Professional Documents
Culture Documents
By
NURPUDJI ASTUTI
SCHOOL OF MEDICINE HASANUDDIN UNIVERSITY MAKASSAR 2003
OF IMMUNE SYSTEM.
FOOD ALLERGY CAN BE MEDIATED BY Type I, Type
FOOD ALLERGY
IS COMMON IN INFANCY
PREVALENCE 1 3% ONLY REPRESENTS A SMALL
TYPE I HYPERSENSITIVITY
INVOLVES
SYMPTOMS
SENSITIZATION
B-CELL LYMPHOCYTES PRODUCE ALLERGEN SPECIFIC IgE ANTIBODIES IgE MOLECULES COUPLE WITH RECEPTORS ON THE SURFACE OF MAST CELLS ( IN TISSUES) AND BASOPHYL ( IN BLOOD) NO SYMPTOMS ARE OBSERVED ON FIRST EXPOSURE TO THE ALLERGEN
T-cell lymphocytes recognize the antigen as foreign after it is processed by macrophages IgM and later IgG are produced in response to the antigen Ag-Ab complexes are formed The complement cascade is triggered Anaphylatoxins formed in the complement cascade cause the release of inflammatory mediators
TYPE IV HYPERSENSITIVITY
T cell lymphocytes and cytokines
Called as contact allergy T-cells lymphocytes respond to the
allergen - release of cytokine. An immediate reaction when thry come into contact with the lips, tongue, mouth and GIT. Example: Nickel allergy
inflamatory mediators
increases the permeability of capillaries swelling Rhinitis is due to fluid buildup in tissues in nasal passages Excessive fluid in the skin causes urticaria (hives) and angioedema Histamin also causes itching and vasodelation, resulting in flushing or reddening of the skin
Histamin
Continue ----
vasocontriction
Leukotrienes
- contraction of smooth muscle bronhospasm of asthma in conjunction with prostaglandins causes pain. these inflammatory mediators are released or their levels are enchanced by mechanisms that are independent of the immune system this situation considered to be INTOLERANCE rather than ALLERGY
Bradykinin
Sometimes
INCIDENCE OF ALLERGY
5 15 %
if neither parent has allergies 20 40% if one parent has allergies 40 60% if both parents have allergies 60 80% if both parents have the same allergy 25 -35% if one sibling has allergies
INHERITED
PHYSIOLOGICAL CONDITIONS
1.
INCREASED PERMEABILITY OF THE INTESTINAL MUCOSA IMMATURITY INFLAMMATION IN THE DIGESTIVE TRACT COMBINED ALLERGIC REACTIONS ENCHANCES UPTAKE OF FOOD ALLERGENS
2. 3. 4. 5. 6. 7. 8. 9.
EXERCISE
CHANGES IN HORMONE LEVEL STRESS FREQUENCY OF EXPOSURE
any substance, including any source of radiation, the used of which results, or may reasonably be expected to result, in it or its by products becoming a part of or affecting the characteristics of food
monosodium glutamate (MSG) Ripening agents; ethylene Antioxidants; butylated hydroxyanisole (BHA) , butylated hydroxytoluene (BHT), sodium nitrite Emulsifiers, lecithin, polysorbate Texturizers; calcium chloride, Humectants; glycerine, propylene glycol Thickeners & stabilizers; gum tragacanth, agar-agar
MANUFACTURED FOODS PROBLEMS FOR PERSONS WITH FOOD SENSITIVITIES CHEMICALS; DIVERSE IN COMPOSITION AND TYPES DERIVED FROM NATURAL SOURCES ( CHEMICAL PROCESSES) & SYNTHESIZED FROM INORGANIC SOURCES. ??? ---- VERY LITTLE UNDERSTANDING OF HOW THE CHEMICAL CAUSES THE ADVERSE CLINICAL EFFECTS
HYPERACTIVITY
SYMPTOMS RESEMBLE TO MYOCARDIAL INFARCTION, INCLUDING TIGHTNESS AND PAIN IN THE CHEST WHICH RADIATES TO THE ARMS, PALPITATIONS AND FAINTNESS.
USED ANECDOTAL MARKERS, ONE OF THE SIGNS IS DEVELOPMENT OF SENSITIVITY TO ALCOHOL, STARTING WITH ADVERSE REACTIONS TO RED WINE & BEER, AND FOLLOWED BY WHITE WINE AND DESTILLED SPIRITS. SENSITIVITY TO INGESTED CHEMICALS, SUCH AS GASOLINE, CIGARETTE SMOKE, PAINT SOLVENTS, HOUSE-HOLD CLEANERS
ARE MULTISYSTEM RAECTIONS, ESPECIALLY CENTRAL NERVUS SYSTEM SUCH AS: HEADACHE, FATIGUE, MUSCLE WEAKNESS, SKIN AND RESPIRATORY SYMPTOMS.
AT PRESENT, THE ONLY INDICATOR OF FOOD ADDITIVES
INTOLERANCE IN MOST CASES IS ELEMINATION AND CHALLENGE WITH FOODS CONTAINING THE SUSPECTED ADDITIVE(S)
GLUTAMATES
foods
Person
with asthmatic -- more likely than general population Increased when the person is receiving desensitization injections or is allergic to wasp and bee venom Most commonly food are peanuts, nuts, shellfish, fish, cows milk, and egg Most study --- 80% of atopic children are allergic to only one or two foods.
wheat and chicken in children under three year of age Infant and toddlers tend to outgrow early allergies to certain foods, such as milk, egg, wheat and soy Food allergy occurs after 3 yo, the allergy is likely to be outgrown. Allergies to certain other foods to be outgrown or may persist for a persons lifetime --- such as: peanuts, nut, shellfish and fish.
