Faculty of Medicine

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    Proposal of 0.5 mg of protein/100 g of processed food as threshold for voluntary declaration of food allergen traces in processed food-A first step in an initiative to better inform patients and avoid fatal allergic reactions: A GA²LEN position paper
    (Wiley, 2021-11-06)
    Zuberbier, Torsten
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    Dörr, Tamara
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    Aberer, Werner
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    Alvaro, Montserrat
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    Angier, Elizabeth
    Food anaphylaxis is commonly elicited by unintentional ingestion of foods containing the allergen above the tolerance threshold level of the individual. While labeling the 14 main allergens used as ingredients in food products is mandatory in the EU, there is no legal definition of declaring potential contaminants. Precautionary allergen labeling such as "may contain traces of" is often used. However, this is unsatisfactory for consumers as they get no information if the contamination is below their personal threshold. In discussions with the food industry and technologists, it was suggested to use a voluntary declaration indicating that all declared contaminants are below a threshold of 0.5 mg protein per 100 g of food. This concentration is known to be below the threshold of most patients, and it can be technically guaranteed in most food production. However, it was also important to assess that in case of accidental ingestion of contaminants below this threshold by highly allergic patients, no fatal anaphylactic reaction could occur. Therefore, we performed a systematic review to assess whether a fatal reaction to 5mg of protein or less has been reported, assuming that a maximum portion size of 1kg of a processed food exceeds any meal and thus gives a sufficient safety margin.
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    POLLEN-FRUIT SYNDROMES: A CASE WITH BIRCH-APPLE-CARROT ASSOCIATION
    (Science Publications, 2014-02-01)
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    Marsenic, Mimoza
    Subjects with sensitivities to certain pollen can experience oral or systemic allergic symptoms associated with ingestion of various fruits, vegetables and nuts. In this case report a birch-apple-carrot association in 23-year-old man suffering from pollinosis who experienced few episodes of oral allergy syndrome, generalized urticaria and bronchospasm immediately time after ingestion of fresh and cooked apple and carrot is presented. Skin Prick Tests (SPT) to standard inhalant and food allergens were positive for birch, lime, apple and carrot. SPT for apricot was also positive, despite the patient did not experienced any allergic symptom after consumption of fresh or cooked apricot. This case report represents the description of an IgE-mediated systemic allergic reaction to both apple and carrot in both fresh and cooked form which is not usual reaction in the patients with birch-food association.
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    Immunological Outcomes of Allergen-Specific Immunotherapy in Food Allergy
    (Frontiers Media SA, 2020)
    Schoos, Ann-Marie Malby
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    Bullens, Dominique
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    Chawes, Bo Lund
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    Costa, Joana
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    De Vlieger, Liselot
    IgE-mediated food allergies are caused by adverse immunologic responses to food proteins. Allergic reactions may present locally in different tissues such as skin, gastrointestinal and respiratory tract and may result is systemic life-threatening reactions. During the last decades, the prevalence of food allergies has significantly increased throughout the world, and considerable efforts have been made to develop curative therapies. Food allergen immunotherapy is a promising therapeutic approach for food allergies that is based on the administration of increasing doses of culprit food extracts, or purified, and sometime modified food allergens. Different routes of administration for food allergen immunotherapy including oral, sublingual, epicutaneous and subcutaneous regimens are being evaluated. Although a wealth of data from clinical food allergen immunotherapy trials has been obtained, a lack of consistency in assessed clinical and immunological outcome measures presents a major hurdle for evaluating these new treatments. Coordinated efforts are needed to establish standardized outcome measures to be applied in food allergy immunotherapy studies, allowing for better harmonization of data and setting the standards for the future research. Several immunological parameters have been measured in food allergen immunotherapy, including allergen-specific immunoglobulin levels, basophil activation, cytokines, and other soluble biomarkers, T cell and B cell responses and skin prick tests. In this review we discuss different immunological parameters and assess their applicability as potential outcome measures for food allergen immunotherapy that may be included in such a standardized set of outcome measures.