Diagnosis and Immunotherapy in Food Allergy


Allergy is a body disorder that is related to the immune system. Allergy is commonly referred to as atopy a condition experienced in a sensitized person minutes after contact. It is a sensitivity reaction to certain allergens or an abnormal immune system reaction to things which are actually harmless to most people.

An allergic reaction is believed to occur when the immune system of the body mistakenly believes that a substance in contact to your body is harmful to the body. The substance causing allergy reactions are dust, foods, plant pollen or even medicine. All these that cause allergies are known as allergens. The bodys immune system produces the kind of antibodies called IgE to that allergen which cause certain cells in the body to release chemicals into the bloodstream such as histamine. The chemical, histamine acts on the eyes, nose lungs, throat, skin or gastrointestinal tract and this causes the symptoms that reflect an allergic reaction. Such symptoms are Sneezing, cramps, vomiting, running nose, itchy eyes, difficulty in breathing, severe headache, itching on the skin and many more.

Some allergic reactions can be very severe and others mild while others would produce multiple symptoms. The severe reaction is called anaphylaxis and the signs of such intense case include difficulty in breathing, difficulty in swallowing, swelling of lips, tongue and other parts of the body and other victims would experience dizziness or loss of consciousness. Anaphylaxis often occurs just after exposure, a few minutes the symptoms starts revealing after the trigger substance. However, some reactions would take a little more time an average of 3-4 hours although such severe cases do not occur frequently and they would often be treated with availability of proper medical procedures.

ALLERGY DIAGNOSIS
Symptoms and signs can certainly give a strong indication that a person is indeed suffering from allergies although various tests are required to ascertain and confirm a diagnosis. The testing depends on the type of allergic disease in question.

Atopic Dermatitis
This is a long lasting chronic skin disease and it is believed to be affecting large percentage of the population. The atopic dermatitis is called eczema, dermatitis or atopy the three terms are often used in reference of the same disease. It is a common form of skin disease or sensitivity.  It includes asthma, hay fever and eczema although there is a hereditary form of that seen in some families whose predominant factors include skin rashes and itching. DERMATITIS means inflammation of the skin ATOPIC refers to hereditary diseases that tend to run in family kinship and occur together. In atopic dermatitis, dry skin is a rampant symptom and an underlying cause of some of the typical rashsymptoms. The skin is extremely itchy and inflamed causing swelling, cracking, crusting, redness, weeping, and scaling. Most Atopic is more in infants and young children although it can affect persons of any age.

A large number of patients tend to have long term causes and various challenges and this can persist from childhood or later show up in adult life. Multiple factors can trigger or worsen dermatitis such as environmental factors which would activate the symptoms at any time of lives of individuals who have inherited the atopic disease trait. Such environmental factors include exposure to hash soaps and detergents, new skin products or creams and cold weather. In Atopic dermatitis, no laboratory tests that can be used to diagnose it but rather a physician would examine a patients history and review her symptoms.

Diagnosing Atopic Dermatitis
Allergies
The person must have allergies and at least one positive skin test and or a family history of allergic diseases in close relatives. However, there may be rare cases in which a person has atopic dermatitis without evidence of allergies but in most witnessed cases it is picked from family traits.

Eczema
Eczema refers to appearance of rashes in patients with atopic dermatitis. The rash appears red, with small blisters or bumps. These may ooze or flake with further scratching. Over the long-term, the skin appears thickened and leathery.

Itching
The patient must experience itching and has to be scratching in order for the rash to occur. In cases where the skin or areas of the rash do not itch or have not been scratched, then the person does not have atopic dermatitis. So the predominant factor here is that the patient suffering from atopic dermatitis has to expressly experience both itching and a prolonged severe scratching.

People suffering from atopic dermatitis should have a skin test performed to aeroallergens (pollens, moulds, dust mite and pet dander) as well as common food allergens hence avoiding common triggers is one important step involved in treatment of Atopic Dermatitis.

