Co-influence of respiratory and food allergies
Different forms of allergies affect approximately one-third of the world’s population in Europe, and the rates are growing. There is a tendency for several allergic diseases to be present in the same individual simultaneously [42]. In the epidemiological study, allergic rhinitis occurred in 46.4%, asthma was in 11.2 %, and allergic multimorbidity was diagnosed in 9.7% compared with a single allergic disease in 43.4%. The current study’s findings indicated an association between food allergies and the presence of at least one allergic disease [43].
However, isolated allergic rhinitis and asthma are not inherent in food allergic reactions, but respiratory symptoms may be part of anaphylaxis. Most asthmatic reactions to inhaled food allergens are described in occupational settings [44]. In the workplaces, 372 different potential causative allergens were identified, including seafood, wheat flour, and hen’s eggs that might lead to asthma. Workers exposed to inhaled egg allergens developed rhinitis and asthma first and subsequently other allergic symptoms to the ingested egg. Subjects who inhaled wheat flour developed asthma with or without wheat ingestion [44].
Food allergy is frequently underestimated in association with asthma, but food allergy has been shown to trigger or exacerbate bronchial obstruction in asthma. There were reported that 34–78% of 82 asthmatic patients in Taiwan had food-related symptoms. Foods most commonly linked with their complaints were crab (67.9%), cow’s milk (53.6%), shrimp (50%), and other food allergens [45]. 1722 children between 0 and 14 years old in Sichuan province, China, were enrolled in this study. 59.7% of children were allergic to at least one allergen, comprising 24.9% to aeroallergen and 38.8% to a food allergen, respectively, whereas 36.28% of children were allergic to both aeroallergen and food allergen. Also, there have been revealed that milk, egg, and house dust mites were the most common allergens. However, an analysis of the pattern of food allergen and aeroallergen sensitization was invaluable to the effective diagnosis and treatment of allergic diseases [46].
In the study of 200 patients in Iraq in which skin prick testing was conducted, it has been found that 46% of allergic rhinitis cases were caused by foods, including cumin (88.98%), tea (62.96%), pepper (59.25%), almond (51.85%) and other food allergens [47]. 252 patients with asthma, allergic rhinitis, and combined pathology in north India participated in the study. The prevalence of food sensitization based on specific IgE to respective foods was 17% with cereals and legumes [48]. Among 258 patients in Mexico included in the study, the most common underlying condition was allergic rhinitis (59 %). The prevalence of food sensitization (preferably to soybeans) was 40 % [49].
In the clinical study of a case of a 38-year-old mold-allergic patient, it has been demonstrated that prior sensitization to mold aeroallergens might explain severe food reactions to cross-reacting homologs mushroom proteins. In addition, there was a well-recognized relationship between sensitization to airborne molds and allergy to mushrooms ingestion [50]. In another clinical study of a series of six patient cases with immediate occupational allergy (allergic rhinitis, asthma, and urticaria) to buckwheat, it has been revealed that patients had anaphylaxis after ingestion of food that contained buckwheat [51].
So, food allergy and non-enteric atopic diseases often coexist, and they are interconnected beyond the presence of simple comorbidity [44].