Supplementary Table 1.
Mechanisms and Clinical Manifestations of IgE-Associated Food allergy
| Organ system | Clinical manifestations | Immunopathology | Features | Age and natural course |
|---|---|---|---|---|
| Skin | Urticaria, angioedema Flush, pruritus Oral allergy syndrome (local itching and tingling and/or edema of lips, tongue, palate and pharynx) |
IgE-mediated mast cell/basophil degranulation | Acute onset after food ingestion (minutes-hours) | In infants and adults, may resolve with age Appears mainly in adults with established pollen allergies, long-lived, boosted by pollen contact |
| Contact urticaria | After direct skin contact | In infants and adults | ||
| Atopic dermatitis Protein contact dermatitis |
T cell-mediated (with or without involvement of IgE) | Delayed type reaction > 24 hours after food ingestion | In infants and adults | |
| Respiratory tract | Laryngeal and/or pharyngeal edema Hoarseness, cough |
IgE-mediated mast cell/basophil degranulation | Acute onset after food ingestion (minutes-hours) | In infants and adults |
| Rhinoconjunctivitis Bronchial asthma |
T cell-mediated (with or without involvement of IgE) | Delayed type reaction > 24 hours after food ingestion | In infants and adults Baker’s asthma in adults |
|
| Gastrointestinal tract | Colitis Diarrhea Gastroenteritis Anorexia Nausea, vomiting Abdominal pain Flatulence Abdominal distension |
IgE-mediated mast cell/basophil degranulation | Acute onset after food ingestion (minutes-hours) | In infants and adults |
| Gastroenteritis | T cell-mediated (with or without involvement of IgE) | Delayed type reaction > 24 hours after food ingestion, increased pro-inflammatory cytokine responses | In infants and adults, may resolve with age | |
| Eosinophilic gastroenteritis Eosinophilic esophagitis |
Eosinophilic gastroenteritis | Eosinophil-activation by cytokines | In infants and adults | |
| Cardiovascular system | Tachycardia Hypotension Vascular collapse Anaphylactic shock Cardiac dysrhythmia |
IgE-mediated mast cell/basophil degranulation | Acute onset after food ingestion (minutes-hours) | In infants and adults |
| Nervous system | Irritability Anxiety |
IgE-mediated mast cell/basophil degranulation? | Acute onset after food ingestion (minutes-hours) | In infants and adults |
| Confusion | and/or | and/or | ||
| Loss of consciousness | T cell-mediated (with or without involvement of IgE)? | Delayed type reaction > 24 hours after food ingestion | ||