I was recently invited to write an article for Arab News, focusing on the increased incidence of allergies in the 𝐌𝐢𝐝𝐝𝐥𝐞 𝐄𝐚𝐬𝐭.
This included the significant growth of 𝘩𝘢𝘺𝘧𝘦𝘷𝘦𝘳 and 𝘢𝘭𝘭𝘦𝘳𝘨𝘪𝘤 𝘢𝘴𝘵𝘩𝘮𝘢 and its 𝘴𝘰𝘤𝘪𝘰𝘦𝘤𝘰𝘯𝘰𝘮𝘪𝘤 𝘪𝘮𝘱𝘢𝘤𝘵.
It was published on the 14th of May under the name “𝐌𝐢𝐝𝐝𝐥𝐞 𝐄𝐚𝐬𝐭 𝐦𝐮𝐬𝐭 𝐚𝐝𝐝𝐫𝐞𝐬𝐬 𝐩𝐫𝐞𝐯𝐚𝐥𝐞𝐧𝐜𝐞 𝐨𝐟 𝐚𝐥𝐥𝐞𝐫𝐠𝐢𝐞𝐬”.
If you want to read it, please go to
Also known as
𝐏𝐫𝐞𝐜𝐚𝐮𝐭𝐢𝐨𝐧𝐚𝐫𝐲 𝐀𝐥𝐥𝐞𝐫𝐠𝐲 𝐋𝐚𝐛𝐞𝐥𝐥𝐢𝐧𝐠 (𝘗𝘈𝘓)
This is of extreme importance to improve the quality of life of allergy sufferers.
Despite its existence, often, there are still episodes of allergic reactions.
Almost half of adult patients have suffered moderate to severe allergic reactions to pre-packed food.
Recent research has shown both allergic and non-allergic sufferers struggle to understand what the different 𝘗𝘈𝘓 mean.
In fact, they incorrectly associate different wording to different risk levels.
The higher the health education of people in the study, the more they would give different risk levels to various food labels.
Interestingly, non-allergy sufferers give a higher risk to food labels than allergy sufferers.
According to the research, consumers felt “𝐏𝐫𝐨𝐝𝐮𝐜𝐞𝐝 𝐢𝐧 𝐚 𝐟𝐚𝐜𝐭𝐨𝐫𝐲” was associated with less risk than “𝐌𝐚𝐲 𝐜𝐨𝐧𝐭𝐚𝐢𝐧” or “𝐓𝐫𝐚𝐜𝐞𝐬 𝐨𝐟”.
To make matters worse, a high proportion of allergy sufferers do not read 𝘗𝘈𝘓 and rely on their own previous experience.
The problem is that there are 𝐧𝐨 𝐠𝐮𝐢𝐝𝐞𝐥𝐢𝐧𝐞𝐬 on 𝘗𝘈𝘓 wording or when they should be used.
It is also not compulsory in the 𝐄𝐔, being of voluntary use by producers.
In the 𝐔𝐊, it became compulsory due to 𝘕𝘢𝘵𝘢𝘴𝘩𝘢’𝘴 𝘓𝘢𝘸.
There is an urgent need to enforce legislation, making the wording better and clearer.
It would start with the sole use of “𝐌𝐚𝐲 𝐜𝐨𝐧𝐭𝐚𝐢𝐧” in 𝘗𝘈𝘓, this way levelling the information, potentially decreasing the risk for all allergy sufferers.
Often 𝐬𝐞𝐚𝐟𝐨𝐨𝐝 is what is named to anything coming from the sea.
But this name seems to be mixed or interchanged with 𝐬𝐡𝐞𝐥𝐥𝐟𝐢𝐬𝐡.
Let’s clarify this.
𝐒𝐡𝐞𝐥𝐥𝐟𝐢𝐬𝐡 is made of 𝘴𝘦𝘢 𝘮𝘰𝘭𝘭𝘶𝘴𝘤𝘴 and 𝘤𝘳𝘶𝘴𝘵𝘢𝘤𝘦𝘢𝘯𝘴
Both groups are very different.
