Drug Treatment in the Management of Food Allergy

At present, drug treatment has little part to play in the management of food allergies. There are two exceptions. First, there are a very small number of cases in which the reaction to a food is exclusively gastrointestinal, and in whom the reaction can be blocked by taking the drug sodium cromoglycate by mouth 20min before the trigger food is swallowed. Second, there are a small number of individuals who develop the life-threatening reaction, of anaphylactic shock when exposed to a trigger food. There are three ways in which anaphylactic shock may prove fatal. First, rapid swelling of the soft tissues in the pharynx may completely obstruct the airway; the treatment is to bypass the obstruction, either by passing an endotracheal tube, or by performing a tracheostomy. Another mechanism is severe shock, with a profound drop in blood pressure; the life-

saving treatment is to restore the circulating volume with intravenous fluids and to give oxygen. The third mechanism is severe bronchoconstriction (asthma); here, the life-saving treatment is with bronchodilator drugs and artificial ventilation. If patients with life-threatening anaphylactic shock are to be saved, they must be given urgent (within minutes) medical attention. For individuals who have already experienced a life-threatening allergic reaction to a food, it is common practice to provide them with a syringe preloaded with adrenaline (epinephrine), with the aim that this should be administered while waiting for medical help. Unfortunately, self-administered adrenaline is not without its hazards (e.g., inadvertent intravenous administration causing fatal cardiac arrest), and there is no proof that it is life saving; indeed, there are many cases in which the subject died despite the use of epinephrine. Nevertheless, it is the best one can do when faced with someone who is experiencing a life-threatening allergic reaction to a food. The need for urgent medical help cannot be overemphasized.

There is little evidence that antihistamine drugs are of any value. It would be reasonable to take a nonsedating fast-acting antihistamine such as terfe-nadine if experiencing an allergic reaction to a food, but it is questionable whether it will have much effect.

A number of new approaches to the treatment of IgE-mediated food allergy are being examined. In a double-blind placebo-controlled study of monthly injections of a preparation of anti-IgE antibodies, treated patients with peanut allergy required significantly greater amounts of peanut protein to elicit allergic symptoms compared with control subjects. Another anti-IgE preparation has been used in the treatment of asthma but has not been evaluated in peanut allergy. Theoretically, anti-IgE antibody treatment should be protective against multiple food allergens, although it would have to be administered indefinitely. Other experimental approaches include a concoction of traditional Chinese herbs, injection of heat-killed Escherichia coli containing mutated recombinant peanut proteins Ara h 1 to Ara h 3, the use of immunostimulatory sequences, and the use of chimeric protein that could form complexes with allergen-specific IgE bound to mast cells and basophils.

Allergic To Everything

Allergic To Everything

The human body And Todays chemical infested world. Here is a news flash You are not allergic to pollen, pet dander, or whatever it is that makes your body revolt Rather, your body just can not handle that one thing, what ever it is, anymore, due to the massive barrage of toxic chemicals you and everyone else are ingesting every single day.

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