• allergy
• children
• history
• immunotherapy
• persistence
• risk factors
• sesame

• Humans
• Retrospective Studies
• Male
• Female
• Sesamum/immunology
• Sesamum/adverse effects
• Child
• Food Hypersensitivity/immunology
• Food Hypersensitivity/epidemiology
• Food Hypersensitivity/diagnosis
• Immunoglobulin E/blood
• Child, Preschool
• Skin Tests
• Risk Factors
• Allergens/immunology
• Desensitization, Immunologic/methods
• Adolescent
• Anaphylaxis/immunology
• Anaphylaxis/etiology
• Anaphylaxis/epidemiology
• Infant
• Follow-Up Studies

• Food safety
• Mycotoxins
• Pesticides
• Salmonella
• Sesamum indicum
• Value chain

• Humans
• Animals
• Sesamum/immunology
• Arachis/immunology
• Desensitization, Immunologic/methods
• Peanut Hypersensitivity/therapy
• Peanut Hypersensitivity/immunology
• Milk Hypersensitivity/immunology
• Milk Hypersensitivity/therapy
• Female
• Administration, Oral
• Child
• Milk/immunology
• Male
• Allergens/immunology
• Allergens/administration & dosage
• Child, Preschool
• Cattle
• Adult

• Anaphylaxis
• Diagnosis
• Food allergy
• Immunotherapy
• Sesame
• Threshold

• Humans
• Sesamum
• Food Hypersensitivity/diagnosis
• Food Hypersensitivity/therapy
• Food Hypersensitivity/epidemiology
• Allergens/therapeutic use
• Seeds
• Immunoglobulin E

• Food allergy
• IgE
• basophil activation test
• diagnosis
• immunotherapy
• omalizumab
• severity
• skin prick test

• Child
• Adult
• Humans
• Immunoglobulin E/therapeutic use
• Food Hypersensitivity/epidemiology
• Food Hypersensitivity/therapy
• Food Hypersensitivity/diagnosis
• Allergens
• Skin Tests
• Basophil Degranulation Test

• G0902018 Medical Research Council

• Animals
• Cattle
• Female
• Allergens
• Food Hypersensitivity/epidemiology
• Food Hypersensitivity/prevention & control
• Immunoglobulin E
• Infant Food
• Infant Formula
• Lactation
• Milk Hypersensitivity/prevention & control
• Milk, Human
• Prospective Studies

• Ses i 1
• component-resolved diagnostics
• cosensitization
• oral food challenge
• peanut allergy
• sesame allergy
• skin prick testing

• Humans
• Child
• Sesamum/adverse effects
• Anaphylaxis
• Arachis
• Nuts
• Plant Extracts

• Sesame allergy
• mechanisms
• prevalence
• processing for reducing allergenicity
• sesame allergen

• Humans
• Allergens/chemistry
• Food Hypersensitivity/epidemiology
• Food Hypersensitivity/diagnosis
• Sesamum
• Prevalence
• Nuts
• Epitopes

Food allergy is a growing concern due to its increasing world-wide incidence. Strict avoidance of allergens is a passive treatment strategy. Since the mechanisms responsible for the occurrence and development of food allergy have not yet been fully elucidated, effective individualized treatment options are lacking. In this review, we summarize the pathways through which food antigens enter the intestine and review the proposed mechanisms describing how the intestine acquires and tolerates food antigens. When oral tolerance is not established, food allergy occurs. In addition, we also discuss the contribution of commensal bacteria of the gut in shaping tolerance to food antigens in the intestinal tract. Finally, we propose that elucidating the mechanisms of intestinal uptake and tolerance of food antigens will provide additional clues for potential treatment options for food allergy.

