The Indian Journal of Pediatrics

, Volume 67, Issue 10, pp 713–720 | Cite as

Allergenicity of Common Foods Restricted in Respiratory Allergy

  • Jyotsna SharmanEmail author
  • Lata Kumar
  • Surjit Singh
Original Article


Although hypersensitivity to foods is often linked to exacerbations of symptoms of respiratory allergy, no such information is available regarding the foods traditionally considered to play a probable etiological role in respiratory allergy in India, which are in fact quite different from the ones implicated in the West. The present study was undertaken to investigate whether the practice of withholding certain common foods by parents and practitioners of indigenous systems of medicine (i.e. Ayurvedic and Unani systems of medicine) in children suffering from respiratory allergy had any scientific basis or explanation as judged by modern techniques of investigation. Skin prick tests were performed on 64 children with symptoms pertaining to respiratory allergy (32 each in study and control group) using crude antigenic food extracts. Oral food challenges were administered to children to confirm or rule out allergenicity of food (s) incriminated on the basis of the clinical history and/or a positive skin test. Parental history of food restriction alone, in absence of positive skin prick test was of little value in predicting a positive response to the food challenges (1 challenge positive out of 77 based on food restriction: 1.29%). Only 27.02% and 18.75% of positive skin tests were found to be clinically significant in study and control groups respectively. Traditionally, food beliefs were upheld in only 12.5% children for immediate onset clinical reactions (with 5.31% of the foods restricted in their diet) and 9.37% children for delayed onset clinical reactions (with 3.19% of the foods restricted in their diet). The present study shows that even though food restriction is a common practice in patients with respiratory allergy in India, objective documentation of Type I reactions due to these foods cannot be obtained in a majority of such children.

