OBJECTIVE: The intent of this review article is to familiarize the reader with the clinical implications of cross-allergenicity among foods, the allergens involved in the oral allergy syndrome, and the progress to date in the identification of major food allergens. DATA SOURCES: English language papers identified through a Medline search and bibliographies of the identified papers. STUDY SELECTION: Reference were selected that provided historical background or contributed significantly to our current understanding of the objectives. RESULTS: (1) Cross-allergenicity in food families is commonly demonstrated in vitro or by skin testing, but oral challenge results indicate that clinically relevant food allergy is usually specific, and dietary restrictions of entire food families are rarely needed. (2) Patients with pollinosis and the oral allergy syndrome have IgE binding that cross-reacts secondarily to binding of highly homologous proteins found in various unrelated plants (pollens) and foods. (3) Identification and characterization of several major food allergens from codfish, milk, egg, peanut, soybean, and shrimp have been accomplished. (4) Commercial food allergy extracts are currently non-standardized and not well characterized. CONCLUSIONS: Accurate diagnosis of food allergy is essential because of the potential for serious adverse reactions, but this fact should not lead to the unnecessary prescription of overly restricted diets based solely on results of in vitro or skin testing. The further identification of major allergenic components of food and the identification of specific IgE antibodies to these allergens should make the clinical approach to the treatment, understanding, and diagnosis of food hypersensitivity easier.
OBJECTIVE: The intent of this review article is to familiarize the reader with the clinical implications of cross-allergenicity among foods, the allergens involved in the oral allergy syndrome, and the progress to date in the identification of major food allergens. DATA SOURCES: English language papers identified through a Medline search and bibliographies of the identified papers. STUDY SELECTION: Reference were selected that provided historical background or contributed significantly to our current understanding of the objectives. RESULTS: (1) Cross-allergenicity in food families is commonly demonstrated in vitro or by skin testing, but oral challenge results indicate that clinically relevant food allergy is usually specific, and dietary restrictions of entire food families are rarely needed. (2) Patients with pollinosis and the oral allergy syndrome have IgE binding that cross-reacts secondarily to binding of highly homologous proteins found in various unrelated plants (pollens) and foods. (3) Identification and characterization of several major food allergens from codfish, milk, egg, peanut, soybean, and shrimp have been accomplished. (4) Commercial food allergy extracts are currently non-standardized and not well characterized. CONCLUSIONS: Accurate diagnosis of food allergy is essential because of the potential for serious adverse reactions, but this fact should not lead to the unnecessary prescription of overly restricted diets based solely on results of in vitro or skin testing. The further identification of major allergenic components of food and the identification of specific IgE antibodies to these allergens should make the clinical approach to the treatment, understanding, and diagnosis of food hypersensitivity easier.