Importance of food allergy and food intolerance in allergic multimorbidity
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Faculty of Health Sciences, Medical University, Warsaw, Poland
Department of Prevention of Environmental Hazards and Allergology, Medical University, Warsaw, Poland
Department of Women’s Health, Institute of Rural Health, Lublin, Poland
Corresponding author
Iwona Bojar   

Department of Women’s Health, Institute of Rural Health, Lublin, Poland, Poland
Ann Agric Environ Med. 2020;27(3):413-417
Allergy affects approximately one-third of the world’s population, and the rates are growing. In Europe, it has been noticed that the risk of asthma and allergy is lower in the rural as opposed to urban population. There is a tendency for several allergic diseases to be present in the same person at the same time.

The aim of the study was to verify the co-occurrence of allergic multimorbidity and food allergy and intolerance in a group of children.

Material and methods:
The multicentre cross-sectional study enrolled 1,008 children and adolescence aged 6–18 years (51.2% boys, 48.8% girls). The study comprised a questionnaire (respondents’ declarations) and an outpatient examination (diagnostic examination followed by a medical diagnosis). The study was conducted as part of the 2016–2020 National Health Programme.

In the study group, allergic rhinitis (AR) was present in 46.4%, bronchial asthma (BA) in 11.2% and atopic dermatitis (AD) in 6%. Allergic multimorbidity (simultaneous presence of 2 or more of the allergic diseases AR, BA and AD) was diagnosed in 9.7%. A single allergic disease (of the 3) was diagnosed in 43.4%. A diagnosis of food allergy and food intolerance was reported respectively at 29.6% and 14.3% participants with doctor-diagnosed allergic multimorbidity. Among those without any of the 3 allergic diseases, the percentage were 14.4% and 9.1%, respectively.

Food allergy or food intolerance was more common in subjects with allergic multimorbidity than in subjects diagnosed with one allergic disease or those free of allergic diseases.

