Gıda Kaynaklı Alerjiler ve İntoleranslar
Özet
Gıda kaynaklı alerji ve intoleranslar, artan görülme sıklığı ve sağlık üzerindeki etkileri nedeniyle önemli bir halk sağlığı sorunudur. Bu bölümde, gıda alerjileri bağışıklık yanıtı temelli olarak sınıflandırılmış; oral alerji sendromu, anafilaksi ve eozinofilik hastalıklar gibi durumlara yer verilmiştir. Alerjen proteinlerin yapısal özellikleri, hayvansal ve bitkisel kaynaklarına göre sınıflandırılarak değerlendirilmiştir. Gıda intoleransları ise enzimatik, farmakolojik ve idiopatik türleriyle ele alınmış; laktoz intoleransı, histamin duyarlılığı ve katkı maddelerine bağlı reaksiyonlar gibi örneklerle açıklanmıştır. Alerji ve intoleransların yaygınlıkları ve neden oldukları ekonomik/toplumsal etkiler karşılaştırmalı olarak sunulmuştur. Veteriner Halk Sağlığı perspektifinden gıda güvenliği zincirinde alerjen kontrolünün nasıl sağlanabileceği, politika, eğitim ve endüstri uygulamaları çerçevesinde tartışılmıştır.
Referanslar
Allen, K. J., Turner, P. J., Pawankar, R., Taylor, S., Sicherer, S., Lack, G., & Wong, G. W. K. (2014). Precautionary labelling of foods for allergen content: Are we ready for a global framework? World Allergy Organization Journal, 7(1), 10. https://doi.org/10.1186/1939-4551-7-10
Ayuso, R., Lehrer, S. B., & Reese, G. (2002). Identification of continuous, allergenic regions of the major shrimp allergen Pen a 1 (tropomyosin). International Archives of Allergy and Immunology, 127(1), 27–37. https://doi.org/10.1159/000048166
Bernhisel-Broadbent, J., Strause, D., & Sampson, H. A. (1992). Fish hypersensitivity. I. In vitro and oral challenge results in fish-allergic patients. Journal of Allergy and Clinical Immunology, 89(1), 166–173. https://doi.org/10.1016/0091-6749(92)90381-B
Berry, G. T. (2014). Classic galactosemia and clinical variant galactosemia. GeneReviews. University of Washington, Seattle. https://www.ncbi.nlm.nih.gov/books/NBK1518/
Boyce, J. A., Assa’ad, A., Burks, A. W., Jones, S. M., Sampson, H. A., Wood, R. A., ... & Plaut, M. (2011). Guidelines for the diagnosis and management of food allergy in the United States. Journal of Allergy and Clinical Immunology, 126(6), S1–S58. https://doi.org/10.1016/j.jaci.2010.10.007
Breiteneder, H., & Mills, E. N. C. (2005). Molecular properties of food allergens. Journal of Allergy and Clinical Immunology, 115(1), 14–23. https://doi.org/10.1016/j.jaci.2004.10.022
Breiteneder, H., & Radauer, C. (2004). A classification of plant food allergens. Journal of Allergy and Clinical Immunology, 113(5), 821–830. https://doi.org/10.1016/j.jaci.2004.01.779
Codex Alimentarius Commission. (2020). General standard for the labelling of prepackaged foods CXS 1-1985. FAO/WHO. https://www.fao.org
EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA). (2013). Scientific Opinion on the safety of “citicoline” as a Novel Food ingredient. EFSA Journal, 11(10), 3421. https://doi.org/10.2903/j.efsa.2013.3421
EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA). (2014). Scientific opinion on the evaluation of allergenic foods and food ingredients for labelling purposes. EFSA Journal, 12(11), 3894. https://doi.org/10.2903/j.efsa.2014.3894
European Commission. (2011). Regulation (EU) No 1169/2011 on the provision of food information to consumers. Official Journal of the European Union, L 304, 18–63. https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=CELEX:32011R1169
FAO, & WHO. (2020). Principles and guidelines for the exchange of information between countries on rejections of imported food. FAO/WHO. https://www.fao.org
FAO/WHO. (2020). General standard for the labelling of prepackaged foods: Codex Stan 1-1985 (Amended 2020). Food and Agriculture Organization of the United Nations/World Health Organization. https://www.fao.org/fao-who-codexalimentarius
Feuille, E., & Nowak-Wegrzyn, A. (2015). Food protein-induced enterocolitis syndrome, allergic proctocolitis, and enteropathy. Current Allergy and Asthma Reports, 15(8), 50.
