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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrition and Public Health".

Deadline for manuscript submissions: closed (1 July 2021) | Viewed by 40027

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Special Issue Editors

Dr. Nicolette W. De Jong

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Guest Editor

Department of Internal Medicine, Division of Allergology & Clinical Immunology, Erasmus MC, 3015 GD Rotterdam, The Netherlands
Interests: food allergy; prevention; diagnosis and treatment

Prof. Dr. Harry J. Wichers

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Guest Editor

Wageningen Food & Biobased Research, Wageningen UR, The Netherlands
Interests: immunology; biochemistry; food chemistry; food allergies; allergies
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Special Issue Information

Dear Colleagues,

Food allergy is a global health problem that affects about 1.5% of adults and 5% of young children. Besides environmental and genetic factors, the exact causes of food allergy are still largely unknown. Delayed maturation of the infantile immune system, also as a consequence of a less diversely developed intestinal microbiota, is one of the factors that is hypothesized to be associated with the rapid increase of allergies.
Sensitization to food allergens more often occurs in children with atopic dermatitis, which led to the hypothesis that allergens enter the broken skin and reach the immune system. The hypothesis is based on a skin–gut axis, where the gut plays an important role in the allergic reaction.
The repeated inflammation, damage, and repair of the tissue characteristic of allergic diseases may also increase the risk of unfavourable cardio-metabolic profiles such as cardiovascular disease (CVD) and type 2-diabetes. It is unknown whether the allergic inflammation stimulates the metabolic one or vice versa.
Once a patient has developed a food allergy, an elimination diet is inevitable. The nutritional hazards, risks of allergic reactions to new allergens, problems with misused labelling (precautionary allergen labelling(PAL)), and problems with the re-introduction of allergens lead to worse QoL in patients with food allergies.
The composition of the Western diet is also associated with allergies. Insufficient intake of, for example, dietary fibre leads to less production of short-chain fatty acids (crucial metabolic products of gut microbiota responsible for many protective effects against food allergy), a less favourable composition of these microbiota, and less mild stimulation of the gut-associated lymphoid tissue (GALT).
Possible topics include but are not limited to the following:

Skin–gut axis in sensitization to food allergens;
Gut microbiota and food allergy;
Link between TH1 and TH2 immune disorders, what can be learned from big data.
Elimination diets, nutritional hazards, and the re-introduction of food allergens;
Immunomodulation in food allergy;
Effects postbiotics on atopic disorders.

Dr. Nicolette W. De Jong
Prof. Dr. Harry J. Wichers
Guest Editors

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Keywords

food allergy
nutrition
gut microbiota
skin–gut axis
immune maturation
postbiotics

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Published Papers (10 papers)

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Editorial

Jump to: Research, Review

5 pages, 218 KiB

Open AccessEditorial

Update on Nutrition and Food Allergy

by Nicolette W. de Jong and Harry J. Wichers

Nutrients 2022, 14(10), 2137; https://doi.org/10.3390/nu14102137 - 20 May 2022

Cited by 3 | Viewed by 2340

Abstract

Food-induced anaphylaxis is an immediate adverse reaction, primarily triggered by the cross-linking of allergen-specific immunoglobulin (Ig) E bound to the high-affinity IgE receptor (FcεRI) on mast cells (MCs) after re-exposure to the same food allergen [...] Full article

(This article belongs to the Special Issue Update on Nutrition and Food Allergy)

Research

Jump to: Editorial, Review

11 pages, 284 KiB

Open AccessArticle

Introduction of Heated Cow’s Milk Protein in Challenge-Proven Cow’s Milk Allergic Children: The iAGE Study

by Nicolette W. de Jong, Marloes E. van Splunter, Joyce A. M. Emons, Kasper A. Hettinga, Roy Gerth van Wijk, Harry J. Wichers, Huub F. J. Savelkoul, Aline B. Sprikkelman, R. J. Joost van Neerven, Liu Liu, Gerbrich van der Meulen, Irene Herpertz, Yvonne C. M. Duijvestijn, Mijke Breukels, Marianne I. Brouwer, Jaap Schilperoord, Olga van Doorn, Berber Vlieg-Boerstra, Jochum van den Berg, Linette Pellis, Severina Terlouw, Astrid I. Hendriks, Marco W. J. Schreurs, Frank E. van Boven and Nicolette J. T. Arends Show full author list Hide full author list

