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. 2003 Jun;111(8):1114–1121. doi: 10.1289/ehp.5811

Clinical and laboratory investigation of allergy to genetically modified foods.

Jonathan A Bernstein 1, I Leonard Bernstein 1, Luca Bucchini 1, Lynn R Goldman 1, Robert G Hamilton 1, Samuel Lehrer 1, Carol Rubin 1, Hugh A Sampson 1
PMCID: PMC1241560  PMID: 12826483

Abstract

Technology has improved the food supply since the first cultivation of crops. Genetic engineering facilitates the transfer of genes among organisms. Generally, only minute amounts of a specific protein need to be expressed to obtain the desired trait. Food allergy affects only individuals with an abnormal immunologic response to food--6% of children and 1.5-2% of adults in the United States. Not all diseases caused by food allergy are mediated by IgE. A number of expert committees have advised the U.S. government and international organizations on risk assessment for allergenicity of food proteins. These committees have created decision trees largely based on assessment of IgE-mediated food allergenicity. Difficulties include the limited availability of allergen-specific IgE antisera from allergic persons as validated source material, the utility of specific IgE assays, limited characterization of food proteins, cross-reactivity between food and other allergens, and modifications of food proteins by processing. StarLink was a corn variety modified to produce a (Italic)Bacillus thuringiensis(/Italic) (Bt) endotoxin, Cry9C. The Centers for Disease Control and Prevention investigated 51 reports of possible adverse reactions to corn that occurred after the announcement that StarLink, allowed for animal feed, was found in the human food supply. Allergic reactions were not confirmed, but tools for postmarket assessment were limited. Workers in agricultural and food preparation facilities have potential inhalation exposure to plant dusts and flours. In 1999, researchers found that migrant health workers can become sensitized to certain Bt spore extracts after exposure to Bt spraying.

