• Clinical and Experimental Pediatrics
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• v.64 no.8
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• pp.393-399
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• 2021

Food allergies and food-induced anaphylaxis are important health problems. Several cofactors modulating the onset of anaphylaxis have been identified. In the presence of cofactors, allergic reactions may be induced at lower doses of food allergens and/or become severe. Exercise and concomitant infections are well-documented cofactors of anaphylaxis in children. Other factors such as consumption of nonsteroidal anti-inflammatory drugs, alcohol ingestion, and stress have been reported. Cofactors reportedly play a role in approximately 30% of anaphylactic reactions in adults and 14%-18.3% in children. Food-dependent exercise-induced anaphylaxis (FDEIA) is the best-studied model of cofactor-induced anaphylaxis. Wheat-dependent exercise-induced anaphylaxis, the most common FDEIA condition, has been studied the most. The mechanisms of action of cofactors have not yet been fully identified. This review aims to educate clinicians on recent developments in the role of cofactors and highlight the importance of recognizing cofactors in food allergies and food-induced anaphylaxis.

• Journal of Life Science
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• v.20 no.4
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• pp.511-518
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• 2010

Exercise-induced anaphylaxis (EIA) is defined as the onset of allergic symptoms during, or immediately after, exercise, the clinical signs being various degrees of urticaria, angioedema, respiratory and gastrointestinal signs, and even anaphylactic shock. Food-dependent exercise-induced anaphylaxis (FDEIA) is a specific variant of exercise-induced anaphylaxis that requires both vigorous physical activity and the ingestion of specific foods within the preceding several hours. To describe the physiopathologic mechanism, etiologic factors, and clinical manifestations, we evaluated the supplementation of vitamin C and catalase on spleen index, proliferation assay, ROS, and ASAS in sensitized and exercise trained mice. The results were as follows: Spleen index showed the highest level in the ST12 group compared to other groups; this level increased in a time dependent manner and in significant amounts. In proliferation assay of Med and OVA, the ST12 group showed the highest level compared to other groups; this level also increased in a time dependent manner. On the other hand, spleen ROS did not show a statistically significant difference, and peritoneal ROS showed the highest level in the ST12 group. ASAS showed the highest level in the ST12 compared to the S; this was also in a time dependent manner and in significant amounts. From the results, we chose the ST9 and ST12 groups to evaluate allergy anaphylaxis with supplementation of Vitamin C and catalase. In both the ST9 and ST12 groups, peritoneal ROS and ASAS were lower in vitamin C treatment group than in the catalase treatment group. This was a statistically significant difference. From the results, allergy anaphylaxis showed a higher level in the long trained group than in the short trained group. Also, treatment with vitamin C was more effective in lowering allergy anaphylaxis than catalase treatment.

• Nutrition Research and Practice
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• v.7 no.5
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• pp.347-351
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• 2013

Food-dependent exercise-induced anaphylaxis (FDEIAn) is induced by different types and various intensities of physical activity, and is distinct from food allergies. It has been shown that consumption of allergenic food followed by exercise causes FDEIAn symptoms. Intake of allergenic food or medication before exercise is a major predisposing factor for FDEIAn. Urticaria and severe allergic reactions are general symptoms of FDEIAn. Dermatological tests and serum IgE assays are the typical prescreening methods, and have been used for several decades. However, these screening tests are not sufficient for detecting or preventing FDEIAn. It has been found that exercise may stimulate the release of mediators from IgE-dependent mast cells that can result in FDEIAn when a certain threshold level has been exceeded. Mast cell degradation might be a major factor to induce FDEIAn but this has not been determined. A number of foods have been reported to be involved in the onset of FDEIAn including wheat, eggs, chicken, shrimp, shellfish, nuts, fruits, and vegetables. It is also known that aspirin increases the occurrence of type I allergy symptoms when combined with specific foods. Moreover, high intensity and frequent exercise are more likely to provoke an attack than low intensity and less frequent exercise. In this paper, we present the current views of the pathophysiological mechanisms underlying FDEIAn within the context of exercise immunology. We also present a detailed FDEIAn definition along with etiologic factors and medical treatment for cholinergic urticaria (UC) and exercise-induced anaphylaxis (EIA).

• IMMUNE NETWORK
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• v.5 no.2
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• pp.117-123
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• 2005

The immune response to any stimulus is complex, requiring coordinated action by several types of cells in a tightly regulated sequence. Thus, a physical stress such as exercise may act at any number of points in the complex sequence of events collectively termed the immune response. Although exercise causes many propound changes in parameters of immune function, the nature and magnitude of such changes rely on several factors including the immune parameters of interest; type, intensity, and duration of exercise; fitness level or exercise history of the subject; environmental factors such as ambient temperature and humidity. Although regular moderate exercise appears to be important factor for increasing immunity, Athletes are susceptible to illness, in particular upper respiratory track infection, during periods of intense training and after competition. In addition, in elite athletes, frequent illness is associated with overtraining syndrome, a neuroendocrine disorder resulting from excessive training. Through this paper, we want to investigate the effects of exercise on the immunosuppression such as exercise induced lymphopenia, asthma, anaphylaxis, URT (upper respiratory track), and TB (tuberculosis) infection. and also, we want to suggest a direct mechanism, protection and therapy of exercise induced immunosuppression.

• Journal of Life Science
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• v.20 no.1
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• pp.147-152
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• 2010

Exercise-induced anaphylaxis (EIA) is a physical allergy, sometimes severe, triggered by exertion following specific food intake. It was defined for the first time in 1980. EIA is associated with different kinds of exercise. The clinical manifestations progress from itching, erythema and urticaria to some combination of cutaneous angioedema and vascular collapse. Mast cell participation in the pathogenesis of this syndrome has been proved by the findings of an elevated serum histamine level during exhaustive exercise. As predisposing factors of EIA, a specific or even nonspecific sensitivity to food has been reported. Food-dependent exercise-induced anaphylaxis (FDEIA) is a distinct form of food allergy induced by physical exercise. It is typified by the onset of anaphylaxis during exercise which was preceded by the ingestion of the causal food allergens. The diagnosis of FDEIA is heavily dependent on clinical history. Allergy tests may need to be performed using a broad panel of food and food additives. As with food allergies, FDEIA diagnosis is based on interview, biological test and skin test. Prophylaxis aims to prevent a recurrence; the patient should be given an emergency kit to deal with any recurrent episodes. After the food allergen has been identified, it should be avoided for at least 4 to 5 hours before any exercise. Two cases of EIA are presented (EIA to circumstances; FDEIA) in this paper, The diagnosis, pathophysiology and therapy of FDEIA are also reviewed.

• Journal of Life Science
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• v.21 no.4
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• pp.542-548
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• 2011

Food-dependent exercise-induced anaphylaxis (FDEIA) is a distinct form of food allergy induced by physical exercise. It is typified by the onset of anaphylaxis during exercise, which is preceded by the ingestion of causal food allergens. Diagnosis of FDEIA is heavily dependent on clinical history. To describe the physiopathological mechanism, etiologic factors, and clinical manifestations, we evaluated the spleen index, proliferation assay of lymphocyte, ROS, ASAS, and cytokines levels in sensitized and exercise-trained mice. One-hundred mice were bred in the animal lab at D and P university under controlled conditions [$22{\pm}2^{\circ}C$, RH 45-55%, and a 12-hour photoperiod]. Animals are 7-weeks-old at the time of study and were fed a standard commercial chow diet from 09:00 to 15:00 over the 8-week study period. The mice were allowed access to distilled deionized water ad libitum. Daily food intake and weekly body gains were routinely recorded throughout the experimental period using computing scale (CAS). Mice were divided into the control group (S; control sensitized, n=25), 30 min swim training group (S30, N=25), 50 min swim training group (S50, N=25), and 80 min swim training group (S80, N=25). The results were as follows: Spleen index showed the highest level in the S80 group compared to other groups; this level was exercise-dependent. In proliferation assay of Med and OVA, the S80 group showed the highest level compared to the other groups; this level also was exercise intensity- dependent. Peritoneal ROS and IL-4 showed a statistically significant difference compared to S; however, there was no significant differences in ROS among S30, 50, and 80. From the results, we concluded that FDEIA is correlated with exercise intensity based on the levels of peritoneal ROS and cytokine profiles.

• Journal of Life Science
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• v.22 no.7
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• pp.897-903
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• 2012

