Catad_TEMA Diseases of the GTS in Children - Articles

Some aspects of pathogenesis and food allergy therapy in children

S.V. Zaitseva
Moscow State Medical and Dental University. A.I. Evdokimova

The article presents a review of literary data on the effect of microflora on the immune system of the intestine and the process of forming food tolerance. The role of probiotics in the prevention and treatment of food allergies is emphasized.
Keywords: Food allergies, food tolerance, probiotics, children.

Some Aspects of Pathogenesis and Treatment of Food Allergies in Children

S.V.Zaytseva.
Moscow State University of Medicine and Dentistry of F.I.Evdokimova, Department of Paediatrics

The Review of Literary Data On Questions Influence of Microflora on Immune System of Intestines and Process Formation of Food Tolerance Is Presented in Article. The Role of Probiotics is Defined in Prevention and Treatment of Food Allergy.
Key Words: Food Allergy, Food Tolerance, Probiotics, Children.

The trend of the last century was an increase in allergic diseases. This problem is particularly relevant in pediatric practice. It is in childhood that the body's sensitization is formed to various allergens and the primary role in this plays food hypersensitivity. Atopic dermatitis, angioedema swelling, urticaria, gastrointestinal symptoms of food allergies are increasingly found in children, starting with breast age.

Perverted reactions to food, including nutritional allergies are known from the time of antiquity. However, over the centuries, issues of terminology, etiologies, pathogenesis and therapy of this disease have undergone changes.

According to modern ideasAll adverse reactions to food products are determined by the term food hypersensitivity (intolerance). It in turn is divided into nutritional allergies and non-allergic food reactions. The basis of food allergies lie immune mechanisms Food reaction. While the food hypersensitivity of the nonallergic type proceeds without the participation of the immune system. It can be caused by the pathology of the gastrointestinal tract, enzymesopathies, pseudo-allergic reactions after the use of products rich in histamine, tiramine, histamineolybererators, as well as many other factors.

The prevalence of food allergies in children varies, according to various authors, from 0.5 to 30% in various age periods. According to the National Children's Nutrition Program (2011), the greatest occurrence of food allergies is noted under the age of 2 and is 6-8%.

The data of domestic researchers indicate that the children of the first year of life most often revealed hypersensitivity to cow milk proteins (85%), chicken egg (62%), gluten (53%), banana proteins (51%), rice (50%). It is less commonly occurring sensitization to the proteins of sin (27%), potatoes (26%), soybeans (26%), even less often to corn proteins (12%), various types of meat (0-3%).

In clinical practice, the question of the role of dairy products in the development of allergies in children is most often early age. According to most pediatricians, in the first year of life, milk proteins are responsible for the development of skin manifestations of allergies, which often leads to the unreasonable elimination of this necessary product from the diet of the child. However, the prevalence of milk proteins is detected only in 2-6% of children of the first years of life. Prospective studies have shown that 85% of the children of the first two years of living with allergies to the proteins of cow milk are tolerance, and in 80% of children with allergies to the egg, tolerance is formed by 5 years.

Increasing the prevalence, gravity of clinical manifestations of food allergies, the possibility of forming oral tolerance to food products stimulated research on the study of pathogenesis of disease and the search for mechanisms for preventing food allergies in children.

It is indisputable to the fact that the basis of allergic diseases is a genetic predisposition. However, only the change in the genotype cannot be explained by the increasing role of allergic diseases in the world. As the analysis of literary data shows, the environmental impact often determines the possibility of implementing hereditary information. That is why a lot of work is dedicated to finding factors that contribute to activation or suppression of food allergies.

The consequence of the search for solutions of this problem was the emergence of several hypotheses explaining the high level of allergies. So, in 1989, the English doctor D.Strachan published the data that was subsequently reflected in the development of the "hygienic concept" of allergies. So, in 1989, the English doctor D.Strachan published the data that was subsequently reflected in the development of the "hygienic concept" of allergies. . In accordance with his observations, transferred to the first two years of life infectious diseases There may be a protective (protective) effect with respect to respiratory allergies. His analysis of life is more than 17 thousand patients showed that less child It has contact with an infectious factor, the higher the risk of developing allergic diseases.

This theory found a lot of experimental confirmations in the following years. So the research team Alex (Akkergies and Endotoxin) from Switzerland, Munich and Salzburg was shown that children born and growing on farms, where parents were engaged in agriculture, 3 times less often had a sensitization to pollen allergens and a pollinosis clinic than children, not Having contact with peasant economy.

At the present level, the immunological basis of the hygienic theory is explained by the imbalance of T-helper subpopulations (TH): TH1 profiles and TH2-profile lymphocytes. Any immune response develops in the direction of either TH1-, or TH2-type and largely determines the nature of the disease. Both of these subpopulations differ in the set of cytokines synthesized by them. In human Th1 cells, as a rule, produce interferon-γ, tumor necrosis factor β and interleukin-2 (IL-2) and participate in inflammatory reactions mediated by cells. Some of the cytokines secreted by TH1 have proof activity, as well as stimulate cytotoxic cells and T-effectors of slow-type hypersensitivity.

In contrast to TH1 cells, TH2 cells are synthesized IL-4, IL-5, IL-6, IL-9, IL-10 and IL-13. These cytokines enhance the formation of antibodies, especially class IgE, and also activate the chemotaxis of eosinophils into the focus of inflammation. In this case, allergic reactions are more likely. In addition, Th1-profile cytokines, suppress the activity of TH2, and vice versa.

Normally, inthetricly differentiation of helper lymphocytes are shifted toward TH2 profile, which provides a favorable course of pregnancy. In the postnatal period, the active impact of the microbial factor occurs, TH2 profile profile of the immune system on TH1 profile, which in turn warns the development of atopy in children. The reasons for blocking this process are currently unknown. However, there are work indicating that this can contribute to a decrease in the microbial stimulation of the immune system, which is a consequence of the uncontrolled application of antibiotics, increasing the level of social-generic measures, changes in dietary traditions and reducing the number of family members.

Taking into account the above, it becomes clear that the definition of factors that stimulate the differentiation of zero th in the direction of Th1 is a perspective direction in the prevention and treatment of allergic diseases. In this regard, work on the study of congenital immunity is interesting. Thus, determining the role of antigen-presenting cells, TOLL receptors, T-regulatory (Treg) lymphocytes and maintaining the immune balance between TH1 and TH2 cells is a great achievement of the last decade.

From the description in 1997, a Toll-Lake Receptor (Toll-Lake Receptor) on the human monocytes began to study the role of a congenital immune system (Innate Immune System) in the immunological response of the body. Currently, it has been established that the first line of protection against infection is created not only with the help of the barrier function of the skin and mucous membranes of congenital immunity. Great importance In this defense, dendritic cells play, which the first recognize pathogenic antigens using the so-called image-recognition receptors (PRR - Pattern Recognition Receptors) located on the cell surface. The activation of these receptors leads to initiation (or leveling) of cytokine cascade products, which, in turn, entails the activation or weakening of the adaptive immune response. These receptors have the specificity of response depending on the antigen and play an important role in the subsequent stimulation of TREG. It is TREG that the lymphocytes secrete cytokines that support balance in the TH1 / TH2-immune response system.

Thus, the stimulation of an innate immune system of the body determines the subsequent direction of the response of the adaptive immune system. At the same time, it is believed that the inflammatory response of an innate immune system, especially the secretion of IL-12 dendritic cells, is an important regulator of protective TH1 reactions of the acquired immune system in relation to the development of allergies.

According to literary data, in the last decade, the role of a natural intestinal microbial flora is actively discussed on the innate immune response and stimulation of postnatal Th1 immune response in the first months of the child's life.

In this regard, another hypothesis of the dual impact of allergens is interesting. This hypothesis of Dennis Ownby suggests that the early effects of allergen on the body contributes to the formation of immunological tolerance. At the same time, the formation of food tolerance is one of the important moments of preventing food allergies.

Food tolerance is a specific active immunological treatment to the antigen, with which the body has previously contacted the oral route of administration. The formation of imunological tolerance is associated with the participation of three key and at the same time interconnected components of the intestine: lymphoid tissue associated with the intestinal mucosa, the factors of the intercellular interaction (cytokines) and commensant bacteria.

Lymphoid fabric, associated with mucous membranes, in volume exceeds all other types of lymphoid tissues focused in the central and peripheral sections of the immune system. So, in the gastrointestinal tract, up to 80% of the entire lymphoid tissue of man, which is probably due to constant contacts digestive system With a variety of antigens. It is determined that the epithelial cells that are included in the gastrointestinal mucosa, along with Lamina Propria, perform the function of not only mechanical protection, but also are active participants in the immune response. The epithelium cells of the mucous membranes along with macrophages, neutrophils, dendritic cells are antigen-representing. They are also represented by PRR receptors that recognize pathogenic antigens. Along with this, in the cells of the epithelium, the formation of a secretory component for Immunoglobulin A.

In recent decades, it has been established that there are also T-lymphocytes-helpers in its own plate of the mucous membrane. It should be noted that on the mucous gastrointestinal tract, along with T-Helpers 1 and 2nd, regulatory T-helpers, which take an active part in the formation of immunological tolerance. This process is provided mainly due to the products of anti-inflammatory cytokines -interlakin 10 (IL-10) and the transforming growth factor β (TGF-β), which are among other effects regulatory impact on the immune response. This confirmation of this may be the data of recent years proving that breast milk contains IL-10 and TGF-β-cytokines, which reduce the risk of developing allergies and contribute to the formation of food tolerance in a child. The higher the level of TGF-β in the colostrum of mothers, the less often the children develop atopic diseases. The protective effect of breast milk in relation to the development of allergies was demonstrated in several clinical studies. Thus, in the work of KULL, during survey, more than 4 thousand children were found that prolonged breastfeeding reduced the risk of developing not only food, but also respiratory allergies.

In recent years, special attention is paid to the immunomodulating activity of the natural intestinal microflora on the formation of oral tolerance. It has been established that the microflora, interacting with PR receptors of antigen-representing cells, provides the balance of pro-inflammatory and anti-inflammatory cytokines on the mucous membranes. A special place is given to the bacteria -commans, which colonize the intestines. The change in the initial colonization of the intestines can adversely affect the subsequent development of allergies. This is confirmed by the frequent development of allergies in children born during the operation of cesarean sections. Thus, the preservation of the natural intestinal microflora can be an important factor in the prevention of allergies.

According to researchers, the microflora of the child's intestinal undergoes significant changes over the first months and years of life. During the first week, after the birth of the flora of the gastrointestinal tract is represented by streptococci, clostridy, neasery, staphylococci and by the end of the first week of life, bifidobacteria dominate the gastrointestinal tract. In early age children predominate the following types of bifidobacteria: b. bifidum, b.breve, b.infantis, B.Parvolorum, B.Lactis. In children on artificial feeding, B.longum prevails. By 6 months, b.catenulatum, b.pseudocatenulatum, b.adolescentis appear. In adults, b.bifidum, B.adolescentis, B.longum are more often detected. Bifidobacteria has an immunomodulatory effect on the system of local intestinal immunity. Thus, the experiment found that B.Breve shows adjuvant activity and increases the products of antigen of specific immunoglobulins a.

Interesting research on the so-called "mightless" mice. It has been established that migrating animals are partially or fully incapable of developing oral immunological tolerance. This is due to the fact that bifido and lactobacillia are able to influence the products of cytokines. For example, B.infantis has an inhibitory effect on the products of mouse splenocytes IL-17 - one of the main pro-inflammatory cytokines, and bifidobacteria, occurring at an early childhood, is significantly less capable of stimulating the products of pro-inflammatory cytokines of mouse macrophages than bifidobacteria characteristic of adults . In the same study it was shown that bifidobacteria characteristic of early children's age, Stimulate the synthesis of IL-10 macrophages, while bifidobacteria, dominating at an older age (B.Dolescentis), do not affect the synthesis of this cytokine by macrophages.

It has been established that changes in the intestinal microflora can precede the appearance clinical symptoms Allergies. Numerous studies show that these changes are characterized mainly by a decrease in the number of bifidobacteria and an increase in the level of clostridium and bacteroids. Probably bifidobacteria, reaching a certain quantitative level, have a regulatory effect on the parameters of the immunity of the mucous membranes. With a decrease in their level of bifidobacteria due to of various reasonsRegulatory processes are violated that in certain cases leads to the imbalance of differentiation of T-lymphocytes in the direction of increasing the share of T-helper 2 types (TH2-lymphocytes) and the development of allergic inflammation.

Along with bifidobacteriums in young children in the intestines, there are lactobacillia-aeroelectric gram-positive unfortunate chopsticks. In the period of the newborn, their number can vary. AT early period Life in children are predominantly lactobacilli - L.Gasseri, L.Salivarius, L.RHAMNOSUS, L.Casei, L.REUTERI, etc. appear at older, L.RHAMNOSUS, L.Casei, L.REUTERI, and more stable. According to modern research, some species, such as L.Casei Shirota, are able to activate cellular immunity and suppress IgE products. At the same time, various influence of lactobacilli on dendritic intestinal cells was revealed with subsequent regulation of the immune response. When studying the effect of lactobacilli on the products of dendritic cells of pro-inflammatory cytokine IL-12, it is shown that L.Casei is largest, and L.reuteri is the leastly capable of stimulation of IL-12. Incubation of intestinal epithelium cells with lacto and bifidobacteriums, characteristic of early childhood, reduces the products of pro-air cytokine IL-8 induced by S.typhimurium.

Currently, it has been established that bifido and lactobacilliors characteristic of early childhood are less capable of products of pro-inflammatory cytokines than bifido- and lactobacillia characteristic of older age groups. This is probably due to the fact that one of the most important functions of normal microflora of young children is the formation of immunological tolerance mechanisms.

Thus, from modern positions, the intestinal microbocynesis is an essential factor in the formation of immunity and forming food tolerance, which largely determines the likelihood of food allergy.

Given the role of microflora in the induction of food tolerance, numerous studies are currently conducted to use it in order to prevent food allergies. In this regard, prospects for the use of drugs and products are interesting. baby foodcontaining pre- and probiotics.

