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Humanized Mediator Release Assay as a Read-Out for Allergen Potency

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Hypersensitivity reactions to food additives.

Shahid Randhawa¹, Sami L Bahna

¹Allergy and Immunology Section, Louisiana State University Health Sciences Center, Shreveport, Louisiana 71130-3932, USA.

Current Opinion in Allergy and Clinical Immunology

|April 25, 2009

Summary

Adverse reactions to food additives are rare but more common in atopic individuals. Diagnosis can be challenging, often requiring elimination diets and challenge testing for confirmation.

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Area of Science:

Allergy and Immunology
Gastroenterology
Clinical Nutrition

Background:

Food additives are widely used in processed foods.
Adverse reactions to food additives are uncommon in the general population but more prevalent in atopic individuals.
Diagnosis of food additive reactions is often difficult, relying heavily on case reports.

Purpose of the Study:

To review current knowledge on adverse reactions to food additives.
To discuss diagnostic approaches for suspected food additive intolerance.
To outline management strategies for individuals experiencing adverse reactions.

Main Methods:

Review of existing literature on food additive adverse reactions.
Analysis of diagnostic challenges and limitations of standard allergy testing.
Evaluation of elimination diets and challenge testing protocols.

Main Results:

Adverse reactions affect 0.01-0.23% of the general population and 2-7% of atopic individuals.
Reactions typically manifest as mild skin, gastrointestinal, or respiratory symptoms, with anaphylaxis being rare.
Identification of specific offending additives is a significant diagnostic hurdle.

Conclusions:

Food additives should be considered in patients with reactions to commercially prepared foods or multiple unrelated foods.
Careful history taking, elimination diets, and challenge testing are key diagnostic tools.
Management involves strict avoidance of identified additives, and severe cases require self-injectable epinephrine and medical identification.