food allergies as abnormal immune responses to food, while food intolerances are non-immune mediated reactions. The document outlines the objectives and scope, describing the major types of food allergies and intolerances, symptoms, most common allergens like peanuts and shellfish, diagnosis, and management through dietary avoidance and emergency epinephrine treatment. It also discusses regulations around food labeling of major allergens.
Food allergies can be IgE-mediated or non-IgE mediated reactions. The major food allergens in both children and adults are milk, eggs, soy, wheat, peanuts, nuts, shellfish and fish. Symptoms range from mild skin reactions to potentially life-threatening anaphylaxis. Diagnosis involves patient history, skin prick tests and oral food challenges. Treatment focuses on strict avoidance of culprit foods, emergency epinephrine administration for reactions, and management of symptoms with antihistamines. Patient education is key for self-management and prevention of accidental exposures.
This document discusses allergies to fruits and vegetables. It begins with an introduction to panallergens like profilin, nsLTPs and Bet v 1 that can cause cross-reactivity between plant foods and pollen. The epidemiology section notes that the prevalence of fruit allergies ranges from 0.1-4.3% while vegetable allergies range from 0.1-0.3%. Several case studies are presented demonstrating pollen-food allergy syndromes. Key allergens like profilin, nsLTPs, Bet v 1 and GRPs are discussed in depth, outlining their clinical relevance and evaluation.
This document discusses food allergies, including that an estimated 15 million people in the US have food allergies, with nearly 6 million children affected. It explains that a food allergy is an abnormal immune system response, while a food intolerance is due to an inability to digest certain foods. Symptoms of an allergic reaction can range from mild to severe and include hives, difficulty breathing, and anaphylaxis. Food allergies are diagnosed through skin prick tests, blood tests, and medical history. Management involves strictly avoiding trigger foods, reading labels, asking about ingredients when eating out, and having emergency epinephrine on hand.
The document provides information about allergy diagnostics and testing. It discusses the different types of allergies including food, environmental, occupational and insect allergies. It describes the importance of taking a thorough case history and outlines different diagnostic methods used to identify allergens including skin prick tests, patch tests and allergen-specific IgE blood tests. Accurately identifying the specific allergens responsible for a patient's symptoms is key to successful management and treatment of their condition.
The document discusses 8 common food allergens: 1) milk, 2) eggs, 3) peanuts, 4) wheat, 5) sesame seeds, 6) seafood, 7) sulphites, and 8) mustard. It notes that food allergies are caused by the immune system mistakenly reacting to harmless food proteins. Reading food labels can help identify foods that may cause allergic reactions by listing the top 8 allergens. People with food allergies should avoid the allergenic foods and carry epinephrine devices in case of emergencies.
This document discusses food allergies, including their epidemiology, causes, types (IgE-mediated vs non-IgE-mediated), symptoms, diagnosis, and management. It notes that food allergies are often seen in individuals with other atopic conditions like asthma and eczema. Common food allergens in infants are milk, eggs, and peanuts, while older children often have allergies to peanuts, tree nuts, and fish. Diagnosis involves taking a thorough history and potentially skin prick tests or blood tests to identify allergen-specific IgE antibodies. Management focuses on avoidance of the offending foods and use of emergency medications for severe or anaphylactic reactions.
This document provides information about food allergies and intolerances. It defines food allergies as immune system reactions to certain foods, while food intolerances involve an inability to digest some foods. The major food allergens are identified as crustaceans, milk, tree nuts, fish, eggs, peanuts, sesame seeds, soybeans, and gluten. Anaphylaxis is described as the most severe allergic reaction. Common food intolerances include lactose intolerance and milk intolerance. The document outlines management of allergies and intolerances through testing, first aid, reading labels, and always asking about ingredients when eating out.
Food allergies occur when the immune system reacts to otherwise harmless food proteins by producing IgE antibodies, which trigger the release of histamine and other substances when the food is consumed, causing allergic symptoms. The major food allergens include milk, eggs, fish, shellfish, tree nuts, peanuts, wheat and soybeans. Food intolerances are adverse reactions to foods that do not involve the immune system and can be caused by lactose, amines, salicylates, glutamates or food additives. Specialist diagnosis and testing is required to identify food allergies and intolerances.
This study evaluated the effect of consumer background on sensory scores of microwaved Angus loins. An untrained panel of 70 consumers of different ages, genders, and tribes evaluated sensory characteristics of microwaved Angus steak. The study found that age had no effect on sensory scores. Gender influenced sustained impression of juiciness, with males scoring it higher than females. Tribe influenced amount of connective tissue perceived. Several sensory characteristics were positively correlated, such as initial and sustained impression of juiciness, and first bite tenderness correlating with sustained juiciness and tenderness. Consumer background thus had some influence on sensory evaluation of microwaved Angus loins.
Recent analysis method of food allergen rakesh mund
Recent analysis method of food allergen
and case study related to recent method for food allergen analysis
rakesh kumar
Msc scholar IARI PUSA campus new delhi
8385884641 ; rakeshmund94@gmail.com
Oral allergy syndrome (OAS) is caused by cross-reactivity between pollen and certain raw fruits and vegetables. It occurs in up to 70% of pollen-allergic patients and involves oral itching and inflammation upon eating raw foods. Cross-reactivity is due to structural similarities between pollen and food allergens like profilin, PR-10, and lipid transfer proteins. Diagnosis involves a clinical history and skin or blood tests to specific food allergens. Treatment focuses on avoidance of raw foods and use of antihistamines for symptoms.
Food “Allergy” Testing for Adverse Food ReactionsAugustin Bralley
Learn how to differentiate classes of adverse reactions to food, understand the mechanism of sensitivity reactions, and interpret reports of IgG4 food antibodies.
Allergy testing is important for diagnosis of allergic conditions. Skin prick tests and blood tests like specific IgE tests can help identify triggers. Specific IgE tests like ImmunoCAP are more accurate than total IgE and are not affected by medications, skin conditions, or pregnancy. Phadiatop is a useful screening test to detect sensitization to common inhalants and foods. Positive results on screening tests should be followed up with customized allergen panels based on symptoms and environment. Reference lab data shows significant prevalence of sensitization to common allergens like dust mites, pollens, foods in the local population tested. Proper history and examination along with selection of right allergen panels is key to allergy diagnosis
Allergies are becoming increasingly common in Australia for a range of reasons. These slides were developed for a course created to help the community better understand and more effectively manage allergies.
Molecular gastronomy is the study of physical and chemical transformations of edible materials. Chefs use various techniques like spherification, gelification, thickening, and emulsification to transform tastes and textures of food. Key equipment used includes an anti-griddle to freeze items, a smoking gun for cold smoking, a rotary vacuum evaporator for essence extraction, sous vide for precise temperature cooking, and a dehydrator. Notable chefs who have innovated include Ferran Adria with olive spheres and Grant Achatz with edible balloons. Farzi Cafe aims to bring Indian cuisine to the forefront using modern presentations and cooking techniques to create illusions with food.
Food allergies are an exaggerated immune response to certain foods, most commonly shrimp, milk, eggs, wheat, and fish. Symptoms usually occur within 2 hours of eating the offending food and can include stomach cramps, nasal congestion, itching, low blood pressure, and asthma. Skin and blood tests are used to confirm allergies, and elimination diets avoid suspected foods until symptoms disappear. Challenge testing under medical supervision may then be done to identify specific allergies, but this carries risks of severe allergic reactions. Treatment involves epinephrine injections for allergic reactions and consulting an allergist or immunologist.
