Presentation of allergen in different food preparations affects the nature of the allergic reaction - a case series

被引:98
作者
Grimshaw, KEC
King, RM
Nordlee, JA
Hefle, SL
Warner, JO
Hourihane, JOB
机构
[1] Univ Southampton, Sch Med, Div Infect Inflammat & Repair, Southampton SO9 5NH, Hants, England
[2] Southampton Univ Hosp Trust, Wellcome Trust Clin Res Facil, Southampton, Hants, England
[3] Univ Nebraska, Dept Food Sci & Technol, Lincoln, NE 68583 USA
关键词
anaphylaxis; food allergy; food challenge; food matrix; IgE; peanut;
D O I
10.1046/j.1365-2222.2003.01795.x
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
Background Characterization of fatal and non-fatal reactions to food indicates that the majority of reactions are due to the ingestion of prepared foods rather than the non-processed allergen. In an ongoing study that used a double-blind placebo-controlled food challenge to investigate peanut allergy and clinical symptoms, the observed reaction severity in four of the first six subjects was greater than anticipated. We hypothesized that this was due to differences in the composition of the challenge vehicle. Objective The aim was to investigate whether the severity of observed challenge reactions would be repeated on re-challenge with a lower fat challenge vehicle. Methods Peanut-allergic subjects were re-challenged with a lower fat recipe after reacting more severely than was anticipated to an initial peanut challenge. Similar challenge vehicle recipes were used, the only difference being the lower fat content (22.9% compared with 31.5%). The peanut content of the two recipes was analysed using RAST inhibition studies and ELISA tests. Results Three of four subjects reacted to much smaller doses of peanut protein on re-challenge (mean dose equivalence - 23 times less peanut) with the lower fat recipe. RAST inhibition showed that neither recipe altered epitope recognition. The higher fat recipe required twice as much peanut to cause 50% inhibition. ELISA detected far lower levels of peanut in the higher fat recipe (220 000 parts per million (p.p.m.)) than in the lower fat recipe (990 000 p.p.m.). Conclusion The fat content of a challenge vehicle has a profound effect on the reaction experienced after allergen ingestion. This is another factor to be considered in assessing the risk of certain foods to food-allergic consumers and adds another dimension to clinical, research and regulatory practice.
引用
收藏
页码:1581 / 1585
页数:5
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