(过敏原管理)Foodallergens

FoodAllergensManagement食品过敏源Contents内容•Definitions定义•Principalsoffoodallergy食品过敏症的原则•Foodallergens食品过敏源•Allergenmanagementprogramme过敏源管理计划•Summary总结Foodallergyversusfoodintolerance食品过敏源与食品不耐性•Foodallergy:theimmune-mediatedstateofhypersensitivityresultingfromexposuretoafood-borneallergen(usuallyaproteinorglycoprotein).Normallydevelopingseriousreactionsandevencausingdeaths.•食品过敏症：高度敏感性的免疫调节状态，系由接触食品携带的过敏源（一般为蛋白质或糖原蛋白）而产生。通常发展为系列反应，甚至导致死亡。•Foodintolerance:arenon-toxic,nonimmune-relatedmainlyduetonaturallyoccurringtoxicants(e.g.gluten),microbialorchemicalfoodcontaminants(e.g.phenylanaline)andinheritedmetabolicdisorders(e.g.lactoseintolerance).Rarelylife-threatening.•食品不耐性：非毒性的、与免疫无关，主要由于自然生成的毒性物质（例如面筋），微生物或化学性食品污染（如苯胺）以及遗传新陈代谢失调（如乳糖不耐）。很少危及生命。Principalsoffoodallergy：Prevalence食品过敏症的原则:流行•Thetrueprevalenceisunknown.真正流行不为人知。•Itisestimatedthat1%ofadultsand5-6%ofchildrenhaveatruefoodallergy.据估算，1%成人、5-6%儿童有真正的食品过敏症。•Approximately950severereactionstofoodsrequiringhospitalisationoccurannuallyintheUS.(AccordingtotheUSDA15%oftheUSpopulationmaybeallergictosomefoodingredients).•美国每年发生大约950例对食品严重的反应,需要住院治疗。(根据USDA调查,15%的美国人口对一些食品原料过敏)•IntheUKitisestimatedthatthereareatotalof15millionsufferersfromallergiestovarioussubstances-notonlyfoodstuffs-(1in4ofthepopulation).英国估计有总数达1500万人对各种物质-不只是食品-过敏(人口总数的四分之一)•Allergicindividualsreacttotracelevelsoftheoffendingallergen.•过敏群体对所引发过敏源痕迹有反应。Keyplayersofallergenicresponse过敏源反应的关键因素Threeessentialcomponents三个关键部分:Antigen抗原(allergen过敏源)IgEAntibodies抗体Effectorcell效应基因细胞(mastcellorbasophil杆细胞或碱性细胞)IgEareproducedbyBcells(Lymphocytes)inresponsetoexposuretotheantigen.B细胞(淋巴细胞）遇到抗体时产生IgEGlycoproteinsthatareabsorbedduringdigestionanddistributedtothebodyviathebloodstream在消化时吸收的糖原蛋白质通过血流分送到全身Mastcellsarefoundintheconnectivetissue杆细胞发现于结缔组织Basophilscirculateinthebloodstream碱性细胞在血流中循环Bothhavehigh-affinityIgEreceptorsonthesurface它们都与表面的IgE受体有密切关系Clinicalmanifestations临床表现•Gastro-intestinal胃肠反应:•Swellingofmouthparts,abdominalcramps,diarrhoea,nausea,vomiting.•嘴部肿胀、腹部痉挛、腹泻、恶心、呕吐。•Respiratory呼吸反应:•runnynose,difficultybreathing,constrictionofthroat.鼻子流涕、呼吸困难、喉咙堵塞。•Cutaneous皮肤反应:•swelling,hivesandskinrash.肿胀、荨麻疹、皮疹。•Systemic=Anaphylacticshock.全身=过敏中风。•Deathoccursduetocardiaorespiratoryarrestandshock.Initialsymptomsusuallybeginwithin30minafterexposure.•由于心脏和呼吸困难及中风导致死亡。通常在接触过敏源30分钟后出现初始症状。食品过敏源欧盟2003/89/EC指出的食品过敏原：花生大豆蛋奶鱼甲壳类树果（坚果）小麦其它一些会引起过敏的食品正在研究中，会及时在媒体公布在美国销售的食品如使用二氧化硫或亚硫酸盐作为防腐剂必须标注。