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Background: Few studies have assessed the nature of accidental allergic reactions (AAR). We assessed the prevalence and risk factors for AAR in Japanese children., Methods: This study included children with immediate-type hen's egg (HE), cow's milk (CM), wheat, or peanut allergy who developed allergic reactions within at least 2 years and were followed up regularly at a single national allergy center in Japan. From January to December 2020, low-dose reactivity was defined as allergic reactions to ≤250, ≤102, ≤53, or ≤ 133 mg of HE, CM, wheat, or peanut protein, respectively. The annualized AAR rate showed the number of reactions per patient per year (95% confidence interval). AAR risk factors were analyzed using multiple logistic regression., Results: Of the 1096 participants, 609, 457, 138, and 90 had HE, CM, wheat, and peanut allergies, respectively. The median (interquartile range) age was 5.0 (2.3-8.6) years, 39% had completely eliminated allergenic food, and 24% had low-dose reactivity. The annualized AAR rate was 0.130 (0.109-0.153) in all sub-cohorts. Moderate and severe symptoms occurred in 50% and 0.7%, respectively, of children who experienced AAR. Multiple logistic regression revealed that low-dose reactivity was a significant risk factor for AAR in the overall and CM cohorts, respectively (p < .001 and p = .036)., Conclusion: In this single-center study in Japan, the annualized AAR rate was relatively low during the COVID-19 pandemic; however, half of the participants with AAR had moderate to severe symptoms. Especially in the case of low-dose reactivity, children would require careful AAR risk management., (© 2024 European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.)

The growing world population, changing dietary habits, and increasing pressure on agricultural resources are drivers for the development of novel foods (including new protein sources as well as existing protein sources that are produced or used in an alternative way or in a different concentration). These changes, coupled with consumer inclination to adopt new dietary trends, may heighten the intake of unfamiliar proteins, or escalate consumption of specific ones, potentially amplifying the prevalence of known and undiscovered food allergies. Assessing the allergenicity of novel or modified protein-based foods encounters several challenges, including uncertainty surrounding acceptable risks and assessment criteria for determining safety. Moreover, the available methodological tools for gathering supportive data exhibit significant gaps. This paper synthesises these challenges, addressing the varied interpretations of "safe" across jurisdictions and societal attitudes towards allergenic risk. It proposes a comprehensive two-part framework for allergenicity assessment: the first part emphasises systematic consideration of knowledge and data requirements, while the second part proposes the application of a generic assessment approach, integrating a Threshold of Allergological Concern. This combined framework highlights areas that require attention to bridge knowledge and data gaps, and it delineates research priorities for its development and implementation., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Rene Crevel reports financial support and travel were provided by International Life Sciences Institute Europe (ILSI Europe). Geert Houben reports financial support was provided by ILSI Europe. Rene Crevel reports a relationship with AllPreT Horizon Europe Marie Curie Doctoral Training Network Project that includes: board membership and travel reimbursement. Geert Houben reports a relationship with Netherlands Organization for Applied Scientific Research that includes: employment. Ross Yarham reports a relationship with InBio that includes: employment. Katrine Lindholm Bogh reports a relationship with Technical University of Denmark National Food Institute that includes: employment. Neil Buck reports a relationship with General Mills Inc that includes: employment. Melina Galano reports a relationship with dsm-firmenich that includes: employment. Kitty Verhoeckx reports a relationship with University Medical Center Utrecht that includes: employment. I have received fees through René Crevel Consulting Ltd for risk assessment of the proposed use of various proteins by Meatable B.V. , Upfield B.V. and Mozza Inc. - R.C. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 International Life Sciences Institute Europe. Published by Elsevier Ltd.. All rights reserved.)