This document provides information about food allergies and allergens. It lists common food allergens such as eggs, fish, milk, cereals containing gluten, and nuts. It then describes what a food allergy is versus a food intolerance, and lists potential symptoms of a food allergy such as hives, abdominal pain, and difficulty breathing. The document explains how to identify food allergens by checking food labels for bold, italicized listings of allergens. Lastly, it provides tips for managing a food allergy such as washing utensils, cleaning surfaces, informing restaurants of allergies, and being cautious of shared serving areas.
Eggs are a nutrient-dense food high in protein, vitamins, and minerals but low in calories. They provide significant amounts of many important nutrients including vitamins A, D, E, B12, riboflavin, phosphorus, selenium, and more. Specialty eggs from chickens fed specific diets can have enhanced levels of nutrients like omega-3s, vitamin E, or lutein. While eggs contribute nutrients to the American diet, it's important they are stored and cooked properly to eliminate any risk of salmonella.
Oral allergy syndrome (OAS), also known as pollen-food allergy syndrome (PFAS), is a localized allergic reaction in the mouth that is usually caused by cross-reactivity between pollen and raw fruits or vegetables. It is estimated that 5% of the general population suffers from PFAS. The condition is caused by cross-reactivity between IgE antibodies produced in response to inhaled pollen proteins and similar proteins found in certain raw foods. Common symptoms include itching and swelling of the lips, tongue, mouth and throat. Diagnosis involves a history of symptoms, skin prick tests, and oral food challenges. Treatment focuses on avoidance of raw trigger foods and use of antihistamines
Parental migration from Asia to Australia is an important risk factor for developing tree nut allergy in children. The prevalence of tree nut allergy varies globally, with hazelnut being most common in Europe and cashew in Australia. Co-sensitization and clinical allergy to multiple tree nuts is common due to cross-reactivity between related proteins. The major tree nut allergens are stable seed storage proteins, though some conformational changes can occur during food processing that potentially impact allergenicity. Clinical reactions can be severe or systemic. Diagnosis involves clinical history, skin prick testing, nut-specific IgE levels, and oral food challenges.
This document presents information about food allergies and intolerances. It defines food allergies as abnormal immune responses to food, while food intolerances are non-immune mediated reactions. The document outlines the objectives and scope, describing the major types of food allergies and intolerances, symptoms, most common allergens like peanuts and shellfish, diagnosis, and management through dietary avoidance and emergency epinephrine treatment. It also discusses regulations around food labeling of major allergens.
Food allergies can be IgE-mediated or non-IgE mediated reactions. The major food allergens in both children and adults are milk, eggs, soy, wheat, peanuts, nuts, shellfish and fish. Symptoms range from mild skin reactions to potentially life-threatening anaphylaxis. Diagnosis involves patient history, skin prick tests and oral food challenges. Treatment focuses on strict avoidance of culprit foods, emergency epinephrine administration for reactions, and management of symptoms with antihistamines. Patient education is key for self-management and prevention of accidental exposures.
This document discusses allergies to fruits and vegetables. It begins with an introduction to panallergens like profilin, nsLTPs and Bet v 1 that can cause cross-reactivity between plant foods and pollen. The epidemiology section notes that the prevalence of fruit allergies ranges from 0.1-4.3% while vegetable allergies range from 0.1-0.3%. Several case studies are presented demonstrating pollen-food allergy syndromes. Key allergens like profilin, nsLTPs, Bet v 1 and GRPs are discussed in depth, outlining their clinical relevance and evaluation.
This document discusses food allergies, including that an estimated 15 million people in the US have food allergies, with nearly 6 million children affected. It explains that a food allergy is an abnormal immune system response, while a food intolerance is due to an inability to digest certain foods. Symptoms of an allergic reaction can range from mild to severe and include hives, difficulty breathing, and anaphylaxis. Food allergies are diagnosed through skin prick tests, blood tests, and medical history. Management involves strictly avoiding trigger foods, reading labels, asking about ingredients when eating out, and having emergency epinephrine on hand.
The document provides information about allergy diagnostics and testing. It discusses the different types of allergies including food, environmental, occupational and insect allergies. It describes the importance of taking a thorough case history and outlines different diagnostic methods used to identify allergens including skin prick tests, patch tests and allergen-specific IgE blood tests. Accurately identifying the specific allergens responsible for a patient's symptoms is key to successful management and treatment of their condition.
The document discusses 8 common food allergens: 1) milk, 2) eggs, 3) peanuts, 4) wheat, 5) sesame seeds, 6) seafood, 7) sulphites, and 8) mustard. It notes that food allergies are caused by the immune system mistakenly reacting to harmless food proteins. Reading food labels can help identify foods that may cause allergic reactions by listing the top 8 allergens. People with food allergies should avoid the allergenic foods and carry epinephrine devices in case of emergencies.
This document discusses food allergies, including their epidemiology, causes, types (IgE-mediated vs non-IgE-mediated), symptoms, diagnosis, and management. It notes that food allergies are often seen in individuals with other atopic conditions like asthma and eczema. Common food allergens in infants are milk, eggs, and peanuts, while older children often have allergies to peanuts, tree nuts, and fish. Diagnosis involves taking a thorough history and potentially skin prick tests or blood tests to identify allergen-specific IgE antibodies. Management focuses on avoidance of the offending foods and use of emergency medications for severe or anaphylactic reactions.
This document provides information about food allergies and intolerances. It defines food allergies as immune system reactions to certain foods, while food intolerances involve an inability to digest some foods. The major food allergens are identified as crustaceans, milk, tree nuts, fish, eggs, peanuts, sesame seeds, soybeans, and gluten. Anaphylaxis is described as the most severe allergic reaction. Common food intolerances include lactose intolerance and milk intolerance. The document outlines management of allergies and intolerances through testing, first aid, reading labels, and always asking about ingredients when eating out.
Food allergies occur when the immune system reacts to otherwise harmless food proteins by producing IgE antibodies, which trigger the release of histamine and other substances when the food is consumed, causing allergic symptoms. The major food allergens include milk, eggs, fish, shellfish, tree nuts, peanuts, wheat and soybeans. Food intolerances are adverse reactions to foods that do not involve the immune system and can be caused by lactose, amines, salicylates, glutamates or food additives. Specialist diagnosis and testing is required to identify food allergies and intolerances.
This study evaluated the effect of consumer background on sensory scores of microwaved Angus loins. An untrained panel of 70 consumers of different ages, genders, and tribes evaluated sensory characteristics of microwaved Angus steak. The study found that age had no effect on sensory scores. Gender influenced sustained impression of juiciness, with males scoring it higher than females. Tribe influenced amount of connective tissue perceived. Several sensory characteristics were positively correlated, such as initial and sustained impression of juiciness, and first bite tenderness correlating with sustained juiciness and tenderness. Consumer background thus had some influence on sensory evaluation of microwaved Angus loins.
Recent analysis method of food allergen rakesh mund
Recent analysis method of food allergen
and case study related to recent method for food allergen analysis
rakesh kumar
Msc scholar IARI PUSA campus new delhi
8385884641 ; rakeshmund94@gmail.com
Oral allergy syndrome (OAS) is caused by cross-reactivity between pollen and certain raw fruits and vegetables. It occurs in up to 70% of pollen-allergic patients and involves oral itching and inflammation upon eating raw foods. Cross-reactivity is due to structural similarities between pollen and food allergens like profilin, PR-10, and lipid transfer proteins. Diagnosis involves a clinical history and skin or blood tests to specific food allergens. Treatment focuses on avoidance of raw foods and use of antihistamines for symptoms.
