Increased leukotriene production by food additives in patients with atopic dermatitis and proven food intolerance

  title={Increased leukotriene production by food additives in patients with atopic dermatitis and proven food intolerance},
  author={Margitta Worm and W Vieth and I. Ehlers and Wolfram Sterry and Torsten Zuberbier},
  journal={Clinical \& Experimental Allergy},
Recently, we identified a subgroup of patients with atopic dermatitis (AD) with a clinical relevant food intolerance proven by double blind placebo controlled challenge. In search of possible pathomechanisms involved in this food intolerance, which leads to aggravation of the disease, the aim of the present study was to determine sulfidoleukotriene production in these patients using isolated leucocytes from the peripheral blood after stimulation with different food additives. 

Increased levels of urinary leukotriene E4 in children with severe atopic eczema/dermatitis syndrome

Urinary leukotriene E4 (U‐LTE4) is a marker of whole‐body cysteinyl‐leukotrienes production that is thought to play a role in the pathogenesis of atopic eczema/dermatitis syndrome (AEDS).

Urinary leukotriene levels are increased during exacerbation of atopic eczema/dermatitis syndrome. Relation to clinical status

This study aimed to compare urinary cysteinyl leukotriene levels during exacerbation and remission of AEDS in relation to clinical status, IgE levels, and eosinophil counts.

The Benefit of Montelukast in Atopic Dermatitis Induced by Food Allergies

Background: Cysteinyl leukotriene levels are elevated in patients with atopic dermatitis, which can lead to eosinophilic infi ltration of the gastrointestinal tract.

Asthma Worsened by Benzoate Contained in Some Antiasthmatic Drugs

The experience on benzoate hypersensitivity is reported, which shows that attention to additives present in some drug formulations and foods may often permit more correct diagnosis of pseudo-allergic reactions.

Standardization of food challenges in patients with immediate reactions to foods – position paper from the European Academy of Allergology and Clinical Immunology

At present, the double blind placebo controlled foodchallenge(DBPCFC)representstheonlywaytoestablishorruleoutanadversereactiontoafoodinolderchildrenand adults, whereas an open challenge controlled

Urinary metabolites of histamine and leukotrienes before and after placebo‐controlled challenge with ASA and food additives in chronic urticaria patients

The recovery of mediator metabolites from urine has the potential to provide a rapid, safe, and easily available index of release of mediators in patients affected by chronic urticaria.

Significance of salicylate intolerance in diseases of the lower gastrointestinal tract.

When presented with patients with chronic active disease who are suffering from these symptoms one should give greater thought to the possibility of salicylate intolerance, all the more as there are meaningful dietetic, diagnostic and therapeutic options available for these persons.

Hypersensitivity reactions to food and drug additives: problem or myth?

The associations between additives and adverse reactions described in literature are reported in literature in order to inform the pediatrician about the potential clinical manifestations and to suggest a practical approach to children suspected to have reactions to food additives.

Q&A: Food additive intolerance

  • M. Worm
  • Medicine, Biology
    BMC medicine
  • 2011
Clinical signs of food additive intolerance include cutaneous symtoms like redness of the skin, urticaria and angioedema as well as other organ related symptoms, such as dyspnea, hypotension or dizziness.

Aromatic components of food as novel eliciting factors of pseudoallergic reactions in chronic urticaria.

Aromatic volatile ingredients in food are novel agents eliciting PARs in chronic urticaria, and Histamine, salicylate, and a direct mast-cell histamine release are not involved in this reactivity to naturally occurring pseudoallergens.



Clinical relevance of food additives in adult patients with atopic dermatitis

  • WormEhlersSterryZuberbier
  • Medicine
    Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology
  • 2000
To date the role of pseudoallergic reactions as an aggravating factor in AD of adult patients remains controversial, however, many adult patients report on food‐related aggravation of the disease and nonallergic hypersensitivity reactions have been incriminated repeatedly.

Enhanced synthesis of cysteinyl leukotrienes in atopic dermatitis

Synthesis of cysteinyl leukotrienes was assessed in patients with atopic dermatitis (AD; n=8) and healthy volunteers (n=8) by measuring urinary excretion of leukotriene E4 (LTE4), the main index

[The histamine-free diet].

The therapeutic efficacy of a histamine-free diet was evaluated in 100 patients with food intolerance and allergic diseases, and results obtained indicate a deficiency of diaminoxidase in patients with intolerance to food or wine.

The leukotriene antagonist zafirlukast as a therapeutic agent for atopic dermatitis.

A 42-year-old man presented with a 10-year history of atopic dermatitis that was refractory to treatment with UV light, oral antihistamines, and high-potency topical corticosteroids; however, this regimen was discontinued secondary to transaminitis due to hepatitis C infection, which was treated with interferon alfa.

Adverse reactions to food additives in children with atopic symptoms

The incidence of intolerance of food additives among children referred to an allergy clinic with symptoms of asthma, atopic dermatitis, rhinitis, or urticaria was 2%, and children with atopic skin symptoms had a statistically increased risk of a positive reaction.

Urinary leukotriene E4 levels in patients with atopic dermatitis

Leukotriene synthesis may be increased in a variety of inflammatory diseases. Urinary leukotriene E4 is a stable metabolite of leukotrienes C4 and D4 which has previously been found to be increased

Food Additive-Induced Urticaria: Studies of Mediator Release during Provocation Tests

Measure the release of inflammatory mediators such as histamine and prostaglandins in recurrent urticaria to see whether the observed changes in mediator levels correlated with objective clinical effects.

Patients with severe atopic dermatitis have activated circulating basophils.

Tartrazine in atopic eczema.

In only one patient did the three tartrazine challenge periods correspond with the highest symptom scores or the highest physician observer scores, and the probability of this occurring by chance in one or more patients out of 12 was 0.46.