New sources of proteins are essential to meet the demands of the growing world population and evolving food trends. Assessing the allergenicity of proteins in novel food (NF) poses a significant food safety regulatory challenge. The Codex Alimentarius Commission presented an allergenicity assessment protocol for genetically modified (GM) foods, which can also be adapted for NF. Since no single laboratory test can adequately predict the allergenic potential of NF, the protocol follows a weight-of-evidence approach, evaluated by experts, as part of a risk management process. Regulatory bodies worldwide have adopted this safety protocol, which, among other things, promotes global harmonization. This review unravels the reliability and various motivations, terms, concepts, and approaches of allergenicity assessments, aiming to enhance understanding among manufacturers and the public. Health Canada, Food Safety Commission JAPAN, and Food Standards Australia New Zealand were surveyed, focusing on the European Food Safety Authority and the US Food Safety Administration for examples of scientific opinions regarding allergenicity assessments for novel and GM foods, from 2019 to 2023. According to our findings, current regulatory allergenicity assessments for NF approval primarily rely on literature reviews. Only a few of the NF assessments proactively presented additional tests. We recommend conducting bioinformatic analyses on NF when a panel of experts deems that there is insufficient prior scientific research., (© 2024 The Authors. Comprehensive Reviews in Food Science and Food Safety published by Wiley Periodicals LLC on behalf of Institute of Food Technologists.)

The dietary avoidance of allergens has been widely recognized as the key intervention in the management of food allergies, but the presence of undeclared allergens makes compliance difficult. The aim of this study was to analyze the presence of undeclared allergens in food labeling through RASFF notifications in the European Union, focusing on those allergens that frequently affect the pediatric population and the implicated products, so as to provide useful information for its risk evaluation and the development of educational materials for patients. The results showed milk (20.5%), gluten (14.8%), and nuts (10.9%) to be the pediatric allergens with higher presences. In 80% of the notifications concerning milk and milk derivatives, the specific compound present (lactose or lactoprotein) was not identified. They were mainly present in cereal and bakery products, prepared dishes and snacks, and cacao and confectionery products, all of which are frequently consumed by the pediatric population. The large quantity (7.6%) of undeclared allergens in "free-from-allergen" products was also remarkable, especially in regard to the supposedly not-present allergens. Undeclared allergens in food products pose an evident risk for allergic patients and knowledge of them should take a relevant role in a patient's nutritional education. It is also necessary to raise awareness among manufacturers and safety authorities.

A significant amount of medical literature has been published on the prevalence and treatment modalities of allergies to common household pets like dogs and cats. Although sensitization rates to horses are high in many urban areas, allergies to horses are rarely discussed. In order for allergists to treat effectively horse-allergic patients, they must be aware of various clinical presentations and treatment modalities that exist. A literature search was conducted in PubMED using the terms horse, immunotherapy, inhalant allergies, and food allergy limited to human studies from any period. What follows is a review of the prevalence, clinical presentations, and treatment modalities of horse aeroallergens and food allergies.

Allergen-specific immunotherapy (AIT) is currently the only potential treatment for allergies including allergic rhinitis (AR) and food allergies (FA) that can modify the underlying course of the diseases. Although AIT has been performed for over a century, the precise and detailed mechanism for AIT is still unclear. Previous clinical trials have reported that successful AIT induces the reinstatement of tolerance against the specific allergen. In this review, we aim to provide an updated summary of the knowledge on the underlying mechanisms of IgE-mediated AR and FA as well as the immunological changes observed after AIT and discuss on how better understanding of these can lead to possible identification of biomarkers and novel strategies for AIT., (© 2020 The Author(s).)

Introduction: Food allergy refers to abnormal reactions of the body caused by an immune system response to food. This study was conducted aiming to investigate allergy to food allergens in children with food allergies., Materials and Methods: This study was conducted as a cross-sectional one on 304 children aged six months to seven years with food allergies admitted to the tertiary referral hospital in Kurdistan Province - Iran, during 2014-2015. All the patients were examined for skin prick test using 49 allergens. Finally, the obtained data were analysed using SPSS15 and chi-square and t tests., Results: The highest percentage of occurrence of bump reaction (wheal) and redness (flare) was due to the consumption of fish, eggs, tomatoes, and cocoa. Moreover, the lowest rate of wheal and flare was caused by exposure to allergens like latex, tea, malt, and wheat flour. The reaction most created due to the consumption of foods was flare which was higher among under three-year-olds group (p<0.05), and between the sexes, girls showed the most common allergic reactions (p<0.05)., Conclusion: Since food allergy has a high prevalence in children, it should be considered with great interest. Considering that avoiding food allergens is the first step in the treatment of food allergies, the present study may be a useful guide in this regard., (Copyright © 2017 SEICAP. Published by Elsevier España, S.L.U. All rights reserved.)