Food “Allergy” Testing for Adverse Food ReactionsAugustin Bralley
Learn how to differentiate classes of adverse reactions to food, understand the mechanism of sensitivity reactions, and interpret reports of IgG4 food antibodies.
Allergy testing is important for diagnosis of allergic conditions. Skin prick tests and blood tests like specific IgE tests can help identify triggers. Specific IgE tests like ImmunoCAP are more accurate than total IgE and are not affected by medications, skin conditions, or pregnancy. Phadiatop is a useful screening test to detect sensitization to common inhalants and foods. Positive results on screening tests should be followed up with customized allergen panels based on symptoms and environment. Reference lab data shows significant prevalence of sensitization to common allergens like dust mites, pollens, foods in the local population tested. Proper history and examination along with selection of right allergen panels is key to allergy diagnosis
Allergies are becoming increasingly common in Australia for a range of reasons. These slides were developed for a course created to help the community better understand and more effectively manage allergies.
Molecular gastronomy is the study of physical and chemical transformations of edible materials. Chefs use various techniques like spherification, gelification, thickening, and emulsification to transform tastes and textures of food. Key equipment used includes an anti-griddle to freeze items, a smoking gun for cold smoking, a rotary vacuum evaporator for essence extraction, sous vide for precise temperature cooking, and a dehydrator. Notable chefs who have innovated include Ferran Adria with olive spheres and Grant Achatz with edible balloons. Farzi Cafe aims to bring Indian cuisine to the forefront using modern presentations and cooking techniques to create illusions with food.
Food allergies are an exaggerated immune response to certain foods, most commonly shrimp, milk, eggs, wheat, and fish. Symptoms usually occur within 2 hours of eating the offending food and can include stomach cramps, nasal congestion, itching, low blood pressure, and asthma. Skin and blood tests are used to confirm allergies, and elimination diets avoid suspected foods until symptoms disappear. Challenge testing under medical supervision may then be done to identify specific allergies, but this carries risks of severe allergic reactions. Treatment involves epinephrine injections for allergic reactions and consulting an allergist or immunologist.
This document provides information about food allergies and allergens. It lists common food allergens such as eggs, fish, milk, cereals containing gluten, and nuts. It then describes what a food allergy is versus a food intolerance, and lists potential symptoms of a food allergy such as hives, abdominal pain, and difficulty breathing. The document explains how to identify food allergens by checking food labels for bold, italicized listings of allergens. Lastly, it provides tips for managing a food allergy such as washing utensils, cleaning surfaces, informing restaurants of allergies, and being cautious of shared serving areas.
Eggs are a nutrient-dense food high in protein, vitamins, and minerals but low in calories. They provide significant amounts of many important nutrients including vitamins A, D, E, B12, riboflavin, phosphorus, selenium, and more. Specialty eggs from chickens fed specific diets can have enhanced levels of nutrients like omega-3s, vitamin E, or lutein. While eggs contribute nutrients to the American diet, it's important they are stored and cooked properly to eliminate any risk of salmonella.
1. World Egg Day was launched in 1996 by the International Egg Commission to raise global awareness of the nutritional benefits of eggs and promote their consumption.
2. Eggs are highly nutritious, containing important proteins, vitamins, minerals, and other nutrients. They are particularly rich in choline and lutein/zeaxanthin, which are essential for brain and eye health.
3. Research shows that regular egg consumption is not associated with increased heart disease risk and may even help reduce the risk of age-related macular degeneration and cataracts.
importancia de los panalergenos en alergia alimentaria y en el sindrome de alergia oral. Reactividad cruzada entre alergenos de animales. Reactividad cruzada entre alergenos vegetales. Alergia entre distintas leches, pescados, mariscos, Síndrome de Látex fruta. Síndrome de Abedul-manzana. Proteína de transferencia lipídica y su importancia en la alergia a múltiples alimentos. Implicancias clínicas en los pacientes con rinitis alérgica. Reacciones alérgicas alimentarias de clase 2
Eggs have been a valuable food source since prehistory. They are rich in proteins, vitamins, and antioxidants. The chicken was likely domesticated for its eggs as early as 7500 BCE in Southeast Asia and India. Eggs provide many health benefits such as boosting vitamin levels and fighting anemia due to their iron content. They are also a good source of the B vitamin choline, which is essential for cell membrane construction. Eggs can be incorporated into the daily diet through various preparations like boiled, poached or scrambled eggs.
Edible eggs can deteriorate quickly after laying if not stored properly. The key factors that affect egg quality are temperature, humidity, and handling. As eggs age, chemical and microbial changes occur. The air cell enlarges, the white thins and spreads out, and the yolk shifts and flattens. Microorganisms like bacteria and mold can cause rotting. Proper storage below 4°C and 70-80% humidity helps maintain freshness. Eggs are graded based on interior and exterior quality standards.
This document discusses eggs, including their composition, market forms, selection factors, uses, storage, and cooking methods. It notes that hen eggs are most common but other bird eggs are also used. Eggs are available as whole, yolks, whites, or dried. A good egg weighs 55-60g and is 80% moisture. Eggs should be stored at 0-5°C and kept away from strong smells. Cooking methods include boiling, scrambling, and frying.
This document provides instructions for a final project creating a 7-day menu for someone with a food allergy. It discusses finding trusted recipe websites, reviewing 5 websites related to the chosen allergy, and posting favorites and least favorites to a discussion board. The goal is to learn which sites are helpful and try new recipes and ingredients to accommodate allergies.
Powerpoint presentation of "Egg Basic" in Principles of food production (.
Disclaimer: I do not own the rights nor property of this powerpoint presentation. All rights reserved to the owner.
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This document discusses feeding management of poultry. It begins by stating that India ranks 3rd in egg production and 4th in broiler production globally. It then discusses the six major classes of nutrients needed in poultry feed: carbohydrates, protein, fats, vitamins, minerals, and water. The document goes on to describe energy and protein requirements, types of protein supplements, mineral requirements including calcium and phosphorus, and vitamin requirements and deficiency diseases. It also discusses factors that affect feed intake and efficiency. Finally, it outlines feeding practices for broiler chickens and layers at different stages.
This document discusses food allergens and their management. It begins by introducing common food allergens like milk, eggs, fish, shellfish, tree nuts, peanuts, soy, wheat, and others. For each allergen, it identifies major allergenic proteins and cross-reactivity. It then discusses how to manage allergens by identifying critical control points in product design, ingredients, processing, packaging, storage and labeling. Proper cleaning, separation of ingredients and equipment, and avoidance of cross-contamination are important. The VITAL system provides a standardized way for companies to communicate potential trace allergen risks to consumers. Overall, good management practices and controls are vital for effective allergen control.
This document discusses techniques for inoculating viruses into embryonated eggs. It outlines three virus cultivation systems - biological systems, embryonated eggs, and tissue culture. Embryonated eggs are described as an in vivo and in vitro system that has advantages over animal inoculation like lower cost, easier maintenance, and less variability. The document details various routes for egg inoculation including the yolk sac, allantoic sac, chorioallantoic membrane, amniotic cavity, and intravenous routes. It provides examples of harvesting allantoic fluid and embryos after inoculation and images demonstrating pathogenic effects of viruses like infectious bronchitis, Newcastle disease virus, and blue tongue virus in eggs.
