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Adverse reactions to food additives

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Abstract

There are thousands of additives used by the food industry for a variety of purposes in the foods we eat. However, only a small number have been implicated in causing adverse reactions in humans. Although there are reported cases of individuals who have reactions to single additives, most of the medical literature involves patients with asthma or chronic idiopathic urticaria/angioedema whose conditions are exacerbated after ingestion of food additives. Many of these reports are characterized by poorly controlled challenge procedures. Recent studies performed under properly controlled conditions imply that sensitivity to food additives in patients with chronic urticaria/ angioedema is very uncommon.

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References and Recommended Reading

  1. Simon RA: Adverse reactions to food and drug additives. Immunol Allergy Clin North Am 1996, 16:137.

    Article  Google Scholar 

  2. Ortolani C, Pastorello E, Fontana A, et al.: Chemicals and drugs as triggers of food-associated disorder. Ann Allergy 1988, 60:358–366.

    PubMed  CAS  Google Scholar 

  3. Genton C, Frei PC, Pecond A: Value of oral provocation tests to aspirin and food additives in the routine investigation of asthma and chronic urticaria. J Allergy Clin Immunol 1985, 76:40–45.

    Article  PubMed  CAS  Google Scholar 

  4. Pearson D, Shaw S: The Life Extension Companion. New York: Warner Books; 1984.

    Google Scholar 

  5. Bock SA, Sampson HA, Atkins F, et al.: Double blind, placebocontrolled food challenge (DBPCFC) as an office procedure: a manual. J Allergy Clin Immunol 1988, 82:986–997.

    Article  PubMed  CAS  Google Scholar 

  6. Sampson HA: Food allergy. Part 2: Diagnosis and management. J Allergy Clin Immunol 2002, 103:981–989.

    Article  Google Scholar 

  7. Simon RA, Bosso JV, Daffern PD, Ward B: Prevalence of sensitivity to food/drug additives in patients with chronic idiopathic urticaria (CIUA). J Clin Immunol 1998, 101:S154-S155.

    Google Scholar 

  8. Prenner BM, Stevens JJ: Anaphylaxis after ingestion of sodium bisulfite. Ann Allergy 1976, 37:180–182.

    PubMed  CAS  Google Scholar 

  9. Yunginger J, Jones R, Kita H, et al.: Allergic reactions after ingestion of erythritol-containing foods and beverages. J Allergy Clin Immunol 2001, 108:650.

    Article  PubMed  CAS  Google Scholar 

  10. Nish WA, Whisman BA, Goetz DW, et al.: Anaphylaxis to annatto dye: a case report. Ann Allergy 1991, 66:129–131.

    PubMed  CAS  Google Scholar 

  11. Beaudouin E, Kanny G, Lambert H, et al.: Food anaphylaxis following ingestion of carmine. Ann Allergy Asthma Immunol 1995, 74:427–430. In this paper, which was the first reporting reactions to the natural red food color carmine, concern about "chemical" additives is explored and quelled.

    PubMed  CAS  Google Scholar 

  12. Weber RW, Hoffman M, Raine DA, Nelson HS: Incidence of bronchoconstriction due to aspirin, azo dyes, non-azo dyes, and preservatives in a population of perennial asthmatics. J Allergy Clin Immunol 1979, 64:32–37.

    Article  PubMed  CAS  Google Scholar 

  13. Vedanthan PK, Menon MM, Bell TD, Bergin D: Aspirin and tartrazine oral challenge: incidence of adverse response in chronic childhood asthma. J Allergy Clin Immunol 1977, 60:8–13.

    Article  PubMed  CAS  Google Scholar 

  14. Samter M, Beers RF: Intolerance to aspirin: clinical studies and considerations of its pathogenesis. Ann Intern Med 1968, 68:975–983.

    PubMed  CAS  Google Scholar 

  15. Settipane GA, Pudupakkam RK: Aspirin intolerance. III. Subtypes, familial occurrence, and cross-reactivity with tartrazine. J Allergy Clin Immunol 1975, 56:215–221.

    Article  PubMed  CAS  Google Scholar 

  16. Spector SL, Wangaard CH, Farr RS: Aspirin and concomitant idiosyncrasies in adult asthmatic patient. J Allergy Clin Immunol 1979, 64:500–506.

    Article  PubMed  CAS  Google Scholar 

  17. Stenius BSM, Lemola M: Hypersensitivity to acetylsalicylic acid (ASA) and tartrazine in patients with asthma. Clin Allergy 1976, 6:119–129.