Purpose of Review: Food allergies (FAs) are a growing epidemic in western countries with poorly defined etiology. Defined as an adverse immune response to common food allergens, FAs present heterogeneously as a single- or multi-organ response that ranges in severity from localized hives and angioedema to systemic anaphylaxis., Recent Findings: Current research focusing on epithelial-derived cytokines contends that temporal regulation by these factors impact initial sensitization and persistence of FA responses upon repeated food allergen exposure. Mechanistic understanding of FA draws insight from a myriad of atopic conditions studied in humans and modeled in mice. In this review, we will highlight how epithelial-derived cytokines initiate and then potentiate FAs. We will also review existing evidence of the contribution of other atopic diseases to FA pathogenesis and whether FA symptoms overlap with other atopic diseases.

Food allergies have become a growing public health concern worldwide, affecting a significant number of individuals. Accurate detection and management of allergens in food products are essential to prevent adverse reactions and ensure the safety of allergic individuals. The aim of the current review was to discuss the recent advancements, challenges, and future prospects of using nanobiosensors for allergen detection in food packaging. It covered various aspects, including different types of biosensors, recognition elements, signal transduction mechanisms, and fabrication techniques. Nanobiosensors offer high sensitivity and real-time response, making them suitable for integration into different packaging materials. Techniques like layer-by-layer assembly, electrospinning, and inkjet printing enable precise placement of nanobiosensors. The potential of nanofabrication techniques is highlighted for the development of highly sensitive and selective devices. Overall, nanobiosensors have the potential to revolutionize the food industry by improving food safety for individuals with allergies. It is necessary to tackle issues such as interference, stability, and regulatory concerns, while future prospects hold promise for enhancing food safety and quality through nanobiosensor applications. Also, by enabling more effective allergen detection and management, nanobiosensors have the potential to significantly improve food safety for individuals with allergies and enhance overall consumer confidence in the quality and integrity of packaged food products. [ABSTRACT FROM AUTHOR]

BackgroundFor young children with peanut allergy, dietary avoidance is the current standard of care. We aimed to assess whether peanut oral immunotherapy can induce desensitisation (an increased allergic reaction threshold while on therapy) or remission (a state of non-responsiveness after discontinuation of immunotherapy) in this population.MethodsWe did a randomised, double-blind, placebo-controlled study in five US academic medical centres. Eligible participants were children aged 12 to younger than 48 months who were reactive to 500 mg or less of peanut protein during a double-blind, placebo-controlled food challenge (DBPCFC). Participants were randomly assigned by use of a computer, in a 2:1 allocation ratio, to receive peanut oral immunotherapy or placebo for 134 weeks (2000 mg peanut protein per day) followed by 26 weeks of avoidance, with participants and study staff and investigators masked to group treatment assignment. The primary outcome was desensitisation at the end of treatment (week 134), and remission after avoidance (week 160), as the key secondary outcome, were assessed by DBPCFC to 5000 mg in the intention-to-treat population. Safety and immunological parameters were assessed in the same population. This trial is registered on ClinicalTrials.gov, NCT03345160.FindingsBetween Aug 13, 2013, and Oct 1, 2015, 146 children, with a median age of 39·3 months (IQR 30·8-44·7), were randomly assigned to receive peanut oral immunotherapy (96 participants) or placebo (50 participants). At week 134, 68 (71%, 95% CI 61-80) of 96 participants who received peanut oral immunotherapy compared with one (2%, 0·05-11) of 50 who received placebo met the primary outcome of desensitisation (risk difference [RD] 69%, 95% CI 59-79; p

Copyright of Polish Journal of Allergology / Alergologia Polska is the property of Termedia Publishing House and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Food allergies became a major public health and food safety interest in the past decades as their prevalence is increasing, and their only available treatment is a strict elimination diet that necessitates appropriate food labelling regulations. While such regulations are available worldwide, most of them are not taking into account inadvertent allergen cross-contamination and they usually do not define threshold doses that could support the industry in their endeavour to provide reliable food labels for allergic consumers. This resulted in the proliferation of the "may contain" type precautionary allergen labelling (PAL), which is voluntary and is intended to warn consumers for potential unintended contamination with an otherwise undeclared allergen. As this kind of labelling is hardly ever based on actual risk assessment, it puts both the industry and the consumer into a difficult position. A promising tool towards the solution of this problem could be allergen threshold doses based on clinical data, which are becoming increasingly available. This review intends to present this process, the new ways of improved risk assessment it opens, and its implications for food analysis. [ABSTRACT FROM AUTHOR]