This document provides an overview of peanut allergy, including its epidemiology, allergens, clinical manifestations, diagnosis, and management. Peanut allergy prevalence is around 1-2% in western countries and appears to be less common in Asia. It is caused by sensitization to 17 major peanut allergens, especially seed storage proteins which are highly stable and associated with severe reactions. Symptoms range from mild to anaphylaxis. Diagnosis involves clinical history, skin prick testing, peanut-specific IgE levels, and oral food challenges. Component resolved testing helps identify primary versus cross-sensitization. Strict peanut avoidance is the primary management approach.
Alpha-gal syndrome is caused by IgE antibodies against the carbohydrate alpha-gal found in mammalian meat. It results in delayed allergic reactions 3-6 hours after eating beef, pork, or lamb. Diagnosis involves testing for alpha-gal-specific IgE antibodies or doing oral food challenges. Skin prick tests often underdiagnose it due to low alpha-gal levels in test solutions. The condition most often affects adults who developed sensitization from tick bites and had previously eaten mammalian meats without issues.
Alergias mediadas por anticuperpos ig e versus alergias mediadas por iggMEDIAGNOSTIC
IgG-mediated food sensitivity reactions are delayed, taking hours or days to appear after ingesting the offending food. Unlike immediate IgE-mediated food allergies, IgG sensitivities are difficult to detect without specialized testing and can involve multiple foods. Symptoms of IgG food sensitivity can affect any tissue or organ and include conditions like irritable bowel syndrome, asthma, and behavioral issues in children. Testing for IgG antibodies to specific foods can help identify sensitivities and guide elimination diets to improve conditions like rheumatoid arthritis and autism.
This document discusses vaccine allergies and reactions. It outlines different types of vaccine reactions including IgE-mediated and non-IgE mediated reactions. Specific allergens in vaccines like gelatin, egg, latex, and yeast are examined. Data on the risk of anaphylaxis from vaccines is presented from various studies. Skin testing for vaccine allergy diagnosis and management of patients with suspected vaccine hypersensitivity is addressed. Reactions to individual vaccines such as influenza, MMR, and yellow fever are also reviewed.
This document discusses the prevalence of food allergies in Southeast Asia based on a presentation by Dr. BW Lee from the National University of Singapore. It provides data on the prevalence of various food allergies like peanut allergy from studies in countries in the region. It notes that food allergy patterns may be related to environmental allergens through cross-reactivity. It also presents several case studies of allergic reactions triggered by novel allergens like prebiotics in cow's milk formula and discusses mechanisms of carbohydrate allergen epitopes.
This document summarizes research on wheat allergy. It finds that wheat allergy prevalence is approximately 0.4-1% in children and 0.3-0.5% in adults. Symptoms typically present as skin reactions, gastrointestinal issues, or respiratory symptoms. Wheat allergy often resolves by ages 6-7. Key wheat allergens include alpha-amylase inhibitors, lipid transfer proteins, gliadins and glutenins. Diagnosis involves tests for wheat-specific IgE or oral food challenges. Wheat allergy is associated with increased risk of developing respiratory allergies.
The document discusses food immunotherapy for treating food allergies. It provides definitions and outlines immune mechanisms and efficacy evidence from studies on peanut, cow's milk, egg, and wheat oral immunotherapy (OIT). Peanut OIT studies showed 67-78% of children achieved desensitization and 21-46% achieved sustained unresponsiveness. Cow's milk and egg OIT also demonstrated desensitization in 50-75% of children. Wheat OIT studies found 52-69% achieved desensitization. OIT was effective at increasing tolerance but also increased rates of adverse events during treatment.
201911 - Villalta - Novità in ambito di diagnostica molecolare nella sensibil...Asmallergie
This document discusses advances in molecular diagnostics for mite sensitization. It begins with a brief history of allergy to house dust mites and an overview of the major allergenic molecules from mites, including Der p 1, Der p 2, and Der p 23. It describes the concept of "molecular spreading" where the IgE response spreads from initial sensitization to major allergens to include other milder allergens over time. The document then covers classical and molecular diagnostic techniques for mite allergy. It concludes by discussing the potential predictive role of antibody patterns to different mite allergens.
This document discusses allergy diagnosis and testing. It provides information on:
1. The types of allergies including asthma, rhinitis, food allergy.
2. Allergy tests including skin prick tests, specific IgE tests, basophil histamine release tests.
3. Indications for allergy testing including persistent asthma, occupational exposures, and before immunotherapy.
4. Cases demonstrating how test results along with clinical history are used to diagnose conditions like allergic rhinitis, Churg-Strauss syndrome, and food allergy.
Relevancia clínica de las pruebas tipo eliza para determinación de intoleranc...MEDIAGNOSTIC
This document discusses IgG food allergy testing using ELISA (Enzyme-Linked Immunosorbent Assay). It notes that while IgE-mediated food allergies are well-established, most food allergies involve non-IgE immune responses detectable by IgG testing. The document examines limitations of traditional IgE tests like skin prick tests and discusses advantages of ELISA for detecting both IgE and IgG responses. It emphasizes the importance of IgG in delayed food allergies and outlines technical and quality standards laboratories must meet to ensure ELISA provides reliable, reproducible and valid results.
The document discusses alpha-gal syndrome, which causes delayed allergic reactions to red meat in some individuals. It may be triggered by tick bites that induce IgE antibodies against the alpha-gal oligosaccharide found in mammalian meat. Patients report generalized hives, swelling, or anaphylaxis hours after eating beef, pork or lamb. The condition is diagnosed by positive tests for alpha-gal IgE antibodies. Management involves strictly avoiding all mammalian meat and organs as well as tick bites. The cause of the delayed reactions and high antibody levels from tick bites remains unknown.
Wheat is one of the most important global food sources and wheat allergy prevalence varies from 0.4-4% depending on age and region. Several wheat proteins have been identified as major allergens, including omega-5-gliadin, alpha-amylase inhibitors, and glutenins. Studies have found that serum testing for IgE antibodies to specific wheat allergens, such as omega-5-gliadin, glutenins, and alpha-amylase inhibitors, can help diagnose wheat allergy and distinguish between mild and severe cases. Sensitization to different wheat allergens is associated with wheat-dependent exercise-induced anaphylaxis versus occupational baker's asthma. Proper diagnosis and
This document summarizes information about wheat allergy, including its prevalence, wheat proteins and allergens, clinical manifestations, diagnosis, and management. Some key points:
- Wheat allergy prevalence varies by age and region, ranging from <1% to over 3% in Europe and the US. It is less common in Asia-Pacific regions.
- Major wheat allergens include alpha-amylase inhibitors, lipid transfer proteins, gliadins like omega-5-gliadin, and glutenins. These can cause reactions from baker's asthma to food allergy.
- Clinical manifestations depend on exposure route and age. Symptoms include immediate reactions like anaphylaxis as well as
Skin prick testing of pediatric allergies copy.pptxdrgsvt
Skin prickly test is the most useful, easiest and affordable investigation to identify the suspected allergen as to the cause of sensitisation … it will detect bound IgE … it is preferred to immunocap assay test…
Tree nut allergy is prevalent in approximately 0.6-1.2% of the American population. Major tree nuts that commonly cause allergies include walnut, almond, pistachio, cashew, pecan, hazelnut, macadamia, Brazil nut, and pine nut. Diagnosis involves taking a careful history, skin prick testing, measuring nut-specific IgE levels, and oral food challenges. Thermal processing may reduce the allergenicity of some but not all tree nut proteins. Reactions can range from mild oral symptoms to potentially life-threatening anaphylaxis.