Key words

Antigen Asthma Food hypersensitivity Respiratory allergy Traditional medicine 


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  1. 1.
    Wakhlu I, Sharma NL. A clinical study of bronchial asthma in children.Indian Pediatr 1974; 11: 789–792.PubMedGoogle Scholar
  2. 2.
    Rishi Agnivesh, ed.Charak Samhita. Jamnagar: Shri Gulabkunverba Ayurvedic Society, 5000-3000 BC, reprinted 1949; Vol. 3 : 1567, 1718, 1990.Google Scholar
  3. 3.
    Kaushik GPS, ed.Madhava Nidan. Lucknow: Tejpur Book Depot Pvt Ltd., 1974; 106.Google Scholar
  4. 4.
    Khanna S, ed.Bal Tantra. Varanasi: Chowkhamba Surbharti Prakashan, 1981.Google Scholar
  5. 5.
    Pathak KR, ed.Kaya Chikitsa. Varanasi: Chaukhamba Bharati Academy, 1991; Vol 3 : 3.Google Scholar
  6. 6.
    Singh D, ed.Unani Chikitsa Saar. Varanasi: Shri Vaidyanath Ayurved Bhawan Ltd, 1988; 395.Google Scholar
  7. 7.
    Bock SA, Lee WY, Remigio LK, May CD. Studies of hypersensitivity reactions to foods in infants and children.J Allergy Clin Immunol 1978; 62: 327–334.PubMedCrossRefGoogle Scholar
  8. 8.
    Businco L, Falconieri P, Giampietro P, Bellioni B. Food allergy and asthma.Pediatr Pulmonol Suppl. 1995; 11: 59–60.PubMedCrossRefGoogle Scholar
  9. 9.
    Kumar L, Kumar V, Kaur A. Food beliefs of allergic patients (unpublished).Google Scholar
  10. 10.
    Phillips GL. Preparation of allergenic extracts for testing and treatment. In: Sheldon JM, Lovell RG, Mathews KP, eds.A Manual Of Clinical Allergy. Philadelphia & London; WB Saunders Co, 1967; 507–531.Google Scholar
  11. 11.
    Little JR, Donahue H.Methods Immunol Immunochem 1968; 2: 163.Google Scholar
  12. 12.
    Pepys J. Skin tests in diagnosis. In: Gell PGH, Coombs RRA, Lachmann PJ, eds.Clinical Aspects of Immunology. Oxford; Blackwell Scientific Publications, 1975; 55.Google Scholar
  13. 13.
    Sampson HA, Albergo R. Comparison of results of skin tests, RAST, and double-blind, placebo-controlled food challenges in children with atopic dermatitis.J Allergy Clin Immunol 1984; 74: 26–33.PubMedCrossRefGoogle Scholar
  14. 14.
    Watson JG, Bird AG, eds.Handbook of Immunological Investigations in Children. Butterworth and Co Ltd, 1990; 201.Google Scholar
  15. 15.
    Bock SA, Sampson HA, Atkins FM,et al. Double-blind, placebo-controlled food challenge (DBPCFC) as an office procedure: A manual.J Allergy Clin Immunol 1988; 82 : 986–997.PubMedCrossRefGoogle Scholar
  16. 16.
    Gopalan C, Rama Sastri BV, Balasubramaniam SC, eds. In:Nutritive Value of Indian Foods. New Delhi; Indian Council of Medical Research, 1985.Google Scholar
  17. 17.
    Goldman L. Quantitative aspects of clinical reasoning. In: Wilson JD, Braunwald E, Isselbacher KJ,et al. eds.Principles of Internal Medicine. New York; McGraw-Hill, 12th edn, 1987; 5–10.Google Scholar
  18. 18.
    Cooke RA, ed.Allergy in Theory and Practice. Philadelphia; WB Saunders Co, 1947; 529.Google Scholar
  19. 19.
    Onorato J, Merland N, Terral C,et al. Placebo-controlled double-blind food challenge in asthma.J Allergy Clin Immunol 1986; 78: 1139–1146.PubMedCrossRefGoogle Scholar
  20. 20.
    Bock SA, Atkins FM. Patterns of food hypersensitivity during sixteen years of double-blind, placebo-controlled food challenges.J Pediatr 1990; 117: 561–567.PubMedCrossRefGoogle Scholar
  21. 21.
    Hill DJ, Firer MA, Shelton MJ, Hosking CS. Manifestations of milk allergy in infancy: Clinical and immunologic findings.J Pediatr 1986; 109 : 270–276.PubMedCrossRefGoogle Scholar
  22. 22.
    Host A, Halken S. A prospective study of cow’s milk allergy in Danish infants during the first three years of life.Allergy 1990; 45: 587–596.PubMedCrossRefGoogle Scholar
  23. 23.
    Goldman AS, Anderson DW Jr, Sellars WA,et al. Milk allergy. I. Oral challenge with milk and isolated milk proteins in allergic children.Pediatrics 1963; 32: 425–443.PubMedGoogle Scholar
  24. 24.
    Sampson HA. Role of immediate hypersensitivity in the pathogenesis of atopic dermatitis.J Allergy Clin Immunol 1983; 71: 473–480.PubMedCrossRefGoogle Scholar
  25. 25.
    Bousquet J, Michel FB. Food allergy and asthma.Ann Allergy 1988; 61: 70–74.PubMedGoogle Scholar
  26. 26.
    Novembre E, De Martino M, Vierucci A. Foods and respiratory allergy.J Allergy Clin Immunol 1988; 81: 1059–1065.PubMedCrossRefGoogle Scholar
  27. 27.
    Bock SA. A critical evaluation of clinical trials in adverse reactions to foods in children.J Allergy Clin Immunol 1986; 78: 165–174.PubMedCrossRefGoogle Scholar
  28. 28.
    Hagy GW, Settipane GA. Risk factors for developing asthma and allergic rhinitis: A seven-year follow-up study of college students.J Allergy Clin Immunol 1976; 58 : 330–336.PubMedCrossRefGoogle Scholar
  29. 29.
    Horak F. Manifestation of allergic rhinitis in latent-sensitized patients: A prospective study.Arch Otorhinolaryngol 1985; 242 : 242–249.Google Scholar
  30. 30.
    Atkins FM, Steinberg SS, Metcalfe DD. Evaluation of immediate adverse reactions to foods in adult patients. I. Correlation of demographic, laboratory, and prick skin test data with response to controlled oral food challenge.J Allergy Clin Immunol 1985; 75: 348–355.PubMedCrossRefGoogle Scholar
  31. 31.
    Halonen M, Barbee RA, Lebowitz MD,et al. An epidemiologic study of the interrelationships of total serum immunoglobulin E, allergy skin-test reactivity and eosinophilia.J Allergy Clin Immunol 1982; 69: 221–228.PubMedCrossRefGoogle Scholar
  32. 32.
    Barbee RA, Lebowitz MD, Thompson HC, Burrows B. Immediate skin-test reactivity in a general population sample.Ann Intern Med 1976; 84: 129–132.PubMedGoogle Scholar
  33. 33.
    Ortolani C, Miadonna A, Adami R,et al. Correlation of the specific IgE in serum and nasal secretions with clinical symptoms in atopies.Clin Allergy 1981; 11: 249–256.PubMedCrossRefGoogle Scholar
  34. 34.
    Bock SA, May CD. Adverse reactions to foods caused by sensitivity. In: Middleton E Jr, Reed CE, Ellis EF, eds.Allergy Principles And Practice, 2nd edn; St Louis; CV Mosby Co, 1983, 1415–1427.Google Scholar
  35. 35.
    May CD, Bock SA. A modern clinical approach to food hypersensitivity.Allergy 1978; 33: 166–188.PubMedCrossRefGoogle Scholar
  36. 36.
    Hansen TK, Bindslev-Jensen C. Codfish allergy in adults: Identification and diagnosis.Allergy 1992; 47 : 610–617.PubMedCrossRefGoogle Scholar
  37. 37.
    Norgaard A, Bindslev-Jensen C. Egg and milk allergy in adults: Diagnosis and characterization.Allergy 1992; 47 : 503–509.PubMedCrossRefGoogle Scholar
  38. 38.
    Aas K. Antigens in food.Nutr Rev 1984; 42: 85–91.PubMedCrossRefGoogle Scholar
  39. 39.
    Taylor SL. Food allergies.Food Technol 1985; 39: 98.Google Scholar
  40. 40.
    Taylor SL. Immunologic and allergic properties of cow’s milk proteins in humans.J Food Prot 1986; 49: 239.Google Scholar
  41. 41.
    Saavedra-Delgado AM, Metcalfe DD. Interactions between food antigens and the immune system in the pathogenesis of gastrointestinal diseases.Ann Allergy 1985; 55: 694–702.PubMedGoogle Scholar
  42. 42.
    Crumpton MJ. Protein antigens: The molecular basis of antigenicity and immunogenicity. In : Sela M, ed.The antigens II. New York; Academic Press, 1974; 1.Google Scholar

Copyright information

© Dr. K C Chaudhuri Foundation 2000

Authors and Affiliations

  1. 1.Department of PediatricsPostgraduate Institute of Medical Education and ResearchChandigarh

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