ISAAC – International Study of Asthma and Allergy In Childhood; ECRHS II – European Community Respiratory Health Survey II; BA – bronchial asthma; AR – allergic rhinitis; AD – atopic dermatitis; FI – food intolerance; WHO – World Health Organisation; FA – food allergy; ECAP – Epidemiology of Allergic Diseases in Poland; ARIA – Allergic Rhinitis and its Impact on Asthma
Igea JM. The history of the idea of allergy. Allergy. 2013; 68(8): 966–73.
Butrym I, Płaczkowska S, Pawlik-Sobecka L, Smolińska S. Podstawowe testy wykorzystywane w diagnostyce alergii IgE-zależnej i alergii kontaktowej. Diagnostyka Laboratoryjna. 2017; 53(3): 169–174.
European Allergy White Paper, The UCB Institute of Allergy. Allergic diseases as a public health problem in Europe. UCB Institute of Allergy 1997.
Ibrahim NK, Alghamdi AA, Almehmadi MM, Alzahrani AA, Turkistani AK, Alghamdi K. Allergy and related clinical symptoms among medical students and interns. Pak J Med Sci. 2019; 35: 1060–1065.
Samoliński B, Raciborski F, Lipiec A, et al. Epidemiologia chorób alergicznych w Polsce ECAP. Alergol Pol. 2014; 1: 10–8.
European Community Respiratory Health Survey: Variations in the prevalence of respiratory symptoms, self- reported asthma, and use of asthma medication in the European Community Respiratory Health Survey. Eur Respir J. 1996; 9: 687–695.
Lipiec A, Wawrzyniak ZM, Sybilski AJ, et al. The association between paracetamol use and the risk of asthma, rhinitis and eczema in the Polish population. Ann Agric Environ Med. 2018; 25(3): 428–432.
Van Niekerk CH, Weinberg EG, ShoreSC, Heese HV, Van Schalkwyk J. Prevalence of asthma: a comparative study of urban and rural Xhosa children. Clin Allergy 1979; 9: 319–324.
Riedler J, Eder W, Oberfeld G, Schreuer M. Austrian children living on a farm have less hay fever, asthma and allergic sensitization. Clin Exp Allergy. 2000; 30: 194–200.
Radlović N, Leković Z, Radlović V, Simić D, Ristić D, Vuletić B. Food allergy in children. Srp Arh Celok Lek. 2016; 144(1–2): 99–103.
Ebisawa M, Ito K, Fujisawa T, Committee for Japanese Pediatric Guideline for Food Allergy, The Japanese Society of Pediatric Allergy and Clinical Immunology, The Japanese Society of Allergology. Allergol Int. 2017; 66(2): 248–264.
Sicherer SH, Sampson HA. Food allergy: a review and update on epidemiology, pathogenesis, diagnosis, prevention, and management. J Allergy Clin Immunol. 2018; 141(1): 41–58.
Yu W, Freeland DMH, Nadeau KC. Food allergy: Immune mechanisms, diagnosis and immunotherapy. Nat Rev Immunol. 2016; 16: 751–765.
Crowe SE. Food Allergy Vs Food Intolerance in Patients With Irritable Bowle Syndrome. Gastroenterol Hepatol (N.Y). 2019; 15(1): 38–40.
Agache I, Aojanu C, Laculiceanu A, Rogozea L. Critical Points on the Use of Biologicals in Allergic Diseases and Asthma. Allergy Asthma Immunol Res. 2020. (1): 24–41.
Bednarek A, Klepacz R, Surtel A, Mazur A, Saran T, Zarzycka D, et al. Influence of environment on residence and selected demographic and clinical parameters of preschool children with IgE-dependent asthma. Ann Agric Environ Med. 2019; 26: 439–444.
Nutten S. Atopic dermatitis: global epidemiology and risk factors. Ann Nutrit Metab. 2015; 66(Suppl 1): 8–16.
Cabanillas B, Brehler AC, Novak N. Atopic dermatitis phenotypes and the need for personalized medicine. Curr Opin Allergy Clin Immunol. 2017; 17: 309–315.
Thomsen SF. Atopic dermatitis: Natural history, diagnosis, and treatment. ISRN Allergy. 2014; 2014: 354250.
McPherson T. Current Understanding in Pathogenesis of Atopic Dermatitis. Indian J Dermatol. 2016; 61(6): 649–655.
Sybilski AJ, Raciborski F, Lipiec A, et al. Atopic dermatitis is a serious health problem in Poland. Epidemiology studies based on the ECAP study. Postepy Dermatol Alergol. 2015; 32: 1–10.
Brzoznowski W. Standardy diagnostyczne i terapeutyczne alergicznego nieżytu nosa. Forum Med Rodz. 2009; 3(3): 173–180.
Head K, Snidvongs K, Glew S, Scadding G, Schilder AG, Philpott C, et al. Saline irrigation for allergic rhinitis. Cochrane Datab Syst Rev. 2018; 6.
Samoliński B, Raciborski F. Znaczenie AZS w wielochorobowości alergii. I. Interdyscyplinarna Akademia Atopii. 2017.
Megna M, Napolitano M, Patruno C, Villani A, Balato A, Monfrecola G, et al. Systemic treatment of adult atopic dermatitis: a review. Dermatol Ther (Heidelb). 2017; 7(1): 1–23.
Humbert M, Bousquet J, Bachert C, Palomares O, Pfister P, et al. IgE-Mediated Multimorbidities in Allergic Asthma and the Potential for Omalizumab Therapy. J Allergy Clin Immunol Pract. 2019; 7(5): 1418–1429.
Krogulska A. Znaczenie alergenów pokarmowych u dzieci i dorosłych z alergią wziewną. Alergia Astma Immunol. 2016; 21(1): 16–27.
Hanif T, Laulajainen-Hongisto A, Numminem J, Kääriäinen J, Myller J, et al. Hierarchical clustering in evaluating inflammatory upper airway phenotypes; increased symptoms in adults with allergic multimorbidity. Asian Pac J Allergy Immunol. 2019.
Raciborski F, Bousquet J, Namysłowski A, Krzych-Fałta E, Tomaszewska A, Piekarska B, Samel-Kowalik P, Białoszewski AZ, Walkiewicz A, Lipiec A, et al. Dissociating polysensitization and multimorbidity in children and adults from a Polish general population cohort. Clin Transl Allergy. 2019; 9: 23.
Prescott SL, Pawankar R, Allen KJ. Campbell D. A global survey of changing patterns of food allergy burden in children. World Allergy Organ J. 2013; 6(1): 21.
Paller AS, Spergel JM, Mina-Osorio P, Irvine AD. The atopic march and atopic multimorbidity: Many trajectories, many pathways. J Allergy Clin Immunol. 2019; 143(1): 46–55.
Lack G. Update on risk factors for food allergy. J Allergy Clin Immunol. 2012; 129(5): 1187–1197.
Licari A, Manti S, Marseglia A, et al. Food Allergies: Current and Future Treatments. Medicina (Kaunas). 2019 May; 55(5): 120.
Priftis KN, Mermiri D, Papadopoulou A, Papadopoulos M, Fretzayas A, Lagona E, et al. Asthma symptoms and bronchial reactivity in school children sensitized to food allergens in infancy. J Asthma. 2008; 45(7): 590–5.
Wang J, Visness CM, Sampson HA. Food allergen sensitization in inner-city children with asthma. J Allergy Clin Immunol. 2005; 115: 1076–1080.
Arabkhazaeli A, Vijverberg SJ, van Erp FC, Raaijmakers JA, van der Ent CK, van der Maitland Zee AH. Characteristics and severity of asthma in children with and without atopic conditions: a cross-sectional study. BMC Pediatr. 2015; 15: 172.
Roberts G, Patel N, Levi-Schaffer F, Habibi P, Lack G. Food allergy as a risk factor for life-threatening asthma in childhood: a case-controlled study. J Allergy Clin Immunol. 2003; 112(1): 168–174.
Jarmillo R, Massing M, Sicherer S, et al. High-level sensitization to foods is associated with asthma ER visits and current asthma in the US: results from NHANES 2005–2006. J Allergy Clin Immunol. 2009; 123: 2–419.
Dhar S, Srinivas SM. Food allergy in atopic dermatitis. Indian J Dermatol. 2016; 61: 645–8.
Bergmann M, Caubet J, Boguniewicz M, Eigenmann P. Evaluation of food allergy in patients with atopic dermatitis. J Allergy Clin Immunol Pract. 2013; 1(1): 22–8.
Tsakok T, Marrs T, Mohsin M, Baron S, du Toit G, Till S, Flohr C. Does atopic dermatitis cause food allergy? A systematic review. J Allergy Clin Immunol. 2016; 137(4): 1071–1078.
Al-Rabia MW. Food-induced immunoglobulin E-mediated allergic rhinitis. J Microsc Ultrastruct. 2016; 4: 69–75.
Al-Abri R, Al-Amri AS, Al-Dhahli Z, Varghese AM. Allergic rhinitis in relation to food allergies: Pointers to future research. Sultan Qaboos Univ Med J. 2018; 18(1): 30–3.
Tariq SM, Matthews SM, Hakim EA, Arshad SH. Egg allergy in infancy predicts respiratory allergic disease by 4 years of age. Pediatr Allergy Immunol. 2000; 11: 162–167.
Nicolaou N, Siddique N, Custovic A. Allergic disease in urban and rural populations: increasing prevalence with increasing urbanization. Allergy. 2005; 60: 1357–60.
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