Food-induced asthma

The role of atopy in anaphylaxis has not completely been resolved. On the one hand there is for example no evidence of a higher risk of severe reactions in venom-allergic patients. A recent study by Sturm et al. [38] indicated that patients with high total IgE levels predominantly developed mild to moderate reactions. By contrast, atopy may increase the risk and severity of systemic reactions in beekeepers and their family numbers [39]. On the other hand, atopy and in particular allergic asthma are risk factors for food allergy and therefore are also important risk factors for food-induced anaphylaxis. This is most likely also true for exercise-induced anaphylaxis, but also non-IgE-dependent anaphylaxis induced by NSAIDs or contrast media. 

Oren E, Banerji A, Clark S, Camargo CA Jr Food-induced anaphylaxis and repeated epinephrine treatments. Ann Allergy Asthma Immunol 2007 99 429-432. 

The mechanism of sulfite-induced asthma is not well-understood. Reactions to sulfited foods probably depend on the sulfite residue level in the food, the sensitivity threshold of the individual, the type of food consumed, and whether sulfite exists in the free (more toxic) form or combined (less toxic) form. The toxicology of sulfites has been reviewed by Madhavi and Salunkhe (1995). Sulfite sensitivity is not a true allergic reaction (Taylor et al., 1988). The FDA initially estimated that more than 1 million Americans are sensitive to sulfites, but more recent estimates lowered the number of asthmatics who may be sulfite sensitive to 80,000-100,000 (Bush et al., 1986). 

Food intolerances are mostly caused by substances other than proteins and affect a limited number of individuals. Examples include sulfite-induced asthma, lactose intolerance, MSG-induced headache and flushing, etc., yet these substances are only associated with these symptoms and remain unproven as causative agents. Significant levels of these non-flavor ingredients are typically required to elicit this type of reaction, and there is no evidence that flavoring substances are involved (Taylor and Dormedy, 1998). 

Food-induced and occupational asthma due to barley flour. Ann Allergy HV206 Asthma Immunol 1995 75(2) 121-124-... 

Cases of allergenic hypersensitivity caused by food additives are rather rare (0.03%-0.23% of population) (Wuthrich 1993) and difficult to diagnose (Spergel and Fiedler 2005). The prevalence rate of food-additive-induced asthma exacerbations obtained by using double-blind, placebo-controlled trails is about 5% (23%-67% of asthmatics believe that food additives exacerbate their asthma) (Bush and Montalbano 2008). One of the reasons why it is difficult to diagnose the exact effect of food additives is the fact that ingredients which appear in food products in very... 

In a blind study, MSG ingestion has been demonstrated to induce asthma in people who have this condition. Forty-one percent of those tested developed asthma and other symptoms of MSG ingestion within 1-2 h of eating MSG-containing food. 42 ... 

Asthma can be induced by chemicals that are ingested or dermally applied as well as inhaled chemicals. Sulfites in wine, salads, other foods, and some medications are known to induce asthma when ingested, I41-43 ... 

Asthma can be induced by chemicals that are ingested or dermally applied as well as inhaled chemicals. Sulfites in wine, salads, other foods, and some medications are known to induce asthma when ingested [7, 45 7] and many chemicals, including isocyanates and anhydrides, have been shown to induce asthma following dermal exposure [48, 49]. The discussion in this section, however, will be limited to inhaled chemical mixtures as causative agents for asthma. 

JECFA, Combined compendium of food additive specifications, http //www.fao.org. Tabar-Purroy, A.I. et al.. Carmine (E 120) induced occupational asthma revisited, J. Allergy Clin. Immunol, 111, 415, 2003. 

Only nine allergic reactions to cuttlefish have been described (Caffarelli et ah, 1996 Ebisawa et ah, 2003 Shibasaki et ah, 1989). One patient was a 10-year-old female who experienced a severe reaction to ingestion of cuttlefish that was manifested by urticaria, angioedema, asthma, abdominal pain, laryngeal edema, and hypotension (Shibasaki et ah, 1989). SPT and RAST were positive. This patient reportedly tolerated octopus, clam, oyster, abalone, mussel, and scallop but reacted to crab and shrimp. Caffarelli et ah (1996) describe a 14-year-old female who had cuttlefish-dependent, exercise-induced anaphylaxis. Ebisawa et ah (2003) reported 7 cases of allergy to cuttlefish among a series of 305 pediatric cases of food allergy but provided no specifics on the circumstances or symptoms of these patients. 

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