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Food and respiratory allergies in children

Arnaldo Cantani, Monica Micera

Asthma is one of the most common respiratory manifestations in children and can be provoked by food allergens through ingestion or inhalation. Clinical evidence acquired in recent years shows that the role of food in asthma is still unclear, while food allergy (FA) is regarded as one of the leading causes of atopic disease. Food allergies can result in a range of manifestations including urticaria, abdominal pain and anaphylaxis, but, above all, FA can trigger atopic dermatitis (AD). It could be that, as in AD, food allergens induce a cutaneous hyper-reactivity comparable to the bronchial hyper-reactivity (BHR) reported in allergic children with asthma. Eosinophils seem to play a major role in inducing and maintaining skin lesions, as they do in asthma. These observations suggest that the characteristic chronic AD skin lesions can be initiated, amplified and perpetuated by immunological and non-immunological factors acting in various ways and at different levels, beginning a vicious circle that results in different, but synergistic, reactions. Studies have suggested a possible link between inflammatory mediators and food-induced asthma that can be distinguished from asthma with FA. While nonspecific stimuli can contribute to triggering and worsening skin lesions, they may play a primary role in the induction of BHR. Epidemiologic studies should investigate both facets of the problem, such as asthma with FA and food-induced asthma in children. Personal data on the prevalence of respiratory symptoms in children with FA will be analyzed. We suggest that in young children food should be considered one of causes of asthma.