Probiotics are living organisms and / or substances of microbial origin that have a natural method of introducing favorable effects on physiological functions through the optimization of its microbiological status. The term "probiotics" was first introduced in 1965 Lilly and Stilluell as opposed to antibiotics. Probiotics were described as microbial factors that stimulate the growth of other microorganisms. In 1989, Roy Fuller stressed the need for probiotics viability and put forward an idea about their positive effect on patients. Lact and bifidobacteria strains are often used as probiotics. Also in this role can act the yeast saccharomyces cerevisiae and some sishemnel strains.

Currently, these numerous studies have been proven that the effectiveness of probiotics consists not in the normalization of the microflora of the body. Probiotics do not become members of the organism normal microflora. They disappear after 48-72 hours after their reception, as tolerance is not formed to them. The influence of probiotics on the body is that they have an immunomodulatory effect on epithelial and dendritic cells of the subepithelial layer, where they activate the articular receptors, which producing cytokines contribute to increasing the number and activation of regulatory T cells of different types. This is extremely important for the formation of food tolerance in the body.

These literature on the effectiveness of probiotics during therapeutic purposes during allergies are ambiguous. Currently, several paths are established, by which probiotics modulate allergic inflammation. Among them, for example, the impact of proteases on food proteins. It was so revealed that probiotics proteases destroy the casein of cow milk, while the immunogenic properties of the protein change. It is experimentally established that in children sensitized to cow's milk, Lactobacillus GG is capable of proteolytic effect on casein and inhibit IgE synthesis and activation of eosinophils. Another way is implemented by exposure to a cytokine profile. For example, it was experimentally found that after receiving the Lactobacillus Rhamnosus GG (ATCC 53103), there is a decrease in the secretion of the tumor necrosis factor, increasing the synthesis of interferon in the intestine in patients suffering from allergies to the cow's milk. At the same time, probiotics can reduce intestinal permeability, preventing the penetration of allergens.

There are a number of clinical studies on the assessment of preventive and therapeutic effect Probiotics in atopic diseases conducted in recent years. The most studied in randomized controlled studies of the strains of L. Rhamnosus GG and B. Lactis VI-12. The metaanalysis of the results indicate the effectiveness of the probiotic strain of L. Rhamnosus GG and B. Lactis B-12 in the prevention and treatment of atopic eczema.

Thus, in the double-blind slave-controlled study, 62 mothers and children with a high risk of atopy occurred were conducted. It was shown that the appointment of probiotics L. Rhamnosus GG and B. Lactis VI-12 Women during pregnancy and breastfeeding significantly (by 68%) reduced the risk of atopic eczema during the first 2 years of life compared to placebo (15 and 47%, respectively; p \u003d 0.01). Interesting is the fact that the most pronounced effect of the use of probiotics by mothers was noted in children with increased level IgE in cord blood. At the same time, mothers who received probiotics during pregnancy and lactation were noted an increase in the level of anti-inflammatory cytokine - transforming growth factor - 2 in milk.

A favorable safety profile of these lacto and bifidobacteria allows you to widely recommend these probiotic microorganisms from almost all categories of patients.

It is important to note that the use of probiotics during pregnancy and breastfeeding Included in the "Recommendations for conducting patients with atopic dermatitis" developed by the American Academy of Dermatology, and has the highest level of evidence - i.

Classifications of probiotics are based on the number of microorganisms included in the drug, their generic affiliation or the presence of additional components in the preparation. Probiotics are divided into monocomponent (monoproprobiotics), single-component sorbed, polycomponent (polyprobiotics), combined (synbiotics); According to the composition - on bifido-containing, lact-containing, core and consisting of dispute bacteria and sugarmitzeth (self-electronized antagonists).

Despite the rather widespread use, bacterial preparations based on living microorganisms are not always highly efficient. This is due, on the one hand, with the rapid elimination of strains introduced into aggressive Wednesday The gastrointestinal tract, on the other, is the presence of evidence that, when entering the gastrointestinal tract, only 5% of lyophilized bacteria representing the base of probiotic is activated.

Therefore, at present, preference is given to polyprobiotics. Their advantage is that various strains with a variety distinctive features Have more chances for survival and colonization. Their probiotic effect is strengthened due to the combination specific properties strains, and positive relationships between strains increase their biological activity.

Currently, the drug Linex containing L.ACIDOPHILUS, S.Faecium B.infantis is actively used in pediatric practice. No less interesting probiotic Baibi Baibi. This probiotic, which is allowed to use in children from the first days of life, contains Bifidobacterium Lactis BB-12 (1x10 9 Code) and Streptococcus Thermophilus TH-4 (1x10 8 CFU).

Since the end of 2010, Polyprobiotics of Rioplora Nikomed, developed on the basis of WinClove Bio Industries B.V, developed on the basis of WinClove Bio Industries B.V. (Netherlands). WinClove has more than 20 years of experience in the development and production of probiotic drugs. WinClove develops and creates polyprobiotics in collaboration with leading hospitals of European universities. Over the years, polyprobiotics shown for use in antibiotic-associated diarrhea, constipation, inflammatory bowel diseases, traveler diarrhea, allergies and vaginal infections were developed. Balanced combination of probiotic microorganisms (Bifidobacterium, Lactobacillus, Lactococcus Lactis and Streptococcus Thermophilus) helps to strengthen immunity. Balance of intestinal microflora provides normal digestion, as well as the natural protection of the body from infections and the effects of adverse environmental factors.

The bacterium included in the probiotic complex normalize the intestinal microflora balance, have a positive effect on immunity and contribute to the formation of oral tolerance. Two drugs were proposed on our market: "Rioflora Immuno" and "Rioflora Balance".

Complex preparation "Immuno RioFlora" contains 9 strains of probiotic microorganisms: Bifidobacterium lactis NIZO 3680, Bifidobacterium lactis NIZO 3882, Lactobacillus acidophilus, Lactobacillus plantarum, Lactococcus lactis, Bifidobacterium longum, Lactobacillus paracasei, Lactobacillus salivarius, Streptococcus thermophiles.

Each capsule contains at least one billion (1.0x10 9) Core / caps. Probiotic microorganisms.

Complex preparation "RioFlora Balance" contains 8 strains of probiotic microorganisms: Bifidobacterium lactis, Lactobacillus plantarum, Bifidobacterium bifidum, Lactobacillus acidophilus W37, Lactobacillus acidophilus W55, Lactobacillus rhamnosus, Lactobacillus paracasei, Lactobacillus salivarius. Each capsule contains at least two and a half billion (2.5x10 9) Code / Capps. Probiotic microorganisms.

These drugs are recommended as biologically active additive To food, as a source of probiotic microorganisms (bifido- and lactobacilli). It is recommended to receive capsules to adults and children over 3 years old preferably on an empty stomach (in the morning or before bedtime). It is possible to dissolve the contents of the capsule in warm water (if it is impossible to swallow a whole capsule).

Thus, experimental and clinical studies confirm the role of natural microflora in the formation of food tolerance, as well as in the prevention and treatment of atopic diseases in children. Large clinical interest is work on the study of the effectiveness of probiotics in preventive and therapeutic schemes. At the same time, these data require further research, which would determine the optimal strains of microorganisms in various age periods, doses, appointment regimes and indications for the use of probiotics in the treatment of food allergies.

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Food allergies is characterized by an increased sensitivity of the body to food products and the development of signs of non-efficiency of food caused by the reaction of the immune system.

It is well known that the mechanisms of intolerance to food products are very diverse. Reactions to food having an allergic nature are much less common than many consider.

Views

Food allergies, as a rule, develops for the first time in childhood.

Among people with diseases of the gastrointestinal tract and biliary system, the prevalence of allergy to food products is higher than among persons who do not suffer from these diseases (Nogaller A., \u200b\u200b1983).

Among the reactions of intolerance to food products, you can select the reactions to food having toxic and non-toxic.

Toxic reactions They develop after the use of food products containing in the form of impurities toxic substances. Manifestations of these reactions and their severity depend on the dose and chemical properties Toxic compounds, not from the type of food product.

Among non-toxic reactionsthe food is distinguished by two main types of intolerance, differing development mechanisms:

1) reactions to food products due to disorders in the immunity system (food allergy),

2) the reaction is not an immunological nature (food intolerance).

Food intolerance can develop in diseases of the gastrointestinal tract, a biliary system, endocrine pathology, congenital and acquired enzymes and other diseases that are not related to impairment in the immunity system.

With the normal functioning of the gastrointestinal tract and the biliary system, allergization to food products does not develop.

Essential in the formation of increased sensitivity to food products has a genetic predisposition to allergies.

As studies have shown, approximately half of the patients suffering from food allergies, there is a burdened family or own allergic anamnesis.

This means that either they themselves suffer from any allergic diseases (pollinosis, atopic bronchial asthma), or they suffer from their nearest relatives (parents, brothers, grandmothers, etc.).

The reasons

Formation of allergies in childhood

The formation of food allergies contribute to nutritional disorders during pregnancy and feeding (abuse of certain products with pronounced allergizing activity: fish, eggs, nuts, milk, etc.).

Provoking factors for the development of the disease are

• early translation of the child to artificial feeding;
• nourishing disorders in children, expressed in the inconsistency of the volume and the ratio of food ingredients weighing and age of the child;
• concomitant diseases of the gastrointestinal tract,
• diseases of the liver and biliary tract, etc.

Normal digestion and suction of food products is ensured by the state endocrine system, the structure and function of the gastrointestinal tract, the biliary system, the composition and volume of digestive juices, the composition of the intestinal microflora, the state of the local immunity of the intestinal mucosa (lymphoid tissue, secretory immunoglobulins, etc.) and other factors.

Normally, food products are cleaved to compounds that do not have allergizing properties, and the intestinal wall is impermeable for non-absolute products.

Causes of adults

The development of food allergies is provoked by common agents and children factors.

• First of all, it is an increase in the permeability of the intestinal wall, which is noted under inflammatory diseases of the gastrointestinal tract.
• The impairment (reduction or acceleration) of the absorption of food compounds may be due to a violation of the digestion steps with an insufficient function of the pancreas, lack of enzymes, dyskinesia of biliary tract and intestines, etc.
• Meanous food, rare or frequent meals lead to a violation of the stomach secretion, the development of gastritis and other disorders causing the formation of food allergies or pseudo-allergies.
• The formation of increased sensitivity to food products of protein nature is influenced not only by the amount of food and diet disorders, but also the acidity of the gastric juice (corner of A., 1985).

At the heart of true allergic reactions to food products lies increased sensitivity and immune response to repeated administration Food allergen. When the food product enters the body for the first time, antigens of food fall into the bloodstream, in response to which antibodies relating to the immunoglobulin class A. have healthy man The absorption of the antigen of the food product and the flow of it in the bloodstream ensures the "indifference" of the immune system with the subsequent hit of it in the body, and this process is under genetic control.

Food allergies can develop when genetic predisposition To the formation of allergies for food antigens with the participation of immunoglobulin immunoglobulin antibodies

Sometimes allergic can develop on some nutritional supplements, especially nzo-dyes (in particular, tartrosine).

Often the reason for the development of a pseudo-allergic reaction to food products is not the product itself, but various chemical additives made to improve taste, odor, colors and providing the duration of storage. To the category of food additives applies large group Substances: dyes, flavors, antioxidants, emulsifiers, enzymes, thickeners, bacteriostatic substances, preservatives, etc.

Among the most common food dyes, you can mention a tartrazine, providing orange-yellow staining of the product; Sodium nitrite, preserving red in meat products, etc. For canning, sodium glutamate, salicylates, in particular acetylsalicylic acid, and others are used.

Vasoactive Amin - BetaPhenylethylamine, contained in chocolate, in fermented products (for example, cheese), fermented cocoa beans, causes pseudo-allergic reactions.

Manifestations of food allergies

The manifestations of the disease are diverse in shape, localization, severity and forecast.

The most early and typical manifestation of true food allergies is the development of oral allergic syndrome. It is characterized by the appearance of itching in the oral cavity, numbness and / or a sense of "cutting" of the language, solid and / or soft sky, the swelling of the oral mucosa after the use of the guilty food allergen.

The most frequent gastrointestinal manifestations of the disease include:

• vomot
• colic
• loss of appetite
• allergic enterocolitis.

Vomiting in food allergies may occur during from several minutes to 4-6 hours after meals, more often than the patient tears eaten food. Sometimes vomiting takes persisting character. The occurrence of vomiting is mainly due to the reduction of the gatekeeper when the edible allergen in the stomach is inserted.

Allergic colic abdominal pains can be observed immediately after eating or a few hours later and caused by the spasm of a smooth intestinal musculature. Pain in the stomach is usually pronounced. Abdominal pain in food allergies may not be so intense, but constant, accompanied by a decrease in appetite, the presence of mucus in a chair and other disorders.

The absence of appetite can be selective in relation to the causal-significant food allergen, or a general decline in appetite can be marked. Popps in food allergies are due to spasm smooth muscles Different sections of the intestine.

The frequent, liquid chair appearing after the reception of the causal-meaningful food allergen is one of the most common signs of food allergies in both adults and children. Especially often diarrhea is observed in food allergies to milk.

Allergic enterocolitis in this disease is characterized by sharp pain in the abdomen, the presence of meteorism, a liquid chair with the disheve of the vitreous mucus. Patients with allergic enterocolitis complain about harsh weakness, decreased appetite, headache, dizziness.

Skin manifestations, or allergling, with food allergies are most widely distributed, both in adults and children.

For true food allergies, the most characteristic skin manifestations are

UDC / UDK 637: 57.083.322 DOI 10.21323 / 2414-438x-2017-2-2-23-36

food HyperSensitivity and Products of Animal Origin Resources

food hypersensitivity and products from raw materials of animal origin

Lisitsyn A.B., Chernukha I.m., Lunina O.I.

