Food Allergies…101
Amy Simonne, Ph.D.
Assistant Professor
FYCS
University of Florida
Food, Nutrition and Health Update 2002, Feb 12, 2002
Outlines
Statistics
What is food allergy
Immunology concepts
What foods causes allergies
Possible ways to deal with food allergy
Resources for food allergies
How prevalence is food
allergy?
Experts agree that allergies in developed
countries are becoming more common.
In the U.S., food allergies afflict 2-2.5% adults
and 6-8% children.
100-175 people in the U.S. die each year.
Death generally result from anaphylactic
shock, often to peanuts or tree nuts.
More than 160 foods have been associated
with allergic reactions.
C&EN/January
C&EN/January7,7,
2002
2002page
page21.
21.
What is food allergy?
Food allergy is an inappropriate immune
response to an otherwise harmless food.
True food allergy involves several types of
immunological responses.
Food allergens are usually proteins.
Some foods may contain haptens or haptens
carrier. (A hepten- a small molecule that has the
ability to combine with an Ab or a cell-surface
receptor.)
Types of food allergies
Immediate hypersensitivity with IgE which
occurs within minutes to a few hours after
ingestion of offending foods.
Systemic: Itching, urticaria (hives), Vomiting, Abdominal cramps, diarrhea and
respiratory distress, and in severe cases anaphylactic shock
Localized: hives and eczema or atopy (an umbrella term covering clinical
presentations of food allergy etc)
Delayed hypersensitivity reactions (>8hours
after ingestion): cellular immunity involving T-
lymphocytes and macrophages
What are stages of food allergy or
hypersensitivity
A. Sensitization: initial meeting of an
allergen and the immune system that
results in IgE production!
B. Activation of mast cells
IgE
Non-IgE substances (eg. Drugs)
Understanding Immunological
concepts
Human body has many defense mechanisms
to fight off infectious diseases and other toxic
foreign substances.
Strong healthy adult human can fight off most
of infectious diseases.
Ability to fight off disease can be modulated
by genetics, age, race and lifestyles (diets,
exercise and amount of sleep etc.)
Terminology
Allergic reactions are Antigen-Antibody
reactions
Antigen = a foreign substance
Antibody = a protein produced in response to
an antigen that is capable of binding
specifically to the antigen!
Haptens - a small molecule that has the ability to
combine with an Ab or a cell-surface receptor.
Understanding Immunological concepts
Human body has two categories of defense
system
Non specific defenses
Physical barriers (skin and mucous membrane)
Chemical barriers (saliva, mucus, gastric juices etc)
Cellular defenses (certain cells can eat invaders-
phagocytes)
Inflammation (reddening, swelling and temperature
increase of the affected sites)
Fever (elevated body temperature)
Molecular defenses (interferons or complementary system
etc.)
Specific defenses or specific immunity**
Antibodies (many kinds of antibodies for many kinds of
antigens)
Understanding Immunological
concepts
Food allergies is related to specific defenses
or specific immunity
Immune literary means “free of burden”
Actions of the immune system are triggered
by antigens (foreign substances).
Most antigens are large protein molecules;
Some antigens are polysaccharides and few
are glycoproteins (carbohydrate and protein)
or nucleo-proteins.
Specific Immunity
Immunity
An = Antibodies
Innate (inborn) Acquired
Genetic factors
Passive
(Ready-made-An)
Active
(own An)
Natural
Natural Maternal An Artificial
(Exposure to Artificial (An from
Foreign Agents) (immunization) Other sources)
What are Acquired-Active-Natural
Specific Antibodies (Immunoglobulins)
There are five classes of Immunoglobulins
1) IgG: Main class of antibodies in blood-also from
mother-to-child (20%)
2) IgA: Small amount in blood, but larger amount
in tears, milk, saliva, mucus and the lining tissues
3) IgM: First Antibody secreted during the primary
response
**4) IgE (Reagin): Found mainly in body fluids and
skin --- Associated with allergy reactions!
5) IgD: Found in B-Cell membrane
Nature of IgE Allergic Reactions
Antigen + IgE + Mast cells = Mediator release
Mediators= histamine and others
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Who makes the immunoglobulin IgE?
The allergen enters the body
and is recognized by sIg on a
B-lymphocyte. The B-
lymphocyte proliferates and
differentiates into plasma cells
that produce and secrete IgE
against the allergen.
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What’s next?
The next time the
allergen enters the
body, it cross-links
the Fab portions of
the IgE bound to the
mast cell. This
triggers the mast cell
to degranulate, that
is, release its
histamine and other
inflammatory
mediators.