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Selected References

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  1. Aalberse R. C., Stapel S. O. Structure of food allergens in relation to allergenicity. Pediatr Allergy Immunol. 2001;12 (Suppl 14):10–14. doi: 10.1034/j.1399-3038.2001.121403.x. [DOI] [PubMed] [Google Scholar]
  2. Bernstein I. L., Bernstein J. A., Miller M., Tierzieva S., Bernstein D. I., Lummus Z., Selgrade M. K., Doerfler D. L., Seligy V. L. Immune responses in farm workers after exposure to Bacillus thuringiensis pesticides. Environ Health Perspect. 1999 Jul;107(7):575–582. doi: 10.1289/ehp.99107575. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Bock S. A. Prospective appraisal of complaints of adverse reactions to foods in children during the first 3 years of life. Pediatrics. 1987 May;79(5):683–688. [PubMed] [Google Scholar]
  4. Breiteneder H., Ebner C. Molecular and biochemical classification of plant-derived food allergens. J Allergy Clin Immunol. 2000 Jul;106(1 Pt 1):27–36. doi: 10.1067/mai.2000.106929. [DOI] [PubMed] [Google Scholar]
  5. Bucchini Luca, Goldman Lynn R. Starlink corn: a risk analysis. Environ Health Perspect. 2002 Jan;110(1):5–13. doi: 10.1289/ehp.021105. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Burks A. W., Mallory S. B., Williams L. W., Shirrell M. A. Atopic dermatitis: clinical relevance of food hypersensitivity reactions. J Pediatr. 1988 Sep;113(3):447–451. doi: 10.1016/s0022-3476(88)80626-7. [DOI] [PubMed] [Google Scholar]
  7. Cartier A., Malo J. L., Forest F., Lafrance M., Pineau L., St-Aubin J. J., Dubois J. Y. Occupational asthma in snow crab-processing workers. J Allergy Clin Immunol. 1984 Sep;74(3 Pt 1):261–269. doi: 10.1016/0091-6749(84)90256-2. [DOI] [PubMed] [Google Scholar]
  8. Champion R. H., Roberts S. O., Carpenter R. G., Roger J. H. Urticaria and angio-oedema. A review of 554 patients. Br J Dermatol. 1969 Aug;81(8):588–597. doi: 10.1111/j.1365-2133.1969.tb16041.x. [DOI] [PubMed] [Google Scholar]
  9. Hall R. P. The pathogenesis of dermatitis herpetiformis: recent advances. J Am Acad Dermatol. 1987 Jun;16(6):1129–1144. doi: 10.1016/s0190-9622(87)70148-0. [DOI] [PubMed] [Google Scholar]
  10. Hamilton R. G., Kagey-Sobotka A. In vitro diagnostic tests of IgE-mediated diseases. Clin Allergy Immunol. 2000;15:89–110. [PubMed] [Google Scholar]
  11. Hide D. W., Guyer B. M. Cows milk intolerance in Isle of Wight infants. Br J Clin Pract. 1983 Sep;37(9):285–287. [PubMed] [Google Scholar]
  12. Hänninen A. R., Mikkola J. H., Kalkkinen N., Turjanmaa K., Ylitalo L., Reunala T., Palosuo T. Increased allergen production in turnip (Brassica rapa) by treatments activating defense mechanisms. J Allergy Clin Immunol. 1999 Jul;104(1):194–201. doi: 10.1016/s0091-6749(99)70135-1. [DOI] [PubMed] [Google Scholar]
  13. Høst A., Husby S., Osterballe O. A prospective study of cow's milk allergy in exclusively breast-fed infants. Incidence, pathogenetic role of early inadvertent exposure to cow's milk formula, and characterization of bovine milk protein in human milk. Acta Paediatr Scand. 1988 Sep;77(5):663–670. doi: 10.1111/j.1651-2227.1988.tb10727.x. [DOI] [PubMed] [Google Scholar]
  14. Iacono G., Carroccio A., Cavataio F., Montalto G., Kazmierska I., Lorello D., Soresi M., Notarbartolo A. Gastroesophageal reflux and cow's milk allergy in infants: a prospective study. J Allergy Clin Immunol. 1996 Mar;97(3):822–827. doi: 10.1016/s0091-6749(96)80160-6. [DOI] [PubMed] [Google Scholar]
  15. James J. M., Bernhisel-Broadbent J., Sampson H. A. Respiratory reactions provoked by double-blind food challenges in children. Am J Respir Crit Care Med. 1994 Jan;149(1):59–64. doi: 10.1164/ajrccm.149.1.8111598. [DOI] [PubMed] [Google Scholar]
  16. James J. M., Eigenmann P. A., Eggleston P. A., Sampson H. A. Airway reactivity changes in asthmatic patients undergoing blinded food challenges. Am J Respir Crit Care Med. 1996 Feb;153(2):597–603. doi: 10.1164/ajrccm.153.2.8564104. [DOI] [PubMed] [Google Scholar]