Seeds
Millet Subflower Sesame Cottonseed extract Annatto ( color ) Psyllum
Grains
Wheat Rice
Continues --
Vegetables
Potato Celery Pea Pinto bean Soybean Chickpea Corn
Poultry
chicken
Beverages
Chamomile tea wine Shellfish crab Shrimp Lobster Limpet Milk products cows milk
Egg
Hen
Fish
Fruit
orange Tangerine Mango Banana Kiwi fruit
Cod Halibut
BETWEEN TWO OR MORE ALLERGENS, WHEATHER RELATED OR NOT, THAT CAUSES OF THEM TO INDUCE SIMILAR CLINICAL REACTIONS
NOT VALID PLANTS BELONG TO THE SAME FAMILY,
DEMONSTRATED THE PRESENCE OF CROSS REACTING ANTIGRNS IN BOTANICALLY UNRELATED, ALLERGENIC PLANT SPECIES. THE ALLERGENS MAY BE INHALED OR CONSUMED AS FOOD
COMMON ANTIGENS HAVE BEEN DEMONSTRATED WITHIN EACH OF THE FOLLOWING GROUPINGS:
1. BIRCH POLLEN, HAZELNUT, POTATO AND APPLE 2. APPLE, CARROT AND CELERY 3. BIRCH POLLEN, NUT, APPLE AND FRUIT WITH STONE 4. HAZELNUT, RYE GRAIN, SESAME SEEDS, KIWI, AND
POPPY SEED 5. BIRCH POLLEN, MUGWORT POLLEN, APPLE, CELERY AND CARROT 6. BIRCH POLLEN, APPLE, CELERY, CARROT, POTATO, HAZELNUT, ORANGE, TOMATO AND PEANUT 7. REGWEED POLLEN AND WATERMELON 8. REGWEED POLLEN, MELON AND BANANA 9. LATEX, BANANA, AVOCADO, KIWI FRUIT, CHESTNUT, SOYBEAN, PEANUT, PAPAYA, FIG.
AVOIDED ??? example: person allergic to soy, should all form of soy be eliminated from the diet, including hydrolyzed soy protein, lecithin made from soy, fermented soy ( soy sauce) and so on??
FOR SAFETY, THE ALLERGIC PERSON IS USUALLY ADVISED
IMPACT:
great deal of work social economy stress annoyance nutritional deficiency fearful of ingesting the allergen --- fail to describe of ingredients in manufactured foods.
Green
Tree
peas
nut
Shellfish
Finfish Egg
white
milk protein in infants
Cows
adult is 20 grams
shrimp
Peanuts
Annatto
Dairy products (cheese, butter) Coloring agent Breakfast cereal ( yellow to pink) Baked goods margarines
MILK ALLERGY
BIOLOGICAL MECHANISMS
Results when the immune system produces antibodies against milk allergen
HEAT LABILE
Serum protein and beta casein THE MOST HEAT LABILE Beta - lactoglobulin
Alpha - lactalbumin
sometimes IgA
Food substitutes
Milk provide:
protein, calcium and vitamin D
Protein substitute
Readily available from fish, mat or combinations of legumes, nut, grains Adequate dietary protein does not depend on ingesting milk
Calcium substitute
Canned fish such as tuna , sardines, salmon eaten with the bones Green leafy vegetable: broccoli, beet, turnip Calcium from vegetable is not as readily available as from animal sources
LACTOSA INTOLERANCE
Not involve a response by the immune system No antibodies are produced
damaged --- inflammation (infection or allergy) --- or congenital characteristic, the sugar remain undigested microbial enzymes metabolize lactose variety organic acid (lactic and propionic acids), gases (hydrogen) imbalance result from the exceed sugar and acid ---
lactose
sugar in human milk and infants require lactase to digest their mothers milk.
Secondary lactase deficiency can develop in infant following a
TREATMENT
COMPLETE DIETARY EXCLUSION OF
COWS MILK
70 -80% ALLERGIC TO COWS ARE ALSO
NECESSARY
Peanut allergy
Peanuts are legumes Peanuts and soy the most allergenic of the
family leguminosae 30 species including fresh or dried peas and beans, all type lentils, soy beans, carob and licorice. member of the legume family is rare
reaction to peanuts, extreme caution must be exercised to avoid all sources of peanut
An allergy to nuts should be distinguished from
an allergy to peanuts or other legumes, otherwise the diet can become stressful and cumbersome if all traces of peanuts are avoided, as well as all traces of other nuts.
Warning !!!!!!!!!
Sometimes no differentiation is made in marketing
peanuts and other nuts, and the two are sold together in nut mixtures.
In the manufacture of candies, confectioneries and
be advised to avoid any product containing any type of NUT because the danger of encountering peanuts inadvertently.
Vomiting
Rhinorrhea Itching --- contact dermatitis Nausea
Allergic conjunctivitis
anaphylaxis
allergic adult can tolerate pure peanut oil without any clinical reactions.
The allergic reactivity occurs to the
may contaminate the oil, individuals who are anaphylactic to peanut, or to any another plant, should be cautioned to avoid oil derived from allergenic plant.
EGG ALLERGY
Mayor proteins for egg allergy present in egg white
Ovalbumin Conalbumin Ovomucoid
( ovotransferrin )
blood of the hen Cross reactivity may occur between white and yellow egg Ovomucoid is heat stable, persons allergic to this component react to both cooked and raw egg Ige Antibodies are produces to egg proteins, which differ from the protein in chicken flesh
MEAL
SCRAMBLED,
BOILED, FRIED OR
OMELETE
EGGS INCLUDED AS AN INGREDIENT IN PREPARED
OVOMUCOID
OVOMUCIN LYSOZYME
OVOINHIBITOR
AVIDIN