This document provides an overview of immunoglobulin E (IgE) and IgE receptors. It discusses the history and discovery of IgE, the structure and function of IgE, and IgE receptors such as FcεRI and CD23. It also covers the clinical significance of IgE levels in various diseases, including allergic diseases, infections, and non-atopic diseases. IgE plays an important role in type I hypersensitivity reactions and defense against parasites. The production and role of IgE is highly complex and involves interactions between immune cells, cytokines, and environmental exposures.
Similar to Egg allergy: new allergens and molecular diagnosis (20)
- Cat and dog allergens such as Fel d 1 and Can f 1 are major allergens found in fur, dander, and saliva that can become airborne and cause sensitization in a large percentage of allergic individuals.
- Lipocalins make up many mammalian allergens and show cross-reactivity between species due to structural similarities, explaining co-sensitizations between cats, dogs, horses, and other animals.
- Higher levels of IgE antibodies to specific dog lipocalins are associated with more severe asthma in children with dog allergy.
1) DRESS syndrome is a severe cutaneous drug reaction characterized by fever, lymphadenopathy, hematologic abnormalities, multisystem involvement, and viral reactivation. It has a delayed onset of 2-3 weeks after starting the culprit drug.
2) The skin manifestations are typically a polymorphous maculopapular eruption and facial edema. Systemic involvement can include the liver, kidneys, lungs and other organs.
3) Diagnosis is based on clinical criteria including the RegiSCAR scoring system which evaluates morphology, timing of onset, organ involvement, hematologic abnormalities and viral reactivation.
Major indoor allergens include dust mites, domestic animals like cats and dogs, insects like cockroaches, mice, and fungi. Dust mites thrive in warm, humid environments like mattresses, bedding, and upholstered furniture, where they feed on human skin scales and excrete allergenic fecal particles. Cat allergens like Fel d 1 accumulate in fur and can become airborne, causing worse asthma outcomes in sensitized individuals. Minimizing exposure involves removing carpets, frequent washing of bedding, humidity control, HEPA filtration and ventilation.
This document provides information on Hymenoptera, focusing on the families Apidae and Vespidae. It discusses the epidemiology and prevalence of insect venom allergy. It also covers the taxonomy, venom composition, and clinical manifestations of common stinging insects like honeybees, hornets, wasps and yellow jackets. Key allergens are identified for different species.
- NSAIDs hypersensitivity can present with distinct clinical phenotypes based on organ system involvement and timing of symptoms. It is estimated that less than 20% of reported adverse reactions to NSAIDs are true hypersensitivities.
- AERD/NERD involves eosinophilic rhinosinusitis, asthma, and nasal polyps. Exposure to aspirin or other NSAIDs exacerbates bronchospasms and rhinitis. Management involves lifelong avoidance of culprit and cross-reacting NSAIDs.
- Various phenotypes are described beyond the EAACI classification, including blended reactions involving multiple organs, food-dependent NSAID-induced anaphylaxis, and NSAID-selective immediate reactions. Proper diagnosis relies
This document summarizes X-linked agammaglobulinemia (XLA), an inherited primary immunodeficiency caused by mutations in the Bruton's tyrosine kinase (Btk) gene. XLA is characterized by absent B cells and low immunoglobulin levels, leading to recurrent bacterial infections starting in infancy. Management involves immunoglobulin replacement and antibiotic therapy. With treatment, life expectancy has improved dramatically though complications can include lung disease. The document also briefly discusses other forms of agammaglobulinemia caused by defects in genes important for early B cell development.
This document discusses histamine and anti-histamines. It provides information on:
1. The structure and function of histamine and its receptors in immune response regulation. Histamine plays a role in processes like antigen presentation and influencing T and B cell responses.
2. The classification and structures of different types of anti-histamines, including first and second generation anti-histamines from different chemical classes.
3. Some anti-histamines have the potential to cause hypersensitivity in rare cases, even those from different chemical classes with no structural similarity.
The document discusses beta-lactam allergy, including penicillin and cephalosporin allergies. It covers the epidemiology, classifications, structures, mechanisms, and investigations of beta-lactam allergies. Specifically, it notes that penicillin is the most commonly reported antibiotic allergy. It describes the hapten concept of small molecules like beta-lactams binding covalently to proteins to form antigen complexes. Skin testing and in vitro tests are used to investigate immediate IgE-mediated allergies, while patch testing is used for delayed reactions.
This document provides an overview of intravenous immunoglobulin (IVIG) therapy. It discusses the structure and classes of immunoglobulins, mechanisms of action including neutralization, opsonization, and modulation of immune cells. It also covers the manufacturing process, pharmacokinetics, indications for use in primary immunodeficiencies and autoimmune diseases, dosing, administration, and adverse effects. The differences between IVIG products are also reviewed.
Local anesthetics are commonly used drugs that stabilize neuronal membranes and inhibit neural impulses. The most commonly used local anesthetics include lidocaine, bupivacaine, prilocaine, mepivacaine, and articaine. True allergy to local anesthetics is rare, estimated to be less than 1% of reactions. When allergic reactions occur, they are usually type I or IV hypersensitivity responses. Preservatives like PABA and methylparaben, and additives like sulfites and epinephrine, may also cause reactions. Evaluation of local anesthetic allergy involves careful history taking and consideration of various reaction types and potential cross-reactivities.
10 Benefits an EPCR Software should Bring to EMS Organizations Traumasoft LLC
The benefits of an ePCR solution should extend to the whole EMS organization, not just certain groups of people or certain departments. It should provide more than just a form for entering and a database for storing information. It should also include a workflow of how information is communicated, used and stored across the entire organization.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
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• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
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In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
5-hydroxytryptamine or 5-HT or Serotonin is a neurotransmitter that serves a range of roles in the human body. It is sometimes referred to as the happy chemical since it promotes overall well-being and happiness.
It is mostly found in the brain, intestines, and blood platelets.
5-HT is utilised to transport messages between nerve cells, is known to be involved in smooth muscle contraction, and adds to overall well-being and pleasure, among other benefits. 5-HT regulates the body's sleep-wake cycles and internal clock by acting as a precursor to melatonin.
It is hypothesised to regulate hunger, emotions, motor, cognitive, and autonomic processes.
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The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
Mercurius is named after the roman god mercurius, the god of trade and science. The planet mercurius is named after the same god. Mercurius is sometimes called hydrargyrum, means ‘watery silver’. Its shine and colour are very similar to silver, but mercury is a fluid at room temperatures. The name quick silver is a translation of hydrargyrum, where the word quick describes its tendency to scatter away in all directions.
The droplets have a tendency to conglomerate to one big mass, but on being shaken they fall apart into countless little droplets again. It is used to ignite explosives, like mercury fulminate, the explosive character is one of its general themes.
The skin is the largest organ and its health plays a vital role among the other sense organs. The skin concerns like acne breakout, psoriasis, or anything similar along the lines, finding a qualified and experienced dermatologist becomes paramount.
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Travel Clinic Cardiff offers comprehensive travel health services, including vaccinations, travel advice, and preventive care for international travelers. Our expert team ensures you are well-prepared and protected for your journey, providing personalized consultations tailored to your destination. Conveniently located in Cardiff, we help you travel with confidence and peace of mind. Visit us: www.nxhealthcare.co.uk
3. Introduction
• Egg allergy may be defined as an adverse reaction of
immunologic nature induced by egg proteins
– IgE ,non-IgE , mixed IgE-mediated disorders
• hen’s egg allergy is the second most common food
allergy in infants and young children
• closely associated with atopic dermatitis
• Increase risks of sensitization to aeroallergens and
asthma in children with egg allergy
Pediatr Clin N Am 2011;58:427–443
4. Prevalence
• estimated prevalence : varies depending on method
of data collection or definition
• A meta-analysis of the prevalence of egg allergy in
children
– Self-reported prevalence : up to 7%
– challenge-confirmed egg allergy : up to 1.7%
Allergy 2010; 65: 283–289
5. Prevalence
In Thailand
• Santadusit S, et al.
