food Flashcards
define
Autotolernace
balance of the innate and adaptive immune system in the GI tract whereby systemic immune responses to ingestatnts and commensal bacteria are prevented
Class 1 chitinases:
plant defense proteins, lost allergeneticity with heating
Conformational epitope
allergenic domains at non contiguous aa regions of folded proteins
Lipid transfer protein (LTP):
9-kDA polypeptides found nin vegetables and implicated in cuticle formation and defense against pathogens → thermostable and resistant to pepsin digestion so are potent food allergens
name 6 legumes
Fabacea family
Alfalfa, clover, beans, peas, chickpeas, lentils, lupins, meqsuite, carob, soybean, peanut and tamarind
what to check with red meat anaphy
galactose-alpha-1, 3 galactose (alpha gal) → avoid all mamalian meats if positive
3-6 h after eating beef, pork, lamb and venison, SPT not always positive
INTRADERMAL can help
Alpha gal sIgE avail
name 6 cross reactive to latex
With latex allergy: cross reactive to BACK GP (banana, avocado, chestnut, kiwi, green pepper and potato) and other fruits and nuts
Hevea brsilienesis
30-50% reative to 1 or more foods
Sen of SPT is 90%, spec is 50%
whats the outgrow rate for foods
Milk and egg: 80% by 4 years of age (19% by 4yo, 64% at 12yo, 79% by 16yo)
Wheat: 29% by 4yo, 65% by 12 yo
Soy: 25% by 4yo and 69% by 10yo)
Peanut, tree nut, fish and shellfish → stay q 2-5 y
peanut : 20% outgrow
Tree nut: 10% outgrow
risks for SCIT anaphylaxis
Increased risk factors for anaphylaxis
• Uncontrolled asthma and/or FEV < 70% predicted
• Asthmatic symptoms present immediately before receiving allergen immunotherapy
• Concomitant treatment with beta-blockers, ACE inhibitors
• Previous history of systemic reactions to allergen immunotherapy
• Allergen immunotherapy from new maintenance vials
• Intravascular injection
• Dosing errors
OAS compnent names
Birch - Bet V1
Ragweed - AmbA1
Mugwort (Art v4 -profilin)
Alder-Alng1-cherries, peaches, apples, pear, parsely, celery, almond
Latex
- Food protein induced allergic conditions-give 6 diseases
- Cows milk protein induced proctitis/proctocolitis
- CM protein induced enteropathy
- CM induced enterocolitis/FPIES
- EoE
- EGE
- Immediate hypersensitivity
- Celiac Dz
- Possibly Atopic dermatitis
good food antigen?
5 things that make a food a good antigen
- Heat stable
- Acid stable
- Protease stable
- Water soluble
- Abundant
- High # disulfide bonds
- Interaction of lipids
- Glycosylation and glycation
- Ligand binding
- Oligomerization and steric hindrance
- Repetitive sequences
what is
celery mugowart spice syndrome
mugwart mustard sx
latex fruit syndrome
and bird egg sydnroem
- Celery-mugwort-spice syndrome: potentially severe allergic reactions in celery-allergic patients who are sensitized to both birch and mugwort. With this syndrome, reactions to other foods of the Apiaceae family (carrot, caraway, parsley, fennel, coriander, aniseed) as well as to paprika, pepper, mango, garlic, leek and onion may be seen.
- Mugwort-Mustard syndrome: patients sensitized to mugwort may develop an allergy to mustard and experience severe reactions. +may also be sensitized to other foods in the Brassicaceae family (cauliflower, cabbage, broccoli)
- Latex-fruit syndrome. ~30-50% of individuals allergic to latex have an associated hypersensitivity to a plant-derived food (avocado, bananas, kiwi, chestnuts, peaches, tomatoes, white potato, bell pepper)
3) bird egg - feahters inhaled resp, gal d5 egg anaphylaixs/systmeic sx
0 month old with a history of anaphylaxis to egg. Describe approach to MMR vaccine and influenza vaccine. 20 minutes after MMR vaccine he develops anaphylaxis-what are the contributing allergens.
Contributing allergens:
Generally:
1.Gelatin
- Egg
- cow milk
- Preservative: Thimerosol, aluminum, phenoxyethanol, neomycin
a. No testing available for thimerosol and neomycin - Antimicrobials
- Latex (not in MMR)
- Yeast
MMR (MMR-II) Amino acid, bovine albumin or serum, chick embryo fibroblasts, human serum albumin, gelatin, glutamate, neomycin, phosphate buffers, sorbitol, sucrose, vitamins
MMRV (ProQuad) Bovine albumin or serum, gelatin, human serum albumin, monosodium L-glutamate, MRC-5 cellular protein, neomycin, sodium phosphate dibasic, sodium bicarbonate, sorbitol, sucrose, potassium phosphate monobasic, potassium chloride, potassium phosphate dibasic
Eoe
Describe 3 possible findings on endoscopy. Give 2 cellular abnormalities and
Endoscopic Findings:
•Stacked circular rings (“feline” esophagus)): 44 percent
- Strictures (particularly proximal strictures) : 21 percent
- Attenuation of the subepithelial vascular pattern: 41 percent
- Linear furrows: 48 percent
- Whitish papules (representing eosinophil microabscesses): 27 percent
- Small caliber esophagus: 9 percent
Histologic Findings:
•an increased number of eosinophils. The vast majority of patients have at least 15 eosinophils per high power field (peak value) in at least one biopsy specimen after taking a PP
- Eosinophil microabscesses
- Superficial layering of eosinophils
- Sheets of eosinophils
- Extracellular eosinophil granules
- Subepithelial and lamina propria fibrosis and inflammation
- Basal cell hyperplasia
- Papillary lengthening
