Food immediate hypersensitivity reaction

Individualistic adverse reactions to foods can occur through several different types of mechanisms (Taylor and Hefle, 2001). True allergic reactions can include both IgE-mediated immediate hypersensitivity reactions and cell-mediated delayed h)q5ersensitivity reactions (Taylor and Hefle, 2001). However, only IgE-mediafed reactions have been documented to occur with ingestion of molluscan shellfish in sensifive individuals. 

May, C. D., 1976, Objective clinical and laboratory studies of immediate hypersensitivity reactions to foods in asthmatic children, J. Allergy Clin. Immunol. 58 500. 

A severe type I hypersensitivity reaction such as systemic anaphylaxis (eg, from insect envenomation, ingestion of certain foods, or drug hypersensitivity) requires immediate medical intervention. 

The production of antibodies known as IgE and a series of interactions between various cell types and chemical mediators are known to be involved in most confirmed cases of food allergy. This type of IgE-mediated allergy or type I hypersensitivity reaction produces immediate symptoms, the most severe form being anaphylaxis. Other immediate symptoms, such as rhinitis, urticaria, and other affections of the mouth, gut, skin, and respiratory tract, may precede anaphylaxis or occur alone as a less severe manifestation. These reactions would be considered as immediate hypersensitivities. Any food that contains protein has the potential to elicit such allergic sensitization. More than 170 different foods have been documented to be responsible for eliciting immediate hypersensitivities (Taylor, 2000). 

Other foods have been known to be linked to delayed hypersensitivities. Symptoms associated with delayed hypersensitivity reactions may not begin to appear until 24 h after ingestion of the offending food. The symptoms of delayed hypersensitivity reactions do not reach the severity involved in immediate hypersensitivity. However, thresholds triggering reactions, or the level of tolerance for the offending food, is equally low for delayed as well as immediate hypersensitivities. Mechanisms involved in delayed hypersensitivities remain poorly defined, except perhaps for celiac disease (Taylor, 2000 Kagnoff, 2007 Braini et al., 2008). 

Of all forms of contact dermatitis in chefs, sensitivity to garlic [252, 253] is perhaps best known and recognizable, and while it is usually thought of as causing delayed hypersensitivity reactions, immediate sensitivity is also reported [254]. In some countries, hand dermatitis in housewives (if one considers this occupational) which seems nonspecific may actually be caused by garlic dermatitis in 12.9% of housewives tested [252]. However, most such reactions are seen as occupational dermatitis, especially in caterers and other food-service occupations. Caterers and chefs are also at risk for sensitization to flavors, for which balsam of Peru is one marker [255]. 

Contact urticaria usually clears spontaneously repeated exposure may produce dermatitis (eczema). In addition, it may be associated with allergic contact dermatitis (type-IV hypersensitivity), von Krogh and Maibach [4] tested 67 patients for immediate and delayed hypersensitivity, and 22 (33%) developed a positive delayed response subsequent to the initial wheal-and-flare reaction. The responsible agents were food products, rubber latex, cinnamic aldehyde, para-aminodiphenylamine, ethylaminobenzoate, ammonium persulfate, teak, epoxy resin and lemon perfume. They suggested that the term contact dermatitis of immediate and delayed type be used for patients exhibiting both types of reactions in the test situation, whether the initial reaction is uncharacteristic, urticarial or vesicular [4]. 

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