소아알레르기와 식품첨가물

Abstract

Many different additives are added to the food which we consume and the number of additives are estimated ranges from 2,000 to 20,000. These substances include preservatives, stabilizers, conditioners, thickeners, colorings, flavorings, sweeteners, and antioxidants. Despite the multitude of additives known, only a surprisingly small number have been associated with hypersensitivity reactions. A number of investigators have suggested that a significant population of patients with chronic urticaria, angioedema, atopic dermatitis, and asthma have symptoms related to the ingestion of food additives. However, the incidence and mechanism of reactions to additives in patients with chronic urticaria, angioedema, and atopic dermatitis remains unknown. Monosodium glutamate (MSG) produces the flavor-enhancing properties of seaweed, a traditional component of Japanese and Chinese cooking. A few study of MSG reported to be associated with atopic dermatitis, but its relation between them remains unknown. Dyes approved under the Food Dye and Coloring Act are coal tar derivatives, the best known of which is tartrazine (FD&C yellow no. 5). The group of azo dyes includes ponceau (FD&C red no. 4) and sunset yellow (FD&C yellow no. 6). Amaranth (FD&C red no. 5) was banned from use in the US in 1975 because of claims related to carcinogenicity. The most of them reported to be associated with aggravation of atopic dermatitis. Parabens are aliphatic esters of parahydroxybenzoic acid. Sodium benzoate is a closely related substance usually reported to cross-react with these compounds. These agents, which are widely used as preservatives in both foods and drugs, are well recognized as cause of severe contact dermatitis. Additives would have to act as haptens to create a response mediated by IgE. Only a few reports have suggested IgE-mediated reactions, notably to sulfites and parabens. Instead, the overwhelming majority of these reactions are not of the immediate hypersensitivity type. Many cases of additive- provoked urticaria or dermatitis occur as late as 24 hours after challenge, arguing against an IgE- mediated mechanism. In conclusion there are still remained to solve the questionable association between the allergic diseases such as atopic dermatitis and food additives.