Practical protocol of the food allergy committee of the SEICAP on open oral food challenges to nuts

Abstract

Food allergy is rising rapidly among children, and allergy to nuts is one of the most prevalent allergies among them. The category “nuts and seeds” include several plant foods from different botanical families, very different from each other. It is not uncommon to detect co-sensitization to different nuts. However, true co-allergy is less frequent. Up to 80% of patients with positive skin prick tests or specific IgE without true history of reaction who avoid certain nuts, might tolerate them in an Oral Food Challenge (OFC). Although molecular diagnostic techniques help to improve nut allergy diagnosis, OFC still remains the gold standard. For this reason, after reviewing the current bibliography and the recommendations of different allergy societies on standardization of open OFC, the Food Allergy Committee of the Spanish Society of Pediatric Allergy, Asthma and Clinical Immunology (SEICAP) food allergy working group proposed a unified protocol to undertake these OFC, which include preliminary recommendations, unification of total dose, number of doses and interval between doses. Additionally, this group offers an interactive table to facilitate calculation of doses specific to each nut under study.

Effect of the Combined Ultrasound with Other Technologies on Food Allergenicity: Ultrasound before, under, and after Other Technologies

“…Food allergies are an adverse health effect arising from a specific immune response that occurs reproducibly on exposure to a certain food, which is considered as a major public health concern. , Food allergies are classified into immunoglobulin E (IgE), non-IgE-mediated, and mixed-mediated (both IgE and non-IgE) reaction types. , It was reported that food allergies affected approximately 2–10% of the world’s population . The prevalence of food allergies has steadily increased in recent years, especially in industrialized countries, reaching 6% in Europe, USA, and Canada. − In addition, the prevalence of food allergies in children under four years of age was on the rise, reaching 11% . According to the Food and Drug Administration (FDA) in the U.S., more than 90% of food allergies are triggered by nine major allergenic foods: tree nuts, shellfish, fish, egg, soybean, peanut, milk, wheat and sesame .…”

“…5−7 In addition, the prevalence of food allergies in children under four years of age was on the rise, reaching 11%. 8 According to the Food and Drug Administration (FDA) in the U.S., more than 90% of food allergies are triggered by nine major allergenic foods: tree nuts, shellfish, fish, egg, soybean, peanut, milk, wheat and sesame. 9 At present, many studies have demonstrated that various technologies induced the denaturation, degradation, and structural changes in proteins to cause the reduction of allergen contents and disruption/masking of epitopes for reducing the allergenicity in foods, involving heat treatment, 10,11 enzyme catalysis, 12,13 fermentation, 14,15 glycation, 16,17 irradiation, 18,19 polyphenol, 20,21 germination, 22,23 cold plasma bubbling, 24 and ultrasound, 25,26 etc.…”