Food and nutrition in food allergy foreword




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CLINICAL ASPECTS OF FOOD ALLERGY




Marianne Polgár




Madarász Children’s Hospital, Budapest, Hungary




The prevalence of asthma and allergy is increasing world-wide (14). The first manifestation of the allergy in childhood is the food protein allergy. Recently the food allergy has increasing importance because it is not only disease of the childhood, but it can occur in any age. It has got a novel approach in respect to the concept of atopic march. The allergy in infancy, especially the egg’s protein allergy has a strong predictivity to the appearance of asthma and allergic rhinitis. Most of the cases are healing over 4 years of age (4). Moreover in the 15-20 % of cases the food allergy persists and in some patients allergic diseases of the respiratory tract will appear. This process of events is called “atopic march” (20, 21).


NON-SPECIFIC LIPID TRANSFER PROTEINS: “TRUE” VEGETABLE FOOD ALLERGENS



R. van Ree,


Sanquin Research, Amsterdam


Allergy to vegetable foods is often closely linked to pollen allergies. A well-known example is allergy to fruits and tree nuts like apple, pear, peach, cherry and hazelnut, which is usually observed in patients with birch pollinosis. This link is explained by cross-reactivity of IgE antibodies against the major birch pollen allergen Bet v 1 towards homologous proteins in vegetable foods. Production of IgE is induced in the respiratory tract, and the resulting antibodies cross-react with the related food allergens. This group of homologous allergens belongs to the PR10 family of pathogenesis-related proteins. These proteins are extremely labile under proteolytic and acidic circumstances encountered in the gastro-intestinal tract. For this reason, these allergens rarely (if ever) directly sensitise, simply because they are completely destroyed when they reach the intestinal immune system. For similar reasons, these allergens only give rise to relatively mild symptoms of the oral cavity, the so-called oral allergy syndrome. For food allergens to be able to sensitise directly, they need to be resistant to digestion in the gastro-intestinal tract. Such stable allergens are also more likely to cause severe systemic reactions beyond the oral cavity.

Recently, non-specific lipid transfer proteins (LTP) were identified as food allergens in fruits of the family of the Rosaceae like peach, apricot, apple and cherry. Subsequently, it was also shown that LTPs are allergens in many other foods of plant origin. LTPs have a highly conserved tertiary structure, which has been described as a so-called a-barrel structure. Such proteins consist of 4 a-helices held together by 4 highly conserved disulphide bridges. These structural characteristics give an allergen a highly compact structure, and render it highly stable to protease digestion. LTPs can be exposed to low pH (<2) and pepsin for at least one hour without influencing their apparent molecular weight on immunoblot. IgE-binding is not affected by in vitro pepsin digestion as well, suggesting that food LTPs can reach the gastro-intestinal immune system in a fully allergenic form. In other words, LTPs are typical representatives of “true” food allergens, which are able to sensitise after passage through the stomach. In accordance with their extreme stability, LTPs are linked to severe food allergies far more frequently than pollen-related food allergens in the same foods. The availability of recombinant molecules of both pollen-related and true food allergens now offers the possibility to study differences in the mechanism of sensitisation and to determine the factors that influence the severity of clinical symptoms.


FOOD AND NUTRITION IN FOOD ALLERGY



Lucjan Jędrychowski, Barbara Wróblewska



Institute of Animal Reproduction and Food Research of Polish Academy of Sciences,

Department of Food Enzymes and Allergens,

Tuwima str 10, 10-747 Olsztyn, Poland

e-mail eljot@pan.olsztyn.pl


According to available data, one third of the European population suffers from allergies. The occurrence, due to many synergising health , genetic and environmewntal factors, has an increasing tendency. In the last two decades the number of allergic persons has doubled. Allergic reactions to food are very dangerous. In the case of anaphylactic reactions, they make a life threat, at any age. Wűthrich reports many fatal cases caused by allergic reactions to food, which points out a special threat from the so called hidden allergens.

As in the whole world, the occurrence of food allergies in Poland clearly increases and therefore it is necessary to seek some technological and biotechnological solutions aimed at producing hypoallergenic food.

The possibility of influencing the immune system through diet components is scrupulously used by dieticians and implemented in practice in the food and farmaceutical industries. An example can be the increasing use of colostrum, milk from very early lactation period or so called immune milks, i.e. milk with elevated content of IgG and IgA class immunoglobulins. The production of the latter is based on suitable patents. Hyperimmune used for treatment of gut disorders but will still require futher research to increase milk immunoglobulin levels . The normal content of these immunoglobulins in cow’s milk is 2% and 0.4%, respectively, against milk proteins.

The most important is adequate instructing the patient and family to avoid hidden sources of the suspect food and to avoid potential sources of allergen contamination. It is critical to mark appropriately food products and to read carefully food labels by customers. There are lot of threats coming from the possibility of hidden allergens occurring in food. Potential sources of threat are the previously mentioned products obtained using geneticaly modified organisms as well as those made with the use of microorganisms (especially mould), antibiotics and anabolics.

A definite influence of some food antigens on functioning of the immune system and advisability of analysis of antigen threats and evaluation of immunoreactive properties of food products have been proven.

The achievements in production of hypoallergenic formulas for children/infants have to be assessed positively. Further activities in this direction are necessary due to necessity to individualise nutrition for patients with food allergies. Apart from further studies in the field of hypoalleric food also studies on hypoantigenic food should be carried on.


