Food Allergens
Food allergy is an immunological reaction resulting from the ingestion, inhalation or atopic
contact of food. Immunological reactions can be mediated by Ig E antibodies or other immune
cells such as T cells. Some workers define food allergy specifically as being those
immunological responses mediated by immunoglobulin E (Ig E) antibodies, whereas others use
the broader definition of immunological response, which include T-cell mediated responses as
well. In general, any protein-containing food can elicit an allergic response in sensitized
individuals. Allergenic proteins in foods may be enzymes, enzyme inhibitors, structural proteins
or binding proteins with varied biological. The pathogenesis of food allergy begins with a
sensitization phase during which time the body recognizes one or more proteins in a particular
food source as a foreign invader and begins to mount an immune-defensive response. Subsequent
consumption of the offending food can result in an allergic response that may manifest in one of
two forms, that is, immediate or delayed response.
Food Intolerance
Food intolerances are abnormal reactions to food or food components that do not involve the
immune system. They are generally less severe, shorter in duration and more localized than
immunological reactions. Food intolerances are the most common types of food sensitivities and
specific examples include the metabolic food disorders and anaphylactoid responses
Metabolic Food Disorders
Metabolic food disorders arise from inherited genetic deficiencies that reduce the capacity of
afflicted individuals to efficiently metabolize food components. One such example is
Lactose intolerance, which is caused by an inherited deficiency of the digestive enzyme lactase,
which hydrolyses lactose in milk and milk products into galactose and glucose for further
processing within the body. As a result, the undigested lactose cannot be absorbed by the small
intestine and passes into the colon where bacteria metabolize it into carbon dioxide (CO2) and
water (H2O), leading to bloating, abdominal cramping and frothy diarrhea.
Another example is phenylketonuria, a metabolic disorder in which afflicted individuals are
deficient in the hepatic enzyme phenylalanine hydroxylase, which metabolizes phenylalanine
into tyrosine. Thus, phenylalanine and phenylpyruvate accumulate in the body, and if left
untreated, it could affect the central nervous system and cause mental retardation and/or brain
damage in infants and children.
A third example of food intolerance due to a genetic deficiency is favism, where individuals are
intolerant to fava beans or the pollen from the Vicia faba plant. Persons with this intolerance
have an inherited deficiency of the erythrocyte glucose-6- phosphate dehydrogenase (G6PDH)
enzyme, which is essential to protect erythrocyte membranes against oxidative damage. This
deficiency is crucial as several endogenous oxidants present in broad beans, for example, vicine
and convicine, are capable of damaging erythrocyte membranes in G6PDH-deficient individuals,
resulting in acute haemolytic anaemia with pallor, fatigue, dyspnoea, nausea, abdominal and or
back pain, fever and chills. It may even lead to more serious symptoms such as haemoglobinuria,
jaundice and renal failure, but these situations are rare. Symptoms occur quite rapidly, usually
within 5–24 hours following consumption of fava beans.
Anaphylactoid Responses
Anaphylactoid responses are due to the non-immunologic release of chemical mediators, such as
histamine, from mast cells. The specific substances that cause this reaction are not well known,
and the reactions are often confused with true food allergies because they display similar
symptoms.
Anaphylactic shock is one of the most startling symptoms associated with food allergies, and
such food intolerances, and may affect the gastrointestinal tract, skin, respiratory tract and the
cardiovascular system. It can cause severe hypotension, and if not treated properly, it may lead to
death within minutes after ingesting the offending food.