– Egg allergy : 1.52%
J Med Assoc Thai 2005;88:S27-32
• Unpublished data 2012, Chulalongkorn university
– egg allergy : 1.1% (parent reported and physician diagnosis) in young
children
10. Ovomucoid
• dominant allergen in egg
• unique characteristics
– relative stability against heat and digestion with proteinases
– presence of strong disulfide bonds that stabilize protein
• children with persistent egg allergy had significantly higher
specific IgE levels to OVM than children who outgrew their egg
allergy
• A favorable prognosis was associated with the absence or a
decline in OVM-specific IgE titers
Allergy 2007; 62:758–765
Curr Opin Allergy Clin Immunol 2011, 11:210–215
11. Ovalbumin
• heat-labile and less allergenic
• IgE-binding epitopes on OVA might be destroyed
after heating : children who have specific IgE
primarily to OVA are likely to tolerate heated egg
Curr Opin Allergy Clin Immunol 2011, 11:210–215
12. Ovalbumin
• The Maillard reaction occurs between reducing sugars and
proteins during thermal processing of foods
• It produces chemically glycated proteins termed advanced
glycation end products (AGEs) T-cell immunogenicity of
chemically glycated ovalbumin
• The glycation structures of AGEs are suggested to function as
pathogenesis-related immune epitopes in food allergy
J Allergy Clin Immunol 2010;125:175-83.
14. • Diluted egg white proteins were separated by 2-dimensional
(2-D) gel electrophoresis
63 spots
Allergology International. 2010;59:175-183
15. • Immunolabeling was performed on individual patient sera
• 19 child patients with egg white allergy
• 11 negative control subjects
19 patients 11 negative control subjects
-Aged 2.2 ± 1.7 years -Aged 4.0 ± 3.7 years
-Total IgE 434.1 ± 424.7 Iuml -no clinical history of any allergic
-Diagnosis was based on clinical history symptoms
and CAP-RAST results to hen’s egg
white
-Open food challenges : 9/19 patients
Allergology International. 2010;59:175-183
17. 15/25
• Spots of egg white proteins that bound to the patients’ IgE
were identified by mass spectrometry-based proteomics
10/25
Allergology International. 2010;59:175-183
18. Identification of IgE-reactive
spots
• spots were excised
• digested in-gel with trypsin
• The resulting peptide mixtures were analyzed by
26% pt – LC-MS/MS (Liquid chromatographytandem mass
16% pt
spectrometry)
L-PGDS
– MALDI-TOF/MS (matrix assisted laser desorption
(1 anaphylaxis)
ionization time of flight mass spectrometry)
53% pt
Allergology International. 2010;59:175-183
19. L-PGDS
Cystatin
• Reaction to LPGDS and cystatin was confirmed using each purified
protein
Allergology International. 2010;59:175-183
20. Ch21 protein and L-PGDS
• Ch21 protein and L-PGDS belong to the lipocalin Family
• has been reported as allergenic
• Ch21 protein and L-PGDS were minor allergens
• However, the sera from patient (MT,HS), which reacted to spot no.
28 did not seem to react to the major spots, such as nos. 3, 4, 5, 48, or 49
not only the hidden allergen components, but there
are some patients who are preferentially reacting to those
minor egg allergens
• minor allergen does not always mean that it is allergenically
poor
Allergology International. 2010;59:175-183
21. Ch21 protein and L-PGDS
• PGD2 synthesized by L-PGDS is related to allergic
inflammation in vivo and that L-PGDS from chicken shows
PGDS activity
• These reports suggest that L-PGDS induces allergic reactions
in addition to binding to IgE, and that PGD2 may exist in eggs
Allergology International. 2010;59:175-183
22. Cystatin
• cysteine protease inhibitor
• allergen in cats and dogs
• considered to be a major allergen because it showed high
reactivity to IgE from patients with egg allergy
• 2 possible reasons for the lack of literature on cystatin as an
allergen
– similarity in molecular weight of cystatin and lysozyme, a
major allergen, makes it difficult identify cystatin without
using 2-D gel electrophoresis
– presence of only a small amount of cystatin in eggs makes
it difficult to identify without development of LC-MSMS
Allergology International. 2010;59:175-183
24. Egg yolk allergens
• alpha-livetin or chicken serum albumin (Gal d 5) is
the major allergen and is involved in the bird-egg
syndrome
• Several other allergens have been identified in egg yolk
– vitellenin (apovitellenin I) and
– apoprotein B (apovitellenin VI)
– roles in food allergy remain unclear
Pediatr Clin N Am 2011;58:427–443
25. Bird-egg syndrome
• primary sensitization is to airborne bird allergens (feathers,
droppings, serum) and there is secondary sensitization or cross-
reactivity with albumin in egg yolk (Gal d 5)
• respiratory symptoms such as rhinitis and/or asthma with bird
exposure
• allergic symptoms (respiratory and gastrointestinal symptoms) when
egg is ingested
• In children with allergy to birds and egg, egg allergy is usually more
persistent
• Sensitization to other aeroallergens is also greater in individuals with
allergy to birds and egg
Allergy 2001: 56: 754-762
Allergol et Immunopathol 2003;31(3):161-5
27. • Sera from 27 patients (ages 2-74 yrs) with egg allergy
(clinical history and both positive-specific IgE and SPTs to egg)
• sera from 2 non-allergic subjects as negative controls
• The study was performed by
– sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and
– IgE-immunoblotting and
– IgEimmunoblotting- inhibition assays
• egg yolk extract was fractioned by reverse-phase high performance
liquid chromatography (RP-HPLC)
J. Agric. Food Chem. 2010, 58, 7453–7457
28. • A new allergen with an apparent molecular weight around 35 kDa was identified
from the yolk extract and enriched by RPHPLC (Figure 1A)
• 5/27 patients studied (18%of patients) showed specific IgE binding to the allergen
(Figure 1B)
J. Agric. Food Chem. 2010, 58, 7453–7457
30. • new allergen detected was characterized by N-terminal amino acid analysis
• revealed that allergen was the yolk glycoprotein 42 (YGP42) protein,
a fragment of the vitellogenin-1 (VTG-1) precursor (positions 1628-1912)
• The allergen has been designated Gal d 6.0101 by the World Health
Organization (WHO)/International Union of Immunological Societies
(IUIS) Allergen Nomenclature Subcommittee
J. Agric. Food Chem. 2010, 58, 7453–7457
31. • heat-resistant but digestible by pepsin
J. Agric. Food Chem. 2010, 58, 7453–7457
32. J Allergy Clin Immunol 2004;113:805-19
