Adverse Reaction to Foods

8/20/2019 Adverse Reaction to Foods

1/28

ADVERSE REACTION TO

FOODS

Hertanto W Subagio


2/28

ADVERSE REACTION TOFOODS• Merupakan gejala/tanda yg muncul

setelah mengkonsumsi makanantertentu.

• Contoh : - sejumlah buruh pabrik muntah dan diare

setelah makan siang

- bayi diare setelah minum susu - gatal-gatal setelah makan sea food

dst.


3/28

Klasifkasi

ToksikNon toksik

Immune mediated (alergi makanan) :

- Ig E mediated- Non Ig E mediated

Non Immune mediated (toleransi makanan) :

- Enzimatik

- Farmakologikal

- Undefined

Psycological


4/28

Toksin

• Berasal ari !akanan - jamur

- beberapa jenis ikan

- jengkol• Konta!inan

- bakteria: salmonella, campylobacter,shigella

- virus

- non organik : aditif, As, b, etc

i


5/28

Non I!!une "eiateARF

En#i!atik :

Far!akologikal :

Aiti$ :


6/28

En#i!atik

e.g %a&tose intoleran&e ' sukroseintoleran&e

!aktosa yg tdk tercerna tinggal di lumen usus

menimbulkan efek osmotik→

retensi cairan. !aktosa mengalami proses fermentasi oleh

bakteri usus, memproduksi asam organik "hidrogen.

#istensi lumen oleh gas memicu borborigmi "nyeri, serta retensi cairan menyebabkan diare

$erapi : menghindari mkn yg mengandunglaktosa


7/28

Far!akologikal :

• %brp makanan mengandung substansiyg dpt memicu langsung pelepasan selmast " baso&l /vasoaktif amin 'atau

prekursor lain( " neurotransmitter, shgmirip in)amasi alergi. →pseudo allergies.

• Contoh pada seafoods yang tidakdisimpan dengan baik : memproduksi

histamin like substance• Caffeine

• MSG : chinese restaurant syndrome


8/28

Aiti$ :

• %eberapa aditif dpt bertindak sbghaptens, bergabung dgn proteinautolog " memicu reaksi imun,

• Misal :

tatra*ine yello+

ben*oat

salicylates,

sulphites


9/28

Foo allerg(

• mmunologically mediated

• $he most serious form of reaction to

food• ts eect can be rapid, life

threatening and trigerred by minute

amounts of the allergen• amily history of atopic disease


10/28

)re*alen&e

• Hard to determine

• Food allergy : - 1 -2 % of the general population

- 5 – 8 % of the children

• Perceived prevalence is much higher

• he prevalence of non-allergic food

intolerance is almost impossi!le toestimate !ecause of the varia!ility in itscause and effect"


11/28

Cause of food allergy

• esults from a faulty and e0aggeratedresponse of the immune system follo+inge0posure to a foreign protein 'antigen(.

• 1ormally immune system is able todistinguish bet+een antigens that need tobe destroyed and those that do not.

• f learning process in developing toleranceis faulty, an abnormal respons can occur.


12/28

Co!!on "ani$estation

• $he most common is cutaneous' ranging from urticaria,angiooedema, atopic dermatitis(.

• 2astrointestinal reactions 'nausea,vomiting, pain, blood in stool( occur+ithin 3 hour of ingestion

• Contact hypersensitivity of theoropharyn0


13/28


14/28

Symptoms of mildFood-Allergic Reaction

Respiratory tract: ! Itchy, watery eyes, running or stuffy nose,

sneezing, cough, itching or swelling of the lips,

wheezingGI tract:

! abdominal cramps, nausea, vomiting, diarrhea

Skin:

! urtica, eczema, itchy red rash, swelling

S(!+to!s so!eti!es +rogress ra+il( to

se*ere rea&tions


15/28

S(!+to!s o$ a Se*ere

Foo,Allergi& Rea&tionespiratory

! shortness of breath,

! di4culty s+allo+ing,

! itching or s+elling of the mouth or

throat, change in voice

Cardiovascular

! drop in blood pressure, ! loss of consciousness/fainting

! shock


16/28

Four basic type of allergic response

• Type I

results from the interaction of the allergen with specific Ig E

• Type II interaction of the cell bound antigen with Ig G or Ig M

• Type III

immune complex reactions (antigen Ig G complemen !en"yme#

• Type I$ Tlymphocytes


17/28

$ype

• Allergic reaction due to Ig production inresponse to antigen

• !lassic and most common

• "ccur within minutes• Ig binds to mast cells #also eosinophils,

basophils$

• %egranulation triggers anaphylaxis

&ocal: hay fever, bronchial asthma

Systemic: circulatory shock


18/28


19/28

ype II

• Cytotoxic%cytolytic

• IgG or IgMmediated

• &cti'ation of complement pathway andeffector cells (platelets neutrophils

eosinophils macrophages etc#

• &lso immediate


20/28


21/28

Type III

• Immune complex formation

• )ccur some hours after exposure

• *ate

• Combination of Ig G and circulating antigen

results in acti'ation of the complemen system

which triggers en"yme release

• Typical in the s+in and bronchi


22/28


23/28

ype IV

• ,elayed type T cell mediated

• Special subset of T-. cell migrate to site

• /ecognition of antigens bound to tissue cells• &cti'ation of T-. cells to release cyto+ines

• /ecruitment of lymphocytes macrophages

basophils• The second common form of food allergy


24/28

Allergen

• 5vomukoid 'telur(

• Arachin, conarachin, peanut-3'kacang(

• %etalaktoglobulin '%!2(,alfalaktoalbumin 'A!A(, bovin serumalbumin '%6A(, bovin gama globulin

'%22( dari susu sapi

• Allergen M 'ikan(

• dsb


25/28

Dietar( !anage!ent o$

Foo Allerg(

• Ienti$(ing ana*oiing t-eo.ening allergen

• Co!+lete

e/&lusion isi!+erati*e


26/28

Dieteti& guian&e

• All potential sources of allergen areavoided

- foods +hich must avoided

- foods +hich may need to be avoided - +hich can safely be eaten

• $he eects of the e0clusion diet onthe intake of other nutrients andoverall dietary balance are minimi*ed


27/28

Breast Feeing

• 5ers some protection• !essens the e0posure to co+7 s milk

protein

• Contains g A +hich help to block theentry of +hole proteins from thebaby7s immature gut into the bloodstream

• Contain macrophage and otherimmune system +hich may help theinfant7s immune system to mature

more rapidly


28/28

Finis-

Documents

Adverse Reaction to Foods