Food allergy: Edited by Alessandro Fiocchi and Anna Nowak-WegrzynRare, medium, or well done? The effect of heating and food matrix on food protein allergenicityNowak-Wegrzyn, Anna; Fiocchi, AlessandroAuthor Information aJaffe Food Allergy Institute and Department of Pediatrics, Mount Sinai School of Medicine, New York, New York, USA bDepartment of Child and Maternal Medicine, University of Milan Medical School, Melloni Hospital, Milan, Italy Correspondence to Anna Nowak-Wegrzyn, MD, Department of Pediatrics, Mount Sinai School of Medicine, Box 1198, One Gustave L. Levy Place, New York, NY 10029, USA Tel: +1 212 241 5548; fax: +1 212 426 1902; e-mail: [email protected] Current Opinion in Allergy and Clinical Immunology: June 2009 - Volume 9 - Issue 3 - p 234-237 doi: 10.1097/ACI.0b013e32832b88e7 Buy Metrics Abstract Purpose of review To review recent advances in the area of food allergen processing and the effect on protein allergenicity. Recent findings Heating generally decreases protein allergenicity by destroying conformational epitopes. In peanut and shrimp, heat-induced Maillard reaction (glycation) may increase allergenicity. The majority of milk and egg-allergic children tolerate extensively heated (baked with wheat matrix) milk and egg. Introduction of extensively heated milk and egg proteins is associated with decreasing sizes of skin prick test wheals and increasing serum food-specific IgG4 levels. Summary Heating and other methods of food processing have different effects on food allergens, even those contained in the same complex food. Structural homology does not reliably predict the effect of processing on allergenicity, and individual food allergens have to be tested. Interactions with other proteins, fat, and carbohydrates in the food matrix are complex and poorly understood. Introduction of extensively heated milk and egg proteins into the diet of allergic children may represent an alternative approach to oral tolerance induction. Better characterization of these aspects of food allergy is critical for elucidation of food protein interactions with the gut-associated lymphoid tissue, the ability to induce IgE sensitization, the potential to trigger hypersensitivity reactions, and different clinical phenotypes of food allergy with regard to severity and persistence. Copyright © 2009 Wolters Kluwer Health, Inc. All rights reserved.