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Food Allergy: Epidemiology, Pathogenesis, Diagnosis, and Treatment
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Food Allergy: Epidemiology, Pathogenesis, Diagnosis, and Treatment

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Immunology".

Deadline for manuscript submissions: closed (10 August 2023) | Viewed by 9277

Special Issue Editors

Dr. Angela Rizzi

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Guest Editor
UOSD Allergologia e Immunologia Clinica, Dipartimento di Scienze Mediche e Chirurgiche Addominali ed Endocrino Metaboliche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
Interests: food allergy; metal allergy; drug allergy; nasal cytology; immunotherapy; asthma; rhinitis; nasal polyposis, latex allergy; vasculitis
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Sebastiano Gangemi

E-Mail Website
Guest Editor
Department of Clinical and Experimental Medicine, School and Operative Unit of Allergy and Clinical Immunology, University of Messina, 98125 Messina, Italy
Interests: mediators of inflammation, cytokines, and biomarkers of oxidative stress; immunosenescence; immunogenetics; epigenetics; application of machine learning and deep learning in various fields of medicine
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

At present, the prevalence of food allergies represents a major global health problem, affecting approximately 8% of children and 3% of adults, with a dramatically increasing number of hospitalizations due to food-related allergic reactions and food-induced anaphylaxis. The interaction of genetic factors; epigenetic mechanisms such as DNA methylation and microRNAs; environmental changes, including early-life microbial exposure; and innate immune cells may contribute to the clinical heterogeneity of this dysregulated type 2 response to harmless food allergens. The cornerstones of the diagnosis are: clinical history, diagnostic testing (skin prick test and specific serum IgE searching), elimination diets, and oral food challenge. Component-resolved diagnostics and cellular tests such as basophil activation tests and mast cell activation tests have solved most of the limitations of conventional methods toward achieving “precision medicine”. The management of food allergies includes both short-term interventions for acute reactions and long-term strategies to prevent life-threatening events. The latter goal is achieved mainly through an elimination diet, patient/caregiver education, and pharmacological and non-pharmacological strategies to improve the patient’s quality of life. Growing attention is also being given to potential immunomodulatory therapeutic approaches, including immunotherapy, biologics, and novel vaccines.

With this global approach in mind, this Special Issue seeks proposals that focus on epidemiology, pathogenetic mechanisms, diagnostic tools, and validated and emerging therapeutic strategies.

Dr. Angela Rizzi
Prof. Dr. Sebastiano Gangemi
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • food allergy
  • anaphylaxis
  • regulatory immune cells (Tregs and Bregs)
  • oral tolerance
  • diagnosis
  • oral food challenges
  • management
  • food immunotherapy
  • nutrition
  • quality of life

Published Papers (5 papers)