• Conformational epitopes can be destroyed with heating or partial hydrolysis
• Egg-specific IgE molecules that identify sequential or
conformational epitopes of OVM and OVA can distinguish
different clinical phenotypes of egg allergy
– patient with IgE antibodies reacting against sequential epitopes
tend to have persistent allergy
– IgE antibodies primarily to conformational epitopes tend to
have transient allergy
Pediatr Clin N Am 2011;58:427–443
34. Diagnosis
• Double-blind, placebo-controlled food
challenge : gold standard
• open food challenges (OFCs)
– Less resource-intensive
– are generally considered sufficient in clinical
practice
Curr Opin Allergy Clin Immunol2009;9:244–250
35. Diagnosis
• detailed history and physical examination
• in vitro and/or in vivo allergy tests
– used to support diagnosis
– food-specific IgE antibodies
– skin prick tests
– diagnostic elimination diet
– OFC
Pediatr Clin N Am 2011;58:427–443
36. Skin prick tests
• used in screening for egg-specific IgE and should be
performed by trained personnel
• diagnostic accuracy is dependent on quality of the extract,
which should be standardized
• SPT shows a good sensitivity and NPV, but poor specificity and
PPV
– negative test essentially excludes an IgE-mediated egg
allergy
– positive test does not predict clinical reactivity accurately
Allergy 2010; 65: 283–289
37. Skin prick test for diagnosis
References Year Age group (yr) Method Numbers of PPV SPT Wheal
of Dx patients diameter (mm)
Sampson and 1997 Children and DBC 100 85 ≥3*
Ho1 adolescents
Sporik et al2 2000 <2 OC 39 100 ≥ 5 EW
>2 82 ≥ 7 EW
Boyano- 2001 <2 OC 81 93 ≥ 3 EW,EY
Martinez et al 3
Monti et al4 2002 <19 mo (mean 16 mo) OC 107 100 ≥ 5 EW, EY
Hill et al5 2004 <2 OC 30 100 ≥5*
Verstege et al6 2005 All(3 mo-14.5yr) DBC/OC 160 95 ≥ 13 fresh mixed EW&EY
<1 26 ≥ 11.2
>1 134 ≥ 13.3
1JAllergy Clin Immunol 1997;100(4):444–51 4Clin Exp Allergy 2002; : –
2Clin Exp Allergy 2000;30(11):1540–6 5Pediatr AllergyImmunol 2004;15(5):435–41
3Clin Exp Allergy 2001;31(9):1464–9 6Clin Exp Allergy ; ( ): –
38. Serum specific IgE
References Year Age group (yr) Method Numbers of PPV Egg-specific IgE
of Dx patients (kUA/L)
Sampson and 1997 Children and DBC 100 95 6*
Ho1 adolescents
Sampson2 2001 3 mo-14 yrs DBC 75 98 7*
(median 3.8yr)
Boyano- 2002 11-24 mo OC 58 95 2 EW
(mean 16 mo)
Martinez et al3
Osterballe and 2003 0.5-4.9 yr OC 56 95 1.5 EW
Bindslev-Jensen4 (median2.2yr)
Celik-Bilgili et 2005 0.1-16.1 yr OC All 277 95 12.6 *
al5 (median13mo) ≤ 1 yr 41 10.9
> 1 yr 186 13.2
1J Allergy Clin Immunol 1997;100(4):444–51 4 J Allergy Clin Immunol 2003; 112:196–201
2J Allergy Clin Immunol 2001;107:891-6 5Clin Exp Allergy 2005; 35:268–73
3 J Allergy Clin Immunol 2002;110(2):304–9
39. Serum specific IgE (cont.)
References Year Age group (yr) Method Numbers of PPV Egg-specific IgE
of Dx patients (kUA/L)
Komata et 2007 0.2-14.6 yr OC 764 95 ALL ≥ 25.5
al6 (median2.2yr) ≤ 1 : 13
1-2 : 23
≥ 2 : 30
Benhamou 2008 16 mo – 11.9yr OC/DBC 35 95 7*
et al7 (median 3.9 yr)
Ando et al 8 2008 14 mo – 13yr DBC 108 95 (raw EW EW 7.38
(median 34.5 mo) allergy) OVA 9.84
OVM 5.21
84-88 (heated EW 30.7
EW allergy)
OVA 29.3
OVM 10.8
6J Allergy Clin Immunol 2007; 119:1272–4
7Pediatr Allergy Immunol 2008; 19:173–9
8J Allergy Clin Immunol 2008; 122:583–8
40. MOLECULAR DIAGNOSIS IN FOOD ALLERGY
• specific responses at the level of individual allergenic proteins :
component-resolved diagnosis [CRD]
or
• IgE-binding epitopes of allergens : epitope mapping or profiling
Immunol Allergy Clin N Am 2012;32:97–109
41. Microarray-based component-resolved
diagnosis
• ImmunoCAP-ISAC or Immuno Solid phase Allergen Chip
(VBC Genomics-Vienna, Austria; Phadia, Uppsala, Sweden)
• It currently has 112 native/recombinant component allergens
from 51 allergenic sources
• two main advantages:
– assesses simultaneously specific IgE to different components and
requires small amounts of serum(relevant in children)
– cost-efficient approach, as it delivers results for over 100 components
Curr Opin Allergy Clin Immunol 2011;11:210–215
Immunol Allergy Clin N Am 2012;32:97–109
42. • infants and children ,suspected IgE-mediated food (CM or HE)
– Skin (42%), respiratory (6%), GI (16%), combination of skin, RS,GI (32%),
anaphylactic shock (4%)
– Only atopic eczema were excluded
• all patients SPT, sIgE (ImmunoCAP and microarray) and open
food challenge test were performed
• Total 104 patients (62 males and 42 females), median age of 4.9
yrs (range 0.7–15.1)
• hen’s egg allergy 46 patient
Clinical & Experimental Allergy, 2010 (40) 1561–1570
43. • FCT resulted positive in 22/46 (48%) patients with suspected
HE allergy
Clinical & Experimental Allergy, 2010 (40) 1561–1570
44. 95% predicted probability (CDP)of a positive FCT Clinical & Experimental Allergy, 2010 (40) 1561–1570
46. ↓FCT≈15% ↓FCT≈37%
Sequential use of the
two tests did not lead to
a further improvement in
clinical performance
False negative remains relatively high FCT should still be performed
Clinical & Experimental Allergy, 2010 (40) 1561–1570
47. • 68 children (47 male, 69.1%),
• Age 1 - 11 years (median 4.1 years)
• suspected HE allergy based on
– reported history of reactions like asthma, rhinitis, conjunctivitis,
urticaria, worsening of eczema, vomiting, other gastro-intestinal tract
symptoms, anaphylaxis, after ingestion or contact with HE,
– and positive SPT or IgE to HE white extracts
• 42/68 (62%) reported atopic dermatitis as the main allergic
complain
Clinical & Experimental Allergy 2012 :42;441-451
48. • Skin prick test
– Commercial extracts (Allergopharma, Reinbek, Germany) and fresh eggs using
the prick-prick technique
– Fresh: white and yolk from both raw and processed boiled HE
– Positive : wheal greater than 7 mm2
• Total and specific IgE
– HE white and yolk : ImmunoCAP (Phadia AB, Uppsala, Sweden)
– Specific IgE detection for Gal d 1, Gal d 2, Gal d 3 and Gal d5 : ISAC 103
microarray test (PMD, Vienna, Austria)
• Double- blind, placebo-controlled food challenge (DBPCFC)
– First : boiled egg (totol HE protein 6 g)
– Patients tolerating boiled HE were then challenged with raw HE
– patients with positive response to boiled HE challenge were considered likely to
be allergic to both boiled and raw eggs
Clinical & Experimental Allergy 2012 :42;441-451
51. ISAC
20 of 21 Gal d 1 positive
patients (95%) reacted to
raw egg.
