Fachdokumente Online der Landesanstalt für Umwelt Baden-Württemberg

zur LUBW   zum Ministerium für Umwelt, Klima und Energiewirtschaft   zum Ministerium für Ländlichen Raum und Verbraucherschutz   zum Ministerium für Verkehr und Infrastruktur  

Summary

It is well known that IgE mediated food allergy plays an important role in the pathogenesis of atopic dermatitis (AD), at least in childhood, whereas the role of pseudoallergic reactions remains controversial. In order to determine the effect of a low-pseudoallergen diet on the skin status in patients with AD, we monitored 50 patients for 4 weeks under regular conditions followed by 6 weeks under a low-pseudoallergen diet. During the 10 week period, patients were examined every 2 weeks and the eczema was documented by using a modified COSTA-score. Serum eosinophilic cationic protein (ECP) was determined as an objective parameter by ELISA before and after diet. 9/50 patients dropped out. Of the remaining 41 patients, 26 (63%) showed a significant improvement of the modified COSTA-score >35 %. In 23 patients of the responder group a corresponding reduction of serum ECP levels by 39% on average was determined. IgE levels remained unchanged. Patients of the responder group were orally challenged by either double blind exposure to food additives or by open challenge with tomatoes and with meals rich in pseudoallergens. 6/15 patients were reacting to food additives, 7/11 responding to tomato exposure and 20/24 showed a worsening of eczema after intake of food rich in pseudoallergens over 2 days. Taken together, these results show that a subgroup of AD patients clinically improve on avoidance of pseudoallergens.

 


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