BackgroundThe diagnosis of shellfish allergy currently relies on patient history, skin prick test (SPT), and serum specific IgE (sIgE) quantification. These methods lack sufficient diagnostic accuracy, whereas the gold standard of oral food challenges is risky and burdensome. Markers of reactivity and severity of allergic reactions to shellfish will improve clinical care of these patients.ObjectivesThis study compared the diagnostic performance of SPT, sIgE, basophil activation test (BAT), and IgE crosslinking-induced luciferase expression (EXiLE) test for shrimp allergy.MethodsThirty-five subjects with documented history of shrimp allergic reactions were recruited and grouped according to results of double-blind, placebo-controlled food challenge (DBPCFC). In addition to routine diagnostics, BAT (Flow CAST) and EXiLE test with shrimp extract and tropomyosin were performed.ResultsOf 35 subjects, 15 were shrimp allergic with pruritus, urticaria, and itchy mouth on DBPCFC, whereas 20 were tolerant to shrimp. Tropomyosin only accounted for 53.3% of sensitization among subjects with challenge-proven shrimp allergy. BAT using shrimp extract as stimulant showed the highest area under curve value (0.88), Youden Index (0.81), likelihood ratio (14.73), odds ratio (104), and variable importance (4.27) when compared with other assays and tropomyosin diagnosis. Results of BAT significantly correlated with those of EXiLE (r = 0.664, P < .0001).ConclusionsBAT is a more accurate diagnostic marker for shrimp allergy than SPT and shrimp sIgE, whereas the EXiLE test based on an IgE crosslinking assay is a good alternative to BAT. Tropomyosin may not be the most important shrimp allergen in Chinese, which warrants further investigation to search for other major allergens and diagnostic markers.

In the US, sesame was recognized as the ninth major food allergen in 2021, underscoring the importance of updated allergen labeling to facilitate effective prevention plans and anaphylaxis response. This article discusses the prevalence of sesame seed allergy among children in the US and outlines strategies for nurses to understand the assessment, treatment, and education of patients regarding this allergen. [ABSTRACT FROM AUTHOR]

Allergic reactions to allergenic foods can pose a lethal threat to children with food allergies. Previous research has demonstrated the effectiveness of using behavioral skills training (BST) plus in situ training (IST) to teach safety responses to children. However, there has not been an evaluation of using BST to teach food safety to children with food allergies. Three elementary‐school children of neurotypical development with food allergies participated. We evaluated the efficacy of BST with IST in teaching participants to identify and respond to allergenic foods by (a) asking to see the food packaging, (b) scanning the food label for the allergenic food, and (c) reporting the safety threat to an adult while not consuming the food. Trials without allergenic foods were also presented to ensure discriminated responding. All participants demonstrated the three correct safety responses after BST and responded differentially across allergenic and nonallergenic foods, with two participants requiring feedback (IST). [ABSTRACT FROM AUTHOR]

Eosinophilic esophagitis (EoE) is a chronic inflammatory condition of the esophagus. Many new studies have been reported recently that describe EoE management. An expert panel was convened by the American Gastroenterological Association Institute and the Joint Task Force on Allergy-Immunology Practice Parameters to provide a technical review to be used as the basis for an updated clinical guideline. This technical review was developed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework. Eighteen focused EoE management questions were considered, with 15 answered using the GRADE framework and 3 with a narrative summary. There is moderate certainty in the evidence that topical glucocorticosteroids effectively reduce esophageal eosinophil counts to

Shellfish allergy caused by undesirable immunological responses upon ingestion of crustaceans and mollusks is a common cause of food allergy, especially in the Asia-Pacific region. While the prevalence of shellfish allergy is increasing, the mainstay of clinical diagnosis for these patients includes extract-based skin prick test and specific IgE measurement while clinical management consists of food avoidance and as-needed use of adrenaline autoinjector should they develop severe allergic reactions. Such a standard of care is unsatisfactory to both patients and healthcare practitioners. There is a pressing need to introduce more specific diagnostic methods, as well as effective and safe therapies for patients with shellfish allergy. Knowledge gained on the identifications and defining the immuno-molecular features of different shellfish allergens over the past two decades have gradually translated into the design of new diagnostic and treatment options for shellfish allergy. In this review, we will discuss the epidemiology, the molecular identification of shellfish allergens, recent progress in various diagnostic methods, as well as current development in immunotherapeutic approaches including the use of unmodified allergens, hypoallergens, immunoregulatory peptides and DNA vaccines for the prevention and treatment of shellfish allergy. The prospect of a "cure "for shellfish allergy is within reach.