美国FDA指出的食品过敏原：谷类包括麸皮及其制品（如小麦、黑麦、大麦、燕麦及其它们的杂交种）甲壳类及其制品蛋及蛋制品鱼及鱼制品花生及其制品大豆及豆制品奶和奶制品（包括含乳糖制品）坚果类及其制品，如板栗、榛子、腰果、杏仁、胡桃、山核桃等芹菜及其制品芥菜/芥末及其制品芝麻及其制品二氧化硫或亚硫酸盐含量在10ppm以上•比较明确的一些过敏原产品：•小麦制品、荞麦制品、蛋制品、奶制品、花生制品、鲍鱼、墨鱼/鱿鱼、三文鱼子/鱼子酱、虾类、橙桔类、蟹类、猕猴桃、牛肉制品、胡桃、三文鱼、大豆制品、鸡肉制品、猪肉制品、蘑菇/菌类制品、桃制品、芋制品、苹果制品、明胶制品等Mostcommonfoodallergens最常见的食品过敏源•Majorseriousallergensinclude主要严重的过敏源包括(IFST-1999):–“Bigeight八大样”:–eggs,cow´smilk,peanut,soybean,wheat,treenuts,fishandcrustacean–蛋品、牛奶、花生、黄豆、小麦、树木坚果、鱼类和甲壳类食品–“Secondeight八小样”:sesameseeds,sunflowerseeds,cottonseed,poppyseed,fruits,beansotherthangreenbeans,peasandlentils.–芝麻籽、葵花子、棉籽、罂粟籽、水果、豆类（不包括绿豆）、豌豆和小扁豆–Others其它:tartrazine,sulphitesandlatex.KFIfoodallergencategorylist*KFI食品过敏源类别清单–Celery芹菜–Eggs蛋类–Cow´smilk牛奶–Peanut花生–Soybean大豆–Sulphites亚硫酸盐–Wheat小麦–Seeds种子–Seafood海鲜–Treenuts–树木坚果Cottonseed棉籽poppyseeds罂粟子sesameseeds芝麻籽sunflowerseeds葵花子Crustacean甲壳类Fish鱼类almond杏仁brazilnut巴西木坚果cashew贾如树坚果chestnut栗子hazelnut榛子macadamianutpinenuts松子pistachio阿月浑子的果实pecan美洲山核桃walnut核桃*Someexemptionsareincludedinthelist-Example一些例外在-实例表中列出FoodAllergensstability食品过敏源稳定性•Resistancetothedigestivetract:抗消化系统能力–Mostfoodallergensareresistanttoenzymes,acidsandbilesaltspresentinthestomach.大部分过敏源对胃中的酶、酸和胆汁盐具有抵抗力。–FreshfruitsandvegetablesareeasilydigestedintheGItractanddonotcausesystemiceffects.新鲜水果和蔬菜很容易在GI系统中消化并不会影响系统。•Resistancetoproteolysis,hydrolysisanddigestion:抗水解蛋白质、水解和消化–Foodallergensareresistanttoproteolysisanddigestion(e.g.codfish,eggwhite).–食品过敏源对水解蛋白质和消化有抵抗力（如鳕鱼、蛋白）。–Extensivehydrolysisisnecessarytoeliminateallergenicpropertiesoffoodallergens(e.g.casein,wheyproteins,soybean).–广泛的水解对于消除食品过敏源的过敏特性是必要的（例如酪蛋白、乳清蛋白质和大豆）。–Allergeninactivationdependsontheenzymaticorchemicaltreatmentusedduringhydrolysisandproteolysis.–在水解或水解蛋白质时，可使用酶或者化学处理办法使过敏源失去作用。FoodAllergensstability食品过敏源稳定性•Resistancetoheat:抗热性–Mostfoodallergensareresistanttoheat.Fruitandvegetablesareheat-labileandcanbeeatenafterheatingorcanning.大部分食品过敏源抗热。水果和蔬菜遇热不稳定，可加热或制成罐头食品食用。–Peanutandeggallergensremainstablewhenheatedorboiledat100°C.当加热或煮沸到100度时，花生和蛋类过敏源仍保持稳定。–Milkretainsitsallergenicitythroughcondensation,evaporation,anddrying.牛奶在经过凝聚、蒸发和烘干后仍保留过敏性。•Acidstability:酸稳定性–Mostallergensarestabletomoderateacidtreatments.大部分过敏源经过温和的酸处理仍保持稳定性。–PeanutallergensarestableatpH2.8andeggovalbuminatpH3.0.–花生过敏源在PH值2.8,蛋类过敏源在PH值3.0的情况下仍保持稳定.Managementoffoodallergy食品过敏管理•Thebesttherapyconsistofstricteliminationoftheoffendingfoodfromthediet…最好的处理办法是将引发(过敏)的食品从食谱中去除...•Theapplicationofduediligencebymanufacturers制造商在以下几个方面应用时，应非常审慎：–Intheuseofallergensasingredients.使用过敏源作为原料。–Inwarn