Foodservice is integral to safe, adequate and satisfactory food allergy management in the hospital setting. To date, research focused on objective measures of energy and protein provision, implementation and evaluation of food allergy guidelines and assessment of process failures leading to allergen exposure. There is a lack of focus on taking a person-centred approach to understanding the barriers and enablers to optimal food allergy management. A mixed methods phenomenological approach was espoused at a tertiary acute care hospital in Melbourne, Victoria. Data collection techniques included 24-hr diet recall, foodservice satisfaction questionnaires and semi-structured qualitative interviews, all delivered by an Accredited Dietitian. Statistical and thematic analysis was conducted, followed by convergence of the results from each phase of the study. Mean energy intake indicated 64% of requirements and 81% of protein requirements were met; which included external food intake to supplement the hospital diet for around half of the patients. Most patients rated their overall food service satisfaction as ‘Good’, with food quality being the lowest rated foodservice dimension. Addressing sensory, variety and communications aspects of foodservice were focus areas identified by the study patients. These included improving bland flavours and plain appearance, restricted menu choices and automated allergen interface between systems. With a person-centred care focus, the study identified new findings on the views and attitudes of patients with a food allergy on foodservice management in hospital. Within the Food and Meal Science field, the study may be seen as an initial exploratory enquiry for future research on food allergy.

Objetivo: O objetivo desse estudo foi avaliar alterações na resposta clínica e imunológica ao camarão após a imunoterapia com Dermatophagoides pteronyssinus. Métodos: Selecionou-se 35 indivíduos alérgicos a Dermatophagoides pteronyssinus (Der p), os quais foram submetidos a testes cutâneos de leitura imediata para ácaros, baratas, camarão, tropomiosina recombinante, além de cão, gato e fungos. A detecção de IgE espcífica in vitro foi feita para o ácaro, camarão, barata americana e para suas tropomiosinas. Em todos, avaliou-se reatividade clínica ao camarão através de provocação oral. Dez pacientes foram alocados para o grupo controle, e 25 foram submetidos à imunoterapia alérgeno específica para o ácaro. Os testes cutâneos e a dosagem de IgE sérica específica foram repetidas após a indução da imunoterapia, e após 1 ano do início. A reatividade clínica ao camarão foi reavaliada no final do estudo pela provocação oral. Resultados: No grupo dos pacientes que foram submetidos à imunoterapia, observamos diminuição na reatividade nos testes cutâneos e dosagem de IgE específica para Der p, camarão e tropomiosina recombinante. Dos 10 pacientes com testes cutâneos positivos para camarão, 4 foram negativos na dosagem após um ano de imunoterapia (p= 0,04). Quanto à dosagem sérica de IgE para camarão, dos 9 positivos no início, 6 ficaram negativos (p= 0,014). Nenhum paciente submetido a imunoterapia desenvolveu nova sensibilização para camarão. Não houve alteração na reatividade clínica ao camarão após imunoterapia. Conclusão: A imunoterapia para Dermatophagoides pteronyssinus foi acompanhada de diminuição da reatividade imunológica para camarão e clinicamente não houve alteração da sensibilidade a camarão / Objective: The objective of this study was to determine changes in clinical and immunological response to shrimp after immunotherapy with Dermatophagoides pteronyssinus. Methods: We studied 35 allergic subjects to Dermatophagoides pteronyssinus (Der p), submitted to skin tests to mites, cockroach, shrimp, recombinant tropomyosin, and dog, cat and fungi. The detection of serum specific IgE was performed to mite, shrimp, and tropomyosin from American cockroach. In all patients, the clinical reactivity to shrimp was assessed through oral challenge. Ten patients were allocated to the control group, and 25 were submitted to immunotherapy for mite. Skin tests and determination of serum specific IgE were repeated after the induction of immunotherapy (3-4 months) and 1 year after of beginning of the treatment. The clinical reactivity to shrimp was assessed again at the end of the study by oral challenge. Results: In the group of patients who were undergoing immunotherapy, we observed decreased reactivity in the skin tests and specific IgE levels to Der p, shrimp and recombinant tropomyosin. Among the 10 patients with positive skin tests to shrimp, 4 were negative when assessed after one year of immunotherapy (p = 0.04). About serum specific IgE to shrimp, from the 9 positive reactors in the beginning of treatment, 6 became negative (p= 0.014). There was no change in clinical reactivity to shrimp after immunotherapy. Conclusion: The immunotherapy for Dermatophagoides pteronyssinus was accompanied by decreased immune reactivity to shrimp and clinically there was no change in sensitivity to shrimp

