In the UK, Europe and the USA, montelukast is licensed for once-daily oral administration in adults and is also available as a cherry flavored pink tablet or as granules for use in children over the age of 6 months. Zafirlukast is licensed for use in individuals over 12 years of age (Fig above). In some countries such as Japan, another leukotriene receptor antagonists (LTRA), pranlukast, is available for use. In the USA, zileuton is licensed for use in those over 12 years of age (Table below). (more…)

Treating allergic rhinitis may have a downstream effect on concomitant asthma and this may be due to attenuation of the underlying inflammatory process.

Fexofenadine and montelukast exhibited additive effects to moderately high doses of inhaled corticosteroids when used as add-on therapy in the treatment of patients with persistent atopic asthma. (more…)

Over the last 5 years some studies have suggested that the atopy patch test (APT) may be a useful test in atopic dermatitis children who have suspected food hypersensitivity and may even obviate the need for oral challenges. An alternative test to oral allergy challenges with high sensitivity and specificity would be helpful in the diagnosis of food hypersensitivity. (more…)

Cow’s milk is the most frequently encountered food allergen in infancy, and milk allergy is often the earliest indicator that a baby is atopic. Precise figures of the incidence of cow’s milk allergy are hard to find because of the difficulties in obtaining an accurate diagnosis, differences in the populations used for research studies, and disagreement about allergy symptoms (clinical criteria) for the condition. All studies agree, however, that cow’s milk allergy is most prevalent in early childhood with an incidence of 2 to 7.5 percent being reported. (more…)

By definition, allergy is a condition where a person has hypersensitivity to an environmental, drug, or food antigen (allergen) caused by an altered or unusual immune system reaction to the antigen.

Allergenic foods can impact the lungs when an allergic reaction individual inhales food particles that may have been released when the food was cooked or that were dispersed in aerosol form. Allergy to the allergens in cooked food has been reported by highly allergic patients who were exposed to their allergenic foods (say, fish, shellfish, or eggs) in an enclosed area (for example, a restaurant dining room) or during meal preparation. Most cases of asthma triggered by aerosolized food allergens involve adults engaged in specific occupations that regularly expose them to the allergens. In contrast, most cases of asthma in children are triggered when the allergen is eaten, not inhaled.

Many experts believe that if a baby can be protected from becoming sensitized to the most highly allergenic foods when their healthy immune system and the digestive tract are in the most vulnerable stage for allergy to develop, the incidence of lifelong food allergy and potentially life-threatening anaphylactic reactions to foods will be reduced and hopefully entirely prevented. When a baby has been identified to be at risk for developing allergy, measures to reduce allergic sensitization might be implemented at birth and the problems associated with future food allergy may be significantly reduced. However, as we shall see in later discussions, experts disagree on the best way to avoid this early allergic sensitization.

The reaction of asthmatics to these chemical compounds is not an allergy, but is more correctly described as allergy intolerance because the initial response is not a triggering of the immune system. The process involves an increase in the level of the inflammatory mediators that are responsible for the bronchospasm of asthma. These mediators include histamine and leukotrienes. They are released during the reaction to an allergen, and cause the muscular contractions that result in the difficulty in breathing and wheezing that are typical of asthma. By inhibiting (or turning off) other types of mediators, the chemicals in the food additives cause an increase in the level of antihistamine and leukotrienes. This results in increased bronchospasm, and a definite worsening of the asthma symptoms.

Oral allergy syndrome is an allergic reaction to food that is confined to the oral cavity (i.e., to the lips, and around the lips, roof of the mouth, tongue, hard and soft palate, and uvula) and adjacent structures. It differs from other food allergy in that its symptoms do not appear in any other location in the body, and always accompany respiratory allergy to inhaled allergens of plants, particularly plant pollens. Of course, symptoms in the mouth, throat, and upper respiratory tract can be part of a generalized reaction to foods, but in this case they are more accurately described as oral allergy symptoms. The term oral allergy syndrome applies specifically to pollen allergy (pollinosis) accompanied by reactions to certain raw foods when they are in direct contact with oral tissues. Individuals with Oral allergy syndrome typically have hay fever symptoms caused by allergies to trees, grasses, and weeds. They experience irritation in the mouth (lips, tongue, roof of the mouth) and sometimes the throat after eating specific types of raw fruits, vegetables, and sometimes nuts.

The increasing prevalence of allergic disease in the Western world has led to the concept of the ‘allergic march’ to describe the evolving spectrum of disease that often begins in childhood. The use of allergen immunotherapy in children has the potential of altering the natural course of allergic disease. However, concerns regarding the safety of using this treatment in children are an obstacle to attenuating the allergic march. The study of Di Rienzo and colleagues reviews the safety of Sublingual Immunotherapy in children between the ages of 3 and 5 years. (more…)

Patients (and many doctors) frequently use the term ‘allergy’ when referring to any adverse drug reaction, even one that has no features of an IgE-mediated allergy response. However, IgE-mediated allergy explains only about 10% of all adverse reactions to antigen antibody reactions from antibiotics. Patients who have experienced unexplained symptoms during treatment with two or more antibiotics are often said to have ‘multiple antibiotic allergy’; using this definition, the description can be applied to one patient in every 22. (more…)

Gastrointestinal allergy can be classified according to the triggering antigen, the mechanism of immune reaction, or the anatomic site of reaction.

Gastrointestinal allergy may be triggered by food components (e.g. food proteins or glycoproteins), and by other antigen antibody reaction to (e.g. bacterial disease, viral, fungal, and worm antigen), drugs and chemicals, (more…)

Oral allergy syndrome has been most often reported in people who have respiratory allergy (such as hay fever) to specific plant pollens. The pollens most often implicated are produced by :

• Birch and alder trees
• Ragweed (more…)

The oral allergy syndrome is difficult to detect. Common allergy tests to examine allergy are using extracts only in skin scratch testing. But this method is quite useless due to many enzymes involved in allergy reaction are already broken out in the process of extraction. They are not as effective as the original enzymes. Oral Allergy Syndrome is usually diagnoses by symptoms that are appeared. The other method is to look for allergy history to pollen, if any. (more…)