Alergias y Sensibilidades

(Allergies and Sensitivities)

Las alergias son la respuesta del sistema inmunológico a un alimento, inhalante (sustancia en el aire) o sustancia química en particular. En lenguaje común, los términos "alergia" y "sensibilidad" se usan con frecuencia para referirse a lo mismo, aunque muchas sensibilidades no son en realidad alergias. El término “sensibilidad” es genérico y puede incluir alergias verdaderas, reacciones que no afectan al sistema inmunológico (y que por lo tanto no son técnicamente alergias) y reacciones cuya causa no se ha determinado.

Cuadro resumen

Clasificación	Vitaminas, suplementos y hierbas
	Extractos de timo Probióticos (alergia alimentaria)
	Clorhidrato de betaína (alergia alimentaria) Enzimas (alergia alimentaria) Flavonoides Quercetina
Información científica confiable y relativamente consistente que muestra un beneficio importante para la salud. Estudios contradictorios, insuficientes o preliminares que sugieren la existencia de algún beneficio para la salud, aunque sea mínimo. La hierba está respaldada principalmente por el uso tradicional, o bien, la hierba o el suplemento tienen poco respaldo científico o presentan un beneficio mínimo para la salud.

Clasificación

Vitaminas, suplementos y hierbas

Extractos de timo

Probióticos (alergia alimentaria)

Clorhidrato de betaína (alergia alimentaria)

Enzimas (alergia alimentaria)

Flavonoides

Quercetina

3estrellas Información científica confiable y relativamente consistente que muestra un beneficio importante para la salud.

2estrellas Estudios contradictorios, insuficientes o preliminares que sugieren la existencia de algún beneficio para la salud, aunque sea mínimo.

1estrella La hierba está respaldada principalmente por el uso tradicional, o bien, la hierba o el suplemento tienen poco respaldo científico o presentan un beneficio mínimo para la salud.

¿Cuáles son los síntomas?

Entre los síntomas comunes se pueden mencionar ojos llorosos y con comezón, estornudos, cefalea, fatiga, escurrimiento, congestión o comezón en la nariz, irritación de garganta, ojeras, una sensación de comezón en boca y garganta, dolor abdominal, diarrea y la aparición de erupciones con enrojecimiento de la piel y comezón. Las reacciones alérgicas potencialmente mortales son poco comunes y por lo general se relacionan con cacahuates, nueces, mariscos y algunos medicamentos. Cuando se presentan, los síntomas iniciales pueden incluir dificultades para respirar y tragar.

¿Cómo se trata?

Entre los medicamentos que pueden adquirirse sin receta para tratar este problema se encuentran los antihistamínicos como diphenhydramine (Benadryl®), loratadine (Claritin®) y chlorpheniramine (Chlor-Trimeton®), así como el descongestivo pseudoephedrine (Sudafed®). Los descongestivos locales como oxymetazoline (Afrin®) y phenylephrine (Neo-Synephrine®) pueden usarse durante algunos días sin efectos secundarios nocivos. Los aerosoles nasales a base de solución salina como Ocean®, Ayr® y Dristan Saline Spray® pueden usarse para calmar el tejido inflamado por la alergia. La solución nasal cromolyn sodium (Nasalcrom®) puede usarse para prevenir futuros episodios alérgicos.

Los tratamientos con receta incluyen antihistamínicos como fexofenadine (Allegra®), cetirizine (Zyrtec®) y desloratadine (Clarinex®), broncodilatadores como albuterol (Proventil®, Ventolin®), corticosteroides nasales como fluticasone (Flonase®), triamcinolone (Nasacort AQ®), mometasone (Nasonex®) y flunisolide (Nasalide®), así como vacunas antialérgicas semanales (inmunoterapia por desensibilización). Las personas que hayan experimentado reacciones alérgicas graves deben llevar consigo una jeringa para inyección automática de epinephrine (EpiPen®) para usarla en caso de un ataque.

Por lo general, a las personas con alergias y sensibilidades se les recomienda que eviten exponerse a ciertos alergenos, como el polen de árboles y pastos, los ácaros del polvo, mohos, alimentos específicos, látex o irritantes ambientales o presentes en el hogar. Las personas que hayan sufrido alguna reacción alérgica grave deben llevar una placa con información médica en la que se indique a qué son alérgicos.

