ABSTRACT
Allergy, including food allergy, is inflammatory processes in which preformed and newly synthesized mediators from mast cells and basophils, are released following crosslinking of specific IgE on their surface membranes that contribute to the symptoms and clinical condition. Allergic reactions to foods can range in severity from an itchy tongue in some individuals to life-threatening swelling of the throat, asthma, and anaphylaxis in others. Consequently, food allergy, as compared to adverse food reactions, represents a complex and heterogeneous immune deviation from the normal protective immune response in which the production of systemic antigen/allergen specific IgE plays an important role in the pathogenesis of food allergy. Much of the difficulty in discussing adverse food reactions and food allergy has been the nomenclature used in the literature. To resolve these issues, the American Academy of Allergy and Immunology issued guidelines to standardize the literature (Table 1) (1). Definition of Terms https://www.niso.org/standards/z39-96/ns/oasis-exchange/table">
Adverse food reaction: a general term applied to clinically abnormal responses to an ingested food or food additive
Food allergy: (hypersensitivity) an immunological reaction resulting from ingestion of food or food additive
Food anaphylaxis: IgE-mediated classic allergic, systemic hypersensitivity
Food intolerance a : an abnormal physiological response to a food or food additive
Idiosyncratic: an anaphylactoid reaction that represents abnormal responses that differ from physiological or pharmacological effects; non–immune-mediated; e.g., response to radio contrast media
Metabolic: a metabolic effect of the host (intestinal insufficiency); e.g., carbohydrate (lactose) intolerance
Pharmacological: drug-like effect; e.g., caffeine in coffee and tyramine in cheeses
Food toxicity: a direct effect on the host without involvement of immune mechanisms
Toxins: either present in foods or released by microorganisms or parasites contaminating the food (bacterial = botulism; “red tide” = dinoflagellates eaten by mussels, clams, oysters; algal = ciguarta)
Although the immune system is not responsible for the symptoms of food intolerance, the symptoms of food intolerance can resemble those of food allergy and must be differentiated accordingly.
