Psychological burden of food allergy

One fifth of the population report adverse reactions to food. Reasons for these symptoms are heterogeneous, varying from food allergy, food intolerance, irritable bowel syndrome to somatoform or other mental disorders. Literature reveals a large discrepancy between truly diagnosed food allergy and reports of food allergy symptoms by care seekers. In most studies currently available the characterization of patient groups is incomplete, because they did not distinguish between immunologic reactions and other kinds of food reactions. In analysing these adverse reactions, a thorough physical and psychological diagnostic approach is important. In our qualitative review, we present those diagnostic measures that are evidenced-based as well as clinically useful, and discuss the various psychological dimensions of adverse reactions to food. It is important to acknowledge the complex interplay between body and mind： Adults and children suffering from food allergy show impaired quality of life and a higher level of stress and anxiety. Pavlovian conditioning of adverse reactions plays an important role in maintaining symptoms. The role of personality, mood, or anxiety in food reactions is debatable. Somatoform disorders ought to be identified early to avoid lengthy and fiustrating investigations. A future task will be to improve diagnostic algorithms, to describe psychological aspects in clearly characterised patient subgroups, and to develop strategies for an optimized management of the various types of adverse reactions to food.

The Clinical Use of Mediator Release Test in Food Sensitivities

Food sensitivities are non-IgE-mediated, non-coeliac, dose-dependent and delayed systemic responses to food. They consist of a highly complex class of adverse food reactions; however, their last phase is the release of mediators from leukocytes. The Mediator Release Test （MRT） is a functional measure of sensitivity-based inflammatory responses. It is an end-point test, which can account for the widest range of triggering mechanisms involved in sensitivity reactions, including both innate and adaptive pathways. MRT not only tests reactions to foods, food-chemicals, and other substances, but also reliably quantifies the degree of the inflammatory response. The test opens the new therapeutic options for food sensitivities.

Association between Helicobacter pylori infection and food-specific immunoglobulin G in Southwest China

BACKGROUND Helicobacter pylori(H.pylori)has been found to be associated with extragastrointestinal diseases,possibly including adverse food reactions(such as food allergy or intolerance).However,there are few studies on H.pylori and food allergy or intolerance,and the results are inconsistent.Food-specific immunoglobulin(Ig)G has been revealed to be associated with food allergy or intolerance and can be used as a marker to explore the correlation between H.pylori infection and food allergy or intolerance.AIM To explore the relationship between H.pylori infection and food-specific IgG METHODS We retrospectively analyzed the physical examination data of 21822 subjects from February 2014 to December 2018 in this study.H.pylori infection was detected using the 13C urea breath test.Food-specific IgG of eggs,milk and wheat in serum was assessed.Subjects were grouped according to H.pylori positivity,and the positive rates of three kinds of food-specific IgG were compared between the two groups.Multivariable logistic regression analysis was performed to elucidate the association between H.pylori infection and food-specific IgG.RESULTS The total infection rate of H.pylori was 39.3%,and the total food-specific IgGpositive rates of eggs,milk and wheat were 25.2%,9.0%and 4.9%,respectively.The infection rate of H.pylori was higher in males than in females,while the positive rates of food-specific IgG were lower in males than in females.The positive rates of food-specific IgG decreased with age in both males and females.In the H.pylori-positive groups,the positive rates of food-specific IgG of eggs,milk and wheat were all lower than those in the H.pylori-negative groups.Multivariate logistic regression analysis revealed that H.pylori infection was negatively correlated with the food-specific IgG-positive rates of eggs,milk and wheat(odds ratio value of eggs 0.844-0.873,milk 0.741-0.751 and wheat 0.755-0.788,in different models).CONCLUSION H.pylori infection was found to be negatively associated with the food-specific IgG of eggs,milk and wheat in Southwest China.