    Article  PubMed  CAS  Google Scholar 

  18. Stevenson DD, Simon RA, Lumry WR, Mathison DD: Adverse reactions to tartrazine. J Allergy Clin Immunol 1986, 78:182–186. This paper, following more than 100 negative rigorously controlled challenges, shows that tartrazine-provoked asthma, if it exists at all, is extremely rare, even in those who are aspirin sensitive.

    Article  PubMed  CAS  Google Scholar 

  19. Tarlo SM, Broder I: Tartrazine and benzoate challenge and dietary avoidance in chronic asthma. Clin Allergy 1982, 12:303–312.

    Article  PubMed  CAS  Google Scholar 

  20. Goodman PL, McDannell JT, Nelson NS, et al.: Chronic urticaria exacerbated by the antioxidant food preservatives butylated hydroxyanisole (BHA) and butylated hydroxytoluene (BHT). J Allergy Clin Immunol 1990, 86:570–575.

    Article  PubMed  CAS  Google Scholar 

  21. Yang WH, Drouin MA, Herbert M, et al.: The monosodium glutamate symptom complex: assessment in a double blind, placebo controlled, randomized study. J Allergy Clin Immunol 1997, 99:757–762.

    Article  PubMed  CAS  Google Scholar 

  22. Randolph TG, Rollins JP: Beet sensitivity: allergic reactions from the ingestion of beet sugar (sucrose) and monosodium glutamate of beet origin. J Lab Clin Med 1950, 36:407–417.

    PubMed  CAS  Google Scholar 

  23. Squire EN: Angio-oedema and monosodium glutamate. Lancet 1987, 1:988.

    Article  PubMed  Google Scholar 

  24. Allen DH, Baker GJ: Chinese restaurant asthma. N Engl J Med 1981, 305:1154–1155.

    PubMed  CAS  Google Scholar 

  25. Allen DH, Baker GH: Asthma and MSG. Med J Aust 1981, 2:576.

    PubMed  CAS  Google Scholar 

  26. Woessner KM, Simon RA, Stevenson DD: Monosodium glutamate sensitivity in asthma. J Allergy Clin Immunol 1999, 104:305–310. In rigorously performed, double-blind, placebo-controlled challenges, none of the subjects, 100 patients who were at high risk for monosodium glutamate-provoked asthma, had a significant drop in lung function, thereby confirming that MSG is not a cause of asthma, even in those at high risk.

    Article  PubMed  CAS  Google Scholar 

  27. Woods RK, Weiner JM, Thien F, et al.: The effects of monosodium glutamate in adults with asthma who perceive themselves to be monosodium glutamate-intolerant. J Allergy Clin Immunol 1998, 101:765–771.

    Google Scholar 

  28. Aspinall RL, Saunders RN, Pautsch WF, Nutting EF: The biological properties of aspartame: effects on a variety of physiological parameters related to inflammation and metabolism. J Environ Pathol Toxicol 1980, 3:387–395.

    PubMed  CAS  Google Scholar 

  29. Novick NL: Aspartame-induced granulomatous panniculitis. Ann Intern Med 1985, 102:206–207.

    PubMed  CAS  Google Scholar 

  30. Kulczycki A: Aspartame-induced urticaria. Ann Intern Med 1986, 104:207–208.

    PubMed  Google Scholar 

  31. Kulczycki A: Aspartame-induced hives. J Allergy Clin Immunol 1995, 95:639–940.

    Article  PubMed  Google Scholar 

  32. Garriga MM, Berkebile C, Metcalfe DD: A combined single blind, double blind, placebo controlled study to determine the reproducibility of hypersensitivity reactions to aspartame. J Allergy Clin Immunol 1991, 87:821–827.

    Article  PubMed  CAS  Google Scholar 

  33. Geha R, Buckley CE, Greenberger P: Aspartame is no more likely than placebo to cause urticaria/angioedema: results of a multicenter, randomized, double-blind, placebo-controlled, crossover study. J Allergy Clin Immunol 1993, 92:513–520.

    Article  PubMed  CAS  Google Scholar 

  34. Schiffman SS, Buckley CE 3rd, Sampson HA, et al.: Aspartame and susceptibility to headache. N Engl J Med 1987, 317:1181–1185.

