Environmental Food Exposure: What Is the Risk of Clinical Reactivity From Cross-Contact and What Is the Risk of Sensitization. Fecha: Lunes 5 de noviembre de 2018

De
Environmental Food Exposure: What Is the Risk of
Clinical Reactivity From Cross-Contact and What Is
the Risk of Sensitization

Authors:
William J. Sheehan, MDa,b,c , Steve L. Taylor, PhDd , Wanda Phipatanakul, MD, MSc,e, and Helen A. Brough, PhD, FRCPCHf,g,h
aThe Division of Allergy and Immunology, Children’s National Medical Center, Washington, DC
b George Washington University School of Medicine and Health Sciences, Washington, DC
c The Division of Allergy and Immunology, Boston Children’s Hospital, Boston, Mass
d Food Allergy Research and Resource Program, Department of Food Science and Technology, University of Nebraska, Lincoln, Neb
e Harvard Medical School, Boston, Mass
f Paediatric Allergy Group, Department of Women and Children’s Health, School of Life Course Sciences, King’s College London, Guy’s Hospital, London, United Kingdom
g Paediatric Allergy Group, School of Immunology & Microbial Sciences, King’s College London, Guy’s Hospital, London, United Kingdom
h Children’s Allergy Service, Evelina London, St Thomas’ Hospital, London, United Kingdom

 Abstract: 
For food-allergic individuals, the typical exposure to food proteins happens during ingestion; however, individuals may be exposed to foods in other ways. In addition to ingestion reactions, allergic patients may have reactions from cutaneous or mucosal exposures to food proteins, with the classic example being a peanut-allergic child touching a counter with peanut butter and then rubbing their eyes. Similar to hands, saliva can also act as a carrier for food proteins.
Finally, there is a wealth of new research regarding the presence of food proteins in the environment, for example, within household floor dust. This review will focus on (1) cross-contact of food proteins and (2) environmental food protein exposures. Crosscontact occurs when one type of food comes into contact with another type of food resulting in the mixture of proteins. For food allergies, cross-contact is important when an allergen is inadvertently transferred to a food/meal that is thought to not contain that specific allergen. We will discuss the current literature regarding the presence of detectable food proteins in different locations, how and if these proteins are transferred or eliminated, and the clinical implications of exposures to food proteins under these different scenarios.

 DOI: https://doi.org/10.1016/j.jaip.2018.08.001

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