The V.M. Gorbatov All-Russian Meat Research Institute, Moscow, RUSSIA

Keywords: meat products, allergens, technological processing.

annotation

The number of people with food hypersensitivity, namely food intolerance and food allergies grows every year. The following types of food intolerance are classified: enzymopathy, "leather intestinal" syndrome, psychogenic food intolerance, disinfectant failure and true food intolerance. Food allergens are mainly glycoproteins, haptins or polypeptides. Most cases of food allergies are ^-concluded allergic reactions. Opening in medicine In recent years, the detailing and classification of food hypersensitivity require further research to develop modern technological techniques and product receptors with specified properties for consumers with food hypersensitivity. Existing technologies are based on elimination and / or reduced the content of food allergen in the product. The article presents an overview of the causes of food intolerance and food allergies, legal foundations, list food allergens and methods of their control, state of the market of hypo-allergenic nutrition and scientific approaches to create hypoal-lyrgenic products based on animal raw materials.

Introduction

In the last decade, food intolerance and food allergies have become a serious problem in our country and in Europe. Food allergies and food intolerance are distinguished by the reasons for the occurrence and severity of consequences.

Food allergies is the most common form of allergies and is 80% in the structure of the prevalence of allergic diseases in the Russian Federation. According to WHO in Russia, over the past decade, the number of allergies increased by 20%. According to the Deputy Director of the Institute of Immunology of the Federal Medical and Biological Agency (FMBA) N. Ilina from 13% to 35% of Russians suffer various species Allergic diseases, and allergies are most susceptible to people in stressful conditions (RIA Novosti press conference, 2010). The risk group includes categories of citizens who transferred severe diseases, and passed the course of therapy (for example, antibiotics), after which a special hypoallergenic is prescribed

Keywords; MEAT Products, Allergens, Technological Process. Abstract

The Number of People with Food Hypersensitivity, Namely Food Intolerance and Food Allergies, GROWS EVERY YEAR. Food intolerance Is Classified Into Following Types: Enzymopathy; LEAKY GUT SYNDROME; Psychogenic Food intolerance; Detoxification Insufficiency and True Food intolerance. Food Allergens Mainly Are Glycoproteins, Haptens or Polypeptides. MOST CASES OF FOOD ALERGYRE ARE IGE-MEDIATED ALLERGIC REACTIONS. Recent Discoveries in Medicine, Detailing and Classification of Food Hypersensitivity Require Further Researchs to Develop Modern Techniques and Product Recipes with Specified Properties for Consumers with Food HyperSensitivity. Existing Technologies Are Based On The Elimination and Or Reduction of the Content of the Allergenic Substance in Food. The article provides an overview of causes of food intolerance and food allergy, legislative background, a list of food allergens and methods of control, market profile of hy-poallergenic produce and scientific approaches to creating hypoal-lergenic food products based on raw materials of animal Origin.

During The Last Decade, Food Intolerance and Food Allergies Have Become A Serious Problem Both in Russia and European Countries. Food Allergy and Food Intolerance Are Distinguished by Cause and Severity of Consequences.

FOOD ALERGY IS THE MOST COMMON TYPE OF ALERGY AND ACCOUNTS FOR 80% OF THE STRUCTURE OF ALERGIC DISEASE PREVALENCE IN THE RF. According to WHO, Over The Past Decade, The Number of Highly Allergic Individuals in Russia Increased by 20%. According to N. Ilyina, Depeut Director of The National Research Center - Institute of Immunology, Federal Medical-Biological Agency (FMBA), 13% to 35% of Russians Suffer from Various Types of Allergic Diseases, and People WHE ARE Under Stress Are Most Suscepti to Allergy (Ria Novosti Press Conference, 2010). The Risk Group Include Individuals Who Suffer from Severe Diseases and Received Therapy (for example, antibiotics), Which Re-

diet. From 10 to 20% of the adult population suffer from food intolerance - often considering this food allergies.

Children are more than adults are susceptible to allergic diseases and allergic reactions to food products.

On the domestic market you can find an assortment of grain and dairy hypoallergenic products. Meat products with hypoallergenic properties are practically not represented on store shelves. The exception is the children's products of the first year of life.

The article presents an overview of the causes that cause allergic responses of the human body, a list of food allergens, the state of the hypoallergenic and scientific approaches to the creation of hypoal-lyrgenic food based on animal raw materials.

Food hypersensitivity - Definitions and classification

Food intolerance, or food hypersensitivity, is a violation of ordinary digestion and learning processes. Symptoms are diarrhea, nausea, vomiting, gas formation, abdominal pain.

The following types of food intolerance are classified:

Enzymopathy is the insufficiency of digestive enzymes, which causes the impossibility of normal splitting and assimilation of carbohydrates, proteins and amino acids (hypolastication, celiac disease, ha-lactosemia, phenylketonuria);

The "leather intestinal" syndrome - increased permeability of toxins in the bloodstream through the intestinal mucosa;

Psychogenic food intolerance - the inability of the body to absorb food due to the impact or consequences of stress;

Disinfectant insufficiency - the reaction of the immune system on substances, unbelievable origin entering the body with food;

True food intolerance is the body's reaction to natural biologically active substances (histamine, caffeine, salicylates, etc.). In food intolerance, the main method of prevention is the observance of a diet, fully excluding a substance that cannot digest the gastrointestinal tract.

Food allergies - hypersensitivity, this is a negative body reaction to a certain substance (or a food product containing this substance), which violates the operation of the immune system. P. G. H. Gell and R. R. A. Coombs allocated 4 main types of hypersensitivity reactions. To date, 5 types of hypersensitivity reactions are known.

qUIRES PRESRIPTION OF SPECIAL HYPOALLERGENIC DIET. Besides, 10 to 20% of the adult Population Suffer from Food Intolerance and Often Consider It A Food Allergy.

Children Are More Suscept Free to Food Allergens Compared to Adults.

A Range of Hypoallergenic Products Based on Cereals and Milk Is in The Domestic Market Now. Retail Shows Almost Absence of Meat Products with Hypoallergenic Properties. The Only Exception IS Complemenient Foods for Babies of First Year of Life.

The ARTICLE PROVIDES AN OVERVIEW OF CAUSES OF ALERGIC REACTIONS IN HUMAN, A LIST OF FOOD ALERGENS IN HUMAN, MARKET PROFILE OF HYPOALLERGENIC PRODUCE AND SCIENTFIC Approaches to Creating Hypoallergenic Food Products Based On Raw Materials of Animal Origin.

Food HyperSensitivity - Definitions and Classifications

Food intolerance, OR Food Hypersensitivity, IS Abnormality in Usual Processes of Food Digestion and Absorption. Symptoms Are Diarrhea, Nausea, Vomiting, Gas Formation, and Abdominal Pain.

Food intolerance Is Classified Into Following Types:

Enzymopathy - Insymes of Digestive Enzymes, Which Causes Inability of Normal Digestion and Absorption of Carbohydrates, Proteins and Ampo Acids (Hypo-Lactasia, Celiac Disease, Galactosemia, PhenylKetonuria);

Leaky Gut Syndrome - Increased Intestine Permeability for Toxins That Enter Bloodstream Through The Intestinal Mucosa;

Psychogenic Food Intolerance - The Inability of the Body to Digest Food Because of Stress Effects or Consequences;

Detoxification Insufficiency - The Reaction of the Immune System to Artificial Substances That Enter The Body With Food;

True Food Intolerance - The Body "S Response to Natural Biologically Active Substances (Histamine, Caffeine, Salicylates, etc.).

The Main Method of Food Intolerance Prevention Is To Follow A Diet That Complety Excludes The Substance That Cannot Be Digested in The Gastrointestinal Tract.

FOOD ALERGY IS A HYPERSENSITITIVITY, I.E. Negative Reaction of The Body to Certain Substance (or Food Product Containing This Substance), Which Interrupts Immune System Functioning. P. G. H. Gell and R. R. A. Coombs Identified 4 Main Types of HyperSensitivity Reactions. To date, there ARE 5 Types

Fig. 1. FOOD HYPERSENSITIITY | Fig. 1. Food hypersensitivity

The term allergies was saved for the first type of reaction. (Fig. 1). As a result of the admission of allergen in the blood, the patient is particularly dangerous for the patient's life is the heavy Avivers Retczia - Ati phylaccs (the Blood Pressure Drop). At the heart of many allergic diseases ( atopic dermatitis, urticaria, angiootak, allergic cricks, Brolnhi-AlnasvstmB ISR.) Aread Peising Ishhereche ß].

Flashing Avgei - this, l t ^ x ^ axis, glyco-proteins contained in food products, rage - despeptides, guspenden, kets are ereated with BetmTMV P: and! B1R C] - the allergenicness of the pitch ^ pylinine is due to the presence of epitopes. The etipotes is part of the macromolecule antigen, which is recognized immune system: antibodies (immunoglobulins), B-lymphdziyamir, T-lymphoclamm.s ^ form. Grot Eel Kieaos Antiai p ^ A, -yg, I-y, which distinguish the smiling of particular ladder structures and Finka. Iel-tires of food allergies is an IgE-based allergic reactions.

Legal basis

Abroad have developed legislative requirements in which the list of allergens and the process of Sich Rovwroll are included:

Directive T00CC8 9 / UI Mottochi Schkazgnsatn-Gtstedieitis from Xianesvs digestively produce VVI-Yu-Peysky Union)

Director for Alyertenim S0V5 (2C / EC Yvirzvnyaoyi)

Fedsvian anti-evidence. SSCV R01-T10-SSHA)

The labeling law of food allergens and the protection of Ephers Potcher ^ ITIC from 20 (m depth (Food Aistep Jajl ing AN CONSUMER -RODE SV ^ GT AC) of 2004)

Food Code. Standard 1.2.3 (Australia / New Zealand).

of Hypersensitivity Reactions. The Term "Allergy" is Reserved for the first Type of Such Reactions. (Fig. 1). AS A RESULT OF ALERGEN ENERGIC INTO THE BLOOD, AERIOUS ALERGIC REACTION, ANAPHYLAJDS (RAPID DROP IN BOODPRESSURE), IS E ^ J ^^ CIALLY (^ AN ^^ Erous L ^ or P Pysienos OFR. MAPY AHREGK "EASES) UTOPIC ^ ^ RU ^ Rtitis, I ^ Riecariu, AnpioEmap ahe ^ i Rhipiter, T ^ Rmchi-G Asthma, ETA) AOE Basid on Gorjid O) Lergy (3].

a.<^c^ci uPergens ire basacaiiy g^c^c^roteans ionta"d in food and,lcrs oft^i^, poiaatldgsThaptena Pinked tr hood po^^^i^^ idt of allergens and methods of their cgntaop

Phipti "^ E 2003/89 / OU OY TPE INCLLCRTION OP INPREDI-ENTSON THE COMAOSITION OFFOOD PREPUTS IOORRPEAN UNION)

Direative Iopus: .ei An Allergeyi (Puoopeoa Thgion)

C ^ RGG Paris 201ph0 (Uoa)

r FAND AILERGEO LADPLINP YND CANSHMER DROTEETIEN ACT OF 2004

The Food Code. Standard 1.2.3 (Australsapnew Zealand).

In Russia, the list of the most common food allergens, the use of which can cause allergic reactions or contraindicated in certain types of diseases, is indicated in the technical regulations of the Customs Union "Food products in terms of its marking" (Tr Ts 022/2011).

According to FAO, 160 types of food products can be the cause of food hypersensitivity. The legislation of many countries of the world has identified the main groups of allergenic products. Table 1 presents a comparative list of accepted allergens in the EU, USA, Australia and Russia countries.

An even more detailed list of allergens, including new, is presented on the WHO website and the International Union of Immunologists (IUIS) http: // www. allergen.org/.

Causes and sources

food hypersensitivity

Allergens are dangerous in that they can cause the body's response dangerous to human health even in micromal doses.

Allergic response to peanuts can be caused by a dose measured by micrograms. Thermal processing in this case, only increases their al-leverness (according to European Food Safety Authority - EFSA).

Allergy to cow's milk is most often in children. Among the milk proteins, B-Lactoglobulin (A and B) has the highest allergen properties. Lactoprotein - A lacttalbumin, casein and its A-, and, and \\ -Fractions are less allergen. . Milk of other mammals has allergenic properties, for example, goat milk. In a number of references on food allergies, the most important allergen is called cheese due to the high content of the hyst mine.

The frequency of enteropathy (enzymopathy) associated with gluten intolerance in North America - from 0.5 - 1% of the total population. Patients with food intolerance to gluten have risks of allergic reactions to other cereals, so they need to avoid the consumption of barley, rye and oats.

Chicken egg proteins cause allergic reactions. The most pronounced allergen properties have ovalbumin (about 70%), Ovomukoid, Ovotransferin (Conalbumin). The main allergen yolk is Alfa Livetin. Clinical studies show that the doses of an egg protein coming from food, causing allergies - from micrograms to several milligrants. If there is allergies to chicken protein, at the same time increased sensitivity to the proteins of eggs of other types (duck, goose).

In Russia, The List of The Most Common Food Allergens, Consumption of Which May Cause Allergic Reactions or Is Contraindicated for Certain Types of Diseases of the Customs Union "Food Products in Terms of Labeling" (TR TS 022 / 2011).

According to Fao, 160 Food Products CAN CAUSE FOOD HYPERSENSITITIBY. Legislation in Many Countries of the World Identify The Main Groups of Allergenic Products. Table 1 Provides A comparative List of Recognized Allergens In The Eu, USA, Australia and Russia.

An Even More Detailed List of Allergens, Including New Ones, Is Available On The Who WebSite and WebSite of The International Union of Immunological Societies (IUIS) http://www.allergen.org/.

Causes and Sources.

of Food HyperSensitivity

Allergens Are Dangerous Because The Can Cause Reactions Harmful to Human Health, Even in Very Small Doses.

An Allergic Reaction to Peanuts May Be Caused By A Dose Measured in Micrograms. In This Case, Heat Treatment Only Increases Their Allergenic Capacity (According to the European Food Safety Authority - EFSA).

An Allergic Reaction to Cow "S Milk is Found Most Often in Children. Among Milk Proteins, ^ -lactoglobulin (A and B) HAS The Highest Allergenic Capacity. A-Lactalbumin, Casein and Its A-, and \\ -Fractions Are Less Allergenic . Milk of Other Mammals, For Example, Goat "S Milk, Possesses Allergic Properties TOO. In a Number of Reviews on Food Allergies, Cheese IS RECOGNIZED AS The Most Important Allergen Due To the High Content of Histamine.