Food allergies have become a serious health concern in the past two decades, especially in developed countries. Foods associated with allergies include vegetables, some fruits, shellfish, wheat, egg, chicken, and nuts. To describe the specific fundamentals, etiological factors, and clinical manifestations, we analyzed the different physical frequency on spleen index in sensitized and regular exercise-trained mice. We also conducted a proliferation assay of lymphocytes to OVA, ROS, ASAS, and we determined the cytokine levels. Female BALB/c mice were bred in the animal laboratory of the P and D university under controlled conditions ($22{\pm}2^{\circ}C$, RH 45-55%, and a 12-hour photoperiod). The animals were 6 weeks old at the start of the study and were fed a standard commercial chow diet from 09:00 to 15:00 for the 8-week study period. All animals had access to distilled deionized water ad libitum. They were divided into four groups: a control group (S; control sensitized, n=25), a low-frequency training group (F2, n=25), a mid-frequency training group (F3, n=25), and a high-frequency training group (F5, n=25) following the treatment of exercise time per week. The results were as follows: The mice spleen index showed the highest grade in the F5 group compared with the other groups; this level showed in an exercise frequency-dependent manner. In the proliferation assay of OVA, the F5 group showed the highest grade compared with the other groups; this level was also showed in an exercise frequency-dependent manner. Peritoneal ROS and ASAS showed a statistically significant increase in the F5 group and decreased in the F2 group compared with the S group. However, there were no significant differences in the F3 group. The highest level of IL-4 was found in the F5 group compared with the other groups. However, the highest level of INF-${\gamma}$ was in the F2 group. The results suggest that FDEIA is positively correlated with the frequency of exercise due to the direct effect of physical exercise on peritoneal ROS and the cytokine profile. Further research is needed on the specific mechanism underlying the combined effects of exercise intensity and frequency on physical-induced allergy anaphylaxis.

• Journal of Medicine and Life Science
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• v.19 no.3
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• pp.90-94
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• 2022

Food allergy is one of the adverse food reactions, which is developed by immunological reactions. Food allergy is increasing in prevalence among children and adults. In the diagnosis, food challenge is confirmative with history and laboratory tests. Avoidance of culprit food is the only preventive method, especially in patients with severe symptoms. In some food allergies, cross-reactivity among allergens should be considered. Latex-fruit/vegetable syndrome and pollen food allergy syndrome are well-understood phenotypes of food allergy related to cross reaction. Red meat allergy is recently described as one of tick-borne diseases. In a rare phenotype of food-dependent exercise-induced anaphylaxis, factors affecting the absorption of food allergen are important in its pathophysiology.

• Journal of Life Science
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• v.17 no.8 s.88
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• pp.1166-1171
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• 2007

Exercise is the strongest stress to which the body is ever exposed. The body responds to this stress through a set of physiological changes in its metabolic, hormonal, and immunological systems. In this study, responses of the immune system to the long-term aerobic and anaerobic exercises have been investigated. Regular moderate exercise is associated with a reduced incidence of infection compared with a sedentary groups. Aerobic training increases the heart rate and enhances the body's intake of oxygen long enough to benefit the condition of the body. In recent years, the importance of exercise in everyday life has been rapidly increasing. Moderate exercise appears to stimulate the immune system. And also, Exercise elicits an increase in the numbers of circulating lymphocytes and lymphocyte subsets (including NK cells) which is followed by a decrease in the numbers of cells during recovery from exercise. However, prolonged bouts of strenuous exercise cause a temporary depression of various aspects of immune functions (e.g. lymphocyte proliferation, monocyte antigen presentation, open window periods, exercise induced asthma, exercise induced anaphylaxis) that usually lasts 2-24 hr after exercise depending on the intensity and duration of the exercise bout. Exercise-induced bronchoconstriction (EIB) was defined as a decrease of at least 15% in pre exercise forced expiratory volume in one second at any time point after exercise. This includes elevation of cortisol and cathecholamines in plasma. On the other hand, highly trained athletes exhibit a chronic mild hypercortisolism at baseline that maybe an adaptive change to chronic exercise. And, Consuming carbohydrate during prolonged strenuous exercise attenuates rises in stress hormones and appears to limit the degree of exercise-induced immune depression. Recent evidence suggests that antioxidant vitamin supplementation may also reduce exercise stress and impairment of leukocyte functions.

• Journal of Applied Biological Chemistry
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• v.60 no.1
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• pp.55-59
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• 2017

Although wheat is a common staple food in the world, some people suffer from a variety of wheat allergies. For example, wheat-dependent exercise-induced anaphylaxis is induced in the gastrointestinal tract by wheat proteins. Relatively high molecular weight proteins that are salt-insoluble induce many wheat allergies. In the present study, we investigated the induction of an allergy response using crude wheat proteins, which are relatively low molecular weight, salt-soluble proteins. The crude antigen used in this study was extracted using phosphate buffered saline. When the antigen extracts from various wheat cultivars were orally administered, differentiable degrees of allergy responses were observed as measured by serum IgE and histamine secretion compared to the control. Serum IgE levels increased following administration of three of the wheat extracts. This evidence suggests that a combination of salt-soluble wheat proteins could be antigens for the induction of various allergy responses.