Reactivity to allergenic food contaminants: A study on products on the market.

allergen toxicity food allergy hazelnut allergy milk allergy precautionary allergen labelling

Journal

Clinical and translational allergy
ISSN: 2045-7022
Titre abrégé: Clin Transl Allergy
Pays: England
ID NLM: 101576043

Informations de publication

Date de publication:
Sep 2023
Historique:
revised: 17 07 2023
received: 16 06 2023
accepted: 29 08 2023
medline: 25 9 2023
pubmed: 25 9 2023
entrez: 25 9 2023
Statut: ppublish

Résumé

The frequency and severity of reactions in food-allergic consumers exposed to unintentional food allergen contamination during production is unknown. To warn allergic consumers, it has been suggested for pre-packaged foods to be precautionary labelled when the food allergen contamination may exceed the amount to which 1%-5% of the population could react (ED01-ED05). ED01 for hazelnut and milk have been estimated at 0.1 and 0.2 mg, respectively, by the Voluntary Incidental Trace Allergen Labelling (VITAL) initiative. The respective reference doses recommended by the FAO/WHO Codex consultation are 3 and 2 mg. We evaluated the reactivity to potential traces of milk and hazelnut allergens in allergen-free pre-packaged products by children affected by severe allergies to milk and hazelnuts. Oral Food Challenges with commercially available hazelnut-free wafer biscuits and milk-free chocolate pralines were administered to patients with severe food allergies to hazelnut and cow's milk, respectively. Contamination levels of milk or hazelnut allergens were measured using chromatographic separation interfaced with triple quadrupole mass spectrometry. No hazelnut allergic patient showed allergic reactions to exposure to biscuits, nor any milk allergic patient displayed allergic reactions to the dark chocolate praline. While no hazelnut trace was detected in biscuits, the praline was found to be contaminated by milk at concentrations ranging between 8 and 35 mg total protein/kg food. In our dose model, these amounts exceeded 1.5-10 times the VITAL ED01 and reached the threshold suggested by the FAO/WHO Codex consultation. Upon the consumption of food products available on the market, many patients with severe food allergies tolerate significantly higher doses of allergen than reference doses indicated in the VITAL system used for precautionary allergen labelling. These doses support the safety of the FAO/WHO recommended reference doses.

Sections du résumé

BACKGROUND BACKGROUND
The frequency and severity of reactions in food-allergic consumers exposed to unintentional food allergen contamination during production is unknown. To warn allergic consumers, it has been suggested for pre-packaged foods to be precautionary labelled when the food allergen contamination may exceed the amount to which 1%-5% of the population could react (ED01-ED05). ED01 for hazelnut and milk have been estimated at 0.1 and 0.2 mg, respectively, by the Voluntary Incidental Trace Allergen Labelling (VITAL) initiative. The respective reference doses recommended by the FAO/WHO Codex consultation are 3 and 2 mg. We evaluated the reactivity to potential traces of milk and hazelnut allergens in allergen-free pre-packaged products by children affected by severe allergies to milk and hazelnuts.
METHODS METHODS
Oral Food Challenges with commercially available hazelnut-free wafer biscuits and milk-free chocolate pralines were administered to patients with severe food allergies to hazelnut and cow's milk, respectively. Contamination levels of milk or hazelnut allergens were measured using chromatographic separation interfaced with triple quadrupole mass spectrometry.
RESULTS RESULTS
No hazelnut allergic patient showed allergic reactions to exposure to biscuits, nor any milk allergic patient displayed allergic reactions to the dark chocolate praline. While no hazelnut trace was detected in biscuits, the praline was found to be contaminated by milk at concentrations ranging between 8 and 35 mg total protein/kg food. In our dose model, these amounts exceeded 1.5-10 times the VITAL ED01 and reached the threshold suggested by the FAO/WHO Codex consultation.
CONCLUSIONS CONCLUSIONS
Upon the consumption of food products available on the market, many patients with severe food allergies tolerate significantly higher doses of allergen than reference doses indicated in the VITAL system used for precautionary allergen labelling. These doses support the safety of the FAO/WHO recommended reference doses.

Identifiants

pubmed: 37746792
doi: 10.1002/clt2.12301
pmc: PMC10515704
doi:

Types de publication

Journal Article

Langues

eng

Pagination

e12301

Subventions

Organisme : Soremartec Italia S.R.L., Alba, Italy
ID : n.a.
Organisme : Allegria ONLUS, Milan, Italy
ID : n.a.

Informations de copyright

© 2023 The Authors. Clinical and Translational Allergy published by John Wiley & Sons Ltd on behalf of European Academy of Allergy and Clinical Immunology.

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Auteurs

Alessandro Fiocchi (A)

Allergy Dpt, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

Linda Monaci (L)

Institute of Sciences of Food Production, CNR-ISPA, Bari, Italy.

Elisabetta De Angelis (E)

Institute of Sciences of Food Production, CNR-ISPA, Bari, Italy.

Veronica Calandrelli (V)

Allergy Dpt, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

Lamia Dahdah (L)

Allergy Dpt, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

Rocco Valluzzi (R)

Allergy Dpt, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

Sara Urbani (S)

Allergy Dpt, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

Carmen Mazzuca (C)

Allergy Dpt, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

Stefania Arasi (S)

Allergy Dpt, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

Arianna Cafarotti (A)

Allergy Dpt, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

Carla Riccardi (C)

Allergy Dpt, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

Maria Cristina Artesani (MC)

Allergy Dpt, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

Lorenza Putignani (L)

Unit of Microbiology and Diagnostic Immunology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Unit of Human Microbiome, Department of Diagnostics and Laboratory Medicine, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

Valentina Pecora (V)

Allergy Dpt, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

Valeria Marzano (V)

Unit of Microbiology and Diagnostic Immunology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

Vincenzo Fierro (V)

Allergy Dpt, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

Classifications MeSH