The Frequency of Enteropathy (Enzymopathy) Associated with gluten intolerance in North America Accounts for 0.5 to 1% of the Total Population. Patients WITH FOOD INTOLERANCE TO GLUTEN HAVE RISKS OF ALLERGIC REACTIONS TOER CEREALS, SO THEY NEED TO AVOID THE CONSUMPTION OF BARLEY, RYE AND OATS.

Chicken Egg White Cause Allergic Reactions Too. OVAL-BUMIN (About 70%), Ovomucoid, OVOTRANSFERRIN (Conal-Bumin) Have the most pronounced allergenic properties. The Main Yolk Allergen Is Alpha-Livetin. CLINICAL STUDIES SHOW THAT THE DOSES OF EGG WHITE ENTERING BODY WITH FOOD THAT MAY CAUSE ALERGIES ARE Micrograms to Sevel Milligrams. If there is an allergy to Chicken Egg Protein, There May Be An Increased Sensitivity to Egg Proteins of Other Species (Duck, Goose).

Table 1. The Main Groups of Food Allergens | Table 1. Basic groups of food allergens

European union | European Union

Cereals (E.G. Gluten) with Exceptions (E.G. Glucose Syrup, Maltodextrins, Cereals Used to Produce Distillates and Alcoholic Beverages) | Grain crops (containing gluten) with exceptions (for example, glucose syrup, maltodextrins, grain, used to obtain distillates and alcoholic beverages)

Australia | Australia

CEREALS (Containing Gluten) | Grain crops (containing gluten)

Wheat J Wheat

Russia j Russia

Cereals Containing Gluten and Related Processed Products | Cereals containing gluten and their processing products

Cruptaceans (Lobster,

Crustaceans | Crab, Shrimp) | Cruptaceans and Related Processed Products |

2. Cruptaceans | Crustaceans "- 1 crustacean" - R G G G G G G G G G G G G G G

1 g crustacean, g, crustaceans and their products processing

(lobsters, crabs,

shrimp)

Fish, WITH THE EXCEPTION OF FISH GLUTIN OR FISH 3. GLUE | Fish, with the exception of fish gelatin or fish glue

4. Eggs J eggs

Fish (E.G. Bass, Flounder, COD) | Fish (eg, Bass, Kambala, Cod)

Fish and Related Processed Products (Excluding Fish Gelatin Used As A Base in Preparations Containing Vitamins and Carotenoids) | Fish and products of its processing (except for fish gelatin used as a basis in preparations containing vitamins and carotenoids)

Eggs and Related Processed Products | Eggs and processing products

Milk, with the Exception of Milk Used to Produce Distillates and Alcoholic Beverages |

5. Milk, except for useful for distillates and alcoholic beverages

6. Peanuts | Peanut

Nuts, with the Exception of Nuts Used to Produce 7 Distillates and Alcoholic Beverages | Nuts, except used to obtain distillates and alcoholic beverages

Milk J Milk Milk J Milk

Peanuts J Peanuts Peanuts J Peanuts

Tree Nuts (E.G. Almond, Walnuts, Pecan) J tree

GroundNuts J Earthwood

Milk and Related Processed Products (including lactose) | Milk and products of its processing (including lactose)

Peanuts and Related Processed Products | Peanuts and its products processing

Nuts and Related Processed Products J Nuts

MH III TIIII. III IM V -

r 7 and their products processing

oshness (eg,

almonds, Walnuts, Pecan)

Soybeans, with the Exception of Fully Refined Oil and Fat, Tocopherols, Phytosterols, Esters |

Soybeans | Soybeans and Related Processed Products | Soy.

Soybeans, with the exception of completely "", j soybeans | soy "l

Soybeans and its products processing

refined oil and fat, tocopherols, R "R g

phytosterols, esters esters

9. Sesame Seeds | Seeds Sesame Seeds J Seeds Sesame and Related Processed Products | Sesame and products of its processing

lo. Sulfur Dioxide and Sulfites (\u003e 10 MG / KG OR 10 MG / L AS SO2) | Sulfur dioxide and sulfite (\u003e 10 mg / kg or 10 mg / l as SO2) Sulfites j Sulfitis Sulfur Dioxide and Sulfites, If their Total Content Is Greater Than 10 Milligrams Per Liter Based on Sulfur Dioxide | Sulfur dioxide and sulphites, if their total content is more than 10 mg per 1 kg or 10 mg per 1 l in terms of sulfur dioxide

lL. Mustard | Mustard Mustard and Related Processed Products | Mustard and products of its processing

l2. Lupine | Lupine Lupine and Related Processed Products | Lupine and its products processing

13. Celery | Celery Celery and Related Processed Products | Celery and its products processing

l4. Shellfish | Shellfish and Related Processed Products | Mollusks and products of their processing

ls. Aspartame and Aspartame-Acesulfame Salt | Aspartame and aspartame-acesulfam salt

l6. Bee Pollen | Bee pollen

l7. Propolis | Propolis

l8. Royal Jelly | Royal Milk

Food allergies to fish and seafood are due to the presence of sarcoplasmic proteins in them - parvalbumin. The main allergen contained in most clams is muscular protein tropomyosis. It is believed that marine fish is more allergen than the river majority of antigenic components of fishe proteins are thermostable and are not destroyed with culinary processing. The number of fish that can cause an allergic reaction is calculated by milligrams.

With culinary processing, antigenic properties of food products are changed. For example, in milk at boiling, allergenicity of some proteins is lost, others increase; Allergenic properties of certain types of fish at preservation are reduced; Boiled eggs and steep eggs are less allergens than fresh egg. Thermal treatment of peanuts does not reduce its allergenicity, due to the fact that the peanut allergen is practically not destroyed during processing.

Allergic reactions can cause not only food products, but also nutritional supplements included in the product. In food intolerance, it is recommended to avoid consumption in the composition of the following food additives: food dyes E102, E110, E123, preservatives E 210-227, E 249-252, flavoring additives E 621-625, flavors B550-553, and others. For example, aromatic additives in chewing gum, glaze, frozen dairy desserts, lollipops, sausages, syrups can cause food intolerance, which are confused with food allergies to dairy products, vegetables, fruits. Tartrazine dye causes the development of such reactions as the difficulty of breathing and cough, which is mistakenly associated with allergies to food products, which it includes. Preservatives - sorbic acid (E200) can cause skin reactions, benzoic acid (E210) - provoke the seizures of choking, para-oxybenzoic acid methyl ether (E218) - skin rashes and itching. Food consumption (dried fruits and vegetables, non-alcoholic beverages, fruit juices, ferric drinks, wine, beer, sausage products and hamburgers), as part of which sulfur dioxide and sulfite are used as preservatives, often leads to adverse reactions of the body.

Genetic modification of food products, according to some genetic scientists, contributes to an increase in the level of allergic reactions of the human body. Modern methods of growing grain, legumes, vegetables and many other types of agricultural products are based on the use of transgenic technologies in order to increase yields, resistance to infections and weather conditions, improving storage-nominations, etc., as a result of which in DNA of culture

Food Allergy to Fish and Seafood Is Due To the Presnce of Sarcoplasmic Proteins, Parvalbumins. The Main Allergen Present In Most Shellfish Is The Muscle Protein Tropomyo-Sin. IT IS Believed That Marine Fish Is More Allergenic Than Fish From Rivers. Most of the AntiGenic Components of Fish Proteins Are Heat-Stable and Do not Degrade When Cooked. The Amount of Fish That May Cause An Allergic Reaction Is Estimated in Milligrams.

AntiGenic Properties of Food Products Change During Cooking. For example, During Milk Boiling, Allergenic Capacity of Some Proteins is Lost, and for others it is increased. ALLARGENIC PROPERTIES OF SOME FISH SPECIES ARE REDUCED DURING CANNING. Boiled Eggs Are Less Allergenic Than Fresh Ones. Heat Treatment of Peanuts Does Not Reduce Its Allergenic Capacity Due To the Fact That The Peanut Allergen Almost Does Not Degrade During Processing.

Allergic Reactions May Be Caused Not Only by Food Products, But Also by Food AdDitives in their composition. In Food Intolerance, IT IS Recommended to Avoid Consumption of the Following Food Additives in Food Products: Food Colorings E102, E110, E123, Preservatives E210-227, E249-252, Flavor Enhancers E621-625, Flavorings E550-553, etc. . For example, Flavoring Additives in Chewing Gum, Icings, Frozen Milk Desserts, Candies, Sausages, And Syrps May Cause Food Intolerance, Which Is Confused with Food Allergy to Dairy Products, Vegetables, Fruits. Tartrazine Coloring Causes The Development Of Such Reactions AS Dyspnea and Cough Mistakenly Associated with An Allergy to Food Products, In Which It Is Contained. Preservatives: Sorbic Acid (E200) May Cause Skin Reactions; Benzoic ACID (E210) Provoke Asthma Attack; Para-HydroxyBenzoic Acid Methyl ester (E218) Cause Skin Rashes and Itching. Consumption of Food Products (Dried Fruits and Vegetables, Soft Drinks, Fruit Juices, Fermented Milk, Wine, Beer, Sausages and Hamburgers), Which Use Sauzages and Sulfites As Preservatives, Often Leads to Adverse Reactions.

According to Some Genetic Scientists, The Genetic Modification of Food Products Contributees to An Increase in Allergic Reactions in Human. Modern Methods of Growing Cereals, Legumes, Vegetables and Many Other Types of Agricultural Products Are Based on Transgenic Technologies To Increase Yields, Resistance To Infection and Weather Conditions, Improve Storage Capacity, etc. AS A Result, Foreign DNA Sequences Are Artificially Introduced Into The DNA

alien amino acid sequences are artificially introduced to give it the specified properties. It is these changes that lead to the fact that food products grown with genetic engineering causes food intolerance and allergic diseases, especially in children.

Allergies to meat and meat products are observed relatively rarely. Among the various types of meat raw materials allergic to beef and chicken meat occurs more often than the rest of meat.

Meat products made of pork, beef, veal, lamb, horse meat, rabbit meat and hare, goose, chicken, quail, ducks, including wild, beef liver can cause allergic reactions. Differences in the prevalence of reactions to one or another type of meat are also associated with the geographical predominance of their use in the diet and national traditions. Adverse reactions to mammalian meat types such as kangaroo meat, whale, as well as turkey meat, are described. Despite this, the rabbit meat is considered low-allergenic meat raw materials. Turkey meat also has low sensitizing potential.

An allergic reaction may occur as a result of increased sensitivity to allergens, similar to its structure. This is called cross-allergies. Table 2 shows examples of cross-allergy, when food that is not allergenic causes an allergic response of the body in its consumption.

Bovy serum albumin contained in milk in trace quantities, reacts crosswise with beef and veal.

Experts consider possible cross allergies to pollen birch, alder or nuts on apples (50-60% of cases), hazelnut (40-60%), peach (20-30%), cherry (10-20%), carrot (10%) , soy (10%); And also pollen wormwood on celery (40%), spicy herbs (10%).

of Agricultural Plant to Give IT The Specified Properties. IT The Food Food Products Obtained using Genetic Engineering Cause Food Intolerance and Allergic Diseases, Especially in Children.

ALERGY TO MEAT AND MEAT PRODUTS IS RelativeLy Rare. Among All Types of Meat, Allergy to Beef and Chicken Meat Is More Common Than To Other Species.

Meat Products from Pork, Beef, Veal, Mutton, Horse, Rabbit, Goose, Chicken, Quail, Duck (Including Wild One), And Beef Liver May Cause Allergic Reactions. Differences In The Prevalence Of Reactions to a Particular Type of Meat Are Also Associated with the Geographical Predominance of Their Use in the Diet and National Traditions. Adverse Reactions to Mammalian Meat, Such As Kangaroo, Whale, And Turkey Meat Are Described. However, Rabbit Meat IS Considered to Be a Low-Allergy Raw Meat. Turkey Meat Also Has Low Sensitizing Potential.

An Allergic Reaction May Occur As A Result of HyperSensi-Tivity to Allergens Similar in Structure. This Is Called Polyvalent Allergy. Table 2 Presents Examples of Polyvalent Allergy WHEN FOOD THAT IS NOT ALERLGENIC CAUSES AN ALLERGIC REACTION WHEN IT IS CONSUMED.

Bovine Serum Albumin Contained in Milk In Trace Amounts Cross-Reacts with Beef and Veal Meat.

Experts Consider An Allergy to Birch, Alder or Hazel Pollen to Be Polyvalent with Apples (50-60% of Cases), Hazelnuts (40-60%), Peach (20-30%), Cherry (10-20%), Carrots (10%), SOYBEAN (10%), AS Well As Wormwood Pollen to Be Polyvalent with Celery (40%), SPICY HERBS (10%).

Table 2. PolyValent Allergy and Food Cross-Reactivity | Table 2. Cross allergies when

ALLERGENIC PRODUCTS | R ,. "

»1 FOOD PRODUCT | Food

Allergenic products R 1 R "

Cow "S Milk | Cow Milk

Kefir (Kefir Yeast) | Kefir (kefir yeast)

Chicken Eggs | Chicken eggs

Milk of Other Animal Species, Products Containing Cow "S Milk Proteins, Beef, Veal Meat and Related Products | Milk of other animal species, products containing cow's milk proteins, beef, veal and meat products

MOLDS, MOLD Cheese, Yeast Dough, Kvass, Mushrooms | Mold mushrooms, mold grades of cheese, yeast dough, kvass, mushrooms

River and Sea Fish, Seafood, Chicken Meat (Provided That The Chickens Were Fed With Fishmeal) | River and marine fish, seafood, chicken meat (provided that chickens fed fish flour)

Eggs of Other Bird Species and Products Containing Eggs (Egg. Sauces), Chicken Meat and Broth, Mayonnaise | Eggs of other types of birds and products containing eggs (sauces, cream, mayonnaise), chicken meat and broth, mayonnaise

food reactivity

Other | Other

Enzyme Preparations Based On Cattle Pancreas, Cow Wool | Enzyme preparations based on pancreatic cattle, cow wool

Antibiotics of Penicillin Type | Antibiotics of penicillin row

Feathers of Birds, Drugs | Feathers of birds, medicinal preparations

Swedish scientists from Lund University studied strawberry proteoma profiles (Fragaria Ananassa) in order to identify biological changes in protein expression, including allergenic proteins to detect the risk of cross-allergy with dust birch (http: // www.cmple.lu.se/biostruct/people/ Cecilia_Emanuelsson / Strawberry_allergy_Proteomics /).