Yang, Fan. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2010. / Includes bibliographical references (leaves 111-132). / Abstracts in English and Chinese. / ACKNOWLEDGEMENTS --- p.iii / ABSTRACT --- p.iv / TABLE OF CONTENTS --- p.viii / LIST OF FIGURES --- p.xii / LIST OF TABLES --- p.xv / LIST OF ABBREVIATIONS --- p.xvi / Chapter Chatper 1. --- General Introduction --- p.1 / Chapter Chapter 2. --- Literature Review --- p.5 / Chapter 2.1 --- Facts on food allergy --- p.5 / Chapter 2.1.1 --- Food allergy and its prevalence --- p.5 / Chapter 2.1.2 --- Pathogenesis of food allergy --- p.6 / Chapter 2.1.3 --- Clineal disorders caused and diagnosis of food allergy --- p.8 / Chapter 2.2 --- Allergenicity assessment of genetically engineered food --- p.13 / Chapter 2.2.1 --- The structural and sequence homology of proteins as a criterion for food allergenicity assessment --- p.14 / Chapter 2.2.2 --- Digestion stability as a criterion for food allergenicity assessment --- p.15 / Chapter 2.2.3 --- Animal models for Food Allergenicity Assessment --- p.21 / Chapter 2.3 --- The importance of rice and its nutritional facts --- p.27 / Chapter 2.3.1 --- The importance of rice --- p.27 / Chapter 2.3.2 --- Rice nutritional facts and its relationship with malnutrition --- p.28 / Chapter 2.4 --- Food allergenicity research in rice --- p.30 / Chapter 2.5 --- Glutelin overexpression transgenic rice GT3 --- p.33 / Chapter 2.6 --- Recent and future perspectives for treatment of food allergy --- p.36 / Chapter Chapter 3. --- Materials and Methods --- p.39 / Chapter 3.1 --- Rice Seed Protein Extraction --- p.39 / Chapter 3.1.1 --- Rice varieties for protein extraction --- p.39 / Chapter 3.1.2 --- Protein extraction from rice seeds --- p.39 / Chapter 3.1.3 --- Fractionation of major rice seed storage proteins --- p.40 / Chapter 3.1.4. --- Protein quantification --- p.41 / Chapter 3.1.5 --- Tricine SDS-PAGE --- p.42 / Chapter 3.2 --- Simulated Gastric Digestibility Assay --- p.43 / Chapter 3.2.1 --- Assay System --- p.43 / Chapter 3.2.2 --- Preparation of Simulated Gastric Fluid --- p.43 / Chapter 3.2.3 --- Assay Procedures --- p.44 / Chapter 3.2.4 --- Results Interpretation --- p.44 / Chapter 3.3 --- Construction of Mouse Models --- p.45 / Chapter 3.3.1 --- Mouse strain and reagents used --- p.45 / Chapter 3.3.2 --- Mouse Model I --- p.46 / Chapter 3.3.3 --- Mouse Model II --- p.50 / Chapter 3.3.4 --- Mouse Model III --- p.51 / Chapter 3.4 --- Bioinformatic Analysis of Glutelin Sequence --- p.52 / Chapter 3.5 --- Epitope Mapping of Glutelin --- p.55 / Chapter 3.5.1 --- Bioinformatic Analysis --- p.55 / Chapter 3.5.2 --- Direct and Competitive ELISA --- p.56 / Chapter 3.5.3 --- Western Blot Analysis --- p.57 / Chapter 3.5.4 --- IgE-binding assay --- p.58 / Chapter Chapter 4. --- Results and Discussion --- p.60 / Chapter 4.1 --- Rice Seed Protein Extraction --- p.60 / Chapter 4.1.1 --- Rice Protein Extraction --- p.60 / Chapter 4.1.2 --- Extraction of rice major seed storage protein fractions --- p.62 / Chapter 4.2 --- Simulated Gastric Digestibility Assay --- p.64 / Chapter 4.2.1 --- Pepsin Digestibility of total protein from GT3 and WT rice seeds --- p.64 / Chapter 4.2.2 --- Pepsin Digestibility of major storage protein fractions in GT3 and WT rice --- p.68 / Chapter 4.2.3 --- Summary of Pepsin Digestibility Assay --- p.74 / Chapter 4.3 --- Mouse Model I --- p.75 / Chapter 4.3.1 --- Protein-specific IgE levels --- p.75 / Chapter 4.3.2 --- Protein-specific IgG1 and IgG2a levels --- p.77 / Chapter 4.3.3 --- Allergic Response Test --- p.79 / Chapter 4.3.4 --- Summary from Mouse Model I --- p.81 / Chapter 4.4 --- Mouse Model II --- p.83 / Chapter 4.4.1 --- Proteins specific IgE levels --- p.84 / Chapter 4.4.2 --- Proteins specific IgG1 and IgG2a levels --- p.85 / Chapter 4.4.3 --- Allergic Response Test --- p.87 / Chapter 4.4.4 --- Summary from Mouse Model II --- p.88 / Chapter 4.5 --- Mouse Model III --- p.90 / Chapter 4.5.1 --- Protein-specific IgE levels --- p.90 / Chapter 4.5.2 --- Proteins specific IgG1 and IgG2a levels --- p.91 / Chapter 4.5.3 --- Allergic Response Test --- p.93 / Chapter 4.5.4 --- Summary from Mouse Model III --- p.93 / Chapter 4.6 --- Potential allergenicity of rice glutelin by bioinformatics and epitope mapping --- p.94 / Chapter 4.6.1 --- Bioinformatic analysis --- p.94 / Chapter 4.6.2 --- ELISA analysis of synthesized epitopes --- p.97 / Chapter 4.6.3 --- Western Blot Analysis --- p.99 / Chapter 4.6.4 --- IgE-binding assay --- p.103 / Chapter Chapter 5. --- Conclusion and Future Perspectives --- p.109 / References --- p.111

