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Food Sensitivity: Causes and Management

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Clinical Nutrition".

Deadline for manuscript submissions: closed (1 August 2021) | Viewed by 32375

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Special Issue Editor

Prof. Dr. Grazyna Czaja-Bulsa

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Guest Editor

Kathedral and Department of Children’s Diseases and Paediatric Nursing, Pomeranian Medical University, 71-210 Szczecin, Poland
Interests: food allergy; food hypersensitivity; coeliac disease; non coeliac gluten intolerance; Crohn disease; ulcerative colitis; children
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Dear Colleagues,

Food hypersensitivities include allergic (IgE-dependent and IgE-independent food allergies) and non-allergic (lactose, histamine, salicylate or synthetic additives intolerance, coeliac disease, non-celiac gluten intolerance) disorders. Such disorders occur not only among infants and children but also among adults. Treatment involves elimination diets, which can lead to nutritional deficiencies and malnutrition as well as feeding disorders in children.

In recent years, along with the development of molecular diagnostics, new elimination diet principles for the treatment of food allergies have been introduced. For those who are allergic to thermally unstable milk or egg allergens, these products are administered in baked form.

The aim of this Special Issue of Nutrients on "Food Sensitivity: Causes and Management" is to provide information on different forms of food hypersensitivity and different ways of conducting elimination diets. We are in papers covering topics from anaphylactic conditions requiring full elimination of even trace amounts of food to IgE-dependent allergies to milk or egg, in which some patients can be given these products in a baked form.

I invite our readers to share the results of their research in this area.

Dr. Grazyna Czaja-Bulsa
Guest Editor

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Keywords

food allergy
food anaphylaxis
lactose intolerance
histamine intolerance
salicylate intolerance
synthetic additives intolerance
coeliac disease
non-coeliac gluten intolerance
cow milk allergy
gluten-free diet

Published Papers (7 papers)

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Research

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10 pages, 2021 KiB

Open AccessArticle

Molecular Basis of IgE-Mediated Shrimp Allergy and Heat Desensitization

by PeiAo Zhang, Jihui Gao, Huilian Che, Wentong Xue and Dong Yang

Nutrients 2021, 13(10), 3397; https://doi.org/10.3390/nu13103397 - 27 Sep 2021

Cited by 8 | Viewed by 2129

Abstract

Crustacean allergy, especially to shrimp, is the most predominant cause of seafood allergy. However, due to the high flexibility of immunoglobulin E (IgE), its three-dimensional structure remains unsolved, and the molecular mechanism of shrimp allergen recognition is unknown. Here a chimeric IgE was built in silico, and its variable region in the light chain was replaced with sequences derived from shrimp tropomyosin (TM)-allergic patients. A variety of allergenic peptides from the Chinese shrimp TM were built, treated with heating, and subjected to IgE binding in silico. Amino acid analysis shows that the amino acid residue conservation in shrimp TM contributes to eliciting an IgE-mediated immune response. In the shrimp-allergic IgE, Glu98 in the light chain and other critical residues that recognize allergens from shrimp are implicated in the molecular basis of IgE-mediated shrimp allergy. Heat treatment could alter the conformations of TM allergenic peptides, impact their intramolecular hydrogen bonding, and subsequently decrease the binding between these peptides and IgE. We found Glu98 as the characteristic amino acid residue in the light chain of IgE to recognize general shrimp-allergic sequences, and heat-induced conformational change generally desensitizes shrimp allergens. Full article

(This article belongs to the Special Issue Food Sensitivity: Causes and Management)

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8 pages, 779 KiB

Open AccessArticle

No Correlation between Positive Fructose Hydrogen Breath Test and Clinical Symptoms in Children with Functional Gastrointestinal Disorders: A Retrospective Single-Centre Study

by Jarosław Kwiecień, Weronika Hajzler, Klaudia Kosek, Sylwia Balcerowicz, Dominika Grzanka, Weronika Gościniak and Katarzyna Górowska-Kowolik

Nutrients 2021, 13(8), 2891; https://doi.org/10.3390/nu13082891 - 23 Aug 2021

Cited by 2 | Viewed by 2561

Abstract

Fructose malabsorption is regarded as one of the most common types of sugar intolerance. However, the correlation between gastrointestinal symptoms and positive results in fructose hydrogen breath tests (HBTs) remains unclear. The aim of this study was to assess the clinical importance of positive fructose HBT by correlating the HBT results with clinical features in children with various gastrointestinal symptoms. Clinical features and fructose HBT results were obtained from 323 consecutive children (2–18 years old, mean 10.7 ± 4.3 years) that were referred to the Tertiary Paediatric Gastroenterology Centre and diagnosed as having functional gastrointestinal disorders. A total of 114 out of 323 children (35.3%) had positive HBT results, of which 61 patients were females (53.5%) and 53 were males (46.5%). Children with positive HBT were significantly younger than children with negative HBT (9.0 vs. 11.6 years old; p < 0.001). The most frequent symptom among children with fructose malabsorption was recurrent abdominal pain (89.5%). Other important symptoms were diarrhoea, nausea, vomiting, and flatulence. However, no correlation between positive fructose HBT results and any of the reported symptoms or general clinical features was found. In conclusion, positive fructose HBT in children with functional gastrointestinal disorders can be attributed to their younger age but not to some peculiar clinical feature of the disease. Full article

(This article belongs to the Special Issue Food Sensitivity: Causes and Management)

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16 pages, 1174 KiB

Open AccessArticle

The Effectiveness of Probiotic Lactobacillus rhamnosus and Lactobacillus casei Strains in Children with Atopic Dermatitis and Cow’s Milk Protein Allergy: A Multicenter, Randomized, Double Blind, Placebo Controlled Study

by Bożena Cukrowska, Aldona Ceregra, Elżbieta Maciorkowska, Barbara Surowska, Maria Agnieszka Zegadło-Mylik, Ewa Konopka, Ilona Trojanowska, Magdalena Zakrzewska, Joanna Beata Bierła, Mateusz Zakrzewski, Ewelina Kanarek and Ilona Motyl

Nutrients 2021, 13(4), 1169; https://doi.org/10.3390/nu13041169 - 01 Apr 2021

Cited by 39 | Viewed by 11262

Abstract

Probiotics seem to have promising effects in the prevention and treatment of allergic conditions including atopic dermatitis (AD) and food allergy. The purpose of this multicenter randomized placebo-controlled trial was to evaluate the effectiveness of a probiotic preparation comprising Lactobacillus rhamnosus ŁOCK 0900, Lactobacillus rhamnosus ŁOCK 0908, and Lactobacillus casei ŁOCK 0918 in children under 2 years of age with AD and a cow’s milk protein (CMP) allergy. The study enrolled 151 children, who—apart from being treated with a CMP elimination diet—were randomized to receive the probiotic preparation at a daily dose of 10⁹ bacteria or a placebo for three months, with a subsequent nine-month follow-up. The primary outcomes included changes in AD symptom severity assessed with the scoring AD (SCORAD) index and in the proportion of children with symptom improvement (a SCORAD score decreased by at least 30% in comparison with that at baseline). After the three-month intervention, both the probiotic and placebo groups showed a significant (p < 0.0001) decrease in SCORAD scores, which was maintained nine months later. The percentage of children who showed improvement was significantly higher in the probiotic than in the placebo group (odds ratio (OR) 2.56; 95% confidence interval (CI) 1.13–5.8; p = 0.012) after three months. Probiotics induced SCORAD improvement mainly in allergen sensitized patients (OR 6.03; 95% CI 1.85–19.67, p = 0.001), but this positive effect was not observed after nine months. The results showed that the mixture of probiotic ŁOCK strains offers benefits for children with AD and CMP allergy. Further research is necessary to assess the effect of probiotic supplementation on the development of immune tolerance (NCT04738565). Full article

(This article belongs to the Special Issue Food Sensitivity: Causes and Management)

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13 pages, 299 KiB

Open AccessArticle

Assessment of Inflammatory Markers in Children with Cow’s Milk Allergy Treated with a Milk-Free Diet

by Jadwiga Ambroszkiewicz, Joanna Gajewska, Magdalena Chełchowska and Grażyna Rowicka

Nutrients 2021, 13(4), 1057; https://doi.org/10.3390/nu13041057 - 24 Mar 2021

Cited by 3 | Viewed by 2026

Abstract

Background: The aim of the study was to establish whether the use of a strict milk-free diet in children with cow’s milk allergy, resulting in the resolution of clinical symptoms of the disease, also extinguishes the inflammatory reaction induced by the allergy. Methods: We examined 64 children (aged 3–6 years) with a diagnosed cow’s milk allergy who had been treated with an elimination diet for at least six months and showed remission of the disease’s clinical symptoms as a result of the treatment. The control group consisted of 30 healthy children of the same age following an unrestricted age-appropriate diet. Concentrations of cytokines, calprotectin, and adipokines (leptin, resistin, chemerin, neutrophilic lipocalin associated with gelatinase—NGAL) were determined in the serum samples obtained from the studied children by immunoenzymatic assays. Results: Patients with CMA had significantly higher median values of serum IL-6, TNF-α, resistin, chemerin and NGAL in comparison to the healthy children (p < 0.05, p < 0.001, p < 0.05, p < 0.01, p < 0.001, respectively). Serum concentrations of IL-10, leptin, calprotectin and CRP as well as in WBC count were in the same range in both studied groups. We observed direct statistically significant correlations between levels of IL-10 and CRP (p = 0.005), IL-10 and WBC (p = 0.045), TNF-α and WBC (p = 0.038), calprotectin and WBC (p < 0.001), chemerin and CRP (p < 0.001) as well as between NGAL and WBC (p = 0.002) in children with CMA. Conclusion: The use of a strict milk-free diet by children with CMA, resulting in the resolution of clinical symptoms of the disease, does not seem to extinguish the inflammation induced by the allergy. The findings of this study—elevated IL-6, TNF-α, resistin, chemerin and NGAL levels in patients with CMA—suggest that these parameters seem to be involved in the generation of a low-grade proinflammatory environment observed in cow‘s milk allergy and could be used to monitor the effectiveness of treatment. Full article

(This article belongs to the Special Issue Food Sensitivity: Causes and Management)

14 pages, 1190 KiB

Open AccessArticle

Effectiveness of Personalized Low Salicylate Diet in the Management of Salicylates Hypersensitive Patients: Interventional Study

by Paulina K. Kęszycka, Ewa Lange and Danuta Gajewska

Nutrients 2021, 13(3), 991; https://doi.org/10.3390/nu13030991 - 19 Mar 2021

Cited by 9 | Viewed by 5511

Abstract

Salicylic acid and its derivatives (including acetylsalicylic acid/aspirin) are popular in medicine. They also occur naturally in many food products. The aim of the study was to investigate the effect of the personalized low salicylate diet (PLSD) on the reduction of asthma, rhinosinusitis and urticaria symptoms in patients with hypersensitivity to aspirin (ASA) or nonsteroidal anti-inflammatory drugs (NSAIDs). To achieve the research goal, a prospective, nonrandomized, baseline-controlled intervention study was conducted. Thirty patients diagnosed with NSAIDs hypersensitivity, who despite pharmacotherapy had symptoms of hypersensitivity, were included in the study. The PLSD was recommended for all participants for a period of two to four weeks. The intensity of subjectively declared symptoms of asthma, rhinosinusitis and urticaria were measured before and after dietary intervention, using, respectively, the asthma control test (ACT), the sino-nasal outcome test (SNOT-22) and the four-item itch questionnaire (FIIQ). Diet adherence and salicylate intake were measured by a 3-day food record. The severity of symptoms improved significantly after the intervention. The median of the ACT score was 24 scores before and 25 after the dietary intervention (p < 0.002), the median of the SNOT-22 score was 25 before and 13 after a dietary intervention (p < 0.0002) and the median of the FIIQ score was 5 before and 0 after a dietary intervention (p < 0.0002). The intake of salicylates decreased from 0.79 mg/day (before intervention) to 0.15 mg/day (p < 0.001) (during intervention). Although the usefulness of a low salicylate diet in the treatment of salicylate hypersensitivity is controversial, the results of our study indicate that the PLSD may have a positive effect in reducing symptoms of salicylate hypersensitivity and could be an additional tool supporting the therapy of these patients. Full article

(This article belongs to the Special Issue Food Sensitivity: Causes and Management)

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Review

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16 pages, 1364 KiB

Open AccessReview

Histamine Intolerance in Children: A Narrative Review

by Wojciech Nazar, Katarzyna Plata-Nazar, Katarzyna Sznurkowska and Agnieszka Szlagatys-Sidorkiewicz

Nutrients 2021, 13(5), 1486; https://doi.org/10.3390/nu13051486 - 28 Apr 2021

Cited by 12 | Viewed by 5582

Abstract

Histamine intolerance is defined as a disequilibrium of accumulated histamine and the capacity for histamine degradation. This clinical term addresses a non-immunologically mediated pathology when histamine ingested with food is not particularly high, however its degradation is decreased. This paper aims to provide a narrative review on etiopathology, epidemiology, possible diagnostic algorithms and diagnostic challenges of histamine intolerance in children. The clinical picture of histamine intolerance in children is similar to that observed in adults apart from male predominance found in paediatric patients. Both in children and adults, a histamine-reduced diet is typically the treatment of choice. Diamine oxidase supplementation offers another treatment option. There is no symptom or test pathognomonic for histamine intolerance. Nevertheless, manifestations of chronic gastrointestinal symptoms, measurements of diamine oxidase deficits, positive results of histamine provocation tests and improvement in symptoms with histamine-reduced diet considerably increase the probability of histamine intolerance diagnosis. These factors have been included in the proposed diagnostic algorithm for histamine intolerance. In children histamine intolerance most likely co-occurs with allergies and bowel diseases, which creates an additional diagnostic challenge. As the evidence for children is poor further research is needed the determine epidemiology, validate diagnostic algorithms and establish possible treatment options regarding histamine intolerance. Full article

(This article belongs to the Special Issue Food Sensitivity: Causes and Management)

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11 pages, 1388 KiB

Open AccessReview

Wait-and-See Approach or Gluten-Free Diet Administration—The Rational Management of Potential Coeliac Disease

by Anna Szaflarska-Popławska

Nutrients 2021, 13(3), 947; https://doi.org/10.3390/nu13030947 - 15 Mar 2021

Cited by 2 | Viewed by 2202

Abstract

Potential celiac disease (PCD) is a heterogeneous disease; only some patients develop full celiac disease (CD), characterised by advanced atrophic changes in the small intestine. Few accurate prognostic factors exist for the progression of PCD; therefore, therapeutic decisions should be made on an individual basis in each case. Patients with clinical gastroenterological or parenteral symptoms often benefit from a gluten-free diet, and those left on a diet containing gluten should receive clinical, serological and histopathological supervision. Full article

(This article belongs to the Special Issue Food Sensitivity: Causes and Management)

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