Chapter 84 : Tests for Immunological Reactions to Foods

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Food allergy is defined as an adverse health effect arising from a specific immune response that occurs reproducibly on exposure to a given food protein, and is distinguished from food intolerance (e.g. lactose intolerance), which is typically nonimmunologic in origin (1). Food allergic disorders can be divided into those that are immunoglobulin E (IgE)-mediated and those that are non-IgE mediated. Disorders with acute onset of symptoms, defined typically as occurring within 2 hours after ingestion, are usually mediated by IgE antibodies, while subacute and chronic food allergic disorders may be cell mediated (primarily T cell) or of mixed origin with both cell-mediated and IgE-associated mechanisms. The subacute and chronic food allergic disorders primarily affect the gastrointestinal tract. Table 1 lists examples of IgE-, cell-, and mixed IgE- and cell-mediated disorders.

Citation: Santos C, Fleischer D, Wood R. 2016. Tests for Immunological Reactions to Foods, p 815-824. In Detrick B, Schmitz J, Hamilton R (ed), Manual of Molecular and Clinical Laboratory Immunology, Eighth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818722.ch84
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1. Boyce JA, Assa'ad A, Burks AW, Jones SM, Sampson HA, Wood RA, Plaut M, Cooper SF, Fenton MJ, Arshad SH, Bahna SL, Beck LA, Byrd-Bredbenner C, Camargo CA Jr, Eichenfield L, Furuta GT, Hanifin JM, Jones C, Kraft M, Levy BD, Lieberman P, Luccioli S, McCall KM, Schneider LC, Simon RA, Simons FE, Teach SJ, Yawn BP, Schwaninger JM NIAID-Sponsored Expert Panel. 2010. Guidelines for the diagnosis and management of food allergy in the United States: report of the NIAID-sponsored expert panel. J Allergy Clin Immunol 126(Suppl):S1S58.[CrossRef].[PubMed]
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11. Bock SA, Lee WY, Remigio L, Holst A, May CD. 1978. Appraisal of skin tests with food extracts for diagnosis of food hypersensitivity. Clin Allergy 8:559564.[PubMed].[CrossRef]
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23. Ahrens B, Niggemann B, Wahn U, Beyer K. 2012. Organ-specific symptoms during oral food challenge in children with food allergy. J Allergy Clin Immunol 130:549551.[CrossRef].[PubMed]
24. Caffarelli C, Petroccione T. 2001. False-negative food challenges in children with suspected food allergy. Lancet 358:18711872.[CrossRef].[PubMed]
25. Sampson HA. 2001. Utility of food-specific IgE concentrations in predicting symptomatic food allergy. J Allergy Clin Immunol 107:891896.[CrossRef].[PubMed]
26. Sampson HA, Ho DG. 1997. Relationship between food-specific IgE concentrations and the risk of positive food challenges in children and adolescents. J Allergy Clin Immunol 100:444451.[PubMed].[CrossRef]
27. García-Ara C, Boyano-Martínez T, Díaz-Pena JM, Martín-Muñoz F, Reche-Frutos M, Martín-Esteban M. 2001. Specific IgE levels in the diagnosis of immediate hypersensitivity to cows’ milk protein in the infant. J Allergy Clin Immunol 107:185190.[PubMed].[CrossRef]
28. Osterballe M, Bindslev-Jensen C. 2003. Threshold levels in food challenge and specific IgE in patients with egg allergy: is there a relationship? J Allergy Clin Immunol 112:196201.[PubMed].[CrossRef]
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32. Nicolaou N, Poorafshar M, Murray C, Simpson A, Winell H, Kerry G, Härlin A, Woodcock A, Ahlstedt S, Custovic A. 2010. Allergy or tolerance in children sensitized to peanut: prevalence and differentiation using component-resolved diagnostics. J Allergy Clin Immunol 125:191197.[CrossRef].[PubMed]
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37. Ando H, Movérare R, Kondo Y, Tsuge I, Tanaka A, Borres MP, Urisu A. 2008. Utility of ovomucoid-specific IgE concentrations in predicting symptomatic egg allergy. J Allergy Clin Immunol 122:583588.[CrossRef].[PubMed]
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55. Chatchatee P, Järvinen KM, Bardina L, Beyer K, Sampson HA. 2001. Identification of IgE- and IgG-binding epitopes on α(s1)-casein: differences in patients with persistent and transient cow's milk allergy. J Allergy Clin Immunol 107:379383.[CrossRef].[PubMed]
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Generic image for table

Food allergy disorders

Citation: Santos C, Fleischer D, Wood R. 2016. Tests for Immunological Reactions to Foods, p 815-824. In Detrick B, Schmitz J, Hamilton R (ed), Manual of Molecular and Clinical Laboratory Immunology, Eighth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818722.ch84
Generic image for table

Signs and symptoms of food-induced allergic reactions

Citation: Santos C, Fleischer D, Wood R. 2016. Tests for Immunological Reactions to Foods, p 815-824. In Detrick B, Schmitz J, Hamilton R (ed), Manual of Molecular and Clinical Laboratory Immunology, Eighth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818722.ch84

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