Lee, Yuen Shan. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2007. / Includes bibliographical references (leaves 81-102). / Abstracts in English and Chinese. / Abstract --- p.i / Acknowledgements --- p.iv / Table of contents --- p.vi / List of Figures --- p.ix / List of Abbreviations --- p.xi / Chapter Chapter 1. --- General introduction --- p.1 / Chapter Chapter 2. --- Literature review / Chapter 2.1 --- History of food allergy research --- p.3 / Chapter 2.2 --- Prevalence of food allergy --- p.4 / Chapter 2.3 --- Clinical symptoms of food allergy --- p.6 / Chapter 2.4 --- Mechanism of food allergy --- p.6 / Chapter 2.4.1 --- Properties of food allergens --- p.7 / Chapter 2.4.2 --- Exposures to food allergens in the gastrointestinal tract --- p.8 / Chapter 2.4.3 --- Oral tolerance and its relationship to food allergy --- p.9 / Chapter 2.4.4 --- Cellular mechanism of food allergy --- p.13 / Chapter 2.5 --- Studies on seafood allergies and allergens --- p.17 / Chapter 2.6 --- Use of animal models in the study of food allergy --- p.22 / Chapter 2.6.1 --- Selection of species and strain for developing animal models --- p.22 / Chapter 2.6.2 --- Parameters of sensitization protocol --- p.25 / Chapter 2.6.3 --- Lessons from animal models --- p.27 / Chapter 2.6.3.1 --- Investigations on pathogenesis of food allergy --- p.27 / Chapter 2.6.3.2 --- Studies on development of therapeutic strategies --- p.28 / Chapter Chapter 3. --- Characterization of hypersensitive responses to recombinant shrimp tropomyosin in mice / Chapter 3.1 --- Introduction --- p.30 / Chapter 3.2 --- Materials and Methods / Chapter 3.2.1 --- Preparation of the recombinant shrimp tropomyosin / Chapter 3.2.1.1 --- Expression of the recombinant shrimp tropomyosin --- p.32 / Chapter 3.2.1.2 --- Extraction and purification of the recombinant protein under native condition --- p.32 / Chapter 3.2.1.3 --- Sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE) --- p.33 / Chapter 3.2.1.4 --- Quantification of the recombinant protein and detection of level of endotoxin in the protein --- p.34 / Chapter 3.2.2 --- Characterization of hypersensitive responsesin mice / Chapter 3.2.2.1 --- Mice --- p.37 / Chapter 3.2.2.2 --- Sensitization and challenge of mice --- p.37 / Chapter 3.2.2.3 --- Assessment of systemic anaphylaxis responses --- p.38 / Chapter 3.2.2.4 --- Detection of shrimp tropomyosin specific IgE level --- p.39 / Chapter 3.2.2.5 --- Passive cutaneous anaphylaxis (PCA) test --- p.40 / Chapter 3.2.2.6 --- In vitro proliferation assay under stimulation of shrimp tropomyosin --- p.40 / Chapter 3.2.2.7 --- Cytokine profile of splenocytes --- p.42 / Chapter 3.2.2.8 --- Histological examination of small intestine --- p.44 / Chapter 3.2.2.9 --- Statistical analysis --- p.45 / Chapter 3.3 --- Results / Chapter 3.3.1 --- Preparation of the recombinant shrimp tropomyosin --- p.47 / Chapter 3.3.2 --- Induction of systemic anaphylaxis responses after challenge --- p.48 / Chapter 3.3.3 --- Elevated level of shrimp tropomyosin specific IgE --- p.49 / Chapter 3.3.4 --- Passive cutaneous anaphylaxis (PCA) reactions --- p.50 / Chapter 3.3.5 --- Proliferation response of splenocytes under in vitro stimulation --- p.54 / Chapter 3.3.6 --- Cytokine profiles of restimulated splenocytes --- p.58 / Chapter 3.3.7 --- Histology of small intestine --- p.65 / Chapter 3.4 --- Discussion --- p.68 / Chapter Chapter 4. --- General conclusion --- p.78 / References --- p.81