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Nature of IgE Allergic Reactions
Antigen + IgE + Mast cells = Mediator release
Mediators= histamine and others
Picture credit: used with permission from Dr. Gary E. Kaiser
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What does histamine do?
Vasodilation, increased capillary
permeability, bronchoconstriction etc.
Primary and secondary
responses to an antigen
Primary response: first response when host’s B-cell recognize the
antigen
Secondary response: upon second exposure to the antigen, the
Memory cells will divide, thus make more of the total antibody
Symptoms-Food Allergy*
Nausea
Diarrhea
Abdominal cramps
Pruritic rashes
Angioedema
Asthma/rhinitis
Vomiting
Hives
Laryngeal edema
Anaphylaxis
* Exercise exacerbates symptoms
What are common allergenic
foods?
Legumes (Peanuts and Soybeans)
Mollusks (snails, mussels, oysters, scallops,
clams, squid)
Milk
Eggs
Fish (cod, salmon, haddock etc)
Crustacea (shrimp, crawfish, lobster etc.)
Wheat
Tree nuts (almonds, walnuts, Brazil nuts etc)
Selected food additives
It is not easy…living with food allergies!
What would you choose to eat, if
you are allergic to milk or dairy products?
Hidden food ingredients in ready made
food products!
Milk and milk product derivatives
Egg and egg derivatives
Peanuts, tree nuts and derivatives
Fish derivatives (surimi, fish sauce, fish
paste etc)
Soy and its derivatives
What about food Additives?
Sulfur-based preservatives
Sulfites
Aspartame (a sweetener)- PKU
Monosodium glutamate
FD&C Yelow #5 (Tartrazine)
Cross-Reactions: Food and non-food
allergens
Ragweed- Watermelon, cantaloupe,
honeydew, bananas
Mugwort- celery
Birch pollen-carrots, apples, hazelnuts,
potatoes
Banana – latex
* If allergic to one shellfish or legumes,
likely allergic to all!
To make the matter worse!
Eating out is a nightmare?
African, Chinese, Indonesian, Mexican, Thai,
and Vietnamese dishes often contain
peanuts. It is recommended that peanut-
allergic individuals avoid these types of foods
and restaurants.
For traditional food restaurants, cross-
contamination of allergens to other foods can
also a problem.
How to deal with food allergy!
There is no specific antibody for any
specific foods available!
People who have food allergy need a
total avoidance of the offending foods.
Read food ingredient list.
Eliminate cross-contamination during
cooking and preparation!!!!
Common medications prescribed by
doctors
epinephrine (relaxes smooth muscle,
constricts blood vessels, and stimulates
the heart; used for severe systemic
reactions);
antihistamines (block the binding of
histamine to histamine receptors on
target cells);
sodium cromolyn (prevents mast cells
from releasing histamines).
If antidose is given..
Picture credit: used with permission from Dr. Gary E. Kaiser
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Other types of food allergy, Non-IgE Mediated:
Immune Complex-mediated
Symptoms usually gastrointestinal
Delayed type hypersensitivity
Symptoms usually gastrointestinal
How about food intolerance?
Direct effect of food
Enzyme deficiency (e.g., lactase,
sucrase etc)
Symptoms of food intolerance: bloating,
cramping, gas and diarrhea
Main cause of food intolerance:
carbohydrates (lactose, fructose,
sorbitol)
What about Allergy VS Intolerance!
True Allergy-Total avoidance
necessary!
Intolerance- Small amount may be
tolerated
Other causes of allergy-like food
problems
Microbial products- e.g. histamine – Some
food products have high levels of histamine
(eg fermented foods)
Pharmacological reaction-tyramine,
phenylethylamine, cafiene – dose dependent
Idiosyncratic reactions – (adverse reactions
of drugs etc – dose dependent)
Psychological disorders
Food allergy and biotechnology
Although it is not easy to predict potential
allergenicity of foods derived from GMO!,
there are some criteria to go by:
Sources of transferred genetic material:
While the crops from which staple foods are
derived contain tens of thousands of different
proteins, relatively few are allergenic.
Synthesis of allergenic proteins also depends
on the growing conditions and other stress
factors.
Molecular weight of most known allergens
are between 10,000 and 40,000.
Food allergy and biotechnology
The amino acid sequence of many allergens
is readily available.
Labile allergens in foods that are eaten
cooked or undergo other processing before
consumption are of less concern.
Most allergens are resistant to gastric acidity
and to digestive proteases.
New proteins expressed in non-edible
portions of plants, for example are not of a
concern in terms of food allergy.
Resources for food allergies
Food Allergy and Anaphylaxis network
(FAAN)
Other resources
See handouts
I will be glad to entertain any
question!