Thisreview introduced the food allergens and their sensitization mechanism, and summarized the research progress of peanut, soybean, milk, shrimp, egg and kiwifruit allergens in ultrasound treatment. Moreover, the research direction of ultrasound treatment in reducing food sensitization was also prospected.

Exposure to allergens could be life-threatening for people with food allergies. Restaurants and cafes are challenging environments for accommodating food allergies. This study aimed to measure King Saud University female students' awareness about food allergens on restaurants' and cafes' menus. This cross-sectional study was conducted on 379 students aged 18 years and above. A paper-based questionnaire was used, which comprised 16 questions related to the definition of food allergies, food allergens, and food allergy symptoms; the definition and prevention of cross-contact of food allergies; emergency treatment procedures for food allergies; strategies for the prevention of food allergy reactions; customer expectations towards restaurants; and preventive measures taken for food allergies. The results indicate that the overall average score of food allergen awareness was 10.90, which falls in the higher range. Furthermore, female students in the age groups of 23 to 27 years and 33 to 37 years had higher levels of awareness than female students in the age group of 18 to 22 years. The results also showed that the level of awareness among science college and health college students was statistically significantly higher (p < 0.05) than that among humanities college students. Post-graduate students also showed a higher level of awareness of food allergens than bachelor's students. These findings also indicate that listing all allergens in the restaurants and cafes' menus statistically significantly (p < 0.05) increased the level of awareness of female students about food allergens on restaurants' and cafes' menus, compared to restaurants and cafes that do not list all allergens on their menus. In general, female students at King Saud University showed a high level of awareness about food allergies on restaurants' and cafes' menus. The study recommends assessing the impact of awareness of female students with and without food allergies on their practices and behaviors. [ABSTRACT FROM AUTHOR]

There has been concern that patients with asthma may develop more severe disease as a result of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. Recent studies towards the exploration of the clinical aspects of COVID-19 have opened up a new postulation citing that people with minor allergies particularly food allergies have reported to possess lower chances of being infected. This postulation is cited more specifically for food allergies and asthma. However, the research on the validity of the postulation has not been done significantly and therefore the currently available literature does not provide a vivid elucidation of this association. Thus, this article highlights the current gaps and loopholes present in the current literature to give an impetus to the future researches considering to establish the possible connection between the pathobiology of COVID with allergic problems. It also discusses the possible interventions of the postulation in detail in coordination with the currently available confirmations. It will help in understanding the susceptibility and risk factors associated with the SARS-Cov2 virus disease which would eventually lead to the development of novel treatments and therapeutics for allergic conditions and COVID-19 disease.

Eosinophilic esophagitis (EoE) is a recently described disease in which exposure to specific foods and allergens leads to type 2 inflammation, epithelial barrier dysfunction, and difficulty in swallowing. In the current issue of the JCI, Wen and colleagues investigate tissue T cell heterogeneity in patients with EoE using single-cell RNA sequencing (scRNA-seq). Esophageal epithelium from individuals with EoE convtained a prominent population of Th2 cells not seen in controls. The short-chain fatty acid (SCFA) receptor FFAR3 was found to be highly expressed in EoE Th2 cells. Experiments presented here provide evidence that SCFAs may promote type 2 inflammation in allergic diseases such as EoE and asthma. This study provides an early example of scRNA-seq for identifying relevant cell populations and mechanisms underlying allergic diseases.

