Introducing chemists to food allergy.

Area of Science:

• Immunology
• Gastroenterology
• Allergology

Background:

• Adverse food reactions are classified as toxic or non-toxic, with non-toxic immune-mediated reactions termed allergy (IgE-mediated) and non-immunological reactions termed intolerance.
• Food allergy can manifest through various systems, including gastrointestinal (e.g., eosinophilic gastroenteritis), respiratory (e.g., asthma), and cutaneous (e.g., urticaria-angioedema) reactions, as well as anaphylaxis.
• Celiac disease is increasingly recognized as an immunological disorder, highlighting the complex relationship between food and the immune system.

Purpose of the Study:

• To differentiate between food allergy and intolerance based on underlying mechanisms.
• To outline the spectrum of clinical manifestations associated with food allergy.
• To discuss diagnostic approaches and the critical role of specific tests in identifying food allergy.

Main Methods:

• Diagnosis relies on patient history, skin prick tests (SPT), and specific IgE measurements.
• Double-blind placebo-controlled food challenges (DBPCFC) are considered fundamental for diagnosing true food allergy.
• DBPCFC is contraindicated in patients with a history of anaphylaxis due to the risk of severe reactions.

Main Results:

• Food allergy encompasses a range of disorders including oral allergy syndrome, vomiting, diarrhea, protein-induced enterocolitic syndrome, eosinophilic gastroenteritis, rhinitis, asthma, laryngeal edema, urticaria-angioedema, atopic dermatitis, and anaphylaxis.
• Anaphylaxis and severe respiratory reactions are life-threatening consequences of food allergy.
• Even minute amounts of allergenic food, potentially from cross-contamination, can trigger severe reactions in sensitized individuals.

Conclusions:

• Accurate diagnosis of food allergy is essential for managing potentially life-threatening reactions.
• Preventing severe food allergic reactions requires a multidisciplinary approach involving allergists, chemists, food technologists, and the food industry.
• Understanding the distinction between allergy and intolerance, alongside rigorous diagnostic methods, is key to patient safety.