Geha, R. S., Beiser, A., Ren, C., Patterson, R., Greenberger, P. A., Grammer, L. C., ... & Saxon, A. (2000). Multicenter, double-blind, placebo-controlled, multiple-challenge evaluation of reported reactions to monosodium glutamate. Journal of allergy and clinical immunology, 106(5), 973-980. https://doi.org/10.1067/mai.2000.110794
Gupta, R. S., Warren, C. M., Smith, B. M., Jiang, J., Blumenstock, J. A., Davis, M. M., & Nadeau, K. C. (2019). The public health impact of parent-reported childhood food allergies in the United States. Pediatrics, 142(6), e20181235. https://doi.org/10.1542/peds.2018-1235
Lehane, L., & Olley, J. (2000). Histamine fish poisoning revisited. International Journal of Food Microbiology, 58(1–2), 1–37. https://doi.org/10.1016/S0168-1605(00)00296-8
Lomer, M. C. E. (2015). Review article: The aetiology, diagnosis, mechanisms and clinical evidence for food intolerance. Alimentary Pharmacology & Therapeutics, 41(3), 262–275. https://doi.org/10.1111/apt.13041
Luzzatto, L., & Arese, P. (2018). Favism and glucose-6-phosphate dehydrogenase deficiency. The New England Journal of Medicine, 378(1), 60–71. https://doi.org/10.1056/NEJMra1708111
Maintz, L., & Novak, N. (2007). Histamine and histamine intolerance. The American Journal of Clinical Nutrition, 85(5), 1185–1196. https://doi.org/10.1093/ajcn/85.5.1185
Mills, E. C., Mackie, A. R., Burney, P., Beyer, K., Frewer, L., Madsen, C., ... & Van Ree, R. (2007). The prevalence, cost and basis of food allergy across Europe. Allergy, 62(7), 717-722. https://doi.org/10.1111/j.1398-9995.2007.01425.x
Misselwitz, B., Butter, M., Verbeke, K., & Fox, M. R. (2019). Update on lactose malabsorption and intolerance: Pathogenesis, diagnosis and clinical management. Gut, 68(11), 2080–2091. https://doi.org/10.1136/gutjnl-2019-318404
Nowak-Wegrzyn, A. (2015). Food protein-induced enterocolitis syndrome and allergic proctocolitis. In J. M. Spergel (Ed.), Food allergy: Practical diagnosis and management (pp. 131–146). CRC Press.
Prescott, S. L., Pawankar, R., Allen, K. J., Campbell, D. E., Sinn, J. K., Fiocchi, A., ... & Lee, B. W. (2013). A global survey of changing patterns of food allergy burden in children. World Allergy Organization Journal, 6(1), 1-12.
