11/5/03 Food allergy and asthma - is there a link?SummaryFood allergy (FA) is common in childhood, occurring in 6-8% of children, particularly in the first several years of life. Asthma is also common in this population. But is there a link between FA and asthma? This subject was reviewed by Roberts and Lack of the Royal London Hospital in the UK. They pointed out that many parents of asthmatic children are convinced that FA reactions commonly cause acute asthma attacks. However, objective testing suggests that FA plays a pathogenic role in only a minority of asthmatic episodes. However, their group has found, in case-control studies that the presence of FA is associated with an increased risk of have life-threatening asthma exacerbations. Additionally, the presence of active asthma is a risk factor for life-threatening allergic reactions to food. The mechanisms underlying this connection are not defined. Nevertheless, the coexistence of FA should be looked for carefully in all childhood asthmatics and then the offending food avoided as much as possible. Reference Pediatric Respir Rev 2003; 4:205-12 Editor's Comments This subject has interested clinicians and investigators for a long time. In a recent review (Pediatrics 2003; 111:1625-30) James commented that when FA-related asthmatic manifestations occur they are usually part of a multi-system reaction to the food. However, chronic or isolated asthma due to FA reactions is very unusual. Such isolated asthmatic reactions to foods can occur when very sensitive individuals inhale sizable amounts of vapors when close to the stove-top cooking of the offending food; this occurs particularly when the food is "fast cooked" such as stir-frying. This type of cooking is usually associated with less thermal denaturation of thermolabile food allergens.
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