HUMAN MILK ANTIBODIES TO β-LACTOGLOBULIN, α-CASEIN AND CANDIDA ALBICANS, ISOLATED FROM ATOPIC AND HEALTHY MOTHERS

Wanda Karwowska, Danuta Bellaby


Department of Dietetics and Functional Foods, Warsaw Agricultural University- SGGW,Warsaw


This study was designed to investigate the concentration of specific secretory IgA in human milk samples taken from breast feeeding women in different stages of lactation. An enzyme linked immunosorbent assay was used to measure the contents of specific antibodies. The antibodies to allergenic cow’s milk proteins-β-lactoglobulin and α-casein were detected in all samples. The content varied greatly between samples from atopic and non atopic mothers. The antibodies to Candida albicans were detected in 47% of milk samples and were no significant differences between the samples from non atopic mothers and those with a strong history of allergy.


INTRODUCTION Many epidemiological studies have found that enteric and respiratory infections are less common among breast-fed infants. This protection has been attributed to the wide spectrum of immunological agents in human milk ,especially secretory immunoglobulin A (sIgA) [Miletic et al.,1996, Casas et al. 2000]. After penetrating the digestive system of an infant, IgA is absorbed in the the intestines. It impregnates the system and stops the absorption of cammon food antigens.[Stone et al.,1987] The mucous barrier of an infant is physiologically premature and id therefore more susceptible to penetration by many antigens[Telemo & Hanson, 1996]. Pre term milk and term milk delivers specific antibodies of secretory IgA which ensures protection of the mucous membrane of the digestive system against food allergens and microbes in contact with the mother [Restani et al.,2000] . Numerous investigations clearly show that in breast-fed infants from atopic families,the symptoms of allergies develop later. The intestinal flora of the digestive system containing the largest amount of lactic acid bacteria has a major effect on restricting the development of allergies[Kretschmar et al.2002, Zwolinska-Wcisło et al.2001] In our research, we investigated the content of specific antibodies in the milk samples taken from breast feeding mothers.


MATERIAL AND METHODS Human milk samples (n=158) from 37 healthy mothers and from 40 atopic mothers were colected and analysed on the first day, fourth day and fourth month of breast feeding. The 10 ml samples were placed in sterile test tubes and maintained at a temperature of2 50C prior to testing. After de-frosting the samples were rotated in a centrifuge to remove the fat and cellular components, The levels of IgA antibodies to β-lactoglobulin , α-casein and Candida albicans were asseessed with an enzyme linked immunosorbent assay ELISA {Matchinger & Moss,1986].


RESULTS AND DISCUSSION In all 158 samples of human milk , the antibodies to antigen cow’s milk proteins were detected. The antibodies to the somatic antigen Candida albicans were detected in 76 samples from 54 women taking part in the survey. The highest concentration of specific antibodies to cow’s milk antigens was detected in samples taken


in the first week of breast feeding, The average level of anti α-casein antibodies was higher than that of β-lactoglobulin antibodies (p <0,05). As lactation proceeded ,the level of antibodies to allergic parts of cow’s milk decreased. However, the level of β-lactoglobulin antibodies in samples from atopic mothers in the fourth week and fourth month of breast feeding was significantly higher than in samples from healthy mothers (p <0,004). Regarding Candida albicans antibodies,there were no relationships between its concentration in the milk samples and the incidence of atopies in the women ( p > 0,05). By using the somatic antigen Candida albicans , the presence of sIgA antibodies was detected in 47% of human milk samples. Kurnatowski and Seyfarth, concluded that the presance of yeast fungi the Candida genus has an impact on the parameters of humoral and cellular answers [Kurnatowski & Kurnatowska 1999, Seyfarth et al. 1994]. Our results show the benefit of searching for specific IgA antibodies in human milk as prophylaxis against allergies.


CONCLUSIONS The presence of specific antibodies sIgA against allergenic proteins of cow’s milk and against Candida albicans antigen indicates that breast feeding,should be continued by the mother as long possible.

Enzyme linked immunosorbent assay (ELISA) method is especially useful in tests were many repetitions and a small capacity of human milk is required.

REFERENCES


1.Casas R., Bottcher M. F., Duchen K.:Detection of IgA antibodies to cat, beta-lactoglobulin, and ovalbumin allergens in human milk. J. Allergy Clin. Immunol., 2000,105, (6), 1236-40

2.Kretschmar M., Felk. A., Staib P.:Individual acid aspartic proteinases (Saps) 1-6 of Candida albicans are not essential for invasion and colonization of the gastrointestinal tract in mice. Microb. Pathog., 2002 ,32, (2),61-70

3.Kurnatowski P., Kurnatopwska A. J.:Fungi of Candida species in the pharynx and some parameters of humoral and cellular immunity. Panminerva Med.,1999,41 (2), 149

4.Machtinger S., Moss R.:Cow's milk allergy in breast-fed infants: the role of allergen and maternal secretory IgA antibody. J. Allergy Clin. Immunol., 1986, 77,(2), 341-7

5.Miletic I.D., Schiffman S.S., Miletic V.D,:Salivary IgA secretion rate in young and elderly persons. Physiol. Behav., 1996, 60, (1),243-9

6.Telemo E., Hanson L.A.: Antibodies in milk . J.Mammary Gland., 1996,1,(3),243-9

7.Restani P., Gaiaschi A., Plebani A.:Evaluation of the presence of bovine proteins in human milk as a possible cause of allergic symptoms in breast-fed children. Ann Allergy Asthma Immunol., 2000, 84 (3),353-60

8.Seyfarth M., Neumann I., Simm R.:Analysis of Candida-specific antibodies in saliva. Immun. Infekt., 1994, 22(,4),152-3

9.Stone A. A., Cox D. S., Valdimarsdottir H.:Secretory IgA as a measure of immunocompetence. J. Human Stress, 1987, 13,(3),136-40

10.Zwolinska-Wcisło M., Budak A., Bogdal J.:Fungal colonization of gastric mucosa and its clinical relevance. Med. Sci. Monit., 2001,7,(5),982-8

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