Difference of Atopic Dermatitis and eczema
Eczema has been used as a general term to refer many types of skin inflammation commonly known as dermatitis and allergic types of skin rashes that are not eczema. The known eczemas are allergies, contact irritant, and nummular eczema. Atopic Dermatitis is more specific and it includes three associated conditions that occur in the same person including eczema, allergies, and asthma. However, not every component has to be present at the same time, but in many cases, patients are prone to all of these three related conditions.

Atopic dermatitis is very common worldwide and it affects both sexes i.e. male and female and it accounts for 10 percent of all referrals to doctors who specialize in the care of treatment of skins (dermatologists). The condition occurs in infants and its prevalence decreases with age with about 65 percent of patients developing symptoms on first year of life with 90 percent showing symptoms before the age of 5. After the age of 30, it is then less common although it would occur after exposure of the skin to hash environmental conditions with people living in urban areas with a climate of low humidity being at risk of developing atopic dermatitis.

FOOD ALERGY
There is a varied understanding on reactions that involves food either when consumed or when a person comes into contact with certain foods. Not all reactions towards food would be registered as an allergic reaction. That emphasizes the reason why there should be a probe distinction between allergic reactions and other forms of reactions that are not related to allergy at all.

Food allergy is that negative reaction that happens to the body of a person after specific food particles are ingested and enter the blood stream. The food components when they enter the blood stream, they cause what we call an incitement of an allergic reaction to the body. The foods contain protein components called allergens that are proteins in composition and this form of protein are able to resist the heat during cooking, acid in the stomach and some intestinal digestive enzymes. The allergens are then able survive and cross the gastrointestinal lining and enter the blood stream. When in the blood stream, they get into target organs of the body causing an allergic reaction to that organ e.g. eyes, throat, nose, skin and many other organs. The reaction of the body to such allergens involves the body immune system and the factor of hereditary.

Immune system
Food allergic reaction involves two components of immune system i.e. the type of protein which is an antibody called Immunoglobulin E IgE a specific disease-fighting antibody which circulates in the blood system. The body system produces this antibody which then circulates in the body and reacts against specific food substances. A persons ability to produce Immunoglobulin E is based on inheritance from the family of either parent with allergic reaction.  This antibody Immunoglobulin E then attaches itself to the mast cells which are often found in allergic body organs thus causing an allergic reaction.
The other component is the cell that is found in the tissues of the body called a mast cell. This type of cell is always found in body areas such as nose, throat, lungs, skin and gastrointestinal tract where allergic reactions are bound to take place.

Hereditary
A persons body to have a tendency of producing Immunoglobulin IgE to food is arguably inherited. Statistics show that a large number of people over 80 percent of those suffering with allergic conditions have inherited it from their families who bore them. A person from both parents suffering from allergic reactions is more likely to develop food allergies than someone with one allergic parent. That is the reason why medical physicians argue basing their argument on the prevalence on both parents as a more likely prevalence than that of one parent.

The allergy of food is a hypersensitivity reaction this means that before an allergic reaction to an allergen in food can take place, a person needs to have been exposed previously through sensitization of food. At the initial exposure, the allergen in that given food stimulates specialized white blood cells (lymphocytes) to produce the IgE antibody that is specific for the allergen. This IgE then is released and attaches to the surface of the mast cells in different tissues of the body. The next time the person eats that food its allergen hones in on the specific IgE antibody on the surface of the mast cells and prompts the cells to release chemicals such as histamine. Depending upon the tissue in which they are released, these chemicals cause the various symptoms of food allergy in respective organs of the body such as lungs, nose, eyes and many other parts of the body as indicated by A.D.A.M (2009) National Institute of Allergy and Infectious Diseases(online) available from  HYPERLINK httpadam.about.comcareallergyallergy_reactions.html httpadam.about.comcareallergyallergy_reactions.html

There have been myths about various body effects that local folks have gone calling allergies. Most people when they experience some sort of side effect or unpleasant reaction they tend to call it allergy but let it be known that not all unpleasant reactions would amount to allergy. Very minimal cases of children and adult are clinically proven to be allergy conditions.