Suplementos nutricionales que pueden ser beneficiosos

Probióticos (alergia alimentaria): Los probióticos pueden ser importantes para el control de las alergias a los alimentos, dada su habilidad para mejorar la digestión al ayudar al intestino a controlar la absorción de los alergenos o al cambiar las respuestas del sistema inmunológico a los alimentos.

Extractos de timo: Thymomodulin es una preparación especial que se hace con timo de becerros. En un estudio doble ciego en niños alérgicos que lograron completar con éxito una dieta de eliminación, 120 mg diarios de thymomodulin evitaron las reacciones alérgicas en la piel y disminuyeron los niveles de anticuerpos en sangre asociados con los alimentos causantes de la alergia. Estos resultados confirmaron las conclusiones similares de otro estudio controlado anterior.

Cambios en la dieta que pueden ser beneficiosos

Con frecuencia se recomienda a personas que sospechan tener una alergia alimentaria, que sigan una dieta baja en alergenos, también conocida como dieta de eliminación o dieta hipoalergénica, para observar si el evitar alimentos que comúnmente provocan alergias alivia sus síntomas. Esta dieta elimina los alimentos y aditivos para alimentos que se consideran alergenos comunes, como el trigo, los productos lácteos, el huevo, el maíz, la soya, las frutas cítricas, las nueces, los cacahuates, los tomates, los colorantes y conservadores, el café y el chocolate. Algunos libros populares ofrecen una guía para las personas que quieren tratar de probar este tipo de dieta. Sin embargo, la dieta hipoalergénica no es un tratamiento para las alergias. Se trata más bien de una herramienta de diagnóstico que se usa para ayudar a descubrir qué comidas afectan al paciente. Se sigue sólo hasta que se descubre qué alimentos provocan las reacciones y cuáles no. Una vez que se identifican los alimentos que causan las reacciones, se procede a eliminarlos de la dieta; todos los demás alimentos que no afectan a la persona vuelven a agregarse a la dieta. Aunque las recomendaciones acerca de cuánto tiempo debe seguirse este tipo de dieta varían de entre cinco días y tres semanas, muchos expertos en nutrición consideran que una prueba de dos semanas es por lo general suficiente para llevar a cabo el diagnóstico de las reacciones a los alimentos.

A veces, al evitar estrictamente los alimentos que provocan reacciones alérgicas durante un cierto tiempo (por lo general meses o años), éstos dejan de causar la reacción. Las dietas de eliminación restrictiva y la reintroducción de los alimentos deben llevarse a cabo bajo supervisión médica.

Cambios en el estilo de vida que pueden ser beneficiosos

A las personas con alergia a inhalantes se les recomienda reducir la exposición a alergenos comunes en el hogar, como polvo, hongos y las escamas secas de la piel de animales caseros, con la esperanza de reducir los síntomas, incluso si no es posible evitar otros alergenos que se encuentran fuera del hogar. Las estrategias incluyen quitar las alfombras, limpiar y aspirar con frecuencia, usar filtros de aire especiales en el sistema de calefacción, elegir ropa de cama hipoalergénica e impedir el acceso de las mascotas a las recámaras.

Referencias

1. David TJ. Adverse reactions and intolerance to foods. Br Med Bull 2000;56:34–50 [review].

2. Breneman JC. Basics of Food Allergy. Springfield, IL: Charles C Thomas, 1978, 45–53.

3. Darlington LG, Ramsey NW, Mansfield JR. Placebocontrolled, blind study of dietary manipulation therapy in rheumatoid arthritis. Lancet 1986;i:236–8.

4. Beri D, Malaviya AN, Shandilya R, Singh RR. Effect of dietary restrictions on disease activity in rheumatoid arthritis. Ann Rheum Dis 1988;47:69–72.

5. Panush RS. Possible role of food sensitivity in arthritis. Ann Allerg 1988;61(part 2):31–5.

6. Taylor MR. Food allergy as an etiological factor in arthropathies: a survey. J Internat Acad Prev Med 1983;8:28–38 [review].

7. Darlington LG, Ramsey NW. Diets for rheumatoid arthritis. Lancet 1991;338:1209 [letter].

8. Rowe AH, Young EJ. Bronchial asthma due to food allergy alone in ninety-five patients. JAMA 1959;169:1158.

9. Genton C, Frei PC, Pecoud A. Value of oral provocation tests to aspirin and food additives in the routine investigation of asthma and chronic urticaria. J Asthma 1985;76:40–5.