Nutrients 2022, 14(3), 629; https://doi.org/10.3390/nu14030629 - 31 Jan 2022

Cited by 9 | Viewed by 3917

Abstract

The introduction of baked milk products in cow’s milk (CM) allergic children has previously been shown to accelerate induction tolerance in a selected group of children. However, there is no standardized baked milk product on the market. Recently, a new standardized, heated and glycated cow’s milk protein (HP) product was developed. The aim of this study was to measure safety and tolerability of a new, well characterized heated CM protein (HP) product in cow’s milk allergic (CMA) children between the age of 3 and 36 months. The children were recruited from seven clinics throughout The Netherlands. The HP product was introduced in six incremental doses under clinical supervision. Symptoms were registered after introduction of the HP product. Several questionnaires were filled out by parents of the children. Skin prick tests were performed with CM and HP product, sIgE to CM and α-lactalbumin (Bos d4), β-lactoglobulin (Bos d5), serum albumin (Bos d 6), lactoferrin (Bos d7) and casein (Bos d8). Whereas 72% percent (18 out of 25) of the children tolerated the HP product, seven children experienced adverse events. Risk factors for intolerance to the HP product were higher skin prick test (SPT) histamine equivalent index (HEP) results with CM and the HP product, higher specific IgE levels against Bos d4 and Bos d8 levels and Bos d5 levels. In conclusion, the HP product was tolerated by 72% of the CM allergic children. Outcomes of SPT with CM and the HP product, as well as values of sIgE against caseins, α-lactalbumin, and β-lactoglobulin may predict the tolerability of the HP product. Larger studies are needed to confirm these conclusions. Full article

(This article belongs to the Special Issue Update on Nutrition and Food Allergy)

12 pages, 772 KiB

Open AccessFeature PaperArticle

Homemade Food Allergen Extracts for Use in Skin Prick Tests in the Diagnosis of IgE-Mediated Food Allergy: A Good Alternative in the Absence of Commercially Available Extracts?

by Severina Terlouw, Frank E. van Boven, Monika Borsboom-van Zonneveld, Catharina de Graaf-in ‘t Veld, Marloes E. van Splunter, Paul L. A. van Daele, Maurits S. van Maaren, Marco W. J. Schreurs and Nicolette W. de Jong

Nutrients 2022, 14(3), 475; https://doi.org/10.3390/nu14030475 - 21 Jan 2022

Cited by 6 | Viewed by 2693

Abstract

Introduction: The skin prick test (SPT) is the first step in the diagnosis of an immunoglobulin E (IgE)-mediated food allergy. The availability of commercial food allergen extracts is very limited, resulting in a need for alternative extraction methods of food allergens. The objective of this study was to compare the SPT results of homemade food allergen extracts with commercially available extracts. Methods: Adult patients with a suspected food allergy were included. Food allergen-specific symptoms were scored using a questionnaire. SPTs were performed with homemade and commercially available extracts (ALK-Abelló, Kopenhagen, Denmark) from almond, apple, hazelnut, peach, peanut, and walnut. Serum-specific IgE was measured with ISAC or ImmunoCAP™. Intra-class correlation coefficients (ICC) between the SPT results of both extract methods were calculated. The proportion of agreement with food allergen-specific symptoms was analyzed. Results: Fifty-four patients (mean age 36; range 19–69 years; female/male: 42/12) were included. The intra-class correlation coefficient (ICC) between the SPT results of both extract methods were strong for hazelnut 0.79 (n = 44) and walnut 0.78 (n = 31), moderate for apple 0.74 (n = 21) and peanut 0.66 (n = 28), and weak for almond 0.36 (n = 27) and peach 0.17 (n = 23). The proportion of agreement between SPT results and food allergen-specific symptoms was comparable for homemade and commercially available extracts, except for peach; 0.77 versus 0.36, respectively. Conclusion: In the diagnostic procedures to identify an IgE-mediated food allergy, homemade extracts from hazelnut and walnut appear to be a good alternative in the absence of commercially available food allergen extracts. Full article