• food allergy
• food antigens
• gut microbiota
• intestinal barrier
• intestinal immune system
• oral tolerance
• paracellular pathway
• transcellular pathway

Food allergy in children is a major health concern, and its prevalence is rising. It is often over-diagnosed by parents, resulting occasionally in unnecessary exclusion of some important food. It also causes stress, anxiety, and even depression in parents and affects the family’s quality of life. Current diagnostic tests are useful when interpreted in the context of the clinical history, although cross-sensitivity and inability to predict the severity of the allergic reactions remain major limitations. Although the oral food challenge is the current gold standard for making the diagnosis, it is only available to a small number of patients because of its requirement in time and medical personnel. New diagnostic methods have recently emerged, such as the Component Resolved Diagnostics and the Basophil Activation Test, but their use is still limited, and the latter lacks standardisation. Currently, there is no definite treatment available to induce life-long natural tolerance and cure for food allergy. Presently available treatments only aim to decrease the occurrence of anaphylaxis by enabling the child to tolerate small amounts of the offending food, usually taken by accident. New evidence supports the early introduction of the allergenic food to infants to decrease the incidence of food allergy. If standardised and widely implemented, this may result in decreasing the prevalence of food allergy.

• Oral food challenge
• Oral immunotherapy
• Allergens
• Anaphylaxis
• Desensitisation
• Immunoglobulin E
• Eosinophilic gastrointestinal diseases
• Histamine
• Mast cells
• Basophil activation test

Food allergy is increasing in prevalence, posing aheavier social and financial burden. At present, there is still no widely accepted treatment for it. Methods to reduce or eliminate the allergenicity of trigger foods are urgently needed. Technological processing contributes to producing some hypoallergenic foods. Among the processing methods, the Maillard reaction (MR) is popular because neither special chemical materials nor sophisticated equipment is needed. MR may affect the allergenicity of proteins by disrupting the conformational epitope, disclosing the hidden epitope, masking the linear epitope, and/or forming a new epitope. Changes in the allergenicity of foods after processing are affected by various factors, such as the characteristics of the allergen, the processing parameters, and the processing matrix, and they are therefore variable and difficult to predict. This paper reviews the effects of MR on the allergenicity of each allergen group from common allergenic foods.

• Allergens
• Food Hypersensitivity/diagnosis
• Humans
• Sesamum

• Eliciting dose
• Food allergen
• Labeling
• Lebanon
• Probabilistic risk assessment
• Sesame

Food allergy can result in life-threatening anaphylaxis and is considered an increasing public health burden. Hospitalized patients are dependent on the hospital menu to meet their nutritional needs; thus, errors in the meals provided can have a substantial impact on patients’ health outcomes. In Israel, no specific policy protocol exists to ensure food allergy safety in the setting of a hospital foodservice system.

This paper has two aims: 1) to provide an in-depth review of food allergy as a major public health concern and 2) to report actions taken in a single large medical center, as an ongoing project that aimed to ensure patients’ safety, and which ended in developing policy on this matter.

During the years 2017–2019, we initiated several interventions with the goal of achieving food allergy safety and ensuring quality of care for patients with food allergies at Hadassah Hebrew University Medical Center. These included integrating food management safety into the computerized foodservice system, highlighting labels on patients’ food trays, introducing safety checks into the process of food delivery to hospitalized patients; and ensuring the nutritional requirements of patients with allergy restrictions. Moreover, changes were made in specialized menus for patients with various types of food allergy, and specific procedures were implemented regarding enteral feeding, to prevent accidental allergen exposure. All the procedures were incorporated into a written protocol that applies to all hospital employees, and the staff received the relevant training.

Our experience suggests that methods for food allergy safety should be promoted, and that an established policy and suitable set of guidelines on this matter is required. This clearly mandates collaboration between the various sectors of the hospital, including management and the computer department; and the medical, nursing, dietetics and kitchen staffs. Furthermore, routine ongoing knowledge training programs for medical teams and kitchen staff are crucial for such implementational changes. In a technological world, computerized systems delivering food to hospitalized patients must be adapted such as to create a uniformly safe food environment of healthcare systems, and developing a suitable policy should be prioritized accordingly by hospitals across Israel, with collaboration and synergy between institutions management and the departments of nutrition and patient safety and risk management.

• Food allergy
• Hospital foodservice
• Safety policy

• allergy
• diagnosis
• early life
• high threshold
• peanut
• preschool