Search Results (169)

Dietary lipids not only enhance the flavor and nutritional value of food, but more importantly, they offer essential fatty acids and energy for metabolism. The importance of lipid unsaturation has gained increasing attention; however, the impact of the alky chain length on biofunction of dietary lipids remains unclear. This article discusses the effects of the alkyl chain length on the biological function of lipids, focusing on physical and chemical properties, digestion and absorption, and nutritional functions. Firstly, with the increase in the chain length, the melting point of the crystal increases, the symmetry increases, and the hypersensitivity induction decreases. Secondly, the alkyl chain length affects the contact between lipid droplets and lipase, as well as the fatty acids release rate. Finally, medium-chain and short-chain lipids can partially reverse the effect of long-chain lipids. Understanding the effect of the alkyl chain length on the biofunction of dietary lipids can provide valuable insights for designing nutritious diet. Full article

Nutritional strategies based on sourdough fermented breads with wholemeal ancient grains and legumes are emerging as promising modulators of (neuro)immune processes. This study investigated whether prolonged consumption of a sourdough bread enriched with a mixture of ancient cereals and legumes, commercially available in Italy (Primus^® bread, P^®B), modulates neuroimmune systemic responses to repeated lipopolysaccharide (LPS) challenge in mice. For this study, male C57BL/6J mice were fed for 14 days with either a standard diet (SD) or P^®B. Animals then received intraperitoneal LPS (3 mg/kg/day for 3 days) or vehicle. Body weight and food intake were monitored throughout. Pain-like behaviours were assessed by von Frey, plantar and tail flick tests, and plasma cytokine (32-plex panel), splenocyte and peritoneal macrophage cytokine expression, and expression of pro-inflammatory cytokines in sciatic nerves, dorsal root ganglia (DRG) and the spinal cord were analyzed by Reverse Transcription–quantitative Polymerase Chain Reaction (RT-qPCR). P^®B prevented LPS-induced body weight loss and reduced splenomegaly. Unlike SD mice, which exhibited widespread plasmatic cytokine upregulation, P^®B-fed mice displayed only limited increases Interleukin (IL)-1β, IL-12p40 and Tumor Necrosis Factor (TNF)α. Ex vivo cultures of splenocytes and macrophages confirmed attenuated cytokine overexpression. LPS-induced hypersensitivity to mechanical, thermal and nociceptive stimuli was significantly reduced in P^®B mice. Molecular analyses revealed that the P^®B diet blunted the pro-inflammatory cytokine expression present after LPS challenge in the sciatic nerves and DRG, with partial attenuation in the spinal cord. Our findings highlight the great potential of functional foods as affordable dietary strategies to mitigate systemic immune and neuroimmune dysregulation. Full article

Introduction: The potential role of food hypersensitivity in the insurgence of inflammatory activity in arthritis such as Rheumatoid Arthritis (RA) has received intermittent attention, also supported by theoretical links involving mucosal immunity, mast-cell activation, and microbiome–immune interactions. Despite biological plausibility, the clinical significance of dietary antigens in RA remains uncertain. Methods: A systematic review was conducted following the PRISMA guidelines. Searches using PubMed, Scopus, and Web of Science identified studies exploring dietary interventions or food hypersensitivity in RA. Eligible articles included clinical trials, case reports, and observational studies, in English or Italian, up to the 10 December 2025. Data extraction and quality assessment were performed using the Newcastle–Ottawa Scale. Results: Eight studies met the inclusion criteria. Findings indicate that elimination or elemental diets occasionally yielded subjective improvements—such as a reduction in pain, morning stiffness, and functional improvements—yet objective inflammatory markers rarely changed. Small, highly selected, cohorts demonstrated immuno-histological alterations, including reduced mast-cell density, while long-term diets (e.g., gluten-free or vegan) have reduced specific IgG levels without altering radiographic progression. Conclusions: Evidence suggests that dietary interventions may offer symptomatic relief only in a minority of RA patients. Due to methodological constraints, inconsistent outcomes, and limited applicability to contemporary treatments, dietary approaches need further exploration and investigation. Rigorous trials in modern cohorts are warranted to clarify whether food hypersensitivity meaningfully influences RA pathophysiology. Full article

Background: A hypersensitivity reaction has been hypothesized as one of the possible pathophysiological mechanisms involved in non-celiac wheat sensitivity (NCWS). Some studies have reported a high frequency of atopic diseases in NCWS patients. Objectives: This study aimed (A) to define the presence and features of atopic diseases and other hypersensitivities in NCWS patients and (B) to search for possible allergic features which could address a NCWS diagnosis. Methods: Clinical, laboratory and histological data from NCWS patients before the start of a wheat-free diet were retrospectively analyzed and compared to control subjects with celiac disease (CeD) or irritable bowel syndrome/functional dyspepsia (IBS/FD). Results: Atopic disease prevalence was higher in the NCWS patients (32.8%) than in those with CeD (19.3%) and IBS/FD (21.5%) (p = 0.001 for both). Similarly, NCWS subjects reported a higher frequency of multiple food sensitivities (MFSs) (39.8%) and self-reported milk intolerance (SRMI) (65.9%) compared to the control groups (p < 0.001 for both). On multiple logistic regression analysis, a coexistent atopic disease (OR 1.481), MFS (OR 3.882) and SRMI (OR 2.259) proved to be variables associated with the NCWS diagnosis. Conclusions: NCWS subjects have a higher frequency of atopic disease, MFS and SRMI when compared to both CeD and IBS/FD patients. All these conditions could be considered as an expression of an underlying hypersensitivity milieu characterizing NCWS and might be of support in the differential diagnosis between NCWS and functional gastrointestinal disorders, if inserted into a broader diagnostic panel. Full article

The prevalence of allergies is increasing worldwide. In addition to pharmacological treatment, dietary management represents an established component of food allergy care. Elimination diets have long been recognized as an effective therapy for certain conditions, including food allergies. The Autoimmune Protocol (AIP) diet, a restrictive elimination diet originally developed for patients with autoimmune diseases, has gained popularity recently. Its underlying rationale, centered on immune regulation, intestinal epithelial barrier function, and gut dysbiosis, suggests potential relevance to food allergies. Moreover, the AIP excludes most of the major food allergens, which may support symptom reduction and facilitate the identification of individual dietary triggers. The role of histamine in allergic responses further highlights the AIP’s potential applicability in cases of histamine intolerance, where reducing the overall histamine burden could be beneficial. This narrative review aimed to synthesize the limited available evidence on the AIP and explore its potential implementation, mechanisms, and limitations in the context of food allergies. Full article

With the global increase in population aging, allergic diseases in older adults are becoming an increasingly relevant clinical and public health challenge. Age-related molecular and cellular alterations significantly affect the pathophysiology, clinical manifestations, diagnosis, and management of major allergic diseases in the elderly. This review focuses on immunosenescence in major allergic conditions, including asthma, chronic urticaria and angioedema, dermatitis, food and drug allergies, and hymenoptera venom hypersensitivity. Particular emphasis is placed on molecular mechanisms underlying immune aging, such as inflammaging, dysregulation of innate and adaptive immune responses, epithelial barrier dysfunction, microbiota alterations, neuro-immune interactions, and age-related comorbidities. Sex-related differences in immune responses are also addressed, together with current diagnostic and therapeutic strategies, including the opportunities and limitations of biologic therapies in aging populations. Despite growing interest in this field, a major limitation remains the paucity of studies specifically targeting geriatric populations, underscoring the need for age- and sex-specific research and dedicated clinical trials. A personalized approach integrating frailty assessment and immune profiling is essential to optimize the management of allergic diseases in older adults. Full article

Honeybee products (HBPs), including honey, bee pollen, bee bread, royal jelly, propolis, beeswax, and bee brood, are increasingly used in food, nutraceutical, and cosmetic contexts. Because of their natural origin, HBPs can provoke allergic reactions ranging from localised dermatitis to life-threatening, systemic anaphylaxis. As the use of bee products for health purposes grows in apitherapy (a branch of alternative medicine), raising public awareness of their potential risks is essential. This narrative review synthesises the clinical manifestations of HBP allergy, culprit allergens present in each product, immunological mechanisms, diagnostic approaches, at-risk populations, and knowledge gaps. The analysis of the available literature suggests that, although relatively rarely, HPB may trigger allergic reactions, including anaphylactic shock. The sensitisation mechanism may be associated with both primary sensitisation and cross-reactivity and can be classified into type I (IgE-mediated) and type IV (T-cell-mediated). However, bee bread appears less allergenic than other HBPs, potentially due to lactic fermentation that can degrade allergenic proteins. Severe reactions following intake of bee bread have not been reported to date. Management of HBP allergic reactions centres on avoiding the products, educating about the risks, and providing more precise product labelling, specifying the allergen content. Individuals with atopy and beekeepers are at heightened risk of developing anaphylaxis; therefore, they should be particularly aware of the potential dangerous consequences of HPB use. Further research is needed to clarify the mechanisms of HBP allergies and improve safety for all users. Full article

Pediatric food allergies are an escalating public health concern, with nut allergies representing a primary cause of persistent hypersensitivity and anaphylaxis. New data suggests that pediatric populations with multiple nut allergies (MNA) may be at higher anaphylaxis risk than their counterparts with single nut allergies. Despite this, there is an absence of literature posing multiple nut allergies against singular nut allergy cases. The majority of the research in this topic is directed towards singular nut allergy, without any differentiation between children with one versus multiple sensitivities. Epidemiological evidence indicates that multiple nut allergies are associated with lifelong sensitization, high cross-reactivity potential and increased risk and severity of reactions. Compounding clinical risk factors reinforce the already high risk associated with MNA and indicate that these children require careful monitoring and individual management. Diagnostic tools, including component-resolved diagnostics and oral food challenges, enable differentiation between true multi-nut sensitization and cross-reactivity, guiding targeted interventions. Management strategies must therefore be multifaceted, encompassing selective allergen avoidance, emergency preparedness with epinephrine auto-injectors, asthma control, nutritional support, and psychosocial care. Recognizing MNA as a distinct, high-risk phenotype highlights the necessity of precision-based, biomarker-driven clinical approaches to optimize safety, reduce morbidity, and improve quality of life for affected pediatric populations. Full article

Background: Autism spectrum disorder (ASD) constitutes a heterogeneous neurodevelopmental condition frequently accompanied by considerable disturbances in feeding behavior and nutritional balance. These difficulties arise from complex and multifactorial mechanisms, exerting a significant impact on physical health, metabolic homeostasis, and psychosocial functioning. The present review aims to provide a critical synthesis of current evidence regarding the underlying biological and behavioral mechanisms of feeding difficulties in ASD and to delineate the spectrum of comorbid eating disorders within this population. Methods: A narrative review of the peer-reviewed scientific literature was undertaken, emphasizing studies investigating the interrelationship between ASD and nutritional functioning in pediatric and adolescent populations. Particular focus was placed on research exploring sensory processing abnormalities, gut microbiota alterations, and the clinical manifestation of eating disorders in individuals with ASD. Results: The analysis revealed that sensory hypersensitivity, behavioral inflexibility, and disturbances within the gut–brain axis constitute principal determinants of atypical eating patterns in ASD. Individuals on the autism spectrum frequently exhibit pronounced food selectivity, neophobia, and symptoms consistent with Avoidant/Restrictive Food Intake Disorder (ARFID). Furthermore, an increased prevalence of anorexia nervosa and orthorexia nervosa has been documented, likely reflecting shared cognitive and behavioral features with ASD. “Emotional eating” tendencies and a marked preference for high-caloric, energy-dense foods—often potentiated by psychopharmacological treatment and reduced physical activity—further contribute to an elevated risk of overweight and obesity. Conclusions: Children and adolescents with ASD display a bimodal distribution of body mass, encompassing both undernutrition and obesity, indicative of a multifaceted interplay among sensory, behavioral, cognitive, and metabolic determinants. A comprehensive understanding of this heterogeneity is crucial for the development of individualized, evidence-based interventions integrating nutritional management with behavioral and psychotherapeutic approaches. Full article

Background/Objectives: Introduction: Food selectivity is highly prevalent in children with autism spectrum disorder (ASD) and is associated with sensory hypersensitivity, particularly in oral, olfactory, and tactile domains. Although international evidence exists, little is known about this phenomenon in Latin American populations. This study aimed to explore the relationship between sensory hypersensitivity and food selectivity in Chilean children with and without ASD. Methods: A cross-sectional study was conducted with 57 children aged 6–12 years, including 32 with ASD and 25 neurotypical controls. Sensory processing was assessed using the Dunn Sensory Profile 2, while food selectivity was evaluated with the Brief Autism Mealtime Behaviour Inventory (BAMBI) and a Food Frequency Questionnaire (FFQ). Statistical analyses included intergroup comparisons and correlation tests. Results: Children with ASD obtained significantly higher scores across all domains of sensory hypersensitivity (p < 0.001). Selective eating behaviours were more frequent, with texture (78%) and colour (53%) being the most common, and were strongly associated with ritualistic eating (OR 29.39; 95% CI 5.47–136.2; p < 0.0001). BAMBI scores were correlated with oral (p = 0.002), socio-emotional (p = 0.003), and somatic hypersensitivity (p = 0.025). Additionally, children with ASD reported lower intake of vegetables, dairy products, animal proteins, and legumes compared with controls. Conclusions: Food selectivity in Chilean children with ASD is closely related to sensory hypersensitivity, particularly in oral, socio-emotional, and somatic domains. These findings underscore the need for culturally adapted, sensory-based interventions to broaden dietary variety and reduce mealtime difficulties in this population. Full article

Background/Objective: Milk and fermented dairy products are widely consumed functional foods and beverages, offering not only essential nutrients but also bioactive compounds with potential to modulate host immunity, metabolism, and the gut microbiome. This narrative review aims to synthesize current knowledge on the relationship between dairy consumption, gut microbiome, immune modulation, adverse reactions to food, physical performance and cardiometabolic health. Methods: An extensive literature analysis was conducted to explore how milk and fermented dairy products modulate the gut microbiome and influence the immune and cardiometabolic health. This study synthesis focused on key dairy bioactive compounds, such as probiotics, miRNAs, milk-derived peptides and exosomes and on evaluating their proposed mechanisms of action in inflammation and metabolic regulation, and their possible influence on physical performance through gut–microbiome interactions. Additionally, advances in metagenomic and metabolomic technologies were reviewed for their potential to uncover host–microbiota interactions relevant to precision nutrition strategies. Results: Fermented dairy products have shown potential in promoting beneficial bacteria growth such as Lactobacillus and Bifidobacterium, short-chain fatty acid synthesis and reduction in proinflammatory biomarkers. Specific dairy-derived peptides and exosomal components may further support gut barrier integrity, immune regulation and improve physical performance and reduce cardiometabolic risk factors. Additionally, emerging evidence links individual gut microbiota profiles to specific metabolic responses, including tolerance to lactose and bovine milk proteins. Conclusions: Integrating microbiome science with traditional nutritional paradigms enhances our understanding of how dairy influences immune and cardiometabolic health. Overall, current evidence suggests that investigating dairy-microbiome interactions, alongside lifestyle factors such as physical activity, may inform future personalized nutrition strategies aimed at supporting metabolic and immune health. Full article

Background: Self-reported food allergy is a common concern among adults and often prompts the use of diagnostic allergy testing. However, serum diamine oxidase (DAO) measurement is rarely performed, despite the fact that symptoms of histamine intolerance can closely mimic those of IgE-mediated food allergy. This study aimed to analyze and compare the results of commonly used food allergy tests in relation to serum DAO levels in this patient population. Methods: A total of 61 adult patients with self-reported food-related symptoms were enrolled. All participants underwent skin prick testing and serum DAO measurement using an enzyme-linked immunosorbent assay (ELISA). In addition, serum-specific IgE (sIgE) testing was performed in 29 of the 61 patients. DAO levels were compared across groups based on skin prick testing and sIgE results. Results: Fewer than half of the patients had positive test results, 36% for skin prick testing and 38% for sIgE, and 38% showed reduced serum DAO levels. DAO levels did not differ significantly between patients with positive and negative skin prick or sIgE results; however, a slight decrease in DAO was observed in patients with negative sIgE. Patients with negative skin prick tests were significantly older than those with positive results. Conclusions: The majority of adults with self-reported food allergies had negative allergy test results and normal DAO levels. Nevertheless, a considerable proportion showed either positive allergy tests or reduced DAO levels, suggesting the potential role of histamine intolerance. These findings underscore the importance of a detailed pre-test clinical assessment that considers both IgE- and non-IgE-mediated mechanisms in patients with suspected food-related hypersensitivity. Full article

Background/Objectives: Food protein-induced enterocolitis syndrome (FPIES) is a food-related hypersensitivity disorder characterized by delayed repeated vomiting that typically presents within the first years of life. Although FPIES has traditionally been considered a pediatric condition, it has more recently been observed also in teenagers and adults. Adult FPIES may be a continuation of childhood-onset disease or new-onset forms developing later in life. This review aims to describe the peculiarities of FPIES across the lifespan and to provide an update from the last years on the studies focused on FPIES in adolescence. Methods: Papers focusing on FPIES in adolescents, in English and published in PubMed, were reviewed. Results: There is less data available in the literature on FPIES in adolescents. Multiple sensitizations to food can compromise nutritional status in patients with FPIES. Several potential diagnostic biomarkers related to genomic susceptibility, altered immunologic response, mucosal inflammation and intestinal microbiota are under study/validation. The lack of age-specific diagnostic algorithms makes it difficult to understand the clinical features of persistent forms of FPIES. Conclusions: Shared transition medicine protocols tailored to adolescents could help us better understand the clinical, pathophysiological, diagnostic, and therapeutic characteristics of this delicate phase of life. Full article

Although omalizumab is currently approved for a limited number of indications—such as asthma, chronic rhinosinusitis with nasal polyps, and chronic spontaneous urticaria—its potential applications are expanding each year. Owing to its diverse and not yet fully elucidated mechanism of action, including effects on both IgE- and non-IgE-mediated hypersensitivity reactions with delayed onset, this monoclonal antibody may be beneficial in a wide range of allergic and non-allergic conditions. To date, numerous clinical trials and case reports have documented the successful off-label use of omalizumab. It appears particularly promising for patients with difficult-to-treat hypersensitivities, such as food and drug allergies, which continue to pose significant challenges in modern allergology. Even though further research is needed to establish clear indications for its use in these contexts, omalizumab holds considerable potential to enhance the outcomes and clinical efficacy of food immunotherapy and drug desensitization protocols. The aim of this review is to present the current and potential future applications of omalizumab as an adjunctive treatment in food allergy therapy and in desensitization protocols for patients with hypersensitivity to selected drugs. Full article

Folic acid and its derivatives (e.g., folinic acid) are a group of water-soluble compounds collectively known as vitamin B9. Synthetic folic acid is a component of dietary supplements, medications and other pharmaceuticals and fortified foods. Folinic acid (5-formyltetrahydrofolic acid) is the active metabolite of folic acid. It is used to treat vitamin B9 deficiency and as an adjunct to various combination therapies. Hypersensitivity reactions to folic acid or folinic acid are rare and occur following exposure to synthetic folic acid or its derivatives but not on natural folates. In people allergic to folates, cross-reactions are possible following exposure to folic acid analogues (including antifolates, e.g., methotrexate). The mechanism of hypersensitivity to folic acid and/or folinic acid has not been clearly established. Both IgE-dependent and non-IgE-dependent hypersensitivity reactions are likely. It is possible that folic or folinic acid is either an immunogen or a hapten. Diagnosing hypersensitivity to folic/folinic acid is difficult. There are no validated in vitro or in vivo diagnostic tests. The basophil activation test (BAT) appears to be a promising tool for diagnosing folate allergy. The aims of the manuscript were to review published clinical cases of hypersensitivity reactions to folic or folinic acid, potential mechanisms of these reactions and possible cross-allergies, and current diagnostic possibilities of folate hypersensitivity. Full article