Please activate JavaScript!
Please install Adobe Flash Player, click here for download
ePaper created 2014-09-15, 12:31:02 | version 1.32.01
Food allergy Food allergy is a disease that for a long time was neglected and even disregarded, probably due to the difficulties in diagnosis. Many eczema patients are sensitized to foods, but do not have symptoms related to food exposure. Even in patients who are clearly allergic to food, no more than 50% of the sensitizations found are clinically relevant. Fré de Maat-Bleeker was one of the first clinicians to recognize the problem and discover cross- reactivity between inhalant allergens and food allergens, such as latex, buckwheat and birds’ eggs.[1] Research was focused on improvement of diagnosis by implementing double-blind placebo-controlled food challenges (DBPCFCs), which became the gold standard. Low doses of allergens appeared to be able to elicit allergic reactions.[2] Challenge protocols were developed, starting with low doses and progressing to the dose causing clear symptoms. Thus, it was possible to establish thresholds for clinical reactivity for several different foods in large patient groups, consisting of both adults and children.[3,4] Knowledge of thresholds for clinical reactivity is used in new strategies to improve food labeling on a European level and even world-wide, supported by expert groups of the International Life Sciences Institute (ILSI), in which we participate actively.[5] We have been involved in two major European studies, both coordinated from our center. Firstly, the SAFE project on plant food allergies, involving field-to-table strategies for reducing their incidence in Europe.[6]. Secondly, the Europrevall study on the prevalence, cost and basis of food allergy across Europe.[7] These studies have strongly improved our insight into allergens involved in food allergy, and into the differences between the food allergens involved in different geographical regions. This approach, also called component-resolved diagnostics (CRD), was further developed and makes it possible to standardize diagnostic procedures.[8,9] Data so far indicate that at least for a number of foods, CRD allows better prediction of allergy and/or the severity of the reaction. Curative treatment is just in its infancy. New, potentially safer and more effective routes of allergen administration are currently being investigated. Participation has begun in the VIPES (Viaskin Peanut’s Efficacy and Safety) study, the largest peanut vaccination study to date, using the transcutaneous route of peanut allergen administration. This study is aimed at at assessing the efficacy and safety of administration of several doses of Viaskin peanut in adults and children with peanut allergy. References 1. Maat-Bleeker F de, Stapel SO. Cross-reactivity between buckwheat and latex. Allergy. 1998; 53: 538-9. 2. Koppelman SJ, Wensing M, de Jong GAH, et al. Anaphylaxis caused by the unexpected presence of casein in salmon. Lancet 1999; 354: 2136. 3. Wensing M, Penninks AH, Hefle SL, et al. The distribution of individual threshold doses eliciting allergic reactions in a population with peanut allergy. J Allergy Clin Immunol 2002; 110: 915-20. 4. Peeters KA, Koppelman SJ, Van Hoffen E, et al. Does skin prick test reactivity to purified allergens correlate with clinical severity of peanut allergy? Clin Exp Allergy 2007; 37: 108-15. 5. Crevel RW, Briggs D, Hefle SL, et al. Hazard characterisation in food allergen risk assessment: The application of statistical approaches and the use of clinical data. Food Chem Toxicol 2007; 45: 691-701. 74 BWEADVSMGFINCORR:Opmaak 1 21-07-2014 17:40 Pagina 74