Reese, I., Ballmer-Weber, B. K., Beyer, K., Fuchs, T., Kleine-Tebbe, J., Klimek, L., ... & Werfel, T. (2017). German guideline for the management of adverse reactions to ingested histamine. Allergo Journal International, 26(2), 72–79. https://doi.org/10.1007/s40629-017-0011-5
Sampson, H. A. (2004). Update on food allergy. Journal of Allergy and Clinical Immunology, 113(5), 805–819. https://doi.org/10.1016/j.jaci.2004.03.014
Sampson, H. A., Aceves, S., Bock, S. A., James, J., Jones, S., Lang, D., ... & Wood, R. (2014). Food allergy: A practice parameter update—2014. Journal of Allergy and Clinical Immunology, 134(5), 1016–1025.e43. https://doi.org/10.1016/j.jaci.2014.05.013
Sicherer, S. H. (2011). Epidemiology of food allergy. Journal of Allergy and Clinical Immunology, 127(3), 594–602. https://doi.org/10.1016/j.jaci.2010.11.044
Sicherer, S. H., & Sampson, H. A. (2018). Food allergy: A review and update on epidemiology, pathogenesis, diagnosis, prevention, and management. Journal of Allergy and Clinical Immunology, 141(1), 41–58. https://doi.org/10.1016/j.jaci.2017.11.003
Skypala, I. J., & Vlieg-Boerstra, B. J. (2014). Food intolerance and allergy: Increased incidence or contemporary inadequate diets? Current Opinion in Clinical Nutrition and Metabolic Care, 17(5), 442–447. https://doi.org/10.1097/MCO.0000000000000086
T.C. Tarım ve Orman Bakanlığı. (2011). Türk Gıda Kodeksi Etiketleme ve Tüketicileri Bilgilendirme Yönetmeliği. Resmî Gazete (Sayı: 28157). https://www.resmigazete.gov.tr
T.C. Tarım ve Orman Bakanlığı. (2023). Türk Gıda Kodeksi Gıda Etiketleme ve Tüketicileri Bilgilendirme Yönetmeliğinde Değişiklik Yapılmasına Dair Yönetmelik. Resmî Gazete (Sayı: 32250). https://www.resmigazete.gov.tr
Taylor, S. L., & Hefle, S. L. (2006). Food allergen labeling in the USA and Europe. Current Opinion in Allergy and Clinical Immunology, 6(3), 186–190. https://doi.org/10.1097/01.all.0000225158.75521.ad
U.S. Food and Drug Administration. (2017). Food Allergen Labeling and Consumer Protection Act of 2004 (FALCPA). https://www.fda.gov
U.S. Food and Drug Administration. (2020). Food Safety Modernization Act (FSMA). https://www.fda.gov
Van Spronsen, F. J., van Wegberg, A. M., Ahring, K., Bélanger-Quintana, A., Blau, N., Bosch, A. M., ... & MacDonald, A. (2017). Key European guidelines for the diagnosis and management of patients with phenylketonuria. The lancet diabetes & endocrinology, 5(9), 743-756. https://doi.org/10.1016/S2213-8587(16)30320-5
Verhoeckx, K. C., Vissers, Y. M., Baumert, J. L., Faludi, R., Feys, M., Flanagan, S., ... & Taylor, S. L. (2015). Food processing and allergenicity. Food and Chemical Toxicology, 80, 223–240. https://doi.org/10.1016/j.fct.2015.03.005
Vieths, S., Scheurer, S., & Ballmer-Weber, B. (2002). Current understanding of cross-reactivity of food allergens and pollen. Annals of the New York Academy of Sciences, 964(1), 47–68. https://doi.org/10.1111/j.1749-6632.2002.tb04132.x
Warren, C. M., Jiang, J., & Gupta, R. S. (2020). Epidemiology and burden of food allergy. Current allergy and asthma reports, 20(2), 6. https://doi.org/10.1007/s11882-020-0898-7
World Health Organization & Food and Agriculture Organization of the United Nations. (2021). Risk assessment of food allergens: Part 1—Review and validation of risk assessment frameworks. WHO/FAO. https://www.who.int
World Health Organization. (2020). WHO guidance on food allergen labelling and prevention of cross-contamination. WHO. https://www.who.int
Yu, W., Freeland, D. M. H., & Nadeau, K. C. (2016). Food allergy: Immune mechanisms, diagnosis and immunotherapy. Nature Reviews Immunology, 16(12), 751–765. https://doi.org/10.1038/nri.2016.111
