Relationship Between Respiratory and Food Allergy and Evaluation Of

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Allergol Immunopathol (Madr). 2016;44(3):263---275

Allergologia et

immunopathologia

Sociedad Espanola˜ de Inmunolog´ıa Cl´ınica,

Alergolog´ıa y Asma Pediatrica´ www.elsevier.es/ai

REVIEW

Relationship between respiratory and food allergy and

evaluation of preventive measures

a,∗ b c,d e f,g h

F. Vega , C. Panizo , M.T. Dordal , M.L. González , E. Velázquez , A. Valero ,

i j k l m l

M.C. Sánchez , C. Rondón , J. Montoro , V. Matheu , M. Lluch-Bernal , R. González ,

n o p q j r

B. Fernández-Parra , A. Del Cuvillo , I. Dávila , C. Colás , P. Campo , E. Antón ,

A.M. Navarro , Rhinoconjunctivitis Committee of Spanish Society of Allergology, Clinical

Immunology (SEAIC) 2010

Department of Allergy, Hospital de la Princesa, Instituto de Investigación Sanitaria Princesa (IP), Madrid, Spain

Department of Allergy, Hospital Nuestra Senora˜ del Prado, Toledo, Spain

Department of Allergy, Hospital Municipal Badalona, Spain

Department of Allergy, Sant Pere Claver Fundació Sanitaria, Barcelona, Spain

Department of Allergy, Hospital Clínico San Carlos, Madrid, Spain

QUIRON Sagrado Corazón, Sevilla, Spain

Hospital Victoria Eugenia Cruz Roja, Sevilla, Spain

Department of Pneumology and Allergy, Hospital Clínic i Universitari, Barcelona, Spain

Department of Allergy, CE Virgen de la Cinta, Huelva, Spain

U.G.C. Allergy, IBIMA, Regional University Hospital of Málaga, UMA, Málaga, Spain

Allergy Unit, Hospital Universitario Arnau de Vilanova, Facultad de Medicina, Universidad Católica de Valencia ‘‘San Vicente

Mártir’’, Valencia, Spain

Department of Allergy, Hospital del Tórax-Ofra, HUNS La Candelaria, Santa Cruz de Tenerife, Spain

Department of Allergy, Complejo Hospitalario de Toledo, Toledo, Spain

Department of Allergy, Hospital El Bierzo, Ponferrada, León, Spain

Asthma and Rhinitis Unit, Department of Otorhinolaryngology, Hospital de Jerez, Cádiz, Spain

Department of Allergy, Hospital Universitario, IBSAL, Salamanca, Spain

Department of Allergy, Hospital Clínico Universitario, Zaragoza, Spain

Department of Allergy, Hospital Universitario Marqués de Valdecilla, Santander, Spain

UGC Alergología Sevilla, Hospital el Tomillar, Sevilla, Spain

Received 19 January 2015; accepted 7 May 2015

Available online 25 August 2015

KEYWORDS Abstract Food allergy and respiratory allergy are two frequently associated diseases and with

an increasing prevalence. Several reports show the presence of respiratory symptoms in patients

Allergic asthma;

with food allergy, while certain foods may be related to the development or exacerbation of

Allergic rhinitis;

Breastfeeding; allergic rhinitis and asthma.

∗

Corresponding author.

E-mail address: [email protected] (F. Vega).

http://dx.doi.org/10.1016/j.aller.2015.05.008

264 F. Vega et al.

The present update focuses on this relationship, revealing a pathogenic and clinical association

Epidemiology; between food and respiratory allergy. This association is even more intense when the food

Food allergy; hypersensitivity is persistent or starts in the early years of life. Food allergy usually precedes

Prevalence; respiratory allergy and may be a risk factor for allergic rhinitis and asthma, becoming a relevant

Respiratory allergy; clinical marker for severe atopic asthma. Furthermore, the presence of co-existing asthma may

Solid foods enhance life-threatening symptoms occurring during a food allergic reaction.

Recommendations for dietary restrictions during pregnancy and breastfeeding to prevent the

development of respiratory allergy are controversial and not supported by consistent scientiﬁc

data. Current recommendations from medical societies propose exclusive breastfeeding during

the ﬁrst four months of life, with the introduction of solid food in the fourth to the seventh

month period of life. A delayed introduction of solid food after this period may increase the

risk of developing subsequent allergic conditions.

Further studies are encouraged to avoid unjustiﬁed recommendations involving useless

dietary restrictions.

Introduction

Methods and critical assessment of studies

The relationship between food allergy and respiratory

allergy is included in the concept of atopic march, which Search strategy

states that various manifestations of allergic disorders are

closely related. They usually begin with atopic dermatitis, In order to perform the search for the most suitable and rep-

progressing with the development of food allergy and sub- resentative articles for each of the topics to be addressed,

sequently favouring the occurrence of allergic rhinitis and two allergists with extensive clinical experience in respira-

asthma. Food allergy usually precedes hypersensitivity to tory and food allergy were assembled with the objective of

aeroallergen, sharing a common mechanism which involves updating the conclusions of the articles. Then, they carried

a specific immunoglobulin (Ig) E capable of releasing inflam- out a comprehensive bibliographic search selecting scientific

matory mediators. articles until 2014.

Following the concept of a single united airway which The search was performed through PubMed, a com-

combines the upper and lower respiratory tract, we focus on prehensive database of biomedical literature which allows

the association between food allergy and respiratory symp- access to MEDLINE journals and biological sciences books,

toms, including data concerning the involvement of nasal using different combinations of the following keywords in

and bronchial mucosa. We also include the middle ear, which order to optimise the bibliographic search: food allergy,

may be targeted in the allergic response through a Th2 allergic rhinitis, allergic asthma, respiratory allergy, breast-

response with a local IgE production and the releasing of feeding, solid foods, prevalence and epidemiology. These

mast cell mediators . In addition to these local inﬂammatory words have also remained as the keywords of this review.

processes, a nasopharyngeal oedema occluding the proximal

portion of the tube may also be present, with a remarkable

4 Inclusion criteria

change in the tubal functionality.

Studies on genetics and epidemiology have demonstrated

a close relationship between allergic rhinitis and asthma . Using the terms selected, more than 300 articles were found

The Allergic Rhinitis and its Impact on Asthma (ARIA) guide- on PubMed. Those potential useful papers were initially

lines promoted in 2001 by the World Health Organization selected according to their title and data collected in the

(WHO) and updated in 2008, recognise the importance of summary. Out of them, 197 were categorised as potentially

this association. Around 80---95% of patients with allergic relevant and published in English, Spanish or French lan-

asthma have allergic rhinitis and about 40% of patients with guage, including:

allergic rhinitis develop asthmatic symptoms, being rhinitis

a risk factor for asthma.

- Meta-analysis, reviews, consensus statement and position

The objective of this paper has been to review the epi-

papers that would include any related information to the

demiology and clinical association between respiratory and

subject. They were considered as interesting even if the

food allergy, also updating the recommendations on dietary

relationship was only collateral.

restriction during pregnancy and breastfeeding, and the tim-

- Studies with statistically signiﬁcant results regardless of

ing of introduction of solid foods into the infant’s diet as

their sample size, as well as studies with a suitable pop-

measures to reduce the risk to develop respiratory allergy.

ulation size (n > 200) and including enough data about Download English Version: https://daneshyari.com/en/article/3339647

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