Evaluation of Food Allergies

Year 2017, Volume: 9 Issue: 2, 74 - 77, 15.03.2017

Dr. Ezgi Ulusoy

Abstract

Abstract

Food allergy which can come out with life threatening reactions, is a public health problem with an increasing prevelance. Food allegy is difined as an anormal reaction of immune system to a food protein antigen. Atopic dermatitis, asthma, atopyhistory of family members are primary risk factors for food allergy. The most common foods leading food allergy are cow’s milk (6%), egg (2.5%), peanut (0.4%), soy(1.5%), wheat (%1.5), fish (%2.2) and shellfish (%2.2). Food allergies are classified in three groups as: IgE mediated, non-IgE mediated and mixed food allergy. Skinprick tests and spIgE levels are useful for identifying allergenic food for IgE mediated food allergies. The only definitive diagnostic test for food allrgy is oral food challenge. Currently there isn’t a definitive therapy for food allergies. Strict avoidenceof  foods and immediate management of reactions are the principles of treatment.Oral immunotherapy and  sublingual immunotherapy are new treatment modalities created  for developing tolerance.

Keywords

Allergy, food allergy, immunotherapy

Besin Alerjilerinin Değerlendirilmesi

Abstract

Öz

Besin alerjileri hayatı tehdit eden reaksiyonlarla sonuçlanabilen, sıklığı tüm dünyada artış gösteren bir halk sağlığı sorunudur. Besin alerjisi alınan besin protein antijenine karşı gelişen, immün sistemin anormal bir yanıtı olarak tanımlanmaktadır.Atopik dermatit, astım, ailede atopi öyküsü olması besin alerjisi için primer risk faktörlerini oluşturmaktadır. En sık besin alerjisine sebep olan besinler süt (%6), yumurta (%2,5), fıstık(%0.4), soya (%1.5), buğday (%1.5), balık(%2.2) ve kabuklu denizürünleridir ( %2.2). Besin alerjileri IgE aracılıklı, Non-IgE aracılıklı veya kombine olmak üzere 3 grupta sınıflandırılmaktadır.  IgE aracılıklı besin alerjilerinde spIgE düzeyleri ve deri testleri alerjen besinin tespit edilmesinde faydalıdırlar. Kesin tanı için tek tanısal test oral besin provakasyon testleridir. Besin alerjilerinin henüz kesin bir tedavisi bulunmamaktadır. Alerjen besinden kaçınma ve alerjik reaksiyonlarda acil müdahale tedavi esasını oluşturmaktadır. Oral immünoterapi vesublingual immünoterapi toleransı geliştirmek amacıyla ortaya koyulan yeni tedavi yöntemleridir.

Keywords

Alerji, besin alerjisi, immünoterapi

References

• Kaynaklar 1. Burks AW, Tang M, Sicherer S, et al. ICON: food allergy. J Al-lergy Clin Immunol. 2012;129(4):906-920. 2. Nwaru BI , Hickstein L, Panesar SS, Muraro A, Werfel T, Car-dona V at all; EAACI Food Allergy and Anaphylaxis Guide-lines Group. The epidemiology of food allergy in Europe: asystematic review and meta-analysis.Allergy. 2014Jan;69(1):62-75. 3. Prescott SL1, Pawankar R, Allen KJ, Campbell DE, Sinn JKh,Fiocchi A, Ebisawa M, Sampson HA, Beyer K, Lee BW. A glo-bal survey of changing patterns of food allergy burden in child-ren. World Allergy Organ J. 2013 Dec 4;6(1):21. 4. Gupta, R. S. et al. The prevalence, severity, and distribution ofchildhood food allergy in the United States. Pediatrics 128,e9–e17 (2011). 5. Yu W, Freeland DM, Nadeau KC. Food allergy: immune mec-hanisms, diagnosis and immunotherapy. Nat Rev Immunol.2016 Dec;16(12):751-765. 6. Chafen JJ, Newberry SJ, Riedl MA, Bravata DM, MaglioneM, Suttorp MJ, Sundaram V, Paige NM, Towfigh A, HulleyBJ, Shekelle PG. Diagnosing and managing common foodallergies: a systematic review. JAMA. 2010 May12;303(18):1848-56. 7. NIAID-Sponsored Expert Panel, Boyce JA, Assa'ad A, BurksAW, Jones SM, Sampson HA, Wood RA, at all. Guidelines forthe diagnosis and management of food allergy in the UnitedStates: report of the NIAID-sponsored expert panel. J AllergyClin Immunol. 2010 Dec;126(6 Suppl):S1-58. 8. Patel BY1, Volcheck GW1. Food Allergy: Common Causes, Di-agnosis, and Treatment. Mayo Clin Proc. 2015Oct;90(10):1411-9. 9. Nwaru BI1, Hickstein L, Panesar SS, Roberts G, Muraro A, She-ikh A; EAACI Food Allergy and Anaphylaxis Guidelines Gro-up. Prevalence of common food allergies in Europe: a systema-tic review and meta-analysis. Allergy. 2014 Aug;69(8):992-1007. 10. Yavuz ST1, Sahiner UM, Buyuktiryaki B, Soyer OU, TuncerA, Sekerel BE, Kalayci O, Sackesen C. Phenotypes of IgE-me-diated food allergy in Turkish children. Allergy AsthmaProc. 2011 Nov-Dec;32(6):47-55. 11. Silverberg, J. I. & Simpson, E. L. Association between seve-re eczema in children and multiple comorbid conditions andincreased healthcare utilization. Pediatr. Allergy Immunol.2013;24, 476–486 . 12. Hruz, P. Epidemiology of eosinophilic esophagitis. Dig. Dis.32, 40–47 (2014). 13. Cianferoni, A. & Spergel, J. Eosinophilic esophagitis: a com-prehensive review. Clin. Rev. Allergy Immunol.2016; 50,159–174 . 14. Cianferoni, A. & Spergel, J. M. Eosinophilic esophagitis andgastroenteritis. Curr. Allergy Asthma Rep. 2015;15, 58 . 15. Roberts, G. & Lack, G. Diagnosing peanut allergy with skinprick and specific IgE testing. J. Allergy Clin. Immunol.2005;115, 1291–1296 . 16. Sicherer SH, Sampson HA. Food allergy: epidemiology, pat-hogenesis, diagnosis, and treatment. J Allergy Clin Immunol.2014; 133(2):291-307. 17.Varshney P, Jones SM, Scurlock AM, et al. A randomized con-trolled study of peanut oral immunotherapy: clinical desen-sitizationand modulation of the allergic response. J AllergyClin Immunol. 2011;127(3):654-660. 18. Burks AW, Jones SM, Wood RA, et al. Consortium of FoodAllergy Research (CoFAR). Oral immunotherapy for treat-ment of egg allergy in children. N Engl J Med.2012;367(3):233-243. 19. Skripak JM, Nash SD, Rowley H, et al. A randomized, doub-le-blind,placebo-controlled study of milk oral immunotherapyfor cow’s milk allergy. J Allergy Clin Immunol.2008;122(6):1154-1160. 20. de Boissieu D, Dupont C. Sublingual immunotherapy for cow’smilk protein allergy: a preliminary report. Allergy.2006;61(10):1238-1239. 21. Narisety SD, Frischmeyer-Guerrerio PA, Keet CA, et al.A ran-domized, double-blind, placebo-controlled pilot study of sub-lingual versus oral immunotherapy for the treatment of peanutallergy. J Allergy Clin Immunol. 2015;135(5):1275-1282