There are cases of possible cross-allergies between food allergens and medicines of animal origin. O.A. Subbotina and its colleagues (2014) on the basis of the experiments held for three years received data that food antigens in the process of producing drugs based on animal protein retain their antigenic properties, despite industrial processing and physico-chemical impact in the production process, and There may be the cause of cross-allergic reactions in patients with food allergies.

Specialists, who worked on the study of allergies on meat for a long time, revealed that the main allergens of beef are thermolabile bovine serum albumin (BOS D6) and to a lesser extent - muscle proteins (Aktin, myozin, etc.). Other scholars for this list are added U-globulin and tropomyosis.

Research of patients with red meat allergies have shown that a slow-motion anaphylaxis, mediated by specific IgE to glycoprotein, can develop - galactose-alpha-1,3-galactose (A-GAL). The fact that the beginning of the appearance of allergies to red meat in adults most often preceded bite of ticks, saliva and intestines of which contain A-GAL. There is another fact: a-Gal was found in the antitumor drug Tse-Tuximab (at a concentration of 10.2 μg / 5 mg), which caused the development of anaphylaxia immediately after the first intravenous injection in about 20% of cancer patients.

The meat found seven A-Gal-containing IgE-binding proteins (M-creatinecinase, aspartatenotransferase, ß-entolazes, a-enolaspe, etc.), of which four remained stable during processing. Laminin U-1 and collagen A-1 beef are A-Gal-containing allergens, which explains the cross-reactivity of red meat with gelatin and products, which includes gelatin: sweets, as well as medicinal capsules and vaccine. Scientists have been revealed that the IGA cats (FEL D 5) is an allergen that contains A-GAL. In 1994, the cross reactivity between albumin cats and pork (Syndrome "Pork-cat" was first described.

All new potential allergens are detected worldwide. In the study of allergic re-

Swedish scientists from the Lund University studied proteomic profiles of strawberry (Fragaria ananassa) to detect biological changes in protein expression, including allergen proteins, to identify the risk of polyvalent allergies with birch pollen (http://www.cmps.lu.se/ BIOSTRUCT / PEPLE / CECILIA_EMANUELSSON / STRAWBERRY_ALERGY_PRO-TEOMICS /).

There Are Cases of Possible Polyvalent Allergies Between Food Allergens and Drugs of Animal Origin. Based on Experiments Being Conducted Over Three Years, O.A. Subbotina et al. (2014) Have SHOWED THAT, IN PROTEIN OF DRUGS BASED ON ANIMAL PROTEIN, FOOD ANTIGENS RETAIN THEIR Anti-Genic Properties, Despite Processing and Physicochemical Effects During Polyvalent Allergic Reactions in Patients with Food Allergies.

Specialists WH WORKED ON MEAT ALERGY FOR A LONG TIME HAVE REVEALED THAT THE MAIN ALERGENS OF BEEF AREMOLA-BILE BOVINE SERUM ALBUMIN (BOS D6) AND TO A LESSER EXTENT, MUSCLE PROTEINS (Actin, Myosin, etc.). Other Scientists Add Y-Globulin and Tropomyosin to This List.

Studies of Patients with Allergy to Red Meat Have SHOWN THAT DELAYED ANAPYLAXIS MAY DEVELOP MEDIATED by Specific Ige to Glycoprotein, Galactose-Alpha-1,3-Galactose (A-Gal). It Was Established That The Onset of Allergy to Red Meat in Adults Was Often Preceded by A Bite of Mites, The Saliva and Intestines of Which Contain A-Gal. The Other Fact Is That A-Gal Was Found in the Antitumor Drug Cetuximab (in Concentration of 10.2 ^ G / 5 Mg), Which Led to the Development of Anaphylaxis Immediately After The First Intravenous Injection In Approximately 20% of Cancer Patients.

Seven A-Gal-Containing Ige-Binding Proteins (M-Creatine Kinase, Aspartate Aminotransferase, ^ -enolase, a-e-enolase, etc.) Were Found in The Meat, Four of Which Remained Stable During Processing. Laminin Y-1 And Collagen A-1 Of Beef Are A-Gal-Containing Allergens, Which Explains Cross-Reactivity of Red Meat with Gelatin and Foods That Include Gelantin: Sweets, Drugs in Capsules and Vaccines. Scientists Have Found That Cat "S IGA (FEL D 5) IS An Allergen Containing A-Gal. In 1994, Cross-Reactivity Between Cat Albumin and Pork (" Pork-Cat Syndrome ") Was First Described.

New Potential Allergens Are Detected All Over The World. In The Study of the Allergic Reaction in Human To Hevea

gEVE BRAZILSKY RESOLUTIONS FOR HUVEA BRASILIENSIS) was identified by allergenic proteins: heat shock protein (80 kda), proteosomal subunit (30 kda), protease inhibitor (7,6 kda) and glycel'alde-3-3-phosphate dehydrogenase (37 KDA) which were not previously looked at allergens.

Approaches to the production of hypoallergenic food products

To solve the problem of preventing food intolerance and food allergies, the following approaches are used:

Formation of the diet, excluding food allergens in the body (elimination of edible allergen);

Correction of nutrition through the use of specialized products (hypoallergenic or low allergenity, for example, based on protein hydrolyzes);

The formation of a diet that allows for adequate intestinal colonization with probiotic bacteria, in order to reduce the allergic impact on the body and regulating the immune response.

When developing hypoallergenic products, it is of interest to use the methods for modifying food allergens to reduce allergen allergenium while preserving the immunogenicity of allergens:

Change in allergenic IgE-epitopes, which creates the impossibility of IGE antibodies to recognize allergen;

Reducing the number of pronounced allergen, which helps to reduce IgE binding (there is no complete safety against product consumption);

Full removal of DNA encoding allergenic protein, i.e. absence of allergen;

The need to take into account the complementary effect of developing allergen specific antibodies to other immunoglobulins, such as IgG. It should be borne in mind that modifications can be

food allergens are subjected to non-symatic structural or functional proteins, since their changes in the allergenic structure do not affect the protein function. Changes acting on a protein function are capable of leading to death.

In the Russian market, hypoallergenic products and foods for people with food intolerance are practically not produced.

To correct the intolerance of milk proteins in adults, soy protein-based products are used. However, the shortcomings of its use are negative changes in the functioning of the gastrointestinal tract and an increasing allergy to soy proteins. Dairy products based on

brasiliensis, Allergenic Proteins Have Been Identified: Heat Shock Protein (80 KDA), Proteasome Subunit (30 KDA), ProteaSe Inhibitor (7.6 KDA) and Glyceraldehyde-3-Phosphate Dehydrogenase (37 KDA) That Previously Was Not Considered As Allergens.

Approaches to Hypoallergenic Food Production

To Solve The Problem of Food Intolerance and Food Allergy Prevention, The following: Approaches Are Used:

Following Diet That Excludes Consumption of Food Allergens (Elimination of Food Allergen);

Diet Correction using Specialized Products (Hypoal-Lergenic or with Low Allergenic Capacity, For Examples, Based On Protein Hydrolysates);

Following Diet to Ensure ADEQUATE COLONIZATION OF THE INTESTINES WITH PROBIOTIC BACTERIA IN ORDER TO REDUCE ALERGIC EFFECT AND REGULATE THE IMMUNE RESPONSE.

In The Development of Hypoallergenic Products, The Use of The Methods Modifying Food Allergens to Reduce Their Allergenic Capacity While Preserving the Immunogenicity Is of Particular Interest:

Changes in AllerGenic Ige EpitoPes That Make It Impossible for Ige Antibodies to Recognize The Allergen;

DECREASE IN THE AMOUNT OF ALLERGEN, Which Contributes to Reduction of IGE-Binding (Product ConSuption Is Not Complete Safe);

Complete Removal of DNA Encoding The Allergenic Protein, I.E. ABSENCE OF ALLERGEN;

The Need to Take Into Account The Complemenient Effect of Allergen-Specific Antibodies Production on Other Immunoglobulins, For example IgG.

IT SHOULD BE TAKEN INTO ACCOUNT THAT ONLY FOOD ALERGENS, Which Are Non-Essential Structural or Functional Proteins, Must Be Subjected to Modification, Since Changes in Their Allergenic Structure DO Not Affect Protein Function. Changes Affecting Protein Function May Lead to a Lethal Mutation.

In The Russian Market, Hypoalgergenic Products and Products for People with Food Intolerance Are Almost ABSENT.

To Correct Food Intolerance to Milk Proteins in Adults, Products Based on Soy Protein Are Used. However, The Disadvantages of Its Use Are Negative Changes in The Functioning of the Gastrointestinal Tract and Increasing Allergy to Soy Proteins. Dairy Products Based On The Principles Of

the principles of deep hydrolysis of milk proteins, have unsatisfactory organoleptic indicators (bitter taste) and high cost, which limits their production and consumption.

In the dairy industry, the main direction of obtaining low-allergy products is the production of milk-protein components (casein and whey hydrolyzates), not containing high molecular weight protein fractions in their bulk.

The most promising approach in the development of hypoallergenic products, according to the authors, is based on partial hydrolysis and subsequent selective fractionation of proteins with targeted removal of allergenic fractions. The traditional production technologies are additionally introduced the processes of hydrolysis, ion exchange, industrial chromatography, cascade ultrafiltration, silent osmosis, and the like. In addition, the authors note that the reduction of milk protein allergy can contribute to the control of the temperature modes of milk treatment, the use of certain strains of bacteria that consume peptides with a certain molecular weight, and the use of ultraviolet irradiation in order to influence the peptides.

Hypoallergenic products on meat based on the domestic industry are practically not produced. An exception is hypoallergenic meat products feeding for young children.

The organism of people suffering from food allergies and food intolerance often has a low security of the main nutrients necessary for the full life of a person. In such situations, meat raw materials is the best source of replenishment of basic nutritional nutrients: a full protein, group vitamins B, E and essential highly accessible mineral elements.

One of the principles of creating hypoallergenic products is replacing meat raw materials with a high degree of allergy to hypoallergenic. In this meat industry. V.M. Gorbatov has developed hypo-allegant canned food from pork and horseback for the dust of children from 5-7 months, which showed high therapeutic efficacy in food intolerance.

Specialists of the Far Eastern Federal University were used in the development of hypoallergenic meat pate technology, based on horseback (no antigenic affinity for proteins of cow milk and beef) and lamb (low fat content, presence of lycility, mineral elements, group vitamins B, D, E , K). Into the recipe meat pate as

milk Protein Deep Hydrolysis Have Unsatisfactory Organoleptic Characteristics (Bitter Taste) And High Cost, Which Limits Their Production and Consumption.

In The Dairy Industry, The Main Direction of Obtaining Low-Allergenic Products Is The Production of Milk Protein Components (Casein and Whey Hydrolysates) That Almost Do Not Contain High Molecular Weight Protein Fractions.

According to the authors, The most Promising To the Development of Hypoalgergenic Products Is Based on Partial Hydrolysis and Subsequent Selective Fractionation of ProTeins with Targeted Removal of Allergenic Fractions. Processes of Hydrolysis, Ion Exchange, Industrial Chromatography, Cascade Ultrafiltration, Membraneless Osmosis, etc. Are Introduced in the Traditional Technologies. In addition, the authors note that the reduction of allergenic capacity of milk proteins can be facilitated by regulating the temperature modes of milk processing, the use of special bacteria strains consuming peptides with certain molecular weight, and the use of ultraviolet irradiation to have influence on Peptides.

Hypoallergenic Meat Products Are Almost Not Produced by The Domestic Industry. The Exception IS Hypoallergenic Meat Products for Complemenient FEEDING OF YOUNG CHILDREN.

The Body of People Suffering from Food Allergies and Food Intolerance Often Has a Low Supply of Essential Nutrients Necessary for Normal Vital Functions. In Such Situations, Meat Raw Materials Are The Best Source of Main Food Nutrients: Complete Protein, Vitamins of B Group, E and Easy Available Essential Mineral Components.

One of the Principles in Hypoalgergenic Product Manufacturing Is The Replacement of Meat Raw Materials with High Allergenic Capacity by Hypoallergenic Ones. The V.m. GORBATOV ALL-RUSSIAN MEAT RESEARCH INSTUTUTE HAS DEVELOPED HYPOALLERGENIC CANNED FOOD FOOTING OF CHILDREN AT THE AGE OF 5-7 MONTHS, Which Showed High Therapeutic Effectiveness in Food intolerance.

A Similar Principle WAS Used by SpecialistS of the Far Eastern Federal University to Develop The Technology of Hypoallergenic Meat Pates Based on Horse (Does Not Possess Antigenic Affinity for Cow "S Milk and Beef Proteins) And Lamb Meat (Low Fat Content, The Presence Of Lecithin, Mineral Elements, Vitamins of B Group, D, E, K). The Formulation of Meat Pates Includes "POLYSORBOVIT-95" AS A Sorbent

the sorbent is introduced Polysorbovit-95 and hypoallers-gene or detoxifying ingredient from the dietary fiber group - pectin.

A.I. Jarins with colleagues developed a structural-parametric model of a hypoallers-gene product with an assessment of the quality adequacy, in which the replacement of animal meat proteins and birds, dairy proteins and proteins of egg-producers for adequate drugs and biological values \u200b\u200bof white-containing drugs, in particular, soy protein drugs. However, studies of recent years show that children are sensitized to proteins of cow's milk, allergic reactions to soy mixtures are developing.