(This article belongs to the Special Issue Update on Nutrition and Food Allergy)

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12 pages, 963 KiB

Open AccessFeature PaperArticle

by Nicolette W. de Jong, Severina Terlouw, Frank E. van Boven, M.S. van Maaren, Marco W.J. Schreurs, Dianne B.P.M. van den Berg-Somhorst, Diederik Esser and Shanna Bastiaan-Net

Nutrients 2021, 13(4), 1355; https://doi.org/10.3390/nu13041355 - 18 Apr 2021

Cited by 4 | Viewed by 2786

Abstract

Approximately 70% of birch pollen allergic patients in Europe experience hypersensitivity reactions to Immunoglobulin E (IgE) cross-reactive food sources. This so-called pollen-food syndrome (PFS) is defined by allergic symptoms elicited promptly by the ingestion of fruits, nuts, or vegetables in these patients. So far, in the literature, less attention has been given to Bet v 1 cross-reactive symptoms caused by pear (Pyrus communis). In the Netherlands, pears are widely consumed. The primary objective of this study was to measure the type and severity of allergic symptoms during pear challenges in birch pollen allergic patients, with a positive history of pear allergy, using two different pear varieties. Fifteen patients were included, skin prick test (SPT), prick-to-prick test (PTP), specific Immunoglobulin E (sIgE), and single-blind oral challenges were performed with two pear (Pyrus communis) varieties: the ‘Cepuna’ (brand name Migo^®) and the ‘Conference’ pears. All patients were sensitized to one or both pear varieties. A total of 12 out of 15 participants developed symptoms during the ‘Cepuna’ food challenge and 14/15 reacted during the ‘Conference’ challenge. Challenges with the ‘Cepuna’ pears resulted in less objective symptoms (n = 2) in comparison with challenges with ‘Conference’ pears (n = 7). Although we did not find significance between both varieties in our study, we found a high likelihood of fewer and less severe symptoms during the ‘Cepuna’ challenges. Consequently selected pear sensitized patients can try to consume small doses of the ‘Cepuna’ pear outside the birch pollen season. Full article

(This article belongs to the Special Issue Update on Nutrition and Food Allergy)

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17 pages, 1703 KiB

Open AccessArticle

A Food, a Bite, a Sip: How Much Allergen Is in That?

by Melanie Kok, Astrid Compagner, Ina Panneman, Aline Sprikkelman and Berber Vlieg-Boerstra

Nutrients 2021, 13(2), 587; https://doi.org/10.3390/nu13020587 - 10 Feb 2021

Cited by 8 | Viewed by 2878

Abstract

Detailed information about the amount of allergenic protein ingested by the patient prior to an allergic reaction yields valuable information for the diagnosis, guidance and management of food allergy. However, the exact amount of ingredients is often not declared on the label. In this study the feasibility was studied for estimating the amount of allergenic protein from milk, eggs, peanuts and hazelnuts in frequently consumed composite and non-composite foods and per bite or sip size in different age groups in the Netherlands. Foods containing milk, egg, peanut or hazelnut most frequently consumed were selected for the age groups 2–3, 4–6 and 19–30 years. If the label did not yield clear information, the amount of allergenic protein was estimated based on food labels. Bite or sip sizes were determined in these age groups in 30 different foods. The amount of allergenic protein could be estimated in 47/70 (67%) of composite foods, which was complex. Estimated protein content of milk, egg, peanut and hazelnut was 2–3 g for most foods but varied greatly from 3 to 8610 mg and may be below threshold levels of the patient. In contrast, a single bite or sip can contain a sufficient amount of allergenic protein to elicit an allergic reaction. Bite and sip sizes increased with age. In every day practice it is hard to obtain detailed and reliable information about the amount of allergenic protein incorporated in composite foods. We encourage companies to disclose the amount of common allergenic foods on their labels. Full article

(This article belongs to the Special Issue Update on Nutrition and Food Allergy)