  17. Jansen J. J., Kardinaal A. F., Huijbers G., Vlieg-Boerstra B. J., Martens B. P., Ockhuizen T. Prevalence of food allergy and intolerance in the adult Dutch population. J Allergy Clin Immunol. 1994 Feb;93(2):446–456. doi: 10.1016/0091-6749(94)90353-0. [DOI] [PubMed] [Google Scholar]
  18. Kelly K. J., Lazenby A. J., Rowe P. C., Yardley J. H., Perman J. A., Sampson H. A. Eosinophilic esophagitis attributed to gastroesophageal reflux: improvement with an amino acid-based formula. Gastroenterology. 1995 Nov;109(5):1503–1512. doi: 10.1016/0016-5085(95)90637-1. [DOI] [PubMed] [Google Scholar]
  19. Kemp S. F., Lockey R. F., Wolf B. L., Lieberman P. Anaphylaxis. A review of 266 cases. Arch Intern Med. 1995 Sep 11;155(16):1749–1754. doi: 10.1001/archinte.155.16.1749. [DOI] [PubMed] [Google Scholar]
  20. Kuitunen P., Visakorpi J. K., Savilahti E., Pelkonen P. Malabsorption syndrome with cow's milk intolerance. Clinical findings and course in 54 cases. Arch Dis Child. 1975 May;50(5):351–356. doi: 10.1136/adc.50.5.351. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Lee C. M., Changchien C. S., Chen P. C., Lin D. Y., Sheen I. S., Wang C. S., Tai D. I., Sheen-Chen S. M., Chen W. J., Wu C. S. Eosinophilic gastroenteritis: 10 years experience. Am J Gastroenterol. 1993 Jan;88(1):70–74. [PubMed] [Google Scholar]
  22. Leser C., Hartmann A. L., Praml G., Wüthrich B. The "egg-egg" syndrome: occupational respiratory allergy to airborne egg proteins with consecutive ingestive egg allergy in the bakery and confectionery industry. J Investig Allergol Clin Immunol. 2001;11(2):89–93. [PubMed] [Google Scholar]
  23. Lybarger J. A., Gallagher J. S., Pulver D. W., Litwin A., Brooks S., Bernstein I. L. Occupational asthma induced by inhalation and ingestion of garlic. J Allergy Clin Immunol. 1982 May;69(5):448–454. doi: 10.1016/0091-6749(82)90120-8. [DOI] [PubMed] [Google Scholar]
  24. Machida H. M., Catto Smith A. G., Gall D. G., Trevenen C., Scott R. B. Allergic colitis in infancy: clinical and pathologic aspects. J Pediatr Gastroenterol Nutr. 1994 Jul;19(1):22–26. doi: 10.1097/00005176-199407000-00004. [DOI] [PubMed] [Google Scholar]
  25. Metcalfe D. D., Astwood J. D., Townsend R., Sampson H. A., Taylor S. L., Fuchs R. L. Assessment of the allergenic potential of foods derived from genetically engineered crop plants. Crit Rev Food Sci Nutr. 1996;36 (Suppl):S165–S186. doi: 10.1080/10408399609527763. [DOI] [PubMed] [Google Scholar]
  26. Metcalfe Dean D. Introduction: what are the issues in addressing the allergenic potential of genetically modified foods? Environ Health Perspect. 2003 Jun;111(8):1110–1113. doi: 10.1289/ehp.5810. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Nagata S., Yamashiro Y., Ohtsuka Y., Shioya T., Oguchi S., Shimizu T., Maeda M. Quantitative analysis and immunohistochemical studies on small intestinal mucosa of food-sensitive enteropathy. J Pediatr Gastroenterol Nutr. 1995 Jan;20(1):44–48. doi: 10.1097/00005176-199501000-00008. [DOI] [PubMed] [Google Scholar]
  28. Novembre E., de Martino M., Vierucci A. Foods and respiratory allergy. J Allergy Clin Immunol. 1988 May;81(5 Pt 2):1059–1065. doi: 10.1016/0091-6749(88)90181-9. [DOI] [PubMed] [Google Scholar]
  29. Odze R. D., Wershil B. K., Leichtner A. M., Antonioli D. A. Allergic colitis in infants. J Pediatr. 1995 Feb;126(2):163–170. doi: 10.1016/s0022-3476(95)70540-6. [DOI] [PubMed] [Google Scholar]
  30. Oehling A., Baena Cagnani C. E. Food allergy and child asthma. Allergol Immunopathol (Madr) 1980 Jan-Feb;8(1):7–14. [PubMed] [Google Scholar]
  31. Ortolani C., Ispano M., Pastorello E., Bigi A., Ansaloni R. The oral allergy syndrome. Ann Allergy. 1988 Dec;61(6 Pt 2):47–52. [PubMed] [Google Scholar]
  32. Pastorello E. A., Farioli L., Pravettoni V., Ispano M., Scibola E., Trambaioli C., Giuffrida M. G., Ansaloni R., Godovac-Zimmermann J., Conti A. The maize major allergen, which is responsible for food-induced allergic reactions, is a lipid transfer protein. J Allergy Clin Immunol. 2000 Oct;106(4):744–751. doi: 10.1067/mai.2000.108712. [DOI] [PubMed] [Google Scholar]