    Article  PubMed  CAS  Google Scholar 

  35. Koehler SM, Glaros A: The effect of aspartame on migraine headache. Headache 1988, 28:10–14.

    Article  PubMed  CAS  Google Scholar 

  36. Simon RA: Update on sulfite sensitivity. Allergy 1998, 53:78.

    Article  PubMed  CAS  Google Scholar 

  37. Stevenson DD, Simon RA: Sensitivity to ingested metabisulfites in asthmatic subjects. J Allergy Clin Immunol 1981, 68:26–32.

    Article  PubMed  CAS  Google Scholar 

  38. Bush RK, Taylor SL, Holden K, et al.: The prevalence of sensitivity to sulfiting agents in asthmatic patients. Am J Med 1986, 81:816–820.

    Article  PubMed  CAS  Google Scholar 

  39. Baker GJ, Collett P, Allen DH: Bronchospasm induced by metabisulphite-containing foods and drugs. Med J Aust 1981, 2:614–617.

    PubMed  CAS  Google Scholar 

  40. Simon RA, Green L, Stevenson DD: The incidence of metabisulfite sensitivity in an asthmatic population. J Allergy Clin Immunol 1982, 69:118.

    Article  Google Scholar 

  41. Buckley R, Saltzman HA, Sieker HO: The prevalence and degree of sensitivity to ingested sulfites. J Allergy Clin Immunol 1985, 77:144.

    Article  Google Scholar 

  42. Simon RA, Wasserman SI: IgE-mediated sulfite-sensitive asthma. J Allergy Clin Immunol 1986, 77:157.

    Google Scholar 

  43. Yang WH, Purchase ECR, Rivington RN: Positive skin tests and Prausnitz-Kustner reactions in metabisulfite-sensitive subjects. J Allergy Clin Immunol 1986, 78:443–449.

    Article  PubMed  CAS  Google Scholar 

  44. Jacobsen DW, Simon RA, Singh M: Sulfite oxidase deficiency and cobalamin protection in sulfite-sensitive asthmatics. J Allergy Clin Immunol 1984, 73:135.

    Google Scholar 

  45. Schwartz HJ: Sensitivity to ingested metabisulfite: variations in clinical presentation. J Allergy Clin Immunol 1983, 71:487–489.

    Article  PubMed  CAS  Google Scholar 

  46. Habenicht HA, Preuss L, Lovell RG: Sensitivity to ingested metabisulfites: cause of bronchospasm and urticaria. Immunol Allergy Pract 1983, 5:243–245.

    Google Scholar 

  47. Meggs WJ, Atkins FM, Wright R, et al.: Failure of sulfites to produce clinical responses in patients with systemic mastocytosis or recurrent anaphylaxis: results of a single-blind study. J Allergy Clin Immunol 1985, 76:840–846.

    Article  PubMed  CAS  Google Scholar 

  48. Stricker WE, Anorve-Lopez E, Reed CE: Food skin testing in patients with idiopathic anaphylaxis. J Allergy Clin Immunol 1986, 77:516–519.

    Article  PubMed  CAS  Google Scholar 

  49. Sonin L, Patterson R: Metabisulfite challenge in patients with idiopathic anaphylaxis. J Allergy Clin Immunol 1985, 75:67–69.

    Article  PubMed  CAS  Google Scholar 

  50. Spurlock BW, Dailey TM: Shortness of (fresh) breath-toothpaste- induced bronchospasm (letter). N Engl J Med 1990, 323:1845–1846.

    PubMed  CAS  Google Scholar 

  51. Subiza J, Subiza JL, Valdivieso R, et al.: Toothpaste flavorinduced asthma. J Allergy Clin Immunol 1992, 90:1004–1006.

    Article  PubMed  CAS  Google Scholar 

  52. Feingold B: Why your child is hyperactive. New York: Random House; 1975.

    Google Scholar 

  53. Lipman Mayo JP: Diet and hyperkinesis: an update. J Am Diet Assoc 1983, 83:132–134.

    Google Scholar 

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  1. Division of Allergy, Asthma, and Immunology, Scripps Clinic, 10666 N. Torrey Pines Road, 92037, La Jolla, CA, USA

    Ronald A. Simon MD

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  1. Ronald A. Simon MD
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Simon, R.A. Adverse reactions to food additives. Curr Allergy Asthma Rep 3, 62–66 (2003). https://doi.org/10.1007/s11882-003-0014-9

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  • DOI: https://doi.org/10.1007/s11882-003-0014-9

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