Scientific Information (old)

Do allergies affect Australians?

According to the Australasian Society of Clinical Immunology the frequency of allergic disease has approximately doubled in the past few decades in Australia and New Zealand and around:
• 1 in 3 people will develop allergies at some time during life • Food allergy occurs in around 1 in 20 children and in about 1 in 100 adults • 1 in 5 will develop atopic dermatitis • 1 in 6 will have an attack of hives (urticaria) • 1 in 10 people have asthma • 80 per cent of children diagnosed with allergic rhinitis (hayfever) will still have trouble 10 years later • 85 per cent of children with atopic dermatitis (eczema) improve by their teenage years, but often have dry and irritable skin and problems with soap and some cosmetics for life • 40 per cent of young adults will still be sneezing 20 years later • Allergic rhinitis affects 1 in 5 Australians • 1 in 100 will have a life-threatening allergy known as anaphylaxis.

Double blind studies:

Potential non–immunoglobulin E–mediated food allergies: Comparison of open challenge and double-blind placebo-controlled food challenge

Otolaryngology–Head and Neck Surgery (2007) 137, 803-809

De Yun Wang, MD, PhD, Bruce R. Gordon MD, Yiong Huak Chan, PhD and Kian Hian Yeoh, MD, Singapore, and Hyannis, MA

 OBJECTIVE:

Comparison of open food challenge (OFC) with double-blind placebo-controlled food challenge (DBPCFC). Undertaken by a prospective sequential randomized challenges.

RESULTS:

All Patient reacted to at least 1 food and to all challenges with the same food, with multiorgan symptoms in the nose, nervous system, throat, and lung. There was a correlation in the type and severity of symptoms (P 0.015) for OFC and DBPCFC, and both were significantly (P 0.01) more sever than placebo. Compared with DBPCFC, OFC sensitivity was 66%, and positive predictive value was 89%.

CONCLUSION:

This is the first study showing both concordance of OFC and DBPCFC and also that intradermal tests can identify reactive foods that can be verified by DBPCFC. Because most tests for IgE-mediated food allergy were negative, observed reactions were probably non–IgE mediated.

Antigen induced asthma attenuated by neutralization therapy

Boris M, et al. Clin Ecol. 1985;3:59-62. ABSTRACT: The effect of neutralization therapy on animal antigen-induced asthma was tested. The neutralization dose was determined by the serial dilution technique. Subjects received, in a double blind crossover study, either the neutralizing dose or placebo followed by animal antigen bronchoprovocation challenge. Evaluation through pulmonary function tests demonstrated significant protection after neutralization therapy

Provocation/neutralization

King WP, et al. A two-part study. Part I. The intracutaneous provocative food test: a multi-center comparison study. Otolaryngol Head Neck Surg. 1988;99:263-71. ABSTRACT: This study investigated the clinical usefulness of the intracutaneous provocative-neutralization food test (IPFT). Thirty-seven patients were tested for five identical food allergies by eight physicians in different geographical locations. Throughout the study, comparison was made between the IPFT when interpreted by skin response (IPFT SK) and when interpreted by symptom provocation (IPFT PR). Double-blind IPFT results were compared with those of previously accomplished oral challenge food tests (OCFT). IPFT reliability was determined by a double-blind comparison of the initial IPFT, with two subsequent IPFTs performed 7 days apart. Correlation of the IPFT SK and IPFT PR with the OCFT provided validity coefficients of 0.78 and 0.61 respectively, both significant beyond the 0.01 level of confidence. Reliability of the IPFT SK and IPFT PR was shown to be 0.68 and 0.40, respectively. The IPFT SK was significant beyond the 0.01 level of confidence and the IPFT PR was significant beyond the 0.05 level of confidence. King WP, et al. Provocation/neutralization: A two-part study. Part II. Subcutaneous neutralization therapy: a multi-center study. Otolaryngol Head Neck Surg. 1988;99:272-7. ABSTRACT: Presented is a triple-blind crossover study that investigates the efficacy of subcutaneous neutralization food hypersensitivity therapy. Seven physicians and thirty-three patients from various parts of the country participated. Each patient underwent three 2-week treatment sessions, with 1 week off treatment between each session. During each treatment session, one injection a day was given. The injection consisted of a placebo for one 2-week session, and the active allergen during the other two sessions. The active dose was determined by earlier intracutaneous provocative food testing. The diet during the study period was not varied. Medication-symptoms diaries were maintained and treatment result evaluations for both individual complaints and overall results were detailed on a standard form at the end of each treatment session. While the number of foods treated per patient varied from 1 to 13, the majority were treated with 3 to 5 foods.
Treatment with the active medication was more efficacious than with placebo.
A few patients’ symptoms were aggravated with the active medication. This indicates a correct diagnosis, but incorrect treatment dose. In the clinical setting such adverse response should be reversed.
Overall, neutralization subcutaneous treatment should be beneficial approximately 75% of the time, and further enhanced by supplemental diet manipulation.