Belarusian scientists presented the results of research on the development of an algorithm for creating meat products of hypoallergenic focus, in which the decrease in the allergenicity of meat products occurs not only due to the selection of raw materials (horse, lamb, beef steam, boiled, low-fat pork varieties, lamb, Turkey, rabbit, offal (liver, kidneys)), but also technological processing (cooking, double digestion, freezing). With different methods of processing meat and meat products (drying, cooking, frying, freezing, enzymatic hydrolysis) allergenicity decreases.

In protein hydrolysis during proteolysis, antigenic areas (epitopes) are destroyed, therefore allergenicity of protein hydrolyzes decreases. The degree of decrease in the allergenicity of protein hydrolyzates depends on the type of protease used. Non-specific proteases or mixtures of proteases more effectively reduce protein allergenicity than specific. The dependence of allege into the degree of hydrolysis was revealed: the higher it is higher, the more allergenicity is reduced.

Specialists of the VNIIMP them. V.M. Gorbatov and VNII food biotechnology were assessed by mushroom and bacterial enzyme preparations in determining the substrate specificity with respect to bovine serum albumin - the main animal protein of beef. As a result of experiments, it was found that the most profound hydrolysis of beef protein substances is carried out by an enzyme preparation of a mushroom protease containing the peptidase complex and proteases obtained by the fermentation of the selection strain of Aspergillus ORY-ZAE. This enzyme preparation allows for biotransformation of protein serum albumin to products that do not have allergenic properties (to amino acids and low molecular weight peptides).

aND HYPOOALLGENIC OR DETOXIFYING INGREDIENT FROM THE GROUP OF DIETARY FIBERS, PECTIN.

A.I. Zharinov et al. developed a structural and parametric model of hypoallergenic food product with an assessment of quality adequacy, which provided for a replacement of animal meat proteins, milk proteins and egg proteins with protein-containing preparations adequate in composition and biological value, in particular, soy protein preparations . However, Studies in Recent Years SHOWED THAT CHILDREN SENSITIZED TO COW "S MILK PROTEINS ALSO DEVELOPED ALLORGIC REACTIONS TO SOY PRODUCTS.

Belarusian scientists presented research results concerning development of the algorithm for creating hypoallergenic meat products, in which the reduction in meat products with high allergenic capacity was not only due to the selection of raw materials (horse meat, mutton, steamed or boiled beef, low- Fat Pork (boiled and stewed), Lamb, Turkey, Rabbit, BY-Products (Liver, Kidneys)), But Also Due To The Technological Processing (Boiling, Double Boiling, Freezing). ALLERGENIC CAPACITY IS REDUCED WITH VARIOUS METHODS OF MEAT AND MEAT PRODUCTS PROCESSING (Drying, Boiling, Roasting, Freezing, Enzymatic Hydrolysis).

DURING PROTEOLYSIS, ANTIGENIC SITES (EPITOPES) in Protein Hydrolyses Degrade, Therefore, The Allergenic Capacity of Protein Hydrolysates Decreases. The Degree of Allergenic Capacity Depends on the Type of Protese Used. Nonspecific Proteases or Protese Mixtures Reduce Aller-Genic Capacity of Proteins More Effectively Thanpe The Specific Ones. The Dependence of Allergenic Capacity On The Degree Of Hydrolysis Is Revealed: The More The Degree Is, The More The Merrgenic Capacity Decreases.

Specialists from the v.m. Gorbatov All-Russian Meat Research Institute And The All-Russian Scientific Research Institute of Food Biotechnology Evaluated Fungal and Bacterial Enzyme Preparations to Determine The Substrate Specificity for Bovine Serum Albumin, The Main Protein of Beef. AS A Result of The Experiments, It Was Found That The Deepest Hydrolysis of Beef Protein Was Produced by Enzyme Prepare from Fungal Protese Containing A Complex of Peptidases and Proteases Obtained by Fermentation of Aspergillus Oryzae Selective Strain. This Enzyme Preparation Allows Biotransformation of Serum Albumin to Products with No Allergenic Properties (To Amino Acids and Peptides of Low Molecular Weight).

It should be noted that various types of treatment, destroying proteins and modifying 1ow-binding properties due to the change in the conformation of epito-dials, can lead to the formation of new epito-dues, and thus - to improving product allergenicity, for example, reactions to boiled / fried meat at the same time . Heating also does not always destroy allergens, and sometimes enhances their effect (for example, fried peanuts).

To avoid allergens falling into food in the process of their production, the institute has developed an algorithm for managing allergens. Allergen controls during the production process makes it possible to reduce the risks of food allergens in the finished product, and when it is inevitable to find it in the product - to inform the consumer about its finding to minimize health consequences due to preventive marking, which includes additional information about the possibility of cross-contamination. Products.

Conclusion

The number of people with food hypersensitivity is growing every year. Today, the food industry cannot fully meet the need for hypoallergenic and low-allergenic food products for this category of citizens.

Existing hypoal-lever products are based on the elimination of a substance that causes negative reactions of the organism, from the composition of the food product, the use of low-allergenic raw materials, additional methods of thermal treatment, hydrolysis of enzyme preparations to low molecular weight products that do not have allergenic properties.

Discovery in medicine In recent years, detailing and classification of food hypersensitivity requires further fundamental research, with the involvement of specialists of related disciplines - doctors, biochemists, nutritionists, to develop modern technological methods for creating products with specified properties for people with food hypersensitivity (food intolerance and food allergies ). Existing modern proteoma methods of research make it possible to study the allergenicity of proteins of various types of meat, intolerance to food ingredients, the effect of technological treatment on the degree of allergenicity of the final product and create hypoallergenic and low-allergenic products on a meat-based basis.

IT SHOULD BE NOTED THAT VARIOUS TREATMENTS DESTROYING PROTERTIES AND MODIFYING IGE-BINDING PROTERTIES DUE TO CHANGES IN THE UNITED NEW EPITOPES MAY LEAD TO THE FORMATION OF THE NEW EPITOPES, AND THEREBY TO INCREASE IN THE THE ALERGENIC CAPACITY OF THE PRODUCT, FOR EXAMPLE, RESPONSE TO BOOLED / Fried Meat At The Same Time. Heat Treatment Also Does Not Always Destroy Allergens, And Sometimes Enhances Their Effect (For example, Roasted Peanuts).

IN ORDER TO AVOID THE TRANSFER OF ALLERGENS INTO FOOD PRODUCTS DURING THEIR PRODUCTION, THE INSTITUTE DEVELOPED AN ALGORITHM TO CONTROL ALLERGENS. The Control of Allergens During The Production Process Helps To Reduce The Risks of Food Allergen Transfer INTO The FINISHED PRODUCT. IF The Product, This Approach Allow to Inform The Consumer of Its Presence In Order to Minimize Health Consequences Through Special Labeling That Includes ADDITIONAL INFORMATION ON THE POSSIBILITY OF PRODUCT CROSS CONTAMINATION.

The Number of People with Food HyperSensitivity GROWS Every year. Today, The Food Industry Cannot Fully Meet The Needs for Hypoallergenic and Low-Allergenic Food Products for This Group of Consumers.

Existing Technologies For Hypoallergenic Products Are Based On The Elimination of The Allergenic Substance, The Use of Low-Allergenic Raw Materials, Additional Heat Treatment, Enzymatic Hydrolysis to Product Low-Molecular Products Wort Allergenic Properties.

Recent discoveries in medicine, detailing and classification of food hypersensitivity require further researches of physicians, biochemists, nutritionists to develop modern techniques for creating products with specified properties for people with food hypersensitivity (food intolerance and food allergy). Modern proteomic research methods allow to study allergenic capacity of proteins from various types of meat, intolerance of food ingredients, impact of processing on the degree of allergenic capacity of the final product and to create hypoallergenic and low-allergenic meat-based products.

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Information about the authors belonging to the organization Lisitsyn Andrei Borisovich - Doctor of Technical Sciences, Professor, Academician of the Russian Academy of Sciences, Director, All-Russian Research Institute of Meat Industry named after V.M. Gorbatov.

109316, Moscow, ul. Talalichina, 26 Tel.: Slave. + 7-495-676-95-11 E-mail: info @ vniimp.ru

Chernukh Irina Mikhailovna - Doctor of Technical Sciences, Professor, Corresponding Member of the Russian Academy of Sciences, Leading Researcher, Experimental Clinic-Laboratory of Biologically active substances of animal origin, All-Russian Research Institute of Meat Industry named after V.M. Gorbatov

109316, Moscow, ul. Talalichina, 26 Tel.: Slave. + 7-495-676-97-18 E-mail: [Email Protected]

Lunina Olga Ivanovna - Candidate of Technical Sciences, Senior Researcher of the Department of International Relations, All-Russian Research Institute of Meat Industry named after V.M. Gorbatova 109316, Moscow, ul. Talalichina, 26 Tel.: Slave. + 7-495-676-97-18 E-mail: [Email Protected]

Received 03/28/2017

AUTHOR INFORMATION AFFILIATION

Lisitsyn Andrey Borisovich - Doctor of Technical Sciences, Professor, ACADEMICIAN OF THE RUSSIAN ACADEMY OF SCIENCES, DIRECTOR, THE V.M. Gorbatov All-Russian Meat Research Institute 109316, Moscow, Talalikhina Str., 26 Tel: + 7-495-676-95-11 E-mail: [Email Protected]

Chernukha Irina Mihailovna - Doctor of Technical Sciences, Professor, Correspondsponding Member to the Russian Academy of Sciences, Leading Research Scientist of Experimental Clinic - Laboratory "Bio-Logically Active Substances of An An Animal Origin", The V.M. Gorbatov All-Russian Meat Research Institute 109316, Moscow, Talalikhina Str., 26 Tel: + 7-495- 676-97-18 E-mail: [Email Protected]

Lunina Olga Ivanovna - Candidate Of Technical Sciences, Senior Research Scientist, Department of International Scientific And Technical Cooperation, The V.M. Gorbatov All-Russian Meat Research Institute 109316, Moscow, Talalikhina Str., 26 Tel: + 7-495- 676-97-18 E-mail: [Email Protected]

Food allergies is characterized by an increased sensitivity of the body to food products and the development of clinical symptoms of non-efficiency of food, mediated by the participation of the immune system reactions.

In clinical practice, as a rule (and often perfectly erroneous), the diagnosis of "food allergies" is raised in the presence of a causal connection between the intake of food and the development of clinical symptoms of its intolerance, as a result of the disagreement and disagreements arise in the interpretation of the very concept of food allergies. Moreover, food allergies are only one of the many reactions falling under the definition of "increased sensitivity to food", which includes reactions associated with food intolerance, differing in the development mechanism, clinical symptoms and the forecast. Most often it is food intolerance, food allergies and disgust for food.

Currently it is well known that the mechanisms of food intolerance are very diverse, the reactions to food having an allergic nature are much less common than many doctors consider. Probably, for this reason, there is still no accurate statistical data related to the prevalence of true food allergies.

According to domestic and foreign researchers, the prevalence of food allergies varies widely: from 0.01 to 50%.

Food allergies, as a rule, develops for the first time in childhood.

Among people with diseases of the gastrointestinal tract and the hepatobiliary system, the prevalence of allergies to food is higher than among persons who do not suffer from this pathology (this indicator ranges from 5 to 50%. (Nogaller A., \u200b\u200b1983)).

Often, food allergies develop in people who suffer from atopic diseases, in particular when Polynomia. According to our data, allergic reactions to food products are noted: in patients with atopic dermatitis - in 48% of cases, in patients with polynomation - in 45%, in patients with bronchial asthma and in patients with allergic rhinitis - in 15% of cases.

Almost any food product can act as an allergen and cause food allergies. However, there are foods that have pronounced allergizing properties and having weak sensitizing activity. The most expressed sensitizing properties in products of protein origin containing animals and vegetable proteins, although there is no direct relationship between protein content and allergenity.

Currently, the generally accepted unified classification of food allergies does not exist. Among the reactions of intolerance to food products, you can select the reactions to food having toxic and non-toxic.

Toxic reactions are evolving after the use of foods containing toxic substances in the form of impurities. Clinical manifestations of these reactions and their severity depend on the dose and chemical properties of toxic compounds, and not from the type of food product.

Among non-toxic reactions to food, two main types of intolerances differing in development mechanisms are distinguished: immunologically mediated reactions to food products due to disorders in the immunity system (food allergy), and non-immunological reactions (food intolerance).

Food intolerance can develop in diseases of the gastrointestinal tract, the hepatobiliary system, neuroendocrine pathology, congenital and acquired enzymopathies and other diseases that are not related to impairment in the immunity system.

Among the immunologically indirect reactions to food, two main types of food allergies can be distinguished: true food allergies (IPA) and false food allergies (LPA), or pseudo-allery. According to the Scientific and Advisory Office of the SSC - Institute of Immunology Fu "MedbioExstrom" under the Ministry of Health of Russia, 65% of patients suffering from allergic diseases indicate the intolerance of food. At the same time, true allergic reactions to food allergens are detected in approximately 35% of them, and pseudo-allergic - in 65%. According to the Scientific and Advisory Department of the NTS Clinic - Institute of Immunology of the Ministry of Health of the Russian Federation, true food allergies as the main allergic disease in the structure of all allergopathology over the past 5 years accounted for up to 5.5%, the reaction to impurities in the composition of food products - 0.9%.

Factors contributing to the formation of food allergies

With the normal functioning of the tract and hepatobiliary system, sensitization to food products entering enteral means does not develop. Instrumental importance in the formation of sensitization to food products has a genetically deterministic predisposition to allergies. As studies have shown, about half of the patients suffering from food allergies, there is a burdened family or own allergic history, that is, either they themselves suffer from any allergic diseases (pollinosis, atopic bronchial asthma) Or these ailments suffer from their closest relatives (parents, brothers, grandmothers, etc.).

The formation of food allergies contribute to nutritional disorders during pregnancy and feeding (the abuse of certain products with pronounced sensitizing activity: fish, eggs, nuts, milk, etc.).

Provoking factors for the development of food allergies are the early translation of the child to artificial feeding; Nourishing disorders in children, expressed in the inconsistency of the volume and the ratio of food ingredients weighing and age of the child; Related diseases of the gastrointestinal tract, liver disease and biliary tract, etc.

