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4.
Scand J Immunol ; 91(1): e12824, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31486118

RESUMO

The prevalence of food allergy (FA) has increased too rapidly, possibly due to environmental factors. The guidelines recommend strict allergen avoidance, but FA is still the main cause of anaphylaxis in all age groups. Immunotherapy is the only treatment able to change the course of allergic disease, and oral immunotherapy (OIT) is the more effective route in FA. However, it carries the risk of adverse reactions, including anaphylaxis. To improve OIT safety, adjuvant therapy with the immunoglobulin E (IgE) monoclonal antibody omalizumab has been extensively used. Results suggest particular benefit in patients with high risk of fatal anaphylaxis. An alternative approach is to use omalizumab instead of OIT to prevent severe allergic reactions upon accidental exposure. This paper reviews current evidence regarding IgE-mediated FA, focusing on natural tolerance and food sensitization acquisition, and on avoidance measures and their limitations.


Assuntos
Alérgenos/imunologia , Dessensibilização Imunológica , Hipersensibilidade Alimentar/imunologia , Hipersensibilidade Alimentar/terapia , Alimentos/efeitos adversos , Animais , Dessensibilização Imunológica/efeitos adversos , Dessensibilização Imunológica/métodos , Hipersensibilidade Alimentar/epidemiologia , Hipersensibilidade Alimentar/prevenção & controle , Humanos , Tolerância Imunológica , Imunização , Imunoglobulina E/imunologia
5.
Food Chem ; 302: 125333, 2020 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-31416005

RESUMO

This study was performed to determine Parvalbumin (PV), a well-known fish allergenic protein, digestion kinetics and immunoreactivity of digestion products with Immunoglobulin G/Immunoglobulin E recognition to understand its allergic potential with or without lipid emulsion process. PV was subjected to simulated gastrointestinal digestion in emulsified condition. Digestion kinetics of the protein was analysed by electrophoresis, IgG/IgE binding ability by immunoblotting and indirect ELISA. Lipid emulsion significantly (p < 0.01) reduced the degree of PV hydrolysis by 52.10% for gastric digestion. Immune fragments of gastric digestion were detectable for 90-120 min longer in emulsified condition showing resistance. Consequently, lipid emulsion decreased the digestive ability of PV in stomach, increasing resistance to gastrointestinal digestion by pepsin proteases. It also altered IgG/IgE binding ability of digestion products, thereby indicating that PV with lipid emulsion was resistant to digestion and possessed increased IgE binding ability resulting in higher risk of allergy among sensitized individuals.


Assuntos
Alérgenos/farmacocinética , Emulsões/farmacocinética , Proteínas de Peixes da Dieta/farmacocinética , Hipersensibilidade Alimentar/imunologia , Parvalbuminas/farmacocinética , Alérgenos/imunologia , Alérgenos/metabolismo , Animais , Digestão , Emulsões/química , Ensaio de Imunoadsorção Enzimática , Feminino , Proteínas de Peixes da Dieta/imunologia , Linguados , Hipersensibilidade Alimentar/etiologia , Immunoblotting , Imunoglobulina E/imunologia , Imunoglobulina E/metabolismo , Imunoglobulina G/imunologia , Imunoglobulina G/metabolismo , Lipídeos/química , Lipídeos/farmacocinética , Camundongos Endogâmicos BALB C , Parvalbuminas/imunologia , Parvalbuminas/metabolismo , Pepsina A/metabolismo
6.
Food Chem ; 302: 125348, 2020 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-31442704

RESUMO

Tropomyosin (TM) is the main allergen of shrimp. Glycation reportedly reduced the allergenicity of TM, and the allergenicity reduction was heavily dependent upon the sources of saccharides. In this work we investigated, how glycation of tropomyosin by functional oligosaccharides affected the allergenicity. Compared to TM, the TM glycated by galacto-oligosaccharide (TM-GOS), mannan-oligosaccharide (TM-MOS) and maltopentaose (TM-MPS) had lower allergenicity and induced weaker mouse allergy responses. While the TM glycated by fructo-oligosaccharide (TM-FOS) had stronger allergenicity and induced severe mouse allergy symptoms, due to the generation of neoallergns that belonged to advanced glycation end products (e.g. CML). Therefore, GOS, MOS and MPS could be applied to desensitize shrimp TM-induced food allergy through glycation, while FOS was not suitable to reduce TM allergenicity. Glycation of TM by GOS, MOS and MPS, especially for MPS, significantly reduced allergenicity and alleviated allergy symptoms, which could be potentially explored for immunotherapy for shrimp-allergic patients.