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17 pages, 1893 KiB

Open AccessArticle

Methylglyoxal Decoration of Glutenin during Heat Processing Could Alleviate the Resulting Allergic Reaction in Mice

by Yaya Wang, Xiang Li, Sihao Wu, Lu Dong, Yaozhong Hu, Junping Wang, Yan Zhang and Shuo Wang

Nutrients 2020, 12(9), 2844; https://doi.org/10.3390/nu12092844 - 17 Sep 2020

Cited by 7 | Viewed by 2701

Abstract

Background: It is widely believed that Maillard reactions could affect the sensitization of allergens. However, the mechanism of action of methylglyoxal (MGO) production in Maillard reactions in the sensitization variation of glutenin (a predominant allergen in wheat) during heat processing is still unclear. Methods: This research evaluated the effect of MGO on the immune response against glutenin in a mouse model. The resulting variations in conformation and corresponding digestibility of glutenin were determined. The immune response and gut microflora variation in mice were analyzed following administering of glutenin and MGO-glutenin. Results: The results of the study showed that MGO-glutenin induced a lower immune response than native glutenin. Cytokine analysis showed that MGO-glutenin regulated mouse immune response by inducing Treg differentiation. MGO decoration changed the structure and digestibility of glutenin. In addition, MGO-glutenin contributes to the maintenance of the beneficial gut microflora. Conclusion: MGO decoration of glutenin during heat processing could alleviate the resulting allergic reaction in mice. Decoration with MGO appears to contribute to the aggregation of glutenin, potentially masking surface epitopes and abating sensitization. Furthermore, Bacteroides induced regulatory T-cell (Treg) differentiation, which may contribute to inhibition of the Th2 immune response and stimulation of immune tolerance. Full article

(This article belongs to the Special Issue Update on Nutrition and Food Allergy)

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8 pages, 518 KiB

Open AccessArticle

Improving Successful Introduction after a Negative Food Challenge Test: How to Achieve the Best Result?

by Joyce Emons, Marije van Gunst, Olivia Liem, Lonneke Landzaat and Nicolette Arends

Nutrients 2020, 12(9), 2731; https://doi.org/10.3390/nu12092731 - 7 Sep 2020

Cited by 2 | Viewed by 2680

Abstract

Oral food challenges (OFC) confirm or exclude the presence of a food allergy. The outcome can be positive (allergic symptoms), inconclusive, or negative (no symptoms). In the case of a negative OFC, parents and children are advised to introduce the challenged food allergen into their diet. However, previous studies showed difficulties in a successful introduction at home. The aim of this prospective non-randomized intervention study is to evaluate the effect of a new strategy with more guidance regarding the dietary introduction after a negative food challenge test. We compared two cohorts: an historical (retrospective) control group of 157 children, previously described, who did not receive any special advice after a negative OFC, versus a new cohort consisting of 104 children, who were guided according to our new strategy of written introduction schemes, food diaries, and several phone calls. In the historical control group, introduction was successful in 56%, partially successful in 16%, and 28% failed to introduce at home. After introduction of our new strategy, complete introduction was found in 82%, 11% had partially introduced, and only 8% failed to introduce the allergen. In conclusion, comprehensive advice and dietary recommendation after a negative OFC results in an increase in successful home introduction. Therefore, more attention, guidance, and follow-up of children and parents are desirable after a negative OFC. Full article

(This article belongs to the Special Issue Update on Nutrition and Food Allergy)

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24 pages, 3057 KiB

Open AccessArticle

Peptide Release after Simulated Infant In Vitro Digestion of Dry Heated Cow’s Milk Protein and Transport of Potentially Immunoreactive Peptides across the Caco-2 Cell Monolayer

by Hannah E. Zenker, Harry J. Wichers, Monic M. M. Tomassen, Sjef Boeren, Nicolette W. De Jong and Kasper A. Hettinga