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Research

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12 pages, 819 KiB  
Article
Prevalence of Parent-Reported Food Allergy in a Mexican Pre-School Population
by Jesús Gilberto Arámburo-Gálvez, Oscar Gerardo Figueroa-Salcido, Giovanni Isaí Ramírez-Torres, Elí Terán-Cabanillas, Martina Hilda Gracia-Valenzuela, Aldo Alejandro Arvizu-Flores, Cesar Antonio Sánchez-Cárdenas, José Antonio Mora-Melgem, Luisamaria Valdez-Zavala, Feliznando Isidro Cárdenas-Torres and Noé Ontiveros
J. Clin. Med. 2023, 12(15), 5095; https://doi.org/10.3390/jcm12155095 - 03 Aug 2023
Cited by 1 | Viewed by 1220
Abstract
The magnitude and relevance of food allergies in the preschool population remain unknown in most regions of Mexico and Latin America. Thus, our aim was to estimate the parent-reported prevalence of food allergies in a Mexican preschool population and to characterize their clinical [...] Read more.
The magnitude and relevance of food allergies in the preschool population remain unknown in most regions of Mexico and Latin America. Thus, our aim was to estimate the parent-reported prevalence of food allergies in a Mexican preschool population and to characterize their clinical diagnosis and presentation. A cross-sectional survey was conducted in Culiacán City. A validated questionnaire was utilized. A total of 810 parents responded to the questionnaire (valid response rate, 40.7%). The estimated prevalence rates (95% CI) were: “physician-diagnosed Food Allergy (FA), ever” 5.30% (3.86–7.08); “immediate-type FA, ever” 2.96% (1.91–4.38); “immediate-type FA, current” 1.60% (0.86–2.73); and food-dependent anaphylaxis 1.11% (0.51–2.01). The main food allergens were milk (0.49%), strawberries (0.37%), egg, and soy (0.25% each). Atopic diseases and a family history of allergies were significantly associated with immediate-type FA. Among “immediate-type FA, current” cases, 76.9% required emergency room visits, but the prescription of epinephrine autoinjectors was reported in one case only. The food reactions occurred at home (92.35%), in a relative’s house (38.5), and at restaurants (23%). Immediate-type FA reactions requiring emergency room visits are not uncommon among the studied population. Actions like proper anaphylaxis management and the prevention of cross-contamination of foods should be encouraged. Full article
(This article belongs to the Special Issue Food Allergy: Epidemiology, Pathogenesis, Diagnosis, and Treatment)
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12 pages, 274 KiB  
Article
Impact of Presumed Tree Nut and Peanut Allergy on Quality of Life at Different Ages
by Maria Pasioti, Maria Savva, John Lakoumentas, Evangelia Kompoti, Michael Makris, Paraskevi Xepapadaki and Nikolaos G. Papadopoulos
J. Clin. Med. 2023, 12(10), 3472; https://doi.org/10.3390/jcm12103472 - 15 May 2023
Viewed by 1720
Abstract
Tree nut and/or peanut allergy impairs patients’ quality of life, but data on the impact of age and the type of nut or peanut on the quality of life are lacking. To evaluate the impact at different ages, age-appropriate survey questionnaires accompanied by [...] Read more.
Tree nut and/or peanut allergy impairs patients’ quality of life, but data on the impact of age and the type of nut or peanut on the quality of life are lacking. To evaluate the impact at different ages, age-appropriate survey questionnaires accompanied by FAQLQ and FAIM were distributed to patients with suspected tree nut and/or peanut allergy who presented at the allergy departments of three hospitals in Athens. Out of 200 questionnaires distributed, 106 met the inclusion criteria (46 children, 26 teenagers, 34 adults). The median score of each age group for FAQLQ was 4.6 (3.3–5.1), 4.7 (3.9–5.5), and 3.9 (3.2–5.1) and for FAIM was 3.7 (3.0–4.0), 3.4 (2.8–4.0), and 3.2 (2.7–4.1), respectively. FAQLQ and FAIM scores were correlated with the reported probability of using the rescue anaphylaxis set upon reaction (15.4%, p = 0.04 and 17.8%, p = 0.02, respectively) and pistachio allergy (FAQLQ: 4.8 vs. 4.0, p = 0.04; FAIM: 3.5 vs. 3.2, p = 0.03). Patients with additional food allergies reported worse FAQLQ scores (4.6 vs. 3.8, p = 0.05). Worse FAIM scores were associated with younger age (−18.2%, p = 0.01) and the number of life-threatening allergic reactions (25.3%, p < 0.001). The overall impact of tree nut and/or peanut allergy on patients’ quality of life is moderate but differs with age, the type of nut, the use of adrenaline, and the number of previous reactions. The aspects of life affected and contributed factors also vary across age groups. Full article
(This article belongs to the Special Issue Food Allergy: Epidemiology, Pathogenesis, Diagnosis, and Treatment)

Review

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22 pages, 1083 KiB  
Review
Latex Allergy in Children
by Stefania Arasi, Simona Barni, Lucia Caminiti, Riccardo Castagnoli, Mattia Giovannini, Lucia Liotti, Carla Mastrorilli, Francesca Mori, Luca Pecoraro, Francesca Saretta, Mariannita Gelsomino, Angela Klain, Michele Miraglia del Giudice and Elio Novembre
J. Clin. Med. 2024, 13(1), 124; https://doi.org/10.3390/jcm13010124 - 25 Dec 2023
Viewed by 872
Abstract
Notwithstanding the efforts made in the last decades to mitigate the consequences of natural rubber latex allergy, this disease continues to be a major health problem, especially in developing countries. The categories of patients with greater and frequent exposure to latex (such as [...] Read more.
Notwithstanding the efforts made in the last decades to mitigate the consequences of natural rubber latex allergy, this disease continues to be a major health problem, especially in developing countries. The categories of patients with greater and frequent exposure to latex (such as health care professionals and, in the pediatric field, subjects who undergo repeated surgery, e.g., those suffering from spina bifida and urogenital malformations) have an increased risk of developing sensitization and allergy to latex. Herein we provide an overview of the current knowledge and practical recommendations with a focus on epidemiology, diagnostics, and management (including both prevention and therapy) in order to guide a correct recognition and containment of this potentially fatal condition. Full article
(This article belongs to the Special Issue Food Allergy: Epidemiology, Pathogenesis, Diagnosis, and Treatment)
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19 pages, 835 KiB  
Review
Emerging Role of Alarmins in Food Allergy: An Update on Pathophysiological Insights, Potential Use as Disease Biomarkers, and Therapeutic Implications
by Angela Rizzi, Elena Lo Presti, Raffaella Chini, Luca Gammeri, Riccardo Inchingolo, Franziska Michaela Lohmeyer, Eleonora Nucera and Sebastiano Gangemi
J. Clin. Med. 2023, 12(7), 2699; https://doi.org/10.3390/jcm12072699 - 04 Apr 2023
Cited by 7 | Viewed by 2038
Abstract
Food allergies are immuno-mediated adverse reactions to ingestion or contact with foods, representing a widespread health problem. The immune response can be IgE-mediated, non-IgE-mediated, or with a mixed mechanism. The role of innate immunity and alarmins in the pathogenesis of diseases such as [...] Read more.
Food allergies are immuno-mediated adverse reactions to ingestion or contact with foods, representing a widespread health problem. The immune response can be IgE-mediated, non-IgE-mediated, or with a mixed mechanism. The role of innate immunity and alarmins in the pathogenesis of diseases such as asthma and atopic dermatitis is well known. Some authors have investigated the correlation between alarmins and food allergies, often obtaining interesting results. We analyzed articles published in English from the last 22 years present on PubMed concerning the role of alarmins in the pathogenesis of food allergies and their potential use as disease biomarkers, response biomarkers to therapy, or potential therapeutic targets. Nuclear alarmins (TSLP, IL-33, IL-25) appear to have a critical role in IgE-mediated allergies but are also implicated in entities such as eosinophilic esophagitis. Calprotectin and defensins may play a role as disease biomarkers and could help predict response to therapy, although results in the literature are often conflicting. Despite the promising results, more studies on humans still need to be conducted. Deepening our knowledge regarding alarmins and their involvement in food allergies could lead to the development of new biological therapies, significantly impacting patients’ quality of life. Full article
(This article belongs to the Special Issue Food Allergy: Epidemiology, Pathogenesis, Diagnosis, and Treatment)
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Other

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17 pages, 694 KiB  
Systematic Review
Allergy-Test-Based Elimination Diets for the Treatment of Eosinophilic Esophagitis: A Systematic Review of Their Efficacy
by Constantinos Pitsios, Emilia Vassilopoulou, Katerina Pantavou, Ingrid Terreehorst, Anna Nowak-Wegzryn, Antonella Cianferoni, Georgios Panagiotis Tsigkrelis, Maria Papachristodoulou, Stefanos Bonovas and Georgios K. Nikolopoulos
J. Clin. Med. 2022, 11(19), 5631; https://doi.org/10.3390/jcm11195631 - 24 Sep 2022
Cited by 6 | Viewed by 2572
Abstract
Eosinophilic esophagitis (EoE) is an immune-mediated esophageal disorder, linked with sensitization to food and airborne allergens. Dietary manipulations are proposed for the management of EoE inflammation and are often successful, confirming the etiological role of food allergens. Three different dietary approaches are widely [...] Read more.
Eosinophilic esophagitis (EoE) is an immune-mediated esophageal disorder, linked with sensitization to food and airborne allergens. Dietary manipulations are proposed for the management of EoE inflammation and are often successful, confirming the etiological role of food allergens. Three different dietary approaches are widely used: the elemental, the empirical, and the allergy-test-driven approach. We performed a systematic review to assess the evidence on the association of allergens, detected by allergy tests, with clinically confirmed triggers of EoE. We systematically searched PubMed, Scopus, Embase, and the Cochrane Library, through 1 June 2021. We sought studies examining the correlation of skin-prick tests (SPT), atopy patch tests (APT), specific IgE, and serum-specific IgG4, with confirmed triggers of EoE. Data on the use of prick–prick tests were also extracted. Evidence was independently screened by two authors against predefined eligibility criteria. Risk of bias was assessed with the ROBINS-I tool. Of 52 potentially eligible studies, 16 studies fulfilling quality criteria were included. These studies used one to three different allergy tests detecting food sensitization. The positive predictive value was generally low to moderate but higher when a combination of tests was used than single-test evaluations. None of the selected studies used serum-specific IgG4. Although an extreme methodological variability was noticed in the studies, allergy-based elimination diets were estimated to be efficient in 66.7% of the cases. The efficacy of targeted elimination diets, guided by SPT, sIgE, and/or APT allergy tests, does not appear superior to empirical ones. In the future, tests using esophageal prick testing or ex vivo food antigen stimulation may prove more efficient to guide elimination diets. Full article
(This article belongs to the Special Issue Food Allergy: Epidemiology, Pathogenesis, Diagnosis, and Treatment)
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