Beruflich Dokumente
Kultur Dokumente
AND HYPERSENSITIVITY
INTRODUCTION
CONCLUSION
1
INTRODUCTION
Alergy :
antigens immune responses tissue
inflammation and organ dysfunction.
Food allergy :
food immune mediated symptoms.
eggs 2%,
Hippocrates :
milk gastric distress and urticaria
Rinkel (1934) :
developed the oral food challenge
responses
to
1963 :
provocation techniques
neutralization techniques
dietary management
BASIC IMMUNOLOGY OF
ALLERGY ket di 2 RI, 3 RI,
Immune System
An antigen
The nonspecific immune response :
reacts to broad categories of antigens
The specific immune response :
develops differently in every individual
Immune System
Lymphocytes
Lymphocytes
T cells :
B cells :
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Lymfoct
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Lymphocyt B NK Cell
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NK Cell
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Lymphocytes
T helper cells :
interacts and stimulates B cells
T suppressor cells :
antigen specific suppressor role
inhibit B-cell functions
T cytotoxic cells :
the destruction of infected or malignant cells
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Immunoglobulins
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Immunoglobulins
basic structure :
the heavy chain :
Immunoglobulins
Immunoglobulin E :
Immunoglobulin M (10%) :
Immunoglobulin A :
Immunoglobulin G (70-75 %) :
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Antigen-Processing Cells
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Mediator Cells
histamine
chemotactic factors :
attract other leukocytes affect local tissues
leukotrienes :
control the development and duration of immune
reactions
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Mediator Cells
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Mediator Cells
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Complement
Complement :
Amplification
and regulation of immune
inflammation.
Enhances uptake and removal of immune
complexes by phagocytosis.
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Complement
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Hypersensitivity Reaction
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Type I
Immediate Hypersensitivity
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Type I
Immediate Hypersensitivity
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Type I
Immediate Hypersensitivity
Type ll
Cytotoxic Reactions
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Type ll
Cytotoxic Reactions
Clinical :
hemolytic anemia, transfusion reactions, and
rare cases of food reactions.
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Type III
Immune Complex Reactions
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Type III
Immune Complex Reactions
Type IV
Delayed Type Hypersensitivity
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Type IV
Delayed Type Hypersensitivity
T-cell mediated .
Circulating complexes.
Complement activation.
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THEORY OF ACTION OF
NEUTRALIZATION TREATMENT
Jerne :
immune system negative feedback regulation.
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THEORY OF ACTION OF
NEUTRALIZATION TREATMENT
of
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THEORY OF ACTION OF
NEUTRALIZATION TREATMENT
Increasing intracellular
monophosphate levels.
cyclic
antibody
adenosine
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TYPES OF ADVERSE
REACTIONS TO FOODS
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Food Intolerance
Nonimmunologic Reactions.
Anaphylactoid reactions :
Idiosyncratic reactions :
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Food Intolerance
Toxic reactions :
Food components or additives and toxins released by
microbes in food.
Pharmacologic reactions :
Chemicals in foods produce drug like effects.
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Food Hypersensitivity
an
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Immediate
allergen.
reaction
the
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Atopic Dermatitis
Mechanism
unrelated
to
IgE
mediated
histamine release also can trigger mast cell
degranulation after the ingestion : alcohol,
spicy foods, or additives.
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Asthma
Urticaria
Contact urticaria :
cutaneous contact with prolonged handling of raw food,
and occur around the mouth in children.
developing
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Symptoms :
abdominal cramps, nausea,
watery diarrhea, hypotension.
vomiting,
and
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Anaphylaxis
Clinicaly :
Asthma.
frequency sensitivity
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DIAGNOSTIC
FOR FOOD ALLERGY
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HISTORY
Analyzes :
production.
frequently
eaten
foods
and
symptom
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HISTORY
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Fixed allergy :
mixture of foods
Neurologic Symptoms
Neurologic symptoms :
headaches
learning disabilities
forgetfulness
short attention
insomnia
even seizures can be food triggered
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Ophthalmologic Symptoms
Mild symptoms :
pruritus, stinging, (conjunctival, eyelid,
periorbital, lid) edema with itching, scaling,
and erythema.