Food allergy in migraine

Monro JA. Proc Nutr Soc. 1983;42:241-6. SUMMARY:
This study corroborates the long-held view that migraine is due to food allergy. The immunological mechanisms have yet to be defined but treatment by immunotherapy has been effective in controlling symptoms in the double-blind study.

Elimination of oral food challenge reaction by injection of food extracts

Rea WJ, et al. Arch Otolaryngol. 1984;110:248-52. ABSTRACT: Twenty subjects underwent a double-blind evaluation by analyzing six variables to determine if subcutaneous injection of the food extract neutralizing dose would protect subjects from reactions. Twelve subjects had four of the six variables neutralized 60% of the time following the food antigen neutralizing dose. The placebo trials neutralized four of six variables 15% of the time.
The sign/symptom results show statistical significance favoring food extract neutralization over placebo.
The remaining eight subjects had at least two of the six variables neutralized by the food extract up to 85% of the time. It appears that the phenomenon of subcutaneous food neutralization can be scientifically endorsed for clinical use in the treatment of food reactions.

Use of electrocochleography to monitor antigenic challenge in Meniere’s disease

Viscomi GJ, Bojrab DI. Otolaryngol Head Neck Surg. 1992;107:733-7. ABSTRACT:
Allergy has been reported as a cause of Meniere’s disease. King et al. have established the validity of the provocative food test (PFT) for the diagnosis of food allergy. When the PFT is used to test patients with Meniere’s disease, the test is considered positive if the patient develops aural fullness, hearing loss, increased tinnitus, or dizziness during challenge with the offending food and relief of these symptoms during neutralization.
Ferraro et al. have shown that electrocochleography (ECoG) provides an objective indication of subjective symptoms in Meniere’s disease by demonstrating an increased SP/AP amplitude ratio when the symptoms of aural fullness and hearing loss are present. We present several patients with Meniere’s disease in whom measurement of the SP/AP amplitude ratio was compared with symptom production during antigenic challenge and neutralization.

Scientific Research:

Neural Pathways in Allergic Inflammation

L.Mirotti, 1 J. Castro,1 F. A. Costa-Pinto,2 andM. Russo1 Department of Immunology, Institute of Biomedical Sciences, University of S˜ao Paulo, Brazil and Department of Pathology, School of Veterinary Medicine and Animal Science, University of S˜ao Paulo, Brazil

Journal of Allergy Volume 2010, Article ID 491928, 11 pages doi:10.1155/2010/491928

ABSTRACT Allergy is on the rise worldwide. Asthma, food allergy, dermatitis, and systemic anaphylaxis are amongst the most common allergic diseases. The association between allergy and altered behavior patterns has long been recognized. The molecular and cellular pathways in the bidirectional interactions of nervous and immune systems are now starting to be elucidated. In this paper, we outline the consequences of allergic diseases, especially food allergy and asthma, on behavior and neural activity and on the neural modulation of allergic responses. Read more

Neural correlates of IgE-mediated food allergy

Alexandre Salgado Basso, Frederico Azevedo Costa Pinto, Momtchilo Russo, Luiz Roberto Giorgetti Britto, Luiz Carlos de Sá-Rocha.
Journal of Neuroimmunology Volume 140, Issue 1, Pages 69-77 (July 2003)
ABSTRACT: Although many authors have considered the possibility of a direct interaction between food allergy and behavioral changes, the evidence supporting this hypothesis is elusive. Here, we show that after oral ovalbumin (OVA) challenge, allergic mice present higher levels of anxiety, increased Fos expression in emotionality-related brain areas, and aversion to OVA-containing solution. Moreover, treatment with anti-IgE antibody or induction of oral tolerance abrogate both food aversion and the expression of c-fos in the central nervous system (CNS).
Our findings establish a direct relationship between brain function and food allergy, thus creating a solid ground for understanding the etiology of psychological disorders in allergic patients.
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Mobilisation of specific T cells from lymph nodes in contact sensitivity requires substance P.

Andrew J. Shepherda, Lorna J. Beresforda, Eric B. Bellb, Jaleel A. Miyana . Journal of Neuroimmunology Volume 164, Issues 1, Pages 115-123 (July 2005) ABSTRACT: Capsaicin-mediated depletion of neuropeptides in the skin was previously shown to abolish a dinitrocholorobenzene (DNCB)-induced contact sensitivity (CS) response. To understand the basis for this disruption, we explored whether nerve fibres innervating the draining lymph node (LN) could be involved. As expected, removal of the draining LN after DNCB sensitisation abolished the CS response. Furthermore, the CS response could be abolished by destroying the nerve fibres in the draining LN and could be restored by providing the LN with the neuropeptide substance P. The size of the CS response restored by substance P was dose dependent. The response was also inhibited by exposing the lymph node to a neurokinin-1 receptor antagonist which blocks binding of substance P.
The results suggest that an afferent signal from the skin via the sympathetic arm of the central nervous system evokes an efferent signal to the LN which combines to regulate the CS response. The efferent signal may serve to control or release from the LN primed effector lymphocytes into the circulation.
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