Nutrients 2020, 12(8), 2483; https://doi.org/10.3390/nu12082483 - 18 Aug 2020

Cited by 20 | Viewed by 4696

Abstract

Dry heating of cow’s milk protein, as applied in the production of “baked milk”, facilitates the resolution of cow’s milk allergy symptoms upon digestion. The heating and glycation-induced changes of the protein structure can affect both digestibility and immunoreactivity. The immunological consequences may be due to changes in the peptide profile of the digested dry heated milk protein. Therefore, cow’s milk protein powder was heated at low temperature (60 °C) and high temperature (130 °C) and applied to simulated infant in vitro digestion. Digestion-derived peptides after 10 min and 60 min in the intestinal phase were measured using LC-MS/MS. Moreover, digests after 10 min intestinal digestion were applied to a Caco-2 cell monolayer. T-cell epitopes were analysed using prediction software, while specific immunoglobin E (sIgE) binding epitopes were identified based on the existing literature. The largest number of sIgE binding epitopes was found in unheated samples, while T-cell epitopes were equally represented in all samples. Transport of glycated peptide indicated a preference for glucosyl lysine and lactosyl-lysine-modified peptides, while transport of peptides containing epitope structures was limited. This showed that the release of immunoreactive peptides can be affected by the applied heating conditions; however, availability of peptides containing epitopes might be limited. Full article

(This article belongs to the Special Issue Update on Nutrition and Food Allergy)

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Review

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59 pages, 1375 KiB

Open AccessReview

Brown Seaweed Food Supplementation: Effects on Allergy and Inflammation and Its Consequences

by Simone E. M. Olsthoorn, Xi Wang, Berend Tillema, Tim Vanmierlo, Stefan Kraan, Pieter J. M. Leenen and Monique T. Mulder

Nutrients 2021, 13(8), 2613; https://doi.org/10.3390/nu13082613 - 29 Jul 2021

Cited by 20 | Viewed by 6740

Abstract

Multiple health benefits have been ascribed to brown seaweeds that are used traditionally as dietary component mostly in Asia. This systematic review summarizes information on the impact of brown seaweeds or components on inflammation, and inflammation-related pathologies, such as allergies, diabetes mellitus and obesity. We focus on oral supplementation thus intending the use of brown seaweeds as food additives. Despite the great diversity of experimental systems in which distinct species and compounds were tested for their effects on inflammation and immunity, a remarkably homogeneous picture arises. The predominant effects of consumption of brown seaweeds or compounds can be classified into three categories: (1) inhibition of reactive oxygen species, known to be important drivers of inflammation; (2) regulation, i.e., in most cases inhibition of proinflammatory NF-κB signaling; (3) modulation of adaptive immune responses, in particular by interfering with T-helper cell polarization. Over the last decades, several inflammation-related diseases have increased substantially. These include allergies and autoimmune diseases as well as morbidities associated with lifestyle and aging. In this light, further development of brown seaweeds and seaweed compounds as functional foods and nutriceuticals might contribute to combat these challenges. Full article

(This article belongs to the Special Issue Update on Nutrition and Food Allergy)

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20 pages, 2463 KiB

Open AccessReview

Mechanisms Underlying the Skin-Gut Cross Talk in the Development of IgE-Mediated Food Allergy

by Marloes van Splunter, Liu Liu, R.J. Joost van Neerven, Harry J. Wichers, Kasper A. Hettinga and Nicolette W. de Jong

Nutrients 2020, 12(12), 3830; https://doi.org/10.3390/nu12123830 - 15 Dec 2020

Cited by 22 | Viewed by 7154

Abstract

Immune-globulin E (IgE)-mediated food allergy is characterized by a variety of clinical entities within the gastrointestinal tract, skin and lungs, and systemically as anaphylaxis. The default response to food antigens, which is antigen specific immune tolerance, requires exposure to the antigen and is already initiated during pregnancy. After birth, tolerance is mostly acquired in the gut after oral ingestion of dietary proteins, whilst exposure to these same proteins via the skin, especially when it is inflamed and has a disrupted barrier, can lead to allergic sensitization. The crosstalk between the skin and the gut, which is involved in the induction of food allergy, is still incompletely understood. In this review, we will focus on mechanisms underlying allergic sensitization (to food antigens) via the skin, leading to gastrointestinal inflammation, and the development of IgE-mediated food allergy. Better understanding of these processes will eventually help to develop new preventive and therapeutic strategies in children. Full article

(This article belongs to the Special Issue Update on Nutrition and Food Allergy)

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