The perception people tend to have on allergy outside the professional studies on the same is misinterpretation of between food intolerance with adverse effects with that of clinical allergy. Effects from phenomenon such as food poisoning, toxic reactions from food intolerances and other abnormal responses to foods which can or more less resemble those of food allergy would not still amount to allergies. Allergy cases are and must be determined by that immune system and reveal certain characteristics and features with specific symptoms that are immunological in body response.

Food Intolerance
Digestive system response to certain foods has been construed to be food allergy but clinical fact files draw a line between the two. Food intolerance occurs when a persons digestive or when a persons digestive systems response towards certain food is experiences a breakdown a digestion failure. Such common case of intolerance is found in lactose found in milk and other dairy products.

Symptoms of Food Intolerance
Known symptoms of food intolerance include
Nausea and sweating
Stomach pain leading to diarrhoea
Gas, cramps, or bloating after eating certain foods
Vomiting after eating
Heartburn and belching
Diarrhoea
Headaches and bloating of the stomach
Irritability or nervousness

Food intolerance is associated with lack of enzymes to digest certain food compounds which could result to adverse reactions following consumption of certain foods, this is more appropriately termed asfood intolerance and not food allergy, it should be noted that food allergy involves the immune body system and its response.

Symptoms of a Food Allergy
We have talked previously on food allergy and the causative agent and the immune body reaction that leads to a person construed to be having a food allergy. Now, unlike food intolerance, a patient with allergic food reaction would observe the following symptoms which would range from mild to severe effects and this depends on the intensity of trigger and the immune response of a persons body. These symptoms include-
Rash or hives
Nausea
Stomach pain
Diarrhoea
Itchy skin
Shortness of breath
Chest pain
Swelling of the airways to the lungs
Anaphylaxis
Analysis

Observing on the two cases and there examples of the symptoms, one would confuse a food intolerance to that of food allergy. Some of the symptoms are shared between the two such as vomiting, diarrhoea, nausea and stomach pain. Nearly every person at one time has had a food intolerance issue with something they ate while some people are known to be having specific food intolerances which is not an allergy. Lactose intolerance is the leading food intolerance that affects almost 10 percent of United States Population.

The chain reaction of Food Allergies and Intolerances
Food allergies arise from ingestion of food of sensitive chemical compounds which are proteins in composition. The protein makes the bodys immune system to fight back to protect the body by producing antibodies immunoglobulin E commonly referred to as IgE and other powerful chemicals such as histamine. The histamine is so powerful such that, it can affect the respiratory system, gastrointestinal tract, skin or cardiovascular system. This results to food allergy symptoms occurring in the body. The allergy symptoms discussed earlier on the body depends on where the histamine has been released. A release on nose a patient would have an itchy nose or trouble breathing or swallowing, if released on skin there would be rashes and hives on the skin and in case of a release in the gastrointestinal tract then a victim would develop stomach cramps, pains and diarrhoea.

DIAGNOSIS AND IMMUNOTHERAPY
The diagnosis and immunotherapy applied in recent years to allergic diseases entails crude extracts of allergen source without necessarily defining allergyeliciting molecules. The combination of advanced technology of DNA has resulted in identification, cloning, epitope mapping of clinically significant allergens more possible. The allergens that retain immunological features of natural allergens form the clinical breakthrough of accurate protein-chip based method for the diagnosis of allergic conditions in patients. With the ability to propagate rationally designed hypo-allergic forms of allergens as lead to the development to a safe form of allergy vaccines which have been tested and found to be efficient. The preparations and clinical tests from a recombinant-allergen-based vaccine have already shown positive results and now the emphasis is to derive alternative routes of vaccine delivery which will enhance patient compliance.