  33. Pastorello E. A., Ortolani C., Farioli L., Pravettoni V., Ispano M., Borga A., Bengtsson A., Incorvaia C., Berti C., Zanussi C. Allergenic cross-reactivity among peach, apricot, plum, and cherry in patients with oral allergy syndrome: an in vivo and in vitro study. J Allergy Clin Immunol. 1994 Oct;94(4):699–707. doi: 10.1016/0091-6749(94)90177-5. [DOI] [PubMed] [Google Scholar]
  34. Powell G. K. Milk- and soy-induced enterocolitis of infancy. Clinical features and standardization of challenge. J Pediatr. 1978 Oct;93(4):553–560. doi: 10.1016/s0022-3476(78)80887-7. [DOI] [PubMed] [Google Scholar]
  35. Romano A., Di Fonso M., Giuffreda F., Quaratino D., Papa G., Palmieri V., Zeppilli P., Venuti A. Diagnostic work-up for food-dependent, exercise-induced anaphylaxis. Allergy. 1995 Oct;50(10):817–824. doi: 10.1111/j.1398-9995.1995.tb05055.x. [DOI] [PubMed] [Google Scholar]
  36. Salcedo G., Diaz-Perales A., Sanchez-Monge R. The role of plant panallergens in sensitization to natural rubber latex. Curr Opin Allergy Clin Immunol. 2001 Apr;1(2):177–183. doi: 10.1097/01.all.0000011004.49250.bc. [DOI] [PubMed] [Google Scholar]
  37. Sampson H. A. Infantile colic and food allergy: fact or fiction? J Pediatr. 1989 Oct;115(4):583–584. doi: 10.1016/s0022-3476(89)80285-9. [DOI] [PubMed] [Google Scholar]
  38. Sampson H. A., McCaskill C. C. Food hypersensitivity and atopic dermatitis: evaluation of 113 patients. J Pediatr. 1985 Nov;107(5):669–675. doi: 10.1016/s0022-3476(85)80390-5. [DOI] [PubMed] [Google Scholar]
  39. Sampson H. A., Mendelson L., Rosen J. P. Fatal and near-fatal anaphylactic reactions to food in children and adolescents. N Engl J Med. 1992 Aug 6;327(6):380–384. doi: 10.1056/NEJM199208063270603. [DOI] [PubMed] [Google Scholar]
  40. Sampson H. A., Scanlon S. M. Natural history of food hypersensitivity in children with atopic dermatitis. J Pediatr. 1989 Jul;115(1):23–27. doi: 10.1016/s0022-3476(89)80323-3. [DOI] [PubMed] [Google Scholar]
  41. Schrander J. J., van den Bogart J. P., Forget P. P., Schrander-Stumpel C. T., Kuijten R. H., Kester A. D. Cow's milk protein intolerance in infants under 1 year of age: a prospective epidemiological study. Eur J Pediatr. 1993 Aug;152(8):640–644. doi: 10.1007/BF01955238. [DOI] [PubMed] [Google Scholar]
  42. Smith A. B., Bernstein D. I., Aw T. C., Gallagher J. S., London M., Kopp S., Carson G. A. Occupational asthma from inhaled egg protein. Am J Ind Med. 1987;12(2):205–218. doi: 10.1002/ajim.4700120209. [DOI] [PubMed] [Google Scholar]
  43. Snyder J. D., Rosenblum N., Wershil B., Goldman H., Winter H. S. Pyloric stenosis and eosinophilic gastroenteritis in infants. J Pediatr Gastroenterol Nutr. 1987 Jul-Aug;6(4):543–547. doi: 10.1097/00005176-198707000-00009. [DOI] [PubMed] [Google Scholar]
  44. Sánchez-Monge R., Blanco C., Perales A. D., Collada C., Carrillo T., Aragoncillo C., Salcedo G. Class I chitinases, the panallergens responsible for the latex-fruit syndrome, are induced by ethylene treatment and inactivated by heating. J Allergy Clin Immunol. 2000 Jul;106(1 Pt 1):190–195. doi: 10.1067/mai.2000.107599. [DOI] [PubMed] [Google Scholar]
  45. Volonakis M., Katsarou-Katsari A., Stratigos J. Etiologic factors in childhood chronic urticaria. Ann Allergy. 1992 Jul;69(1):61–65. [PubMed] [Google Scholar]
  46. Waldmann T. A., Wochner R. D., Laster L., Gordon R. S., Jr Allergic gastroenteropathy. A cause of excessive gastrointestinal protein loss. N Engl J Med. 1967 Apr 6;276(14):762–769. doi: 10.1056/NEJM196704062761401. [DOI] [PubMed] [Google Scholar]
  47. Yocum M. W., Khan D. A. Assessment of patients who have experienced anaphylaxis: a 3-year survey. Mayo Clin Proc. 1994 Jan;69(1):16–23. doi: 10.1016/s0025-6196(12)61606-1. [DOI] [PubMed] [Google Scholar]
  48. Young E., Stoneham M. D., Petruckevitch A., Barton J., Rona R. A population study of food intolerance. Lancet. 1994 May 7;343(8906):1127–1130. doi: 10.1016/s0140-6736(94)90234-8. [DOI] [PubMed] [Google Scholar]
  49. Yunginger J. W., Sweeney K. G., Sturner W. Q., Giannandrea L. A., Teigland J. D., Bray M., Benson P. A., York J. A., Biedrzycki L., Squillace D. L. Fatal food-induced anaphylaxis. JAMA. 1988 Sep 9;260(10):1450–1452. [PubMed] [Google Scholar]

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