Normal digestion and suction of food products is provided by the state of the neuroendocrine system, the structure and function of the gastrointestinal tract, the hepatobiliary system, the composition and volume of digestive juices, the composition of the intestinal microflora, the state of the local immunity of the intestinal mucosa (lymphoid fabric, secretory immunoglobulins, etc.) and other factors.

Normally, food products are cleaved to compounds that do not have sensitizing properties (amino acids and other non-antigenic structures), and the intestinal wall is impermeable for non-absolute foods that have or may have a sensitizing activity or the ability to cause pseudo-allergic reactions.

The development of food allergies is provoked by common agents and children factors. First of all, it is an increase in the permeability of the intestinal mucosa, which is noted under inflammatory diseases of the gastrointestinal tract.

The impairment (reduction or acceleration) of the absorption of high molecular compounds may be due to a violation of the stages of the transformation of the edible substrate in the digestive tract with an insufficient function of the pancreas, enzymopathy, dyskinesia of the gusts and intestines, etc.

Meanous meals, rare or frequent meals lead to a violation of the secretion of the stomach, the development of gastritis, hypersection of mucus and other disorders causing the formation of food allergies or pseudo-allergies.

The formation of hypersensitivity to food products of protein nature has an impact of not only the amount of food and diet disorders, but also the acidity of the gastric juice (corner of A., 1985).

In the course of experimental studies, it was found that with an increase in the acidity of the gastric juice, the absorption of non-proposed proteins is reduced.

It is shown that the disadvantage in the feed of calcium salts contributes to an increase in the absorption of non-proposed proteins.

Different researchers using modern diagnostic methods (electronically microscopic, histochemical, histological and others), found that 40- 100% of the surveyed patients with food allergies (Nogaller A. M., 1983; Lesof M. et al., 1986) have The place of metabolic disorders, a decrease in enzyme activity, an increase in the permeability of the mucous membrane of the digestive tract.

Nevertheless, even with the existing heightened permeability of the gastrointestinal mucosa and excessive arrival of antigenic substances through the intestine, the development of food allergies is impossible without the genetically determined ability of the body to produce allergic antibodies, for example, type IgE.

Immune mechanisms for the development of food allergies

At the heart of true allergic reactions to food products lies with sensitization and immune response to the re-administration of edible allergen.

When the food product enters the body for the first time (in children), antigens of food fall into the bloodstream, in response to which in the body they begin to synthesize AT related to the IGA class.

In a healthy person, the absorption of the antigen of the food product and the flow of it in the blood flow ensures the tolerance of the immune system when it falls into the body, and this process is under genetic control.

Food allergies can develop with genetically deterministic antigensical predisposition to the formation of allergy to food antigens involving antibodies of class IgE.

However, genetic factors are not fundamental in the formation of food allergies, which is confirmed by observations over monosic twins, when an allergic disease that has developed from one of the twins does not occur among the second.

Food allergies can flow through the mechanisms of hypersensitivity immediate and slow-type.

The most studied nutritional allergies developed by the mechanisms of the first type (IgE-mediated). To form food allergies, the food allergen must have the ability to induce the function of T-helpers and to coal the activity of T-suppressors, which leads to an increase in IGE products. In addition, the allergen must have at least two identical determinants, located apart from each other, binding receptors on target cells, followed by the release of allergy mediators.

Along with IgE-AT, antibodies of the IGG4 class antibodies are essential in the mechanism of development of food allergies, especially with allergies to milk, eggs, fish.

Sometimes food allergies can develop on some nutritional supplements, especially nzo-dyes (in particular, tartrusin), in this case the latter perform the role of haptins and, forming complexes with protein, for example, with serum albumin, become full antigens, which are produced in the body. Specific Antibodies.

The existence of an IGE antibody antibody against tartrusine was proven during animal experiments; These antibodies and in humans are detected when using Rast.

It is also possible to develop hypersensitivity of a slow-type type, manifested in the form of eczema, with food products containing nitrogen-dyes, benzylhydrooxitoluen, butylhydroxyanisol, chinin, etc. In particular, it has been established that food additives can induce the development of the myth factors, the MEDIATOR GZT and provoke development Slow allergic reactions to food products containing these additives.

To date, the mechanisms for the formation of true food allergies have not been studied enough.

False allergic reactions to food products (pseudo-allery)

More often, food intolerance proceeds through the mechanisms of pseudo-allergic reactions. At the heart of the development of pseudo-allergic reactions to food products lies with the non-specific release of mediators (mainly histamine) from allergy target cells.

The LAP, which flows through the mechanisms of pseudo-allergies, differs from other reactions associated with food intolerance, the fact that the same mediators are involved in its implementation, as for true food allergies (histamine, leukotrienes, prostaglandins and other cytokines), but released from Non-specific targets allergies.

This is possible with the direct effects of the antigens of the food substrate (without the participation of allergic antibodies) on target cells (obese cells, in particular) and indirectly, when activated by an antigen of a number of biological systems (kinine, complement system, etc.). Among the mediators at LAP, the histamine is given a special role.

It is known that the development of pairs for food products provokes a number of factors: excessive admission to the histamine body when using (abuse) of food products rich in histamine, tiramine, histamineolybererators; excess formation of histamine from the food substrate; increased suction of histamine with functional insufficiency of the gastrointestinal mucosa; Increased release of histamine from target cells; Violation of the synthesis of prostaglandins, leukotrienes.

Increasing the level of histamine in blood at LPA may be observed not only with increased admission or formation of it in the intestinal lumen, but also in disruption of inactivation.

Thus, with inflammatory diseases, the GTS decreases the secretion of mucoproteins involved in the inactivation of histamine. In some diseases of the liver, the formation of monoaminoxidase is sharply reduced, which also leads to an increase in the level of histamine in the blood.

The most often pairs are developing after the use of products rich in histamine, tiramin, histamineolybers. In tab. 2 The most common products with high histamine content are presented.

Pseudo-allergic reactions in the form of urticaria, headaches, dizziness, dyspeptic disorders, vegetual reactions, etc. can occur with the use of products rich in tiramin.

Among the factors contributing to the development of symptoms of pairs for food products rich in Tiramin: excessive consumption of products with a high content of tiramine, excess form of tiramine by synthesizing its intestinal flora, partial deficiency of platelet monoaminoxidase, leading to incomplete destruction of endogenous tiramine.

In tab. 3 presents the most common products with a high content of Tiramine (according to Hanligton E.).

In recent years, there have been an increase in steam on impurities with high physical and biological activity (pesticides, fluorine-containing, chloroorganic compounds, sulfur compounds, acid aerosols, microbiological products, etc.), polluting food products.

Often the reason for the development of pairs for food products is not the product itself, but various chemical additives made to improve taste, odor, colors and providing storage duration. To the category of food additives there is a large group of substances: dyes, flavors, antioxidants, emulsifiers, enzymes, thickeners, bacteriostatic substances, preservatives, etc. Among the most common food dyes can be mentioned tartrazine, providing orange-yellow staining of the product; Sodium nitrite, retaining red in meat products, etc.

For canning, sodium glutamate, salicylates, in particular acetylsalicylic acid, and others are used for canning.

Vazoactive amine - Betaphenylethylamine contained in chocolate, in fermented products (for example, cheeses), fermented cocoa beans causes symptoms in patients like those arising under the influence of Tiramine.

The mechanism of action of food impurities and food additives may be different:

• induction of steam - due to the direct action of drugs on sensitive target cells of allergies, followed by non-specific liberation of mediators (histamine);
• violation of the metabolism of arachidonic acid (tartrazine, acetylsalicylic acid) due to the inhibition of cyclooxygenase and disorders of the balance in the direction of the preemptive formation of leukotrienes, which have a pronounced biological effect on various fabrics and systems, causing a spasm of a smooth muscles (bronchospasm), hypersecretion of mucus, increasing the permeability of the vascular wall , reduction of coronary blood flow and others;
• activation of the complement on an alternative way next to nutritional supplements, while complement activation products have an effect of allergy mediators;
• inhibition of enzyme activity of monoaminoxidase.

It should be noted that the division of food allergies to the true and false very conditionally. One patient may develop reactions to food products caused by the participation and specific reactions of immunity, and pseudo-allergic.

Clinical manifestations

Clinical manifestations of food allergies are diverse in shape, localization, severity and forecast. Eliminate systemic allergic reactions arising after the effects of edible allergen, and local reactions. Systemic allergic reactions to food can develop and proceed with preferably lesions of various organs and systems. The most early and typical manifestation of true food allergies is the development of oral allergic syndrome (OAS). The OAS is characterized by the appearance of periorel dermatitis, itching in the oral cavity, numbness and / or a sense of "cutting" of the language, solid and / or soft sky, the swelling of the oral mucosa after the use of the guilty food allergen.

System reactions

The most severe manifestation of true food allergies is anaphylactic shock. Anaphylactic shock with IPA is distinguished by the rate of development (from a few seconds to 4 hours), the severity of the flow (collapse, asphyxia, loss of consciousness, convulsive syndrome, generalized wretchedness and angioemical swelling of quinque, diarrhea, vomiting, involuntary urination and defecation, etc.), serious The forecast (mortality in anaphylactic shock ranges from 20-40% to 70%).

Unlike IAR, with pairs for food products, system reactions can manifest itself in the form of anaphylactoid shock.

Anaphyactoid shock caused by the consumption of the food product develops according to the mechanisms of pseudo-allergies, on clinical symptoms can resemble anaphylactic shock, but differs from the latter lack of polysindrome and a favorable forecast.

In particular, symptoms are noted primarily on the side of one of the organism systems, such as the drop in blood pressure and loss of consciousness, but all other parameters (skin, mucous, breathing, etc.) are not changed. The outlook for an anaphylactoid shock is favorable, and with timely appointment of adequate symptomatic therapy, the clinical effect is observed quickly, as a rule, in the first hours from the start of therapy.

Gastrointestinal manifestations of food allergies

To the most frequent gastrointestinal clinical manifestations of food allergies include: vomiting, colic, anorexia, constipation, diarrhea, allergic enterocolitis.

Vomiting in food allergies can occur from a few minutes, up to 4-6 hours after meals, more often than the patient tears eaten food. Sometimes vomiting takes a stubborn character, imitating acetional. The occurrence of vomiting is mainly due to the spastic reaction of the gatekeeper when the edible allergen is in the stomach.

Allergic colic abdominal pains can be observed immediately after eating or a few hours later and are caused by the spasm of a smooth intestinal musculature associated with a specific or non-specific liberation of allergy mediators. Pain in the stomach is usually intensive in nature and in some cases have to resort to the counseling of the surgeon. Abdominal pain in food allergies may not be so intense, but permanent, accompanied by a decrease in appetite, the presence of mucus in a chair and other dyspeptic disorders.

The absence of appetite in food allergies can be selective in relation to the causal-significant food allergenium or a general decrease in appetite can be marked.

Podcoms in food allergies are due to the spasm of smooth muscles of different sections of the intestine. When X-ray-sensitive studies, as a rule, it is possible to determine the spasmated intestinal areas.

The frequent, liquid chair appearing after the reception of the causal and meaningful food allergen is one of the most common clinical symptoms of food allergies in both adults and in children. Especially often diarrhea is observed in food allergies to milk.

Allergic enterocolitis in food allergies is characterized by sharp pain in the abdomen, the presence of meteorism, a liquid chair with a vitreous mucus, which contains a large amount of eosinophils. Patients with allergic enterocolitis complain about harsh weakness, decreased appetite, headache, dizziness. Allergic enterocolitis as a manifestation of food allergies occurs more often than it is diagnosed.

In histological examination, hemorrhagic changes, expressed tissue eosinophilia, local edema and mucus swelling are detected in patients with allergic enterocolitis.

Skin manifestations, or allergling, with food allergies are most widely distributed, both in adults and children.

In children under a year, persistent diameters can serve as one of the first signs of food allergies when carefully leather care, the appearance of perianal dermatitis and perianal itch arising after feeding. Localization of skin changes in food allergies is different, but more often they appear first in the area of \u200b\u200bthe face, periorally, and then can spread over the entire surface of the skin. At the beginning of the disease in food allergies, a clear connection of the skin exacerbations with the reception of causing food allergen is detected, but over time, allergic changes from the skin are observed and constantly recurring the current, which makes it difficult to determine the etiological factor.

For true food allergies, the most characteristic skin manifestations are the urbin, angioedema swelling of quinque and atopic dermatitis.

Pseudo-allergic food reactions are distinguished by polymorphism of skin rashes: from ultrasound (10-20% of those surveyed individuals), papular (20-30%), erythematous, maculse (15-30%) to hemorrhagic and browse rashes. Skin manifestations with any form of food allergies are accompanied, as a rule, itching of different intensity. Along with skin manifestations, patients with food allergies have a decrease in appetite, poor sleep, asthenonevrotic reactions.

Respiratory manifestations of food allergies

Allergic rhinitis in food allergies is characterized by the appearance of abundant mucous-watery discharge from the nose, sometimes nasal congestion and the difficulty of nasal respiration.

During rhinoscopy, the swelling of the mucous membrane of the nasal shells, having a pale-blue color.

Often, along with the rinorerium or the swelling of the mucous membranes, sneezing is observed, itching the skin around the nose or in the nose. The most common cause of the development of allergic rhinitis in patients with food allergies is fish and fish products, crabs, milk, eggs, honey, etc.

Food bronchial asthma

According to the majority of researchers, the role of food allergens in the development of bronchial asthma is small. In our studies, clinical manifestations of food allergies in the form of seizures of choking were observed approximately in 3% of cases, and although the role of food allergens in the pathogenesis of bronchial asthma is challenged by a number of researchers, the value of food allergens in the development of allergic reactions from the respiratory tract is undoubtedly, and, therefore, this The question requires further study and clarification.

Rare clinical manifestations of food allergies

More rare clinical manifestations of food allergies include changes from the blood system, urinary, neuroendocrine, etc.

Symptoms of allergic granulocyptopenia are more often observed in children and are clearly connected with the reception of causing food allergen.