Shellfish allergy is one of the most common food allergies, with tropomyosin as the major cross-reactive allergen. However, no allergen-specific immunotherapy is clinically available. Recently, we designed two shrimp hypoallergens MEM49 and MED171. This study aimed to examine and compare the efficacy of the MEM49- and MED171-based DNA vaccines (pMEM49 and pMED171) in modulating shrimp allergy in a murine model of shrimp tropomyosin sensitivity. Intradermal immunization of BALB/c mice with pMEM49 or pMED171 effectively down-modulated allergic symptoms, tropomyosin-specific IgE levels, intestinal Th2 cytokines expression, and inflammatory cell infiltration. Both pMEM49 and pMED171 increased the frequency of regulatory T cells, but to a greater extent by pMED171 with upregulation of gut-homing molecules integrin-α4β7. The functionality of the pMED171-induced Treg cells was further illustrated by anti-CD25-mediated depletion of Treg cells and the adoptive transfer of CD4+CD25+Foxp3+Treg cells. Collectively, the data demonstrate that intradermal administration of pMED171 leads to the priming, activation, and migration of dermal dendritic cells which subsequently induce Treg cells, both locally and systemically, to downregulate the allergic responses to tropomyosin. This study is the first to demonstrate the potency of hypoallergen-encoding DNA vaccines as a therapeutic strategy for human shellfish allergy via the vigorous induction of functional Treg cells.

Eosinophilic esophagitis is an emerging disease that is distinguished from gastroesophageal reflux disease by the expression of a unique esophageal transcriptome and the interplay of early life environmental factors with distinct genetic susceptibility elements at 5q22 (TSLP) and 2p23 (CAPN14). Rare genetic syndromes have uncovered the contribution of barrier disruption, mediated in part by defective desmosomes and dysregulated transforming growth factor beta production and signaling, to eosinophilic esophagitis pathophysiology. Experimental modeling has defined a cooperative role of activated eosinophils, mast cells, and the cytokines IL-5 and IL-13, mediated by allergic sensitization to multiple foods. Understanding these processes is opening the way to better treatment based on disrupting allergic inflammatory and type 2 cytokine-mediated responses, including anti-cytokine therapeutics and dietary therapy.

Eosinophilic esophagitis is an emerging disease that is distinguished from gastroesophageal reflux disease by the expression of a unique esophageal transcriptome and the interplay of early life environmental factors with distinct genetic susceptibility elements at 5q22 (TSLP) and 2p23 (CAPN14). Rare genetic syndromes have uncovered the contribution of barrier disruption, mediated in part by defective desmosomes and dysregulated transforming growth factor beta production and signaling, to eosinophilic esophagitis pathophysiology. Experimental modeling has defined a cooperative role of activated eosinophils, mast cells, and the cytokines IL-5 and IL-13, mediated by allergic sensitization to multiple foods. Understanding these processes is opening the way to better treatment based on disrupting allergic inflammatory and type 2 cytokine-mediated responses, including anti-cytokine therapeutics and dietary therapy.

Copyright of Food & Machinery is the property of Food & Machinery Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BackgroundFood allergy is an important public health problem because it affects children and adults, can be severe and even life-threatening, and may be increasing in prevalence. Beginning in 2008, the National Institute of Allergy and Infectious Diseases, working with other organizations and advocacy groups, led the development of the first clinical guidelines for the diagnosis and management of food allergy. A recent landmark clinical trial and other emerging data suggest that peanut allergy can be prevented through introduction of peanut-containing foods beginning in infancy.ObjectivesPrompted by these findings, along with 25 professional organizations, federal agencies, and patient advocacy groups, the National Institute of Allergy and Infectious Diseases facilitated development of addendum guidelines to specifically address the prevention of peanut allergy.ResultsThe addendum provides 3 separate guidelines for infants at various risk levels for the development of peanut allergy and is intended for use by a wide variety of health care providers. Topics addressed include the definition of risk categories, appropriate use of testing (specific IgE measurement, skin prick tests, and oral food challenges), and the timing and approaches for introduction of peanut-containing foods in the health care provider's office or at home. The addendum guidelines provide the background, rationale, and strength of evidence for each recommendation.ConclusionsGuidelines have been developed for early introduction of peanut-containing foods into the diets of infants at various risk levels for peanut allergy.

