OC-54 The role of prevention in food allergies

Abstract

Dietary side effects represent an increasingly prevalent public health issue worldwide. The proper illustration of the differences between food allergies, which involve immunological mechanisms, either IgE or non-IgE mediated, and food intolerances, which appear without immune involvement, is critical for establishing subsequent diagnostic and therapeutic options. Current medical research aims to study the pathogenesis of food allergies in order to develop new therapeutic tools.The existence of an abundance of modulating environmental factors, which act upon a genetic substrate entail a wide phenotypic variability of allergic reactions that leads to complex clinical manifestations. A comprehensive and correct diagnosis followed by prompt, adequate preventive measures, an adequate therapeutic approach, allow the maintaining of a proper nutritional status and psycho-behavioural development, the goal being to establish good quality of life for these patients.Food allergies are a major public health problem. Statistic data concerning the incidence and prevalence of food allergies in children vary. They depend on multiple parameters, such as age, sex, diet, existing comorbidities, genetic factor, socioeconomic factors, geographical area etc. In the general population, food allergies have a medically documented incidence of 10.8%, affecting around 8% of children and 3.7% of adults [1]. Approximately 6%–8% of children under the age of 2 will develop this disorder [2], which in 80% of cases will recede until school age [3]. The vast majority of proteic food allergies (60%) are IgE mediated. In most cases, these appear with exposure to a single type of food and in 35% of cases multiple food allergies are noted [1]. The most frequent type of food allergy in the first years of life is milk protein allergy, which affects 21.1% of children with documented food allergies [1].The trigger of the allergic reaction involves the interaction between food allergen, gastrointestinal barrier and immune system. Gastrointestinal tract is a complex ecosystem, its functions and components ensuring the absorption of nutrients from the ingested food. Furthermore, it is involved in the intestinal immune activity by averting pathogenic agents from entering the body. The intestinal immune components consist of gut-associated lymphoid tissue (GALT), mucosa associated lymphoid tissue (MALT), secretory IgA, effector immune cells (helper and suppressor T cells, macrophages, plasmocytes). Payer’s patches, the enterocytes and the intercellular junctions have the role of macromolecular passageway [6]. The non-immunologic barrier consists of: gastric pH, intestinal mucus, commensal microflora, lactoferrin etc. These components are underdeveloped in infants and toddlers. Therefore, enzymatic activity is reduced and the IgA secretion rate reaches normal values around the age of 4 years, features that determine a high prevalence of food allergies in these age groups [4]. The most significant risk factors involved in developing food allergies are immaturity...