The clinical picture of allergic granulocyptopenia, due to sensitization to food allergens, is characterized by a rapid beginning associated with meals, when the church appears, sharp general weakness, sore throat. Later, angina joins with necrotic and ulceal lesions of the almonds, sky, oral mucosa and lips. Patients marked the pallor of skin, lymphoacident, increasing the spleen. These symptoms disappear against the elimination diet.

Allergic thrombocytopenia

The cause of the development of allergic thrombocytopenia can serve as sensitization to milk, eggs, fish and fish products, marine barbell animals, etc.

We observed the development of allergic thrombocytopenia in children with sensitization to milk and carrots after eating carrot juice and cottage cheese. (Sokolova T.S., Lusus L. V., Roshal N. I., 1974).

In adults, the cause of the development of allergic thrombocytopenia can serve sensitization to food cereals, milk, fish, etc.

The diagnosis of allergic thrombocytopenia is almost never installed immediately due to the absence of specific symptoms.

The disease begins with the development of fever, hemorrhagic spindles on the skin, pain in the abdomen, arthralgia. When analyzing urine, there is a protein, leukocytes, single erythrocytes.

Changes in peripheral blood are ambiguous. In some cases, there is a sharp decrease in platelets content, in others - indicators of platelet content remain normally, but hemorrhagic rashes appear on the skin, and pathological changes (protein, leukocytes, red blood cells) are noted in urine tests.

The diagnosis of food allergies in all of the above cases is established not only on the basis of a positive allergological, food, pharmacological history, as well as the results of a specific allergological examination with food allergens, but also with the full disappearance of symptoms after the elimination diet.

Clinical manifestations of food allergy in the form of migraines are described (Haningten E., 1986, etc.), fever, neurites, Meniere diseases, heart rate disorders, depression development, etc. However, in many cases, the causal role of food allergens in the development of these symptoms is represented Doubt because the diagnosis was put on the only basis that there is an anamnestic causal relationship between the development of symptoms and food intake, and was not confirmed by the results of a specific allergic examination.

Often under the mask of food allergies, diseases of the gastrointestinal tract or acquired enzymopathy, gliste invasions, mental illness, etc. are hidden, and others.

Diagnosis of food allergies

Diagnosis of food allergy represents great difficulties due to the lack of uniform methodological approaches, unified methods for diagnosing food intolerance to identify all the variety of mechanisms involved in the implementation of hypersensitivity reactions to food products.

Principles of diagnosis of food allergies are the same as for all other allergic diseases. The diagnosis is aimed at identifying specific allergic ates or products of the specific interaction of AT with AG, as well as to identify reactions to food products flowing through the hypersensitivity of a slow-type type.

During the diagnosis of food allergies, special attention is paid to the help of the history of living conditions and illness, allergological, food and pharmacological history, as well as the results of a specific allergological examination and clinical and laboratory data.

Unlike other allergic (atopic) diseases, in food allergies, the history does not allow with a sufficient degree of reliability to assess the nature of food intolerance. The presence of communication between the development of the reaction and the reception of certain foods does not always indicate the allergic nature of hypersensitivity to food, and may be due to completely different mechanisms, in particular pathology from the heading and the hepatobiliary system.

In the food allergy, the collection of allergological history, including family, pharmacological and food, requires special care.

When assessing the food history, close attention should be paid attention to the deadlines for the development of an allergic reaction after meals, the features of the flow of clinical symptoms, the duration of the reaction flow, possible changes in the patient's state after eliminating the guilty food product, whether to eliminate the symptoms of the reaction to prescribe a patient with medicines to eliminate the reaction symptoms, And for a number of other signs.

It also matters the fact that the patient took this food product earlier and how it was transferred. Food history data must be compared with the results of the analysis of the food diary.

When collecting a pharmacological anamnesis, the doctor must identify the degree of tolerance of all groups of medicines that the patient ever received. In the case when the patient did not receive medicines, in the corresponding column it should be specified.

When collecting a pharmacological history, special attention should be paid to information on how the drug (inside or parenterally) was introduced, in which dose, for which the introduction of the drug developed the reaction.

Under an interview with the patient, the doctor must obtain comprehensive information on the results of previously conducted clinical laboratory research in order to have an idea of \u200b\u200bthe functional state of various organism systems.

Clinical Laboratory Studies

In the food allergy in peripheral blood, eosinophilia is often detected in the range of 10-12%.

In food allergies with clinical manifestations of allergic rhinitis, conjunctivitis, respiratory symptoms in secrets from the nose, eye, bronchi can also detect eosinophils, from 4 to 90%.

Normally in the nose secret, the content of eosinophils does not exceed 2%, and in sputum - 10%.

The cytological study of smears (prints) with mucous membranes (nasal cavity, conjunctivations, sputum, etc.) is an affordable test that allows you to indirectly clarify the nature of the reaction (allergic, infectious or other).

In a number of works (Nogaller A. M., Gorbunov Yu. V.) was indicated for the possibility of using for the diagnosis of food allergies of some functional and radiological methods after the use of "allergic breakfast".

The authors noted changes in gastrograms comparable to clinical gastrointestinal symptoms, within an hour after receiving the "allergenic breakfast". With radiological studies carried out using contrasting substances and performed after the introduction of a causally significant allergenic product, a delay in the emptying of the stomach associated with pylorospasm, expansion of the stomach and an increased intestinal peristalistic was observed.

It should be noted that the diagnostic value of the X-ray methods of research in food allergies is doubtful, and in children's practice it is simply unacceptable to use these methods. Consequently, such studies are rather historical value.

Skin tests

Skin tests with food allergens should be included in the survey plan of patients with food allergies. However, their informativeness and diagnostic value are becoming completely obvious with true food allergies flowing through an IgE-mediated mechanism.

In the food allergies flowing through other humoral types of allergic reactions, the skin tests with food allergens are negative.

The informativeness of intradermal tests conducted to diagnose food allergies flowing through the mechanisms of hypersensitivity of the slow (cellular, IV type) is very controversial.

The possibility of obtaining false-positive and false-negative results of skin testing with food allergens is not excluded.

Provocative methods

Provocative tests refer to the most reliable methods for diagnosing allergies. Given that these tests can lead to the development of a severe systemic reaction, they are recommended to be carried out only in the hospital or outpatient conditions, in an allergological office that exists on the basis of a multidisciplinary hospital with the separation of intensive therapy. A federal provocative test is often used to diagnose food allergies. 2 weeks before carrying out a provocative test, an eliminational diet is prescribed with the exception of the alleged causal of food allergens. Oral provocative test is carried out in the morning, on an empty stomach, against the background of the overall well-being of the patient. Dry or lyophilized food products can be used as food allergens (milk powder, egg powder, flour, nuts, meat, etc.). The estimated food allergen (8 mg), enclosed in a capsule (for example, gelatinous), is allowed to swallow the patient, after which it is observed for 24 hours by fixing subjective and objective indicators: complaints, condition of skin and mucous membranes, fvd, hesitary blood pressure, Heart rate, dual status, etc. If for 24 hours, allergy symptoms do not appear, the test is repeated after a day, but the dose of the allergen administered increases to 20 mg. In the case of a negative result, the test is repeated after a day, each time doubles the dose of the injected food dry product, gradually bringing it to 8000 mg, which corresponds to 100 g of the source food. If, after the introduction of 8000 mg of food allergen, the reaction will not follow, testing is terminated and believed that the test product is not a food allergen in this patient. Little children who cannot swallow the capsule, the food allergen can be added. The scheme for conducting provocative tests in children is the same as in adults, but the dose of intricate food allergens fluctuates from 8 mg to 2000 mg. In the food allergies, clinical symptoms of intolerance, as a rule, appear 2-12 hours after provocative introduction of the food product: Skin rashes, decrease in FVD by 15% or more of the initial values, gastrointestinal symptoms, etc. Provocative tests are not appointed with those products which (on the basis of anamnesis) can cause severe systemic reactions.

For diagnosis of food allergies, the following tests were previously used: the leukocytolysis reaction, leukocyte alteration reactions, the reaction of blasttransformation of lymphocytes, immune sticking reactions, leukopenic and thrombopenic tests. Currently, these tests for the diagnosis of food allergies are not prescribed or are used very rarely due to their non-informative.

The "hemokode" method for the diagnosis of true food allergies cannot be used, since it cannot be detected specific allergic antibodies to food products.

Other diagnostic methods for researching food allergies

The most informative studies that make it possible to identify food allergies include a radio allergosorbent test (rash), an enzyme immunoassay analysis (ELISA), as well as a test using SAR-System, Mast-Cla-System and others. Informativeness and reliability of agglutination tests, precipitation, passive reaction Hemagglutination for the diagnosis of food allergies is very controversial, so these methods are rarely used. A certain clinical significance is identified in the peripheral blood of patients suffering from food allergies, eosinophilia, and the presence of eosinophils in the coprogram is also characterized.

Differential diagnosis of food allergies should be carried out with diseases of the gastrointestinal tract, mental disorders, metabolic disorders, intoxication, infectious diseases, anomalies for the development of the tract, insufficiency of the endocrine function of the pancreas, celiac disease, IDC, an overdose of drugs, disaccharidase insufficiency, endocrine pathology, irritable syndrome, etc. .

Treatment of food allergies

The basic principles of the treatment of food allergies are an integrated approach and a stagnation in conducting therapy, aimed at eliminating allergy symptoms and to the prevention of exacerbations. An adequate rational nutrition, corresponding to the volume and the ratio of food ingredients of the patient's age, its weight, concomitant somatic diseases and other factors is essential.

With true food allergies, as in any other allergic disease, specific and nonspecific methods of treatment are applied.

Nonspecific methods or pharmacotherapy are aimed at eliminating the symptoms of the developed disease and the prevention of exacerbations.

One of the most important mediators responsible for the development of clinical symptoms of food intolerance is histamine.

A wide range of pharmacological action of histamine determines the diversity of clinical manifestations associated with its release from fat cells and basophils, and involvement in the reaction of different tissues, organs and systems. Due to the most important role of histamine in the development of both true and false food allergies, a special role in the treatment of the disease is given to the appointment of antihistamine drugs. With acute systemic manifestations of food allergies (IPA, LPA) antihistamines I generation I am generation (Tuese, Supratine) are administered parenterally. With clinical symptoms of light and moderate severity, antihistamines of new generation and their generics are used more often: Ebastin (Kestin), Cetirizin (Zirtek, Allertek, Letisen, etc.), Fexofenadine (Telefast), Loratadine (Claritin, Clarisens, etc.). Principles of destination, schemes and methods for the introduction of antihistamine drugs in food allergies are the same as with other forms of allergopathology. Indications, doses and contraindications for the purpose of antihistamine drugs are widely covered in medical printing.

Specific methods of treating food allergies include elimination of edible allergen and asit.

Elimination of edible allergen

Elimination, or exclusion from the diet of the causal and significant food allergen, refers to the main methods of food allergy therapy, and in cases where food allergies develop to rarely used food products (for example, strawberries, chocolate, crabs, etc.) may be It is recognized as the only effective treatment method.

Elimination requires exclusion from the diet not only a particular food product responsible for the development of sensitization, but also any others whose composition is included, even in trace quantities.

When the elimination diet is prescribed, it is necessary to strictly ensure that the diet of the patient corresponds to the volume and ratio of the food ingredients of its weight and age.

A great contribution to the compilation of eliminational diets introduced Rowe, which has developed eliminate diets for patients with food allergies to milk, eggs, food cereals, as well as combined forms of food allergies.

Allergensphecific immunotherapy

Asitant in food allergies is carried out only if the disease is based on a reactive mechanism, and the food product is vital (for example, allergic to milk in children). The first attempts to conduct an ACIT in food allergies belong to the beginning of the 20s. Different methods for carrying out ACITS are proposed: oral, subcutaneous. However, many researchers talk about low efficiency asity of food allergens in food allergies. Nevertheless, we believe that the question of the feasibility of conducting specific immunotherapy in food allergies has not yet been resolved and requires further study.

Literature

1. Clinical reactions to food / ed. M. H. Lessof. M.: Medicine, 1986. 254 p.
2. Nogaller A. M. Food Allergy. M.: Medicine, 1983. 192 p.
3. Clinical allergology / ed. R. M. Khaitova. M.: Medpress-Inform, 2002. 623 p.

L. V. Luss, Doctor of Medical Sciences, Professor
SSC - Institute of Immunology Fu "MedbioExstrem" at the Ministry of Health of the Russian Federation, Moscow

What are the mains causes of food intolerance? What symptoms are manifested, what tests need to be done for proper diagnosis? Here you will find answers and information about intolerance regarding certain foods, which can be used by the body: methods of examination required to detect possible methods of treatment.

It is very difficult to talk about food intolerance, given that the opinions of specialists differ in relation to this disorder. All agree with the existence of two certain intolerances - lactose and gluten. In this case, it is enough to carry out a test, which with high accuracy determines intolerant or not a person to these components.

However, there are symptoms that are not related to other diseases that appear when using some foods. Thus, it is assumed that these products cause intolerance. It is very difficult to accurately determine the component that causes disorders.

For example, you know that it is bad to carry mollusks, but you do not know what, among many, molecules cause a problem. Of all this is the difficulty of diagnosing the disease, as well as uncertainty about its treatment.

What is food intolerance - differences from allergies

To determine food intolerance, it is necessary, first of all, to designate a clear difference from food allergies. On the household level, these two terms are perceived as synonyms, but from a scientific point of view, these are two committed different disorders. True, even for specialists, this question is rather controversial.

Tseliacia. The intolerance of gluten causes inflammation of the intestinal mucosa through the mediation of an IgG immunoglobulin and, as a result, problems with the absorption of nutrients. If the pathology is not treated, children can have serious growth problems, such as growth delay.

Adults can develop osteoporosis due to poor calcium absorption or convulsions and epilepsy due to the calcification of the brain caused by vitamin B9 deficiency. With a long period of constant inflammatory intestinal process, tumors can develop. In pregnant women, poor absorption of nutrients can cause miscarriage.

Lactose intolerance. Problems with the absorption of lactose, as a rule, manifest themselves diarrhea and abdominal problems. There are no research on the consequences of a long lack of treatment for lactose intolerance. Some authors indicate an increase in the incidence of colon cancer, but it is difficult to talk about any certainty.