desensitization of delayed food allergies

[Graven Water]

With classical food allergies, the kind that show up in IgE RAST testing, the
old model is that you just avoid the food. But gradual desensitization by
taking tiny amounts of the food, has been shown to be promising in research.
See for example http://www.medscape.com/viewarticle/711404_6

So could desensitization work for delayed food allergies, of the kind that
might be an IgE-mediated reaction localized in the gut, but don't show up on
skin or blood allergy tests?

Many people with delayed food allergies just avoid the food. That isn't too
bad if you only have one or two food allergies, although people may get
hypersensitive to an allergen when they strictly avoid it.

But when you have many delayed food allergies, avoidance turns into something
that causes a huge amount of trouble, and you may be left with too few foods
to have a reasonably good diet.

Allergists talk about "cyclic food allergies" that develop from eating too
much of a food. These allergies don't show up on conventional skin or blood
allergy testing. But these cyclic food allergies are said to go away after a
few months if you don't eat the food. For that kind of food allergy,
avoidance probably makes sense.

But what if, like me, you have delayed food allergies that don't go away
after a few months of not eating the food? Mine have lasted for many years.

It may be that for strictly eliminating the foods one is allergic to, is
actually bad for one's immune system. The immune system develops tolerance
for allergens, mostly via the GI tract from what I've heard. Lots and lots
of foreign proteins come into the GI tract, and the body has mechanisms for
developing tolerance to these proteins. These mechanisms work by being
exposed to the food, not by avoiding it!

Also, I read that inhalant allergies are thought to be regulated via the
GI tract, because some of the allergens you inhale, end up in the GI tract.

So avoiding the foods one is allergic to completely, may interfere with the
body "learning" to develop tolerance to allergens. Eating tiny quantities
might train one's body to develop tolerance.

Perhaps one should keep on eating foods one is allergic to, in small enough
quantities not to cause a bad reaction. I found that oral cromolyn,
Singulair and probably antihistamines make my food reactions much more mild.
Also Singulair may help. Using those medications, I can consume a tiny
amount of the food without getting too sick. So that's what I'm trying.

I have "rotated" most of my foods for about 10 years. What this means is
that if I eat a food on one day, I don't eat that food again, or anything
related to it, until 4 days later. This helps me avoid developing allergies
to those foods as well. When I haven't rotated foods, I have sometimes
developed new delayed food allergies, even if I only consume small amounts
every day. For example, I developed a ginkgo biloba allergy from taking a
ginkgo supplement every day.

So, I'm trying eating tiny amounts of foods that I've developed an allergy
to, after taking oral cromolyn, Singulair and loratadine. I'm eating a given
food only once every 4 days. Since this clearly helps in maintaining
tolerance to foods, it may help in building tolerance as well.

For a long time, "delayed food allergies" have been thought to be very
different from "true food allergies". People have described "delayed food
allergies" as non-IgE mediated, or even as "food intolerances", meaning the
mechanism does not involve the immune system. In some cases this is true.

However, at least for me, it's looking more like these allergies are rather
similar to "true food allergies" and thus, the way of coping with them may
be similar, too. Some researchers are coming to think this, also.

IgE-mediated allergic reactions involve an immediate reaction, when the mast
cells degranulate and release histamine etc. But they also involve a late
phase, when other parts of the immune system become involved. So some
"delayed food allergies" might be "true food allergies" with a mild early
phase that doesn't show up in conventional allergy testing, but an intense
late phase reaction.

My delayed food allergies start making me feel sick about half an hour after
eating the food. That is actually consistent with IgE-mediated allergy, and
not very consistent with a cell-mediated reaction. Cell-mediated reactions
usually start about 24 hrs after eating the food.

Also, because the mast cell stabilizer cromolyn helps prevent my food
reactions, they probably do start with mast cells degranulating- just like
"true food allergies".

It's been found that mast cells can be degranulated in an antigen-specific
way by immunoglobulin free light chains. See
http://dspace.library.uu.nl/bitstream/handle/1874/221010/groot-kormelink.pdf

FLC's provide a non-IgE mediated allergic reaction that involves mast cells.
So some "delayed food allergies" may be mediated primarily by FLC's. FLC's
may also be involved in inhalant allergies.

Some more info on what's going on with me: I probably have celiac disease,
an autoimmune disease triggered by eating gluten. I'm not thinking of
reintroducing gluten, because it can trigger an autoimmune process. I went
gluten-free in 2003. I have many inhalant allergies that have shown up on
skin and blood tests.

I found out about my "delayed food allergies" by a series of elimination
diets followed by food challenges. It helped me a huge amount emotionally to
eliminate these foods.

However, over years I found I had allergies to almost every food I had been
eating more than occasionally. I hardly have anything left to eat! And none
of my allergies have gone away, with avoidance of the food.

My food reactions start about 1/2 hr after eating the food and last about
4 days. Mostly, it's a groggy sick feeling, but I've also had belly pain,
back pain, frequent urination, joint pain, mild itchiness all over my body,
and psychological symptoms like anxiety, tension, being more emotionally
reactive. This kind of food reaction seems to be rather common, except that
I've had pain in my kidney area and I haven't heard of anyone else having
this symptom. I can have a reaction from a fraction of a milligram of food
protein.

My "oral tolerance" mechanism got messed up for whatever reason - celiac
disease, bad gut microbes, stress, who knows!

But I have asked myself recently, did I help create this awful situation
where I have terrible inhalant allergies AND severe "delayed food allergies"
to almost all common foods - by completely avoiding so many foods? Maybe
my "oral tolerance" mechanism can heal itself if I eat food allergens in
tiny quantities, taking allergy medications beforehand.

I can get oral cromolyn relatively cheaply from a compounding pharmacy. The
brand-name version, Gastrocrom, is extremely expensive.

Alternative-medicine practitioners have tried to deal with "delayed food
allergies". They generally recommend avoidance of the food, probiotics, and
sometimes, special diets. How seriously their recommendations should be
taken, is very unclear. There's some evidence in favor of probiotics.

[Allergist Delaware]

Vào 22:04:44 UTC+7 Thứ Hai, ngày 13 tháng 1 năm 2014, Graven Water đã viết:

Thanks for great tip for treatment allergy.