acase@tulane.edu

Abstract not available

Abstract not available

<p>Reliable methods to analyze food for the presence of almond are important – not only for those allergic to almond, but also for monitoring the compliance with labelling regulations (EG directive 2003/89). Until now the Swedish National Food Administration has used methods like rocket immunoelectrophoresis and real-time PCR to detect almond in food. These methods are, however, not sensitive enough for protecting the most sensitive individuals. Therefore, the performance of a commercial ELISA kit was tested with regard to specificity/cross reactivity and limit of detection for almond both in solution and in different matrixes.</p><p>The limit of quantitation was at least 3,1 ppm (mg/kg) in solution and similar concentrations were measured in bisquits and chocolate. The ELISA method was about 100-fold more sensitive than rocket immunoelectrophoresis and PCR.</p><p>The specificity of the test kit was evaluated against a number of different nuts and seeds. No important cross reactivity was found. The antibodies against almond used in the kit can not differentiate between almond and apricot kernel. For such purposes the PCR method could be used.</p>

Zur Detektion neuer IgE- reaktiver Proteine wurde in dieser Arbeit ein zweidimensionales Proteintrennverfahren verwendet. Resultierende Proteinfraktionen wurden mithilfe von 18 tomatensensibiliesierten Patientenseren im Immunoblot getestet. Detektierte Proteine in der SDS-PAGE wurden mittels LC-MS/MS identifiziert. Dadurch konnten 2 Tomatensamenproteine, die im Immunoblot ein IgE- reaktives Signal zeigten eindeutig mittels Massenspektrometrie identifiziert werden. Diese Proteine sind Legumin und Vicilin. Durch Sequenzabgleich und Proteinstrukturmodellierung im Vergleich zu bereits bekannten Allergenen (Erdnuss und Cashewnuss), konnte eine hohe Homologie gezeigt werden. / For the detection of tomato allergens a multidimensional protein fractionation strategy and LC-MS/MS was used. Putative allergens were detected by IgE immunoblotting using sera from 18 adult tomato sensitised patients selected based on a positive history skin prick test and specific Immunglobulin (Ig) E levels. Two legumin- and vicilin- proteins were purified and showed strong IgE-reactivity in immunoblots. Individual patient sera exhibited varying IgE-sensitivity against the purified proteins. In silico structural modelling indicates high homology between epitopes of known peanut and cashewnut allergens and the detected IgE-crossreactive tomato proteins.

Background: Atopic disease is an increasing problem. Eczema affects 10-20% of young children, and 33-37% of children with eczema are food allergic. Among other factors, nitric oxide (NO) is thought to play a role in eczema and food allergy. Following the atopic march, pproximately 80% of children with atopic eczema will become sensitized to aeroallergens and develop asthma and/or allergic rhinitis. Skin prick test is used for investigating sensitization and is considered a safe method. However, systemic allergic reactions may appear when the test is performed. In diagnosing food allergy and for evaluating achievement of tolerance, the oral food challenge is the method of choice, and the double-blind placebocontrolled fashion is 'the gold standard'. Skin prick test: We examined six cases of generalized allergic reactions in connection with skin prick testing in order to identify risk factors, and thereby increase safety, and we investigated the necessity of performing skin prick tests in duplicate. We found that all six children with generalized reactions were &lt;6 months of age. When analyzing skin prick tests in duplicate, we found only 1.3% that showed diverging results, and in infants &lt;6 months even fewer, 0.9%. Food challenge: We developed recipes and a protocol for low-dose oral food challenge to milk and egg to be used in young children outgrowing their food allergy so as to facilitate early re-/introduction of small amounts of milk and egg. We performed 52 challenges, both open and double-blind placebo controlled. The recipes were validated for blinding. The lowdose challenge was tolerated well by the children and was easy to perform. Four children had a positive challenge outcome, all reacting to very small amounts of milk. All but two of the non-reacting children were able to introduce milk and egg into their diet. Nitric oxide and eczema: We investigated the effect of eczema treatment on the NO levels in urine. The sum of nitrite and nitrate was measured in urinary samples from 94 infants at two visits, with an interval of 6 weeks, and the results were compared with clinical data. The levels of NO products increased significantly when the eczema improved. The atopic march: The aim was to evaluate the atopic march in children with eczema, from referral at &lt;2 years until 4½ years of age. We followed 123 children with eczema, 78 sensitized and 45 not sensitized to milk and/or egg, with respect to eczema severity, other allergic manifestations, development of airway sensitization, and achievement of food tolerance. The difference in severity of eczema at referral was significant when comparing food-sensitized with non-sensitized children. At follow-up, 62% were still affected by eczema, although 56% only mildly so. Tolerance was achieved in 81% of the children allergic to milk and 68% of those allergic to egg. Fifty-eight percent of the food-sensitized children and 26% of the non-sensitized children had become sensitized to aeroallergens, a significant difference. The difference in airway symptoms was not significant. Very few children were exposed to tobacco smoke in their homes. Conclusions: Increased precautions should be considered when performing skin prick tests in infants &lt;6 months of age. The use of a single prick, to avoid the risk of summation of reactions, is justified when performing skin prick tests. We report recipes and a protocol for standardized open and double-blind placebo-controlled low-dose food challenge in young children, enabling the introduction of small amounts of egg and milk into the diet during tolerance development. NO products in urine increases when eczema improves. This might be due to a Th2/Th1 shift induced by the eczema treatment and skin healing, and the variation in NO response may be due to individual variations in NO-induced feedback downregulation of Th1 and Th2 proliferation. The prognosis for achieving clinical tolerance is very good in children early sensitized and allergic to milk and egg, but they will become significantly more often sensitized to aeroallergens.