44/47 Gal d 1 negative
patients (94%) could
tolerate boiled egg
Clinical & Experimental Allergy 2012 :42;441-451
53. ISAC – Other sensitization
• 13 patients had no additional IgE detectable sensitizations on
ISAC (103 microarray system)
– 10 were in ST group
– 3 in PT group
– none in A group
• 54 subjects : positive for at least one non-HE allergen
– higher sensitization prevalence to other food and nonfood
allergens in group A
Clinical & Experimental Allergy 2012 :42;441-451
54. A
PT
ST
Allerrgen group sensitization
LTP: Cor a 8, Pru p 3
Parvalbumin: Cyp c 1, Gad c 1
PR-10: Act d 11, Api g 1, Ara h 8, Bet v 1, Cor a 1.0101, Cora1.0401, Dau c 1, Mald 1, Pru p 1, Gly m 4
Profilin: Bet v 2, Hev b 8, Mer a 1, Ole e 2, Phl p 12
Tropomyosin: Der p 10, Ani s 3, Pen a 1,Pen i 1, Pen m 1;
Clinical & Experimental Allergy 2012 :42;441-451
55. statistically significant differences
Anisakis: Ani s 1
Kiwi: Act d 1, Act d 2,Act d 5
Cow’s milk: Bos d 4, Bos d 5, Bos d 8
Seeds: Ana o 2, Ara h1, Ara h 2, Ara h 3, Ber e 1, Cor a 9, Gly m 5,Gly m 6, Ses i 1;
Wheat: Tri a 18, Tri a 19, Tri a Gliadin
Clinical & Experimental Allergy 2012 :42;441-451
56. Cat: Fel d 1,
Cypress: Cry j 1, Cup a 1;
Dog: Can f 1, Can f 3
Grasses: Phl p 1, Phl p 2, Phl p 4, Phl p 5, Phl p 6, Phl p 11
Mites: Der p 1, Der p 2, Der f 1, Der f 2, Eur m 2
Olive: Ole e 1
Clinical & Experimental Allergy 2012 :42;441-451
57. • IgE detection to Gal d 1 on the ISAC microarray system useful
tool to predict oral tolerance to boiled eggs
• DBPCFC in egg allergic children should be performed first with
boiled eggs to introduce at least well cooked eggs in HE
allergic children’s diet
• Outgrowing clinical allergy leads to negativity of tests later on,
and ISAC IgE detection reaches such condition before all other
tests
– majority of the subjects tested negative for HE allergens on ISAC were in the PT and ST
groups
Clinical & Experimental Allergy 2012 :42;441-451
58. • Patients without previous egg exposure were recruited
between January 2005 and October 2011
• examined to determine their sIgE titers (mostly because of
atopic dermatitis, other food allergies, or family history)
• n= 100, males/females = 69/31
• Median age of 17 months (range 12-23 months)
J Allergy Clin Immunol 2012:129(6);168132
59. • sIgE titers to EW (n = 100) and OVM (n = 80, males/females = 55/25)
: ImmunoCAP System (Phadia AB, Uppsala, Sweden)
• OVM was not determined in 20 patients because of inadequate
sample volume or cost of the testing
• 2 children were sIgE-negative to EW, but they had previously
tested positive to EW or had a positive skin prick test result
J Allergy Clin Immunol 2012:129(6);168132
60. • open OFCs using boiled EW
• Each child ate EW, boiled for more than 20 minutes, in
increasing amounts (trace, 1, 2, 5, and 10 g) at 20-minute
intervals
• total amount : half a large egg, containing 2.0 g of EW protein
• OFC was not conducted in patients with extremely high sIgE
titers to EW and OVM (50 kUA/L or higher [n = 17]) to
decrease the risk of inducing reactions
J Allergy Clin Immunol 2012:129(6);168132
61. • Positive challenges 33 patients
– dermal (n = 31), RS (n = 8), and GI (n = 4) symptoms
– sIgE to OVM was examined in 27 patients
• Multisystem reactions : 12 patients
• 3 required intramuscular epinephrine injection
• The median cumulative EW dose required to provoke allergic
symptoms was 10.6 g (range, 1.0-18.5 g), containing
approximately 1.7 g of EW protein
J Allergy Clin Immunol 2012:129(6);168132
62. • The median concentration of sIgE against EW was
– 15.6 kUA/L (range, 1.58-51.3 kUA/L) in challenge-positive patients,
(significantly higher, P <0.01)
– 4.34 kUA/L (range, 0.35-51.5 kUA/L) in challenge-negative patients
• A similar difference was observed for OVM (P < 0.01)
– 8.12 kUA/L (range, 0.35-48.8 kUA/L)
– 1.00 kUA/L (range, 0.35-32.0 kUA/L; P < .01)
J Allergy Clin Immunol 2012:129(6);168132
63. sIgE to EW
10 kUA/L: 30% PPV
30 kUA/L:65% PPV
The calculated sIgE
titer that indicated a
95% PPV was sIgE to OVM
61.8 kUA/L for EW 10 kUA/L: 54% PPV
26.6 kUA/L for OVM
30 kUA/L:97% PPV
J Allergy Clin Immunol 2012:129(6);168132
64. Patients with undetectable
sIgE against OVM (<0.35 kUA/L; n = 24),
regardless of the sIgE titer to
EW (range, 0.35-27.5 kUA/L), showed
88% (21 of 24) likelihood of a
negative challenge
3 individuals demonstrating a
positive OFC showed only mild
cutaneous symptoms
indicate the advantage of using sIgE titers against OVM to identify
patients who can safely consume boiled egg products
J Allergy Clin Immunol 2012:129(6);168132
65. • OVM IgE : new predictive marker
• sIgE titer against OVM has a better predictive value than does
a titer against EW
• But for safety, we recommend an office challenge to introduce
egg products to the sensitized children, even if sIgE to OVM is
negative
J Allergy Clin Immunol 2012:129(6);168132
66. Treatment
• Standard therapy for egg allergy is strict
avoidance
Or a l i mmu n o t h e r a p y
(O I T ) o r
s p e c i f i c o r a l
Gallus domesticusไก่บ้านImmunocapมี Gal d123 ใน egg white but egg yolk Gal d 5Most of the allergenic egg proteins are found in egg whiteThe main allergen in egg yolk, chicken serum albumin (also called alpha-livetin, Gal d 5), is thought to be involved in thepathogenesis of bird-egg syndrome
OVA : most abundant proteinOVM : dominant allergen OVM 28 kDa glycoprotein comprising 186 amino acids It comprises 3 protein domains, each stabilized by 3 intradomain disulfide bondsส่วน ovotransferrin , lysozymeมีบทบาทน้อยAllergo Sorbent Test (RAST) reported the order of allergenicity as ovomucoid > ovalbumin > ovotransferrin > lysozymeThe allergenicity of proteins depends mostly, but not exclusively, on their resistance to heat and digestive enzymes
Egg-yolk alpha-livetin, chicken serum albumin (CSA),All patients had positive skin tests and serum IgE against egg yolk, chicken serum, chicken meat, bird feathers, and chicken albumin. The presenceof airborne chicken albumin in the domestic environment was con®rmed.Speci®c bronchial challenge to chicken albumin elicited early asthmatic responses in six patients with asthma. An oral challenge with chicken albuminprovoked digestive and systemic allergic symptoms in the two patients challenged. IgE reactivity to chicken albumin was reduced by 88% after heatingat 90uC for 30 min. ELISA inhibition demonstrated only partial cross-reactivity between chicken albumin and conalbumin