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Nutrition and Food Allergy
Nutrition and Food Allergy Definitions Antigenicity: ability of a substance to combine specifically with a preformed antibody from a previously s...
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Willis Walker
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Nutrition and Food Allergy
Definitions Antigenicity: ability of a substance to combine
specifically with a preformed antibody from a previously sensitized organism Allergenicity: abnormal immune reaction
resulting in adverse clinical symptoms
PHYSIOLOGY
c
a Epitelial cell
b
M cell
Peyer’s patch Portal vein Mesenteric lymph node
Lamina propria
a. Via dendritic cell
Antigen
c
a Cél. epitelial
Lamina propria
Denditirc cell
b Lymphatic
Célula M
Placa de Peyer
c
a b. Via M cell Antigen
b
Célula M Dendritic cell
Epitelial cell Follicle Germinal center Placa de Peyer
T cell
T cell IgA Serosa
Lamina propria
c. Via epitelial cell Epitelial cell
c
a Antigen
Lamina propria T cell Macrophage Capillary
b
Célula M Lymphatic
Respuesta inmune intestinal hacia antígenos alimentarios ANTIGENO SOLUBLE
ANTIGENO
ANTIGENO PARTICULADO
3
1
Célula epitelial intestinal
Daño mucosa
Célula M
d
9
C
LTc CD8+
D
LT TGF-BETA IL-10
IgA
8
B
IL-10 Th3
CPA
5 IL-4
C Alergia
Th0
IL-12
7 Th2
Tolerancia oral
2
IL-4
Th1
4
IFN-γ
IgE
E
6
B
RESPUESTA CELULAR
PHYSIOPATHOLOGY
Influence of Dietary Protein on Immune Response DIETARY PROTEIN PROTEIN SOURCE • QUALITY • QUANTITY
DIETARY TREATMENT • DIFFERENT PROTEIN • HYDROLYZED PROTEIN LONG CHAIN POLYUNSATURATED FATTY ACIDS
AGE ??
?
GUT FACTORS • PROCESSING • PERMEABILITY
?
? ?
INFECTION ?
IMMUNE RESPONSE
TOLERANCE GENETICS
ALLERGIC MANIFESTATIONS RAPID REACTION SLOW REACTION Ig E MEDIATED RESPONSE (Permanent: Fish, Peanut)
AGE
ENTERIC RESPONSE (Transient: Cow Milk, Soy)
Food allergy IgE mediated: urticaria angioedema morbilliform rashes acute rhinoconjunctivitis acute asthma Anaphylaxis food-associated exerciseinduced anaphylaxis
IgE associated: contact dermatitis dermatitis herpetiformis celiac disease Heiner syndrome
Classification of GI hypersensitivities to food
IgE
IgE and/or cell
Pollen-food allergy syndrome (oral allergy syndrome) GI anaphylaxis
eosinophilic esophagitis gastroenteritis
Non-IgE proctitis enterocolitis celiac dz
Sampson HA. J Allergy Clin Immunol. 2003;111:S540-S547
Allergy Not Mixed IgE-mediated/non–IgE-mediated: Atopic dermatitis Asthma
Predicting Milk Protein Sensitivity
Up to 72 %
Both parents with same atopic symptoms
43 %
Both parents atopic
32 %
One sibling atopic
20 %
12 %
One parent atopic
No parent atopic
From Kjellman NIM Acta Paediatr Scand. 1977;66:465-471.
Gastrointestinal Manifestations of Milk Allergy Esophagitis Acute Diarrhea Post-enteritis Syndrome Malabsorption Colic Colitis Vomiting- Delayed Gastric Emptying Abdominal Distention Intestinal Bleeding Protein-losing Enteropthy Constipation
Allergic colitis
Most common cause of colitis in the infant Onset within first few mo. of life (Mean 66 d,
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