There has been concern that patients with asthma may develop more severe disease as a result of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. Recent studies towards the exploration of the clinical aspects of COVID-19 have opened up a new postulation citing that people with minor allergies particularly food allergies have reported to possess lower chances of being infected. This postulation is cited more specifically for food allergies and asthma. However, the research on the validity of the postulation has not been done significantly and therefore the currently available literature does not provide a vivid elucidation of this association. Thus, this article highlights the current gaps and loopholes present in the current literature to give an impetus to the future researches considering to establish the possible connection between the pathobiology of COVID with allergic problems. It also discusses the possible interventions of the postulation in detail in coordination with the currently available confirmations. It will help in understanding the susceptibility and risk factors associated with the SARS-Cov2 virus disease which would eventually lead to the development of novel treatments and therapeutics for allergic conditions and COVID-19 disease. [ABSTRACT FROM AUTHOR]

Eosinophilic esophagitis (EoE), a food antigen-mediated disease, is effectively treated with the dietary elimination of 6 foods commonly associated with food allergies (milk, wheat, egg, soy, tree nuts/peanuts, and fish/shellfish). Because wheat shares homologous proteins (including gluten) with barley and rye and can also be processed with these grains, some clinicians have suggested that barley and rye might also trigger EoE as a result of cross-reaction and/or cross-contamination with wheat. In this article, we discuss the theoretical risks of cross-reactivity and cross-contamination among wheat, barley, and rye proteins (including gluten); assess common practices at EoE treatment centers; and provide recommendations for dietary treatment and future studies of EoE.

BackgroundAccurate diagnosis of mosquito allergy has been hampered by the laborious task of obtaining mosquito salivary allergens. We have previously studied 3 recombinant (r) Aedes aegypti mosquito salivary allergens: rAed a 1, rAed a 2 and rAed a 3. Here, we report the expression, purification, identification and evaluation of rAed a 4, a 67-kDa α-glucosidase.MethodsrAed a 4 was expressed using a baculovirus/insect cell system, purified by a combination of anion- and cation-exchange chromatography, and identified by immunoblotting. A. aegypti saliva extract was prepared in our laboratory. An indirect enzyme-linked immunosorbent assay (ELISA) was developed to measure rAed a 4-specific immunoglobulin E (IgE) and IgG antibodies in sera from 13 individuals with a positive mosquito-bite test from a laboratory-reared mosquito. Sera from 18 individuals with a negative bite test served as controls.ResultsPurified rAed a 4 bound to the IgE in mosquito-allergic sera, as detected by ELISA and immunoblotting. The binding of rAed a 4 to IgE could be inhibited in a dose-dependent manner by the addition of an A. aegypti extract. Mosquito-allergic individuals had significantly higher mean levels of rAed a 4-specific IgE and IgG than controls. Using the mean of the controls ± 2 SD as a cut-off level, 46% of the 13 allergic individuals had a positive IgE, while none of the controls was positive (p < 0.001).ConclusionsAed a 4 is a major allergen in mosquito saliva. Its recombinant form has the hydrolase function and can be used for the diagnosis of mosquito allergy.

Background: The prevalence of precautionary allergen labelling (PAL) on food products is estimated at 65%, but PAL is inconsistently applied. Consumers believe that PAL is well regulated, but their knowledge and practice of PAL is unsound, which is inconsistent with their apparent lack of trust in PAL statements. PAL should be clearly visible, easily understandable, reliable and precise in indicating 'real risk'. Objectives: The primary objective was to determine the knowledge and practice (including adherence) of South African parents and/or caregivers regarding PAL in managing immune-mediated food allergies in children. Methods: This study was a descriptive cross-sectional investigation with an analytical component. The study population consisted of parents and/or caregivers of children (birth to ten years) with an immune-mediated food allergy in South Africa. An online self-administered questionnaire was the instrument used for data collection. Results: Of the 140 participants included in the study, 98% were aware that there is a special statement on food labels indicating food allergens. The majority (84%) considered the phrase 'contains' to indicate a real risk of allergen contamination, 64% for 'may contain', 56% for 'made with the same equipment' and 40% for 'made in the same factory'. Only 29% indicated that they would read the food label every time before using a food product. Non-adherence to the PAL statement 'made with the same equipment as (the allergen-containing food)' was associated with a life-threatening reaction (p = 0.007) or a visit to an emergency unit (p = 0.033). Conclusion: This research shows that parents of children with food allergies either do not understand PAL fully or do not implement PAL statements effectively. It is vital to standardise PAL locally and globally to indicate 'real risk' or 'no risk' in order for consumers to recognise best practice in eliminating the risk of being exposed to allergen-containing food products. [ABSTRACT FROM AUTHOR]