Assuntos
Hipersensibilidade Alimentar/imunologia , Produtos Finais de Glicação Avançada/metabolismo , Palaemonidae/imunologia , Proteínas de Frutos do Mar/metabolismo , Tropomiosina/metabolismo , Adulto , Alérgenos/imunologia , Alérgenos/metabolismo , Animais , Pré-Escolar , Feminino , Hipersensibilidade Alimentar/sangue , Glicosilação , Humanos , Masculino , Camundongos Endogâmicos BALB C , Pessoa de Meia-Idade , Oligossacarídeos/imunologia , Oligossacarídeos/metabolismo , Proteínas de Frutos do Mar/química , Proteínas de Frutos do Mar/imunologia , Tropomiosina/química , Tropomiosina/imunologia
7.
Med Clin North Am ; 104(1): 145-155, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31757232

RESUMO

Food allergy presents in all ages and has a significant impact on an individual's quality of life. Some of the food allergies that start in childhood remain into adulthood and new-onset allergies can occur at any point of life. Health care providers caring for adult patients should be aware of various food allergy presentations and syndromes. In this article, the authors cover recent literature on food allergies in adults and discuss the epidemiology of adult food allergy as well as common clinical scenarios and presentations of various types of food allergies.


Assuntos
Hipersensibilidade Alimentar , Adulto , Gerenciamento Clínico , Hipersensibilidade Alimentar/epidemiologia , Hipersensibilidade Alimentar/patologia , Humanos
8.
Med Clin North Am ; 104(1): 15-24, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31757233

RESUMO

Urticaria is a common presenting problem to the primary care provider. Acute urticaria lasting less than 6 weeks may be associated with a drug or food allergens. Chronic urticaria lasting more than 6 weeks is often associated without a known underlying cause. Inducible stimuli causing hives should be excluded using specific provocation testing. Treatment follows a standardized algorithmic approach as outlined by the Joint Task Force Practice Parameter and/or International Urticaria guidelines. Patients not responsive to steps 1 or 2 should be referred to an urticaria specialist for further evaluation and treatment. The prognosis and outcome of urticaria is generally very favorable for most patients.


Assuntos
Atenção Primária à Saúde/métodos , Urticária/diagnóstico , Doença Aguda , Comitês Consultivos/normas , Doença Crônica , Hipersensibilidade a Drogas/complicações , Hipersensibilidade a Drogas/diagnóstico , Hipersensibilidade Alimentar/complicações , Hipersensibilidade Alimentar/diagnóstico , Humanos , Guias de Prática Clínica como Assunto , Atenção Primária à Saúde/normas , Prognóstico , Encaminhamento e Consulta , Urticária/etiologia
10.
Arerugi ; 68(10): 1174-1179, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-31827023
11.
Arerugi ; 68(10): 1206-1212, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-31827029

RESUMO

BACKGROUND: Oral immunotherapy (OIT) for food allergy requires exercise restrictions following the regular consumption of allergens to prevent immediate symptoms. We investigated the efficacy and the safety of exercise provocation tests to assess exercise tolerance after consumption of allergens following OIT. METHODS: This study was based on data from patients who underwent exercise provocation tests with consumption of their allergen after OIT in Miyagi Children's Hospital between April 2012 and March 2019. The results of exercise provocation tests and patients' characteristics were retrospectively analyzed. RESULTS: Fifteen out of 91 patients were positive for exercise provocation tests. The positive rates were 12% (4/33) with egg, 15% (5/34) with cow's milk, and 25% (6/24) with wheat. Intramuscular adrenaline injections were administered to two patients with allergies to egg, one with cow's milk, and one with wheat. CONCLUSION: Following OIT, the assessment using exercise provocation tests should be performed prior to termination of exercise restriction because some patients remain intolerant to exercise.


Assuntos
Dessensibilização Imunológica , Tolerância ao Exercício , Hipersensibilidade Alimentar/diagnóstico , Administração Oral , Alérgenos , Animais , Bovinos , Criança , Hipersensibilidade a Ovo/diagnóstico , Feminino , Humanos , Hipersensibilidade a Leite/diagnóstico , Estudos Retrospectivos , Hipersensibilidade a Trigo/diagnóstico
12.
Arerugi ; 68(10): 1213-1220, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-31827030

RESUMO

BACKGROUND & AIM: In the clinical field of food allergies, dietary management towards patients is done inadequately. One plausible reason for this is the possible deficiency of food allergy education during the training courses for registered dietitians. This time, we will investigate the actual situations of food allergy education practiced in the training courses of registered dietitians, and reveal the point at issue. METHOD: We conducted a factual survey via mailing method towards registered dietitian and dietitian nutritionist training facilities throughout the whole country. The survey items include the existence of lectures or practical trainings about food allergies, the pre-graduate education of food allergies, and much more. RESULTS: We got answers from 213 facilities (collection rate 75%). Lectures about food allergies were conducted in 96% of the facilities, and the median of the lecture hour was 210 minutes. Similarly, practical trainings were conducted in 74% of the facilities, and the median was 90 minutes. The rate of people who strongly feel the need for food allergy education was 49%, and the rate for people who felt it was 50%. However, the rate of an ideal educational condition was 32%, and the rate of people who didn't have any plans of increasing the number of lectures and practical trainings were 82%. The major reasons for this were, the crammed condition of the curriculums, and the difficulties conducting lectures and practical trainings that span over several fields of expertise. CONCLUSION: In the training courses of registered dietitians, the practice of food allergy education is hardly adequate, and the educational sites seem to recognize the problem, but they are also pessimistic regarding the improvement of the situation due to the difficult problems that were revealed in this survey. From now on, it is strongly expected for the government and its people to work together to improve the current situation.


Assuntos
Hipersensibilidade Alimentar/diagnóstico , Hipersensibilidade Alimentar/terapia , Nutricionistas/educação , Humanos , Japão , Inquéritos e Questionários
13.
Georgian Med News ; (295): 61-66, 2019 Oct.
Artigo em Russo | MEDLINE | ID: mdl-31804201

RESUMO

The purpose is to analyze literature data on currently used and promising approaches to the treatment of food allergies in children. It reviewed the variants of allergen-specific food allergy therapy (AST-FA), which allow expanding the range of consumed products to which no reaction is manifested, reducing the risk of developing potential life-threatening allergic reactions if they are accidentally ingested. AST-FA is currently the only potentially effective method of IgE-mediated FA. One of the new options for pathogenetically substantiated therapy of FA is the use of biological drugs that increase the ability to achieve immune tolerance to food antigens. It seems reasonable to consider the possibilities of using a number of non-allergen-specific molecules - cytokines, Toll-like receptors, various cell populations, probiotics and gene therapy - as potential targets for treating patients with multiple food allergies. Further studies are needed to determine the optimal dose, duration of treatment, and long-term effects of biologics used in the treatment of FA.


Assuntos
Dessensibilização Imunológica , Hipersensibilidade Alimentar , Tolerância Imunológica , Alérgenos , Criança , Hipersensibilidade Alimentar/terapia , Humanos , Imunoglobulina E
15.
Int Arch Allergy Immunol ; 180(4): 235-243, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31694044

RESUMO

Over the last decades, an increasing appearance of allergies and atopic disorders, such as asthma, dermatitis, and rhinitis, has been observed. The mechanisms of these disorders remain unclear, and therefore the development of novel therapies is limited. Current treatments are often symptomatic, nonspecific, or may have severe side effects. Further insights into the mechanisms of the underlying disease pathogenesis could reveal novel targets for treatment. In this review, we provide an update on recent basic and translational studies that offer novel insights and opportunities for the treatment of patients with atopic disorders.


Assuntos
Asma/etiologia , Dermatite Atópica/etiologia , Hipersensibilidade Alimentar/etiologia , Rinite Alérgica/etiologia , Alérgenos/imunologia , Asma/genética , Asma/terapia , Dermatite Atópica/genética , Dermatite Atópica/terapia , Hipersensibilidade Alimentar/genética , Hipersensibilidade Alimentar/terapia , Predisposição Genética para Doença/genética , Humanos , Rinite Alérgica/genética , Rinite Alérgica/terapia , Fatores de Risco
17.
Arerugi ; 68(9): 1095-1101, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-31723104
19.
Arerugi ; 68(9): 1115-1120, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-31723107
20.
Arerugi ; 68(9): 1141-1147, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-31723111

RESUMO

We present a case of early childhood-onset pork-cat syndrome possibly due to sensitization by both cats and dogs. A 6-year-old girl was referred to our hospital because of repetitive episodes of urticaria when she consumed pork meat. The patient lived with a dog and the ground floor of her house was a veterinary clinic run by her veterinarian parents. Blood tests demonstrated high specific IgE (≥50UA/ml) against cat dander, dog dander, pork, Sus s 1, Fel d 2, Can f 1, Can f 2, and Can f 3. The skin prick test was positive for raw pork and beef. Western blotting analysis detected hot spots on 67-kDa proteins in pork meat and cat dander extract. Cross-reactivity between these two proteins was confirmed by an inhibition test. Furthermore, crossreactivity between pork meat and dog dander extract was also noted. Taken together, the diagnosis of porkcat syndrome was made, and both cats and dogs were suggested to have led to the sensitization. The patient was advised to only eat well-cooked pork, and has been followed thereafter without additional reactions. The previously reported cases of this syndrome developed during adolescence and young adulthood because a considerable period from the sensitization to the development cross-reactivity with pork meat is required. To our best knowledge, this is the youngest reported case of pork-cat syndrome among English and Japanese literatures. The nomenclature of this syndrome as pet animal-meat syndrome improves the understanding of the underlying pathogenesis of cross-reactivity between animal albumins and meat albumins.


Assuntos
Hipersensibilidade Alimentar/imunologia , Carne Vermelha , Alérgenos , Animais , Gatos , Bovinos , Criança , Reações Cruzadas , Cães , Feminino , Humanos , Imunoglobulina E/sangue , Testes Cutâneos , Suínos , Adulto Jovem
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