Food Allergy Diagnosis
Stephen Barrett, M.D. Many dubious practitioners claim that food allergies may be responsible for virtually any symptom a person can have. In support of this claimwhich is falsethey administer various tests purported to identify offending foods, Allergies Dubious Diagnosis and Treatment. Jan 15 2010.The scientific clinical study shows that there is far difference between allergies and otherwise that people perceived allergies turn out to food intolerance.

Cytotoxic Testing
The test was in late 1980s being used by storefront clinics, laboratories, nutrition consultants, chiropractors, and medical doctors and was believed to determine food sensitivity which was then believed to be liable for diseases such as asthma, arthritis, constipation, diarrhoea, hypertension, obesity, stomach disorders and many of such conditions.

ELISAACT Testing
This was also a kind of test that was being used in locating allergies of which the symptoms showed within minutes after the ingestion of food or chemical. The symptoms included hitching and hives. This either proved unequal to the task in cases where some allergy symptoms delayed to about 2hours to 5 days and the symptoms varying from physical pain to unexplained fatigue.

Using ELISAACT Testing would assess a small portion of certain immune responses some of which might not necessarily be linked to allergy. The ELISAACT is done in culturing a patients lymphocytes and analysing on how they react to up to 300 foods, minerals, preservatives, and other environmental substances. After which the practitioner then recommends dietary modification and supplements.

PRESENT DIAGNOSIS AND IMMUNOTHERAPY
AEE and AEG
Food antigens have been implicated as one of the main cause of allergies
Skin prick test and atopy patch tests can be useful for food allergy diagnosis
Elimination diets or even amino-acid formula can be instituted on the basis of allergy testing, clinical history, biopsy and treatment response
Pharmacologic treatment oral steroids andor swallowed aerosolized (fluticasone) tablets
Anti-IL-5 therapy
Diagnosis (History and Examination)
The physician would reaffirm the following-
History symptoms, timing, reproducibility
Acute reactions on chronic disease
Diet details  and their symptom diary
Specific causal food or foods
Physical examination Evaluate disease severity
Identify general approach
Allergy against intolerance
IgE-mediated against non-IgE mediated

Diagnosing food hypersensitivity disorders  IgE-mediated
Identification and relationship with the food Medical history
To identify specific IgE Skin testsserum specific IgE
To demonstrate that IgE sensitization is responsible for the clinical reaction Controlled challenge tests
Diagnosis is based on the medical history, supported by identification of specific IgE antibodies to the selected pointed suspicious food allergen and confirmed by challenge.

TABLE (a)
Various Foods and their percentage rate in causing allergic reactions
Foods and DrinksAllergy effects in population () Alcohol5.4Legumes (beans)11.4Cereals11.4Fruits7.6Mushrooms2.7Tubers9.8Vegetables7.6Sea Foods14.7In the above table, Sea foods, cereals and Legumes such as beans largely show clinical symptoms in allergy effects.

TABLE (b)
Clinical Symptoms Caused by Floods
Organs affectedSigns and symptomsTotal ()Ear and Nose and Throat (ENT)Diminished hearing, painful, watery nose, sore throat1.2EyeBlurred and diminished vision1MouthMouth irritation, inflamed tongue and overall sour mouth1.2RespiratoryStruggling with breathing, catarrh, asthma, prolonged cough9.6CirculatoryImpairment of heart beat, palpitation of heart1.2The figures represent in the above shows people a percentage of people affected by the group of symptoms out of the total number.

Conclusion
In the stated metadata, fewer people seem to be affected in their body organs namely circulatory, eyes, mouth and Ear Nose and throat whereby the majority of them show more symptoms in their respiratory organ.

Most food that tend to affect or seem to be carrying allergic reaction in most people in the other hand contain nutrients which are fatal for the bodys health and development and in this case, an absolute abstinence would render the victims into malnutrition. This has led to people consuming such vital foods amid suffering continues allergic discomforts.

Food allergy should be recognized as a public health problem and be addressed as so and raise awareness to the public on the challenges and issues and how to best deal with the growing cases of allergies that are associated with foods.

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