The most important allergen is a protein called 𝐭𝐫𝐨𝐩𝐨𝐦𝐲𝐨𝐬𝐢𝐧, and it can be found in the muscle of any of those species.
This is the main reason for cross-reactivity between them.
The incidence of 𝐒𝐡𝐞𝐥𝐥𝐟𝐢𝐬𝐡 allergy depends on diet habits:
As with fish, if you have reacted, but the tests are negative, think of 𝐀𝐧𝐢𝐬𝐚𝐤𝐢𝐬 allergy.
Remember, if you have reacted to 𝐜𝐫𝐮𝐬𝐭𝐚𝐜𝐞𝐚𝐧𝐬, you need to be tested for 𝐡𝐨𝐮𝐬𝐞 𝐝𝐮𝐬𝐭 𝐦𝐢𝐭𝐞𝐬!
Although 𝐟𝐢𝐬𝐡 𝐚𝐥𝐥𝐞𝐫𝐠𝐲 is common, fortunately, it is not as common as other allergies.
Its incidence varies from country to country, and around 40% of people with fish allergy had their first reaction when they were adults.
In 𝘌𝘶𝘳𝘰𝘱𝘦, less than 0.1% of children have a fish allergy.
𝐂𝐨𝐝 has been the primary source of studies and information regarding fish allergy.
Though most fishes contain this protein, this 𝐃𝐎𝐄𝐒 𝐍𝐎𝐓 mean that an allergy to a fish will lead to an allergy to all fish.
If there were no specific allergens on the table I made, it is because none has been identified yet, though some proteins have been.
Some main aspects to note are the following:
There are cases in which an apparent allergic reaction to fish has normal investigations.
Think of the fish in a 𝘧𝘪𝘴𝘩 𝘵𝘢𝘯𝘬!
Parents have asked me if a diagnosis of a food allergy can be made by placing the food on the skin.
The answer is, not always.
Why is that?
Not all concentrations of the allergen can lead to a reaction.
𝐂𝐨𝐧𝐭𝐚𝐜𝐭 𝐃𝐞𝐫𝐦𝐚𝐭𝐢𝐭𝐢𝐬 happens when a substance gets in contact with the skin, causing a localised reaction.
It can be either 𝘪𝘳𝘳𝘪𝘵𝘢𝘯𝘵 (80% of reactions) or 𝘢𝘭𝘭𝘦𝘳𝘨𝘪𝘤 (20% of reactions), leading to different reactions.
It affects people that deal with the substances frequently, though it can happen to anyone.
Treatment starts with avoidance of contact with the substance causing the reaction.
Following this, the creams used are very similar to the ones used in eczema.
It is not frequent the need for oral or intravenous medication.
How to make a diagnosis?
There is also a difference in signs.
Nickel can give irritant and allergic contact dermatitis.
Recent research showed an association between the decrease or absence of anti-inflammatory bacteria and the increase in some 𝐩𝐬𝐲𝐜𝐡𝐢𝐚𝐭𝐫𝐢𝐜 𝐝𝐢𝐬𝐨𝐫𝐝𝐞𝐫𝐬.
This was associated with the increase in pro-inflammatory bacteria.
And what are the bacterias involved?
They believe this relates to the low production of 𝐁𝐮𝐭𝐲𝐫𝐚𝐭𝐞 from the absent bacteria, as this leads to an anti-inflammatory effect, mainly in the bowel.
But please don’t go and start eating it by the bucket load, as this is not the best way to increase 𝐁𝐮𝐭𝐲𝐫𝐚𝐭𝐞 in your system!
Take this research with caution, as the study did not take into account individual variables.
And despite the finding of this exciting relation, some studies directly aimed at this association have not yet proven the link.
What is important is that there starts to exist some evidence that might lead to a better understanding of the connection between gut health and mental health.
This study was done at 𝐊𝐢𝐧𝐠’𝐬 𝐂𝐨𝐥𝐥𝐞𝐠𝐞 𝐋𝐨𝐧𝐝𝐨𝐧, in association with the 𝐌𝐚𝐮𝐝𝐬𝐥𝐞𝐲 𝐇𝐨𝐬𝐩𝐢𝐭𝐚𝐥.
In March this year, researchers from the 𝘈𝘶𝘴𝘵𝘳𝘢𝘭𝘪𝘢𝘯 𝘕𝘢𝘵𝘪𝘰𝘯𝘢𝘭 𝘜𝘯𝘪𝘷𝘦𝘳𝘴𝘪𝘵𝘺 made a fantastic discovery.
They realised that a protein we produce in our bodies significantly influences our immune system’s reaction to allergens.
People who produce less amount of Neuritin have a higher risk of dying of 𝐀𝐧𝐚𝐩𝐡𝐲𝐥𝐚𝐱𝐢𝐬 and developing 𝐚𝐥𝐥𝐞𝐫𝐠𝐢𝐞𝐬.
Studies in mice showed some key components that mediate allergic reactions were substantially raised in mice lacking Neuritin.
They proceeded to give Neuritin to those mice, and it managed to restore the lost function, decreasing the production of 𝐈𝐠𝐄 and other 𝐚𝐧𝐭𝐢𝐛𝐨𝐝𝐢𝐞𝐬.
To make matters more important, it was also found that Neuritin also plays a vital role in decreasing 𝐚𝐮𝐭𝐨-𝐢𝐦𝐦𝐮𝐧𝐞 𝐝𝐢𝐬𝐞𝐚𝐬𝐞, 𝐚𝐬𝐭𝐡𝐦𝐚 and the control of 𝐜𝐚𝐧𝐜𝐞𝐫 cells.
This means we might have a chance to introduce a protein our body produces and give it to patients who are deficient in it, helping them either outgrow their 𝐚𝐥𝐥𝐞𝐫𝐠𝐢𝐞𝐬 and 𝐚𝐬𝐭𝐡𝐦𝐚 or decrease the severity of the symptoms.
It was first described more than 60 years ago but only recently started to be more noted and looked into.
In 2011 the 𝘌𝘶𝘳𝘰𝘱𝘦𝘢𝘯 𝘍𝘰𝘰𝘥 𝘚𝘢𝘧𝘦𝘵𝘺 𝘈𝘨𝘦𝘯𝘤𝘺 raised concerns regarding the high levels of amines (histamine included) present in foods bought in supermarkets, which might be considered a health risk.
Symptoms can happen due to either deficiency of the enzymes that degrade histamine or medication, leading to decreased enzymatic activity.
The main symptoms depend on the organs affected
The best way to reduce symptoms is by either reducing or stopping eating foods containing histamine or taking antihistamines.
The use of DAO (Diamine Oxidase) supplements is still debatable.
They are the most used class of medication in the USA and the 07th in the UK.
The first one discovered in 1937 was a compound called 933F, followed shortly after by 929F.
The big problem is that both were very toxic to the human being.
In 1942 Antergan and in 1945 Diphynhidramine were discovered.
Second generation were only developed in the 1980s.
Currently, there are over 40 different ones.
To make matters slightly more confusing, some second generation also have first generation properties.
But we are only talking about the ones acting on H1 receptors.
These are used for all sorts of allergic reactions:
What are the main differences?
In reality, there are 4 different types of histamine receptors (from H1 to H4).
We have antagonists (actual name is reverse agonists) for H1 and H2, but not for the others.
H1 are further divided into 7 different chemical groups.
This was another blog post collaboration I have done for My Baba.
If you want to read the full article and find how to help your reflux suffering child, click on the link below.
Dr Costa is a Consultant Paediatrician and fellow of the Royal College of Paediatrics and Child Health.