Severe symptoms :
tearing, burning, discharge, photophobia,
rough tarsal mucosa, blurred vision, the
cornea should not be inflamed, or eroded.
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Otologic Symptoms
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Nasal Symptoms
Nasal obstruction
Voice change, Snoring
Sleep disturbance
Edema of the turbinates
Rhinorrhea
Thick postnasal discharge
Crusting
Pruritus, Sneezing
Decreased olfaction
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Oral Symptoms
Dry mouth.
Halitosis.
Geographic tongue.
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Pulmonary Symptoms
chronic cough
shortness of breath
chest tightness
Wheezing
thick-tenacious-colorless sputum
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Gastrointestinal Symptoms
Genitourinary Symptoms
Enuresis
Pruritic
Vaginitis
Musculoskeletal Symptoms
Arthralgias
Myalgias
Stiffness
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Urticaria.
Angioedema.
The Id reaction.
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DIAGNOSTIC TECHNIQUES
FIXED FOOD ALLERGY
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Methods :
radioimmunoassay, fluorometry, high pressure
liquid
chromatography,
glass
microfiber
adsorption of histamine.
Prick Tests
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Modified :
multiple and longer tips introduce greater quantities
of antigen and increase sensitivity similar to
intradermal tests .
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Patch Tests
Patch Tests
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DIAGNOSTIC TECHNIQUES
CYCLIC FOOD ALLERGY
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Cytotoxic test .
Dietary analysis.
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Elimination
Patient instructions :
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Challange
Rechallenge
IPDFT
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Successful neutralization :
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Medical Care.
Education.
Consultations.
Neutralization.
Education
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Consultations
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Medication
Diet
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Elimination, Reintroduction,
and Rotation of Foods
The One-Food-per-Meal
Rotation Diet
Suspect lists :
Safe list :
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COMBINING
DIETS AND NEUTRALIZATION
Neutralization
Dosing Schedules
Trevino :
every day for 2 weeks twice a week for 2 months
once a week for 6 to 7 months.
King :
injections twice weekly for 1 month
month every other week.
weekly for 1
Gordon :
twice weekly injections for as long as required.
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Neutralization
Dosing Schedules
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Sublingual Neutralization
Food injection therapy is begun + dropper vial
(the same food antigens, neutralizing dose strength)
produce prostaglandins
prevent symptoms
(until the injection therapy becomes fully effective)
CONCLUSION
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CONCLUSION
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THANK YOU
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Complement
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Masked Sensitization
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Omission
Hyperacute Sensitization
Circulating antibody :
antigenic food is consumed
provocation of symptoms
Active Sensitization
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Latent Sensitization
No antigen stimulation
The antibody levels decrease.
Continued antigen elimination.
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Tolerance to Foods
After 4-5
avoidance.
months
of
continuous
If tolerance cannot be
avoidance is required.
attained,
antigen
life
long
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Sensitization
Skin Testing
Multiple Foods Simultaneously
Degree of sensitivity.
Elimination, Reintroduction,
and Rotation of Foods
Aim :
preventing an increased production of specific
IgG.
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Elimination, Reintroduction,
and Rotation of Foods
simple to do
work best
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Elimination, Reintroduction,
and Rotation of Foods
Oligoallergenic diets :
Supervised fasting :
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Essential Features
of the Maintenance Rotary Diet
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Essential Features
of the Maintenance Rotary Diet
Essential Features
of the Maintenance Rotary Diet
Patients should
obtainable.
use
the
purest
foods
and
water
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Essential Features
of the Maintenance Rotary Diet
The One-Food-per-Meal
Rotation Diet
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