[Asthma caused by food allergy].
Food allergy (FA) induced asthma is less common than FA induced atopic dermatitis, or angioedema. The incidence reaches 8.5%. Occupational asthma due to the inhalation of various food proteins is increasingly described. Egg proteins could be peculiarly at risk. In the childhood, all the kinds of foods can be incriminated. In adults, FA are predominantly due to vegetal allergens, included in the following botanical families: rosaceae, umbelliferae, and exotic fruits. Bronchi are sensitized either by inhalation of food allergens or by inhalation of cross-reactive pneumoallergens, such as pollens, feathers, latex. The fact that FA might create a bronchial hyperreactivity is controversial. Bronchial challenges induce late-phase reactions and document the acquisition of an inflammatory state. The quantity of allergens gaining access to bronchi plays a major part in the triggering of asthma. It can be modulated by variations of intestinal permeability which are related to viral infections, aspirin, alcohol, etc. The chemical characteristics of proteins, such as hydrophobicity might interfere with the passage through the gut mucosa. The diagnosis is based upon skin tests and the detection of specific IgE, identifying the state of hypersensitivity. Provocation tests are mandatory to establish FA. The pharmacological approach of the treatment is less important than the eviction insofar as the specific immunotherapy is not yet currently performed.
Moneret-Vautrin
D A
DA
Service de médecine D, immunologie clinique et allergologie, hôpital Central, Nancy, France.
Kanny
G
G
Thévenin
F
F
D000328:Adult; D001249:Asthma / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D001980:Bronchi / Q000503:physiopathology; D002648:Child; D005512:Food Hypersensitivity / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D009784:Occupational Diseases / Q000503:physiopathology