B-FAHF-2 plus oral immunotherapy (OIT) is safer and more effective than OIT alone in a murine model of concurrent peanut/tree nut allergy.

BACKGROUND: Concurrent sensitization to peanut (PN) and tree nuts (TN), the most dangerous food allergies, is common. Current oral immunotherapy (OIT) is not fully satisfactory. OBJECTIVE: To determine whether the herbal formula B-FAHF-2 (BF2) ameliorates PN/TN OIT adverse reactions and enhances persistence of a tolerant state. METHODS: Concurrently sensitized PN-, walnut- (WN) and cashew (CSH)-allergic mice received 1-day PN/WN/CSH rush OIT plus 3 weeks of maintenance dosing, with or without 3 weeks prior and 3 weeks BF2 co-treatment. Anaphylactic symptom scores, core body temperatures, plasma histamine levels, basophil numbers, antigen-specific IgE, cytokine levels, and IL-4, INF-γ and Foxp3 gene promoter DNA methylation status, and their correlation with final challenge symptom scores were determined. RESULTS: BF2+OIT-treated mice experienced significantly fewer and less severe adverse reactions than OIT-only-treated mice (P<.01) during the 1-day rush OIT build-up dose phase. Both OIT-only and BF2+OIT mice showed significant desensitization (P<.01 and .001, respectively) at 1 week post-therapy challenge, being greater in BF2+OIT mice. All sham-treated and 91% of OIT-treated mice experienced anaphylaxis whereas only 21% of BF2+OIT-treated mice exhibited reactions during 5-6 weeks of dose escalation single PN and TN challenges. Greater and more persistent protection in BF2+OIT mice was associated with significantly lower plasma histamine and IgE levels, increased IFN-γ/IL-4 and IL-10/IL-4 ratios, DNA remethylation at the IL-4 promoter and demethylation at IFN-γ and Foxp3 promoters. Final challenge symptom scores were inversely correlated with IL-4 DNA methylation levels (P<.0002) and positively correlated with IFN-γ and Foxp3 gene promoter methylation levels (P<.0011) (P<.0165). CONCLUSIONS AND CLINICAL RELEVANCE: Combined BF2/OIT therapy was safer and produced longer post-treatment protection and more tolerance-prone immunological and epigenetic modifications than OIT alone. BF2/OIT may provide an additional OIT option for patients with concurrent PN/TN and other food allergies.

Attentional biases towards food and body stimuli among individuals with disordered eating versus food allergies.

BACKGROUND AND OBJECTIVES: Individuals with disordered eating display heightened attentional biases towards food- and body-related stimuli. However, it is unknown whether these attentional biases reflect maladaptive thinking/eating pathology. We investigated the differences between maladaptive and adaptive ways of thinking about food by assessing food- and body-related attentional biases among individuals with disordered eating, participants with peanut allergies (i.e., individuals who think frequently about food in an adaptive manner), and healthy controls. We also examined the extent to which negative mood and rumination exacerbated attentional biases among those in these groups. METHOD: Three hundred and twenty-one individuals with disordered eating (n = 139), peanut allergies (n = 60), and healthy controls (n = 122) completed food- and body-based Stroop tasks prior to and following a cognitive rumination task designed to increase negative mood. RESULTS: Individuals with disordered eating and individuals with peanut allergies had significantly worse performance on the food and body Stroop tasks relative to healthy controls at baseline (ps < .001). However, there were no perceived differences in performance by group following rumination. LIMITATIONS: The cognitive rumination task heightened negative mood for those in the disordered eating group but not for those in the peanut allergy or healthy control groups. CONCLUSIONS: Findings suggest that frequent thoughts involving food are associated with attentional biases towards food and body stimuli. This appears to be the case regardless of whether these frequent thoughts are due to disordered eating or to fear of an allergic reaction.

Alergia a la proteína de lentejas en el sur de Chile: Reporte de un caso y revisión de la literatura / Allergenicity of lentils in the south of Chile: Reporting a case and Review

El término alergia alimentaria, involucra entidades tan diversas como la proteína de leche de vaca hasta alergias al maní y a las legumbres. La prevalencia mundial de esta entidad ha ido en aumento y en Chile, no existen casos reportados en la literatura que orienten el diagnóstico. Por lo general el médico general es el primero en enfrentarse a estos casos, por lo tanto, deberá conocer muy bien su red de derivación, para dar una solución expedita a cada paciente que lo visita, por una alergia alimentaria. Se presenta el caso de un infante de 3 años, que presentó una reacción urticarial posterior a la ingesta de lentejas cocidas, por tercera vez. Requirió manejo con corticoides y anti-histamínicos para disminuir las molestias. Se concluye que el tratamiento indicado para la alergia alimentaria a lentejas, es la exclusión de la dieta, sin conocer la temporalidad de ésta ni su reinicio, aunque varias guías sugieren intentar realimentación a la edad de 4 a 5 años del infante.

The food allergy, involves entities as diverse as cow's milk protein to peanut allergies as to legumes. The global prevalence of this entity has been increasing. In general, the medical doctor is the first to face these cases, therefore, should know very well their referral network to give an expeditious approach to each patient who visits him for a food allergy. We present the case of a 3-year-old infant who presented an urticarial reaction after the third ingestion of cooked lentils. He required corticosteroids and antihistamine management to reduce discomfort. The treatment indicated for food allergy to lentils is the exclusion of the diet, without knowing the temporality of this or its re-initiation, although several guides suggest attempting feedback at the age of 4 to 5 years.