Food allergen sensitization patterns in a large allergic population in Mexico

Main Article Content

L.T. Ruiz Segura
E. Figueroa Pérez
A. Nowak-Wegrzyn
T. Siepmann
D. Larenas-Linnemann

Keywords

Food allergy, Sensitization, Epidemiology, Prevalence, IgE assay

Abstract

Introduction and objectives: Although food allergy is recognized as a growing worldwide public health problem, there continues to be limited data on prevalence rates in developing and emerging countries. Most prevalence estimates are based on self-reports, with only few studies using objective assessments. The aim was to analyze the frequency of sensitization to food allergens by serum specific IgE in a large group of unselected allergic patients in Mexico.


Materials and methods: We analyzed data registries from patients of all ages with suspected food allergy referred to a specialized laboratory in Mexico City from January 2016 to April 2018. A descriptive analysis, and an age/food-group comparison were made.


Results: A total of 2633 subjects tested for food allergy were identified during the study period; 1795 subjects fulfilled the inclusion criteria. The overall positivity (sIgE ≥ 0.35 kUA/L) to at least one food was 24%. The most frequently positive foods were hazelnut, apple, shrimp, peanut, egg white, egg yolk, peach, almond, tomato, bean, milk, strawberry, kiwi, maize and wheat. Positivity for some foods was more frequent across different age groups, in young children (≤5 years) milk; in older children (6-17 years): peanut, almond, wheat, soy and maize; in adults: apple. We also found other foods with high positivity but less than 50 samples: rye 60%, mango 42.9%, carrot 37.5%, cashew 27.3%, banana 21.1% and oat 20.6%.


Conclusion: Our study reported the presence of a differential regional IgE sensitization pattern as compared with the internationally reported one, highlighting the importance of local staple foods.

Abstract 438 | PDF Downloads 399

References

1. Boyce JA, Assa’ad A, Burks AW, Jones SM, Sampson HA, Wood RA, et al. Guidelines for the diagnosis and management of food allergy in the United States: summary of the NIAID-sponsored Expert Panel Report. J Allergy Clin Immunol. 2010;126:S1---58.

2. Ho HMK, Wong WHS, Chang C. Clinical spectrum of food allergies: a comprehensive review. Clinic Rev Allerg Immunol. 2014;46:225---40.

3. Boye JI. Food allergies in developing and emerging economies: need for comprehensive data on prevalence rates. Clin Transl Allergy. 2012;2:25, http://dx.doi.org/10.1186/2045-7022-2-25.

4. Sicherer SH, Sampson HA. Food allergy: a review and update on epidemiology, pathogenesis, diagnosis, prevention and management. J Allergy Clin Immunol. 2018;141:41---58.

5. Pawankar R, Canonica GW, Holgate ST, Lockey RF, Blaiss MS. WAO white book on allergy: update. World Allergy Organization; 2013.

6. Prescott S, Allen KJ. Food allergy: riding the second wave of the allergy epidemic. Pediatr Allergy Immunol. 2011;22:155---60.

7. Nwaru BI, Hickstein L, Panesar SS, Muraro A, Werfel T, Cardona V, et al. The epidemiology of food allergy in Europe: a systematic review and meta-analysis. Allergy. 2014;69:62---75.

8. Nwaru BI, Hickstein L, Panesar SS, Roberts G, Muraro A, Sheikh A. Prevalence of common food allergies in Europe: a systematic review and meta-analysis. Allergy. 2014;69:992---1007.

9. Sánchez J, Sánchez A. Epidemiology of food allegy in Latin America. Allergol Immunopathol. 2015;43:2185---95.

10. Soares-Weiser K, Takwoingi Y, Panesar SS, Muraro A, Werfel T, Hoffmann-Sommergruber K, et al. The diagnosis of food allergy: a systematic review and meta-analysis. Allergy. 2014;69:76---86.

11. Medina-Hernández A, Huerta-Hernández RE, Góngora-Meléndez MA, Domínguez-Silva MG, Mendoza-Hernández DA, RomeroTapia SJ, et al. Perfil clínico-epidemiológico de pacientes con sospecha de alergia alimentaria en México. Estudio Mexipreval. Rev Alerg Mex. 2015;62:28---40.

12. Rodríguez-Ortiz PG, Munoz-Mendoza ˜ D, Arias-Cruz A, GonzálezDíaz SN, Herrera-Castro D, Vidaurri-Ojeda AC. Epidemiological characteristics of patients with food allergy assisted at regional center of allergies and clinical immunology of Monterrey. Rev Alerg Mex. 2009;56:185---91.

13. Ortega EV, Castrejón Vázquez MI, Tapia JG, Miranda Feria AJ. Most common allergens in allergic patients admitted into a third level attention hospital. Rev Alerg Mex. 2004;51:145---50.

14. Ávila Castanón ˜ L, Pérez López J, Del Río Navarro BE, Rosas Vargas MA, Lerma Ortiz L, Sienra Monge JJL:. Food hypersensitivity by skin test in allergic patients at Hospital Infantil de Mexico Federico Gomez. Rev Alerg Mex. 2002;49:74---9.

15. Medina Segura E, González Díaz SN, Arias Cruz A, Canseco González C. Clinical characteristics of atopic dermatitis in a group of patients attending to the Regional Center of Allergy and Clinical Immunology of Monterrey, Mexico. Rev Alerg Mex. 2004;51:45---8.

16. Arroyave CM. Otitis media recurrente con efusión y alergia a los alimentos en pacientes pediátricos. Rev Alerg Mex. 2001;48:141---4.

17. Ortega Cisneros M, Vidales Díaz MA, Del Río Navarro BE, Sienra Monge JJL. Cutaneous reactivity to foods among patients with allergic rhinoconjunctivitis. Rev Alerg Mex. 1997;44:153---7.

18. Ramos Morín CJ, Canseco González C. Hypersensitivity to common allergens in the central region of Coahuila. Rev Alerg Mex. 1993;40:150---4.

19. Hofer H, Asam C, Hauser M, Nagl B, Laimer J, Himly M, et al. Tackling Bet v 1 and associated food allergies with a single hybrid protein. J Allergy Clin Immunol. 2017;140, 525---33.e10.

20. Burney P, Summers C, Chinn S, Hooper R, Van Ree R, Lidholm J. Prevalence and distribution of sensitization to foods in the European Community Respiratory Health Survey: a EuroPrevall analysis. Allergy. 2010;65:1182---8.

21. Matricardi PM, Kleine-Tebbe J, Hoffmann HJ, Valenta R, Hilger C, Hofmaier s, et al. EAACI Molecular Allergology User’s Guide. Pediatr Allergy Immunol. 2016;27:1---250.

22. van Hage M, Hamsten C, Valenta R. ImmunoCAP assays: pros and cons in allergology. J Allergy Clin Immunol. 2017;140:974---7.

23. Mendez L, Paz D, Galindo J, Toriz J. Frequency of positivity skin test of allergic diseases in the University Hospital of Puebla. Alergia Inmunol Pediatr. 1996;5:54---6.

24. Marrugo J, Hernández L, Villalba V. Prevalence of self-reported food allergy in Cartagena (Colombia) population. Allergol Immunopathol. 2008;36:320---4.

25. Naspitz CK, Solé D, Jacob CA, Sarinho E, Soares FJ, Dantas V, et al. Sensitization to inhalant and food allergens in Brazilian atopic children by in vitro total and specific IgE assay. Allergy Project --- PROAL. J Pediatr (Rio J). 2004;80: 203---10.

26. Tassi R, Lima C, Fernandes MF, Andrade ME, Auns W, Mello J. Sensitization profile in atopic dermatitis patients from HSPE-SPto airborne and food allergens. Rev Brasil Alergia Inmunopatol. 2007;30:101---6.

27. Leal F, Gacía E, Fiorentino S, Gómez E. Sensibilización alérgica a los alimentos tropicales usados en la ablactación. Actualizaciones Pediatr. 1991;1:3---5.

28. Soto-Quiros M, Gutierrez I, Calvo N, Araya C, Karlberg J, Hanson LA, et al. Allergen sensitization of asthmatic and non-asthmatic schoolchildren in Costa Rica. Allergy. 1998;53:1141---7.

29. Martínez J, Méndez C, Talesnik E, Campos E, Viviani P, Sánchez I. Skin prick test of immediate hypersensitivity in a selected Chilean pediatric population sample. Rev Med Chil. 2005;133:195---201.

30. Navarro D, López C, Villalobos D, Flores L, Rodríguez R, González L, et al. Gastrointestinal symptoms in children with atopic dermatitis and its association with food allergy. Arch Venezolanos Puericult Pediatr. 2004;67:181---6.

31. Acker WW, Plasek JM, Blumenthal KG, Lai KH, Topaz M, Seger DL, et al. Prevalence of food allergies and intolerances documented in electronic health records. J Allergy Clin Immunol. 2017;140:1587---91.

32. Kotz D, Simpson CR, Sheikh A. Incidence, prevalence, and trends of general practitioner-recorded diagnosis of peanut allergy in England, 2001 to 2005. J Allergy Clin Immunol. 2011;127, 623---30.e1.

33. Pyrhönen K, Hiltunen L, Kaila M, Näyhä S, Läärä E. Heredity of food allergies in an unselected child population: an epidemiological survey from Finland. Pediatr Allergy Immunol. 2011;22 Pt 2:e124---32.

34. Pyrhonen K, Näyhä S, Kaila M, Hiltunen L, Läärä E. Occurrence of parent-reported food hypersensitivities and food allergies among children aged 1---4 yr. Pediatr Allergy Immunol. 2009;20:328---38.

35. Mullins RJ. Paediatric food allergy trends in a community based specialist allergy practice, 1995---2006. Med J Aust.
2007;186:618---21.

36. Prescott SL, Pawankar R, Allen KJ, Campbell DE, Sinn JKh, Fiocchi A, et al. A global survey of changing patterns of food allergy burden in children. World Allergy Organ J. 2013;6:21, http://dx.doi.org/10.1186/1939-4551-6-21.

37. Rosas Vargas MA, González Reyes M, Del Río Navarro BE, Avila Castanón ˜ L, Velázquez Armenta Y, Sienra Monge JJL. Allergen sensitization and asthma in children from 1 to 3 years of age. Rev Alerg Mex. 2002;49:171---5.

38. Datema MR, Zuidmeer-Jongejan L, Asero R, Barreales L, Belohlavkova S, de Blay F, et al. Hazelnut allergy across Europe dissected molecularly: a EuroPrevall outpatient clinic survey. J Allergy Clin Immunol. 2015;136:382---91.

39. Larenas-Linnemann D, Michels A, Dinger H, Shah-Hosseini K, Mösges R, Arias Cruz A, et al. Allergen sensitization linked to climate and age, not to intermittent-persistent rhinitis in a cross-sectional cohort study in the (sub)tropics. Clin Transl Allergy. 2014;4:20, http://dx.doi.org/10.1186/2045-7022-4-2.

40. Weber RW. Patterns of pollen cross-allergenicity. J Allergy Clin Immunol. 2003;112:229---39.