10. Townes SJ, Mellis CM. Role of acetyl salicylic acid and sodium metabisulfite in chronic childhood asthma. Pediatrics 1984;73:631–7.

11. Boris M, Mandel FS. Foods and additives are common causes of the attention deficit hyperactive disorder in children. Ann Allergy 1994;72:462–8.

12. Carter CM, Urbanowicz M, Hemsley R, et al. Effects of a few food diet in attention deficit disorder. Arch Dis Child 1993;69:564–8.

13. Egger J, Stolla A, McEwen LM. Controlled trial of hyposensitisation in children with food-induced hyperkinetic syndrome. Lancet 1992;339:1150–3.

14. Horesh AJ. Allergy and infection. Proof of infectious etiology. J Asthma Res 1967;4:269–82.

15. Rudolph JA. Allergy as a cause of frequent recurring colds and coughs in children. Dis Chest 1940;6:138.

16. Berman BA. Pseudomononucleosis of allergic origin: a new clinical entity. Ann Allergy 1964;22:403–9.

17. Kudelco N. Allergy in chronic monilial vaginitis. Ann Allergy 1971;29:266–7.

18. Crandall, M. Allergic predisposition and recurrent vulvovaginal candidiasis. J Advancement Med 1991;4:21–38 [review].

19. Hay KD, Reade PC. The use of an elimination diet in the treatment of recurrent aphthous ulceration of the oral cavity. Oral Surg Oral Med Oral Pathol 1984;57:504–7.

20. Wray D. Gluten-sensitive recurrent aphthous stomatitis. Dig Dis Sci 1981;26:737–40.

21. Wright A, Ryan FP, Willingham SE, et al. Food allergy or intolerance in severe recurrent aphthous ulceration of the mouth. BMJ 1986;292:1237.

22. Wray D, Vlagopoulos TP, Siraganian RP. Food allergens and basophil histamine release in recurrent aphthous stomatitis. Oral Surg Oral Med Oral Pathol 1982;54:338–95.

23. Faulkner-Hogg KB, Selby WS, Loblay RH. Dietary analysis in symptomatic patients with coeliac disease on a gluten-free diet: the role of trace amounts of gluten and non-gluten food intolerances. Scand J Gastroenterol 1999;34:784–9.

24. Sewell P, Cooke WT, Cox EV, Meynell MJ. Milk intolerance in gastrointestinal disorders. Lancet 1963;2:1132–5.

25. Haeney MR, Goodwin BJF, Barratt MEJ, et al. Soya protein antibodies in man: their occurrence and possible relevance in coeliac disease. J Clin Pathol 1982;35:319–22.

26. Mike N, Haeney M, Asquith P. Soya protein hypersensitivity in coeliac disease: evidence for cell mediated immunity. Gut 1983;24:A990.

27. Ament ME, Rubin CE. Soy protein—another cause of the flat intestinal lesion. Gastroenterology 1972;62:227–34.

28. Hill DJ, Hosking CS, Heine RG. Clinical spectrum of food allergy in children in Australia and South-East Asia: identification and targets for treatment. Ann Med 1999;31:272–81.

29. Jakobsson I, Lindberg T. Cow’s milk proteins cause infantile colic in breast-fed infants: a double-blind crossover study. Pediatr 1983;71(2):268–71.

30. Evans RW, Fergusson DM, Allardyce RA, et al. Maternal diet and infantile colic in breast-fed infants. Lancet 1981;49:1340–2.

31. Clyne PS, Kulczycki A. Human breast milk contains bovine IgG. Relationship to infant colic? Pediatr 1991;87:439–44.

32. Hill DJ, Hudson IL, Sheffield LJ, et al. A low allergen diet is a significant intervention in infantile colic: results of a community-based study. J Allergy Clin Immunol 1995;96:886–92.

33. Iacono G, Cavataio F, Montalto G, et al. Intolerance of cow’s milk and chronic constipation in children. N Engl J Med 1998;339:1100–4.

34. Daher S, Solé D, de Morias MB. Cow’s milk and chronic constipation in children. N Engl J Med 1999;340:891.

35. Shah N, Lindley K, Milla P. N Engl J Med 199918;340:891–2.

36. Riordan AM, Hunter JO, Cowan RE, et al. Treatment of active Crohn’s disease by exclusion diet: East Anglian Multicentre Controlled Trial. Lancet 1993;342:1131–4.

37. King DS. Can allergic exposure provoke psychological symptoms? A double-blind test. Biol Psychiatry 1981;16:3–19.

38. Brown M, Gibney M, Husband PR, Radcliffe M. Food allergy in polysymptomatic patients. Practitioner 1981;225:1651–4.

39. James JM, Burks AW. Food-associated gastrointestinal disease. Curr Opin Pediatr 1996;8:471–5 [review].

40. McMahan JT, Calenoff E, Croft J, et al. Chronic otitis media with effusion and allergy: modified RAST analysis of 119 cases. Otolaryngol Head Neck Surg 1981;89:427–31.

41. Nsouli TM, Nsouli SM, Linde RE, et al. Role of food allergy in serous otitis media. Ann Allerg 1994;73:215–9.

42. Juntti H, Tikkanen S, Kokkonen J, et al. Cow’s milk allergy is associated with recurrent otitis media during childhood. Acta Otolaryngol 1999;119:867–73.

43. Sampson HA, Scanlon SM. Natural history of food hypersensitivity in children with atopic dermatitis. J Pediatr 1989;115:23–7.

44. Burks AW, Mallory SB, Williams LW, Shirrell MA. Atopic dermatitis: clinical relevance of food hypersensitivity. J Pediatr 1988;113:447–51.

45. Niggemann B, Sielaff B, Beyer K, et al. Outcome of double-blind, placebo-controlled food challenge tests in 107 children with atopic dermatitis. Clin Exp Allergy 1999;29:91–6.

46. Atherton DJ. Diet and atopic eczema. Clin Allerg 1988;18:215–28 [review].

47. Worm M, Ehlers I, Sterry W, Zuberbier T. Clinical relevance of food additives in adult patients with atopic dermatitis. Clin Exp Allergy 2000;30:407–14.

48. Breneman JC. Allergy elimination diet as the most effective gallbladder diet. Ann Allerg 1968;26:83–7.

49. Moneret-Vautrin DA. Cow’s milk allergy. Allerg Immunol (Paris) 1999;31:201–10 [review].

50. McLain BI, Cameron DJ, Barnes GL. Is cow’s milk protein intolerance a cause of gastro-oesophageal reflux in infancy? J Paediatr Child Health 1994;30:316–8.

51. Forget P, Arends JW. Cow’s milk protein allergy and gastro-oesophageal reflux. Eur J Pediatr 1985;144:298–300.

52. Staiano A, Troncone R, Simeone D, et al. Differentiation of cow’s milk intolerance and gastro-oesophageal reflux. Arch Dis Child 1995;73:439–42.

53. Iacono G, Carroccio A, Cavataio F, et al. Gastroesophageal reflux and cow’s milk allergy in infants: a prospective study. J Allergy Clin Immunol 1996:97:822–7.

54. Forget P, Arends JW. Cow’s milk protein allergy and gastro-oesophageal reflux. Eur J Pediatr 1985;144:298–300.

55. Hill DJ, Cameron DS, Catto-Smith A, et al. Multiple food protein intolerance (MFPI) as a cause of reflux oesophagitis in infancy: results of a pilot study. J Allergy Clin Immunol 1998;101:S89 [abstract].

56. Hill DJ, Hosking CS, Heine RG. Clinical spectrum of food allergy in children in Australia and South-East Asia: identification and targets for treatment. Ann Med 1999;31:272–81 [review].

57. Berens C, et al. Allergy in glaucoma. Manifestations of allergy in three glaucoma patients as determined by the pulse-diet method of Coca. Ann Allergy 1947;5:526–35.

58. Raymond LF. Allergy and chronic simple glaucoma. Ann Allergy 1964;22:146–50.

59. Speer F. Multiple food allergy. Ann Allerg 1975;34:71–6.

60. Buczylko K, Kowalczyk J, Zeman K, et al. Allergy to food in children with pollinosis. Rocz Akad Med Bialymst 1995;40:568–72.

61. Ogle KA, Bullock JD. Children with allergic rhinitis and/or bronchial asthma treated with elimination diet. Ann Allergy 1977;39:8–11.

62. Grant ECG. Food Allergies and migraine. Lancet 1979;1:966–9.

63. Henz BM, Zuberbier T. Most chronic urticaria is food-dependent, not idiopathic. Exp Dermatol 1998;7:139–42. [review].

64. Winkelmann RK. Food sensitivity and urticaria or vasculitis. In: Brostoff J, Challacombe SJ (eds.) Food Allergy and Intolerance. Philadelphia: WB Saunders, 1987, 602–17 [review].

65. Lessof MH. Reactions to food additives. Clin Exp Allergy 1995;25 Suppl 1:27–8. [review].

66. Wraith DG, Merrett J, Roth A, et al. Recognition of food allergic patients and their allergens by the RAST technique and clinical investigation. Clin Allergy 1975;9:25–36.

67. Zuberbier T, Chantraine-Hess S, Hartmann K, et al. Pseudoallergen-free diet in the treatment of chronic urticaria. ACTA Dermatologica Venerol (Stockh) 1995;75:484–7.

68. Gibson A, Clancy R. Management of chronic idiopathic urticaria by the identification and exclusion of dietary factors. Clin Allergy 1980;10:699–704.

69. Meyer de Schmid JJ, Zeller J. Urticaria due to vitamin B 12 allergy verified by the lymphoblastic transformation test. Bull Soc Fr Dermatol Syphiligr 1969;76:670–1 [in French].

70. Rippere V. “A little something between meals”: masked addiction not low blood blood-sugar. Lancet 1979;1:1349 [letter].

71. Horesh AJ. Allergy and infection VII. Support from the literature. J Asthma Res 1968;6:3–55 [review].

72. Pang LQ. The importance of allergy in otolaryngology. Clin Ecology 1982;1(1):53.

73. Nsouli TM, Nsouli SM, Linde RE, et al. Role of food allergy in serous otitis media. Ann Allergy 1994;73:215–9.

74. Horesh AJ. Allergy and recurrent urinary tract infections in childhood. II. Ann Allergy 1976;36:174–9.

75. Crandall, M. Allergic predisposition and recurrent vulvovaginal candidiasis. J Advancement Med 1991;4:21–38 [review].

76. Kudelco N. Allergy in chronic monilial vaginitis. Ann Allergy 1971;29:266–7.

77. Paganelli R, Fagiolo U, Cancian M, et al. Intestinal permeability in irritable bowel syndrome. Effect of diet and sodium cromoglycate administration. Ann Allergy 1990;64:377–80.

78. Alun Jones V, McLaughlan P, Shorthouse M, et al. Food intolerance: A major factor in the pathogenesis of irritable bowel syndrome. Lancet 1982;ii:1115–7.

79. Grant EC. Food allergies and migraine. Lancet 1979;i:966–9.

80. Monro J, Brostoff J, Carini C, Zilkha K. Food allergy in migraine. Lancet 1980;ii:1–4.

81. Egger J, Carter CM, Wilson J, et al. Is migraine food allergy? A double-blind controlled trial of oligoantigenic diet treatment. Lancet 1983;ii:865–9.

82. Hughs EC, Gott PS, Weinstein RC, Binggeli R. Migraine: a diagnostic test for etiology of food sensitivity by a nutritionally supported fast and confirmed by long-term report. Ann Allergy 1985;55:28–32.

83. Schaumburg HH, Byck R, Gerstl R, Mashman JH. Monosodium L-glutamate: its pharmacology and role in the Chinese restaurant syndrome. Science 1969;163:826–8.

84. Rosenblum I, Bradley JD, Coulston F. Single and double blind studies with oral monosodium glutamate in man. Toxicol Appl Pharmacol 1971;18:367–73.

85. Kenney RA, Tidball CS. Human susceptibility to oral monosodium L-glutamate. Am J Clin Nutr 1972;25:140–6.

86. Randolph TG. Masked food allergy as a factor in the development and persistence of obesity. J Lab Clin Med 1947;32:1547.

87. Douglas JM. Psoriasis and diet. West J Med 1980;133:450 [letter].

88. Bullock C. Chronic infectious sinusitis linked to allergies. Med Trib 1995;Dec 7:1.

89. Derebery MJ. Otoplaryngic allergy. Otolaryngol Clin North Am 1993;26:593–611 [review].

90. Host A. Mechanisms in adverse reactions to food. Allergy 1995;50(20 suppl):60–3 [review].

91. Bucca C, Rolla G, Oliva A, Farina JC. Effect of vitamin C on histamine bronchial responsiveness of patients with allergic rhinitis. Ann Allergy 1990;65:311–4.

92. Bellioni P, Artuso A, Di Luzio Paparatti U, Salvinelli F. Histaminic provocation in allergy. The role of ascorbic acid. Riv Eur Sci Med Farmacol 1987;9:419–22 [in Italian].

93. Annesi-Maesano I, Oryszczyn MP, Neukirch F, Kauffmann F. Relationship of upper airway disease to tobacco smoking and allergic markers: a cohort study of men followed up for 5 years. Int Arch Allergy Immunol 1997;114:193–201.

94. Ogle KA, Bullock JD. Children with allergic rhinitis and/or bronchial asthma treated with elimination diet: a five-year follow-up. Ann Allergy 1980;44:273–8.

95. Rowe AH, Rowe A Jr. Perennial nasal allergy due to food sensitization. J Asthma Res 1965;3:141–54.

96. Derlacki EL. Food sensitization as a cause of perennial nasal allergy. Ann Allergy 1955;13:682–9.

97. Kern RA, Stewart G. Allergy in duodenal ulcer: incidence and significance of food hypersensitivities as observed in 32 patients. J Allergy 1931;3:51.

98. Reimann HJ, Lewin J. Gastric mucosal reactions in patients with food allergy. Am J Gastroenterol 1988;83:1212–9.

99. Breneman JC. Allergic cystitis: the cause of nocturnal enuresis. General Practice 1959;20:85–98.

100. Zaleski A, Shokeir MK, Garrard JW. Enuresis: familial incidence and relationship to allergic disorders. Can Med Assoc J 1972;106:30–1.

101. Lucarelli S, Corrado G, Pelliccia A, et al. Cyclic vomiting syndrome and food allergy/intolerance in seven children: a possible association. Eur J Pediatr 2000;159:360–3.

102. Abu-Arafeh I, Russell G. Cyclical vomiting syndrome in children: a population-based study. J Pediatr Gastroenterol Nutr 1995;21:454–8.

103. Pelto L, Salminen PL, Lilius E-M, et al. Milk hypersensitivity—key to poorly defined gastrointestinal symptoms in adults. Allergy 1998;53:307–10.

104. Bombardieri S, Ferri C. Low antigen content diet in the management of immunomediated diseases. Isr J Med Sci 1992;28:117–20 [review].

105. Hill DJ, Hosking CS, Heine RG. Clinical spectrum of food allergy in children in Australia and South-East Asia: identification and targets for treatment. Ann Med 1999;31:272–81.

106. AAAAI Board of Directors. Position statement. Idiopathic environmental intolerances. J Allergy Clin Immunol 1999;103:36–40.

107. Arnetz BB. Model development and research vision for the future of multiple chemical sensitivity. Scand J Work Environ Health 1999;25:569–73 [review].

108. Graveling RA, Pilkington A, George JP, et al. A review of multiple chemical sensitivity. Occup Environ Med 1999;56:73–85 [review].

109. Brown AE. Developing a pesticide policy for individuals with multiple chemical sensitivity: considerations for institutions. Toxicol Ind Health 1999;15:432–7 [review].

110. Hartman DE. Missed diagnoses and misdiagnoses of environmental toxicant exposure. The psychiatry of toxic exposure and multiple chemical sensitivity. Psychiatr Clin North Am 1998;21:659–70, vii [review].

111. Kaufman W. Food-induced, allergic musculoskeletal syndromes. Ann Allerg 1953;Mar/Apr:179–84.

112. Gaboardi F, Perlett L, Mihansch MJ. Dermatitis herpetiformis and nephrotic syndrome. Clin Nephrol 1983;20:49.

113. Meadow SR, Sarsfield JK. Steroid-responsive nephrotic syndrome and allergy: clinical studies. Arch Dis Childhood 1981;56:509–16.

114. Walker WA. Pathophysiology of intestinal uptake and absorption of antigens in food allergy. Ann Allergy 1987;59:7–16 [review].

115. Reinhardt MC. Macromolecular absorption of food antigens in health and disease. Ann Allergy 1984;53:597–601 [review].

116. Jalonen T. Identical intestinal permeability changes in children with different clinical manifestations of cow’s milk allergy. J Allergy Clin Immunol 1991;88:737–42.

117. Andre F, Andre C, Feknous M, et al. Digestive permeability to different-sized molecules and to sodium cromoglycate in food allergy. Allergy Proc 1991;12:293–8.

118. Bahna SL. Management of food allergies. Ann Allergy 1984;53:678–82 [review].

119. Crook WG. Detecting your hidden food allergies. Jackson, TN: Professional Books, 1988.

120. Mandell M. Dr. Mandell’s 5-Day Allergy Relief System. New York: Pocket Books, 1979.

121. Sampson HA. Food allergy. Part 2: diagnosis and management. J Allergy Clin Immunol 1999;103:981–9 [review].

122. Klein GL. Controlling allergies by controlling environment. A big help for your patients. Postgrad Med 1992;91:215–8, 221–4 [review].

123. Kirjavainen PV, Gibson GR. Healthy gut microflora and allergy: factors influencing development of the microbiota. Ann Med 1999;31:288–92 [review].

124. Pelto L, Isolauri E, Lilius EM, et al. Probiotic bacteria down-regulate the milk-induced inflammatory response in milk-hypersensitive subjects but have an immunostimulatory effect in healthy subjects. Clin Exp Allergy 1998;28:1474–9.

125. Salminen S, Isolauri E, Salminen E. Clinical uses of probiotics for stabilizing the gut mucosal barrier: successful strains and future challenges. Antonie Van Leeuwenhoek 1996;70:347–58 [review].

126. Majamaa H, Isolauri E. Probiotics: a novel approach in the management of food allergy. J Allergy Clin Immunol 1997;99:179–85.

127. Hunter JO. Food allergy—or enterometabolic disorder? Lancet 1991;24:495–6 [review].

128. Cavagni G, Piscopo E, Rigoli E, et al. Food allergy in children: an attempt to improve the effects of the elimination diet with an immunomodulating agent (thymomodulin). A double-blind clinical trial. Immunopharmacol Immunotoxicol 1989;11:131–42.

129. Genova R, Guerra A. Thymomodulin in management of food allergy in children. Int J Tissue React 1986;8:239–42.

130. Oelgoetz AW, Oelgoetz PA, Wittenkind J. The treatment of food allergy and indigestion of pancreatic origin with pancreatic enzymes. Am J Dig Dis Nutr 1935;2:422–6.

131. McCann M. Pancreatic enzyme supplement for treatment of multiple food allergies. Ann Allergy 1993;71:269 [abstract #17].

132. Kokkonen J, Simila S, Herva R. Impaired gastric function in children with cow’s milk intolerance. Eur J Pediatr 1979;132:1–6.

133. Kokkonen J, Simila S, Herva R. Gastrointestinal findings in atopic children. Eur J Pediatr 1980;134:249–54.

134. Gonzalez H, Ahmed T. Suppression of gastric H2-receptor mediated function in patients with bronchial asthma and ragweed allergy. Chest 1986;89:491–6.

135. Johnston CS, Retrum KR, Srilakshmi JC. Antihistamine effects and complications of supplemental vitamin C. J Am Diet Assoc 1992;92:988–9.

136. Johnston S, Martin LJ, Cai X. Antihistamine effect of supplemental ascorbic acid and neutrophil chemotaxis. J Am Coll Nutr 1992;11:172–6.

137. Gabor M. Anti-inflammatory and anti-allergic properties of flavonoids. Prog Clin Biol Res 1986;213:471–80 [review].

138. Middleton E, Drzewieki G. Naturally occurring flavonoids and human basophil histamine release. Int Arch Allergy Appl Immunol 1985;77:155–7.

139. Amella M, Bronner C, Briancon F, et al. Inhibition of mast cell histamine release by flavonoids and bioflavonoids. Planta Medica 1985;51:16–20.

140. Kasahara T, Amemiya M, Wu Y, Oguchi K. Involvement of central opioidergic and nonopioidergic neuroendocrine systems in the suppressive effect of acupuncture on delayed type hypersensitivity in mice. Int J Immunopharmacol 1993;15:501–8.

141. Kasahara T, Wu Y, Sakurai Y, Oguchi K. Suppressive effect of acupuncture on delayed type hypersensitivity to trinitrochlorobenzene and involvement of opiate receptors. Int J Immunopharmacol 1992;14:661–5.

142. Jian M. Influence of adrenergic antagonist and naloxone on the anti-allergic shock effect of electro-acupuncture in mice. Acupunct Electrother Res 1985;10:163–7.

143. Lau BH, Wong DS, Slater JM. Effect of acupuncture on allergic rhinitis: clinical and laboratory evaