Allergen reference doses for precautionary labeling (VITAL 2.0): Clinical implications

Allen, Katrina J.; Remington, Benjamin C.; Baumert, Joseph L.; Crevel, René; Houben, Geert F.; Brooke‐Taylor, Simon; Kruizinga, Astrid G.; Taylor, Steve L.

doi:10.1016/j.jaci.2013.06.042

Cited by 182 publications

(164 citation statements)

References 63 publications

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“…Adaptive immune responses, such as allergy, consist of two phases: sensitization and elicitation, which must be analysed separately. Quantitative approaches to assess the risk posed by substances eliciting reactions in already sensitized individuals are proving very successful (Allen et al, 2014;Crevel et al, 2014). However, dose responses in relation to sensitization look to be non-linear, probably because exposure may lead to either tolerance or sensitization.…”

Section: Discussionmentioning

confidence: 99%

Approaches to assess IgE mediated allergy risks (sensitization and cross-reactivity) from new or modified dietary proteins

Remington¹,

Broekman

Blom³

et al. 2018

Food and Chemical Toxicology

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A B S T R A C TThe development and introduction of new dietary protein sources has the potential to improve food supply sustainability. Understanding the potential allergenicity of these new or modified proteins is crucial to ensure protection of public health. Exposure to new proteins may result in de novo sensitization, with or without clinical allergy, or clinical reactions through cross-reactivity.In this paper we review the potential of current methodologies (in silico, in vitro degradation, in vitro IgE binding, animal models and clinical studies) to address these outcomes for risk assessment purposes for new proteins, and especially to identify and characterise the risk of sensitization for IgE mediated allergy from oral exposure. Existing tools and tests are capable of assessing potential crossreactivity. However, there are few possibilities to assess the hazard due to de novo sensitization. The only methods available are in vivo models, but many limitations exist to use them for assessing risk. We conclude that there is a need to understand which criteria adequately define allergenicity for risk assessment purposes, and from these criteria develop a more suitable battery of tests to distinguish between proteins of high and low allergenicity, which can then be applied to assess new proteins with unknown risks.

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Section: Discussionmentioning

confidence: 99%

Approaches to assess IgE mediated allergy risks (sensitization and cross-reactivity) from new or modified dietary proteins

Remington¹,

Broekman

Blom³

et al. 2018

Food and Chemical Toxicology

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“…This has prompted the food manufacturing sector to introduce PAL (Allen et al 2014). Voluntary PAL is often undertaken by the food industry to warn of the potential for cross-contamination (and cross-contact) such as in the instance of shared manufacturing equipment and/or facilities.…”

Section: Food Allergen Labelling Regulationsmentioning

confidence: 99%

“…Three parametric models (log logistic, log normal, and Weibull) were applied to derive the estimates of ED 1 (for peanut and cow's milk) and both ED 1 and ED 5 (for egg and hazelnut) whilst the 95% lower confidence interval of the ED 5 was estimated for soybean, wheat, sesame seed, lupine, mustard, cashew, and shrimp. See Allen et al (2014) and Taylor et al (2014) for further elaboration on how the reference doses were derived. Studies have estimated threshold doses that are derived from the ED to trigger a reaction in 1% (ED 01 ), 5% (ED 05 ), or 10% (ED 10 ) of the population such as the reference doses established by the Voluntary Incidental Trace Allergen Labelling (VITAL) expert panel group for 11 major food allergens as listed in Table 5.…”

Section: Quantitative Risk Assessment To Predict Allergenic Reactionsmentioning

confidence: 99%

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“May Contain” Allergen Statements: Facilitating or Frustrating Consumers?

Soon

Manning

2017

J Consum Policy

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As a result of mandatory labelling legislation, major food allergens that commonly cause allergic reactions are declared on packaging. The usage of precautionary allergen labelling (PAL) on packaging is not regulated in all countries, and the food industry uses various forms of "may contain" labelling which firstly is often inconsistent and secondly over time may diminish the value of such advisory statements. Hence, the aims of this paper are to review the current industry usage of PAL and to provide recommendations on future use that are of value to academics, policy makers, food industry, and consumers. A case study example is used to illustrate the likely costs and benefits of improving the current PAL status by considering a "peanut-free" product and calculation using the Voluntary Incidental Trace Allergen Labelling (VITAL) calculator. Governance such as addressing the inconsistent usage of PALs, promoting the harmonization of language used in PALs, and improving PAL status to quantified PAL statements would be helpful in communicating risks to consumers, so they can make informed choices when purchasing food products.

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“…Recently, there has been a joint international effort between clinicians, scientists and the food industry to develop reference allergen dose levels for common food allergens, in order to rationalise and facilitate decision making when it comes to the precautionary food labelling by food manufacturers (29). In return, provision of such information on food packaging will aid parents and children in assessing their risk of accidental exposure to food allergens.…”

Section: Long -Term Managementmentioning

confidence: 99%

The Diagnosis and Management of Food Allergy in Childhood

Semiç-Jusufagiç

2014

Pediatr Today

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Food allergy has reached epidemic proportions in developed countries over the past few decades for reasons not well understood. With the growing disease burden and the need to improve food allergy diagnosis, better diagnostics tools such as component resolved diagnostics (CRD) have been introduced for clinical use. Still, oral food challenges remain the gold standard tool for establishing food allergy diagnosis. Current food allergy management strategies rely on avoidance of the culprit allergen. Inspired by the success of specific immunotherapy in inhalant allergy, the past decade has been marked by increasing international effort to find curative treatments. The results from several clinical trials, examining success of allergen-specific immunotherapy in food allergy, have recently become available and are discussed within this review article. Conclusion -The results from these clinical trials promise new curative therapies for food allergy sufferers in the near future. Moreover, several ongoing interventional studies looking into early-life introduction of allergenic foods could provide us with specific answers on future primary prevention strategies.

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Allergen reference doses for precautionary labeling (VITAL 2.0): Clinical implications

Cited by 182 publications

References 63 publications

Approaches to assess IgE mediated allergy risks (sensitization and cross-reactivity) from new or modified dietary proteins

Approaches to assess IgE mediated allergy risks (sensitization and cross-reactivity) from new or modified dietary proteins

“May Contain” Allergen Statements: Facilitating or Frustrating Consumers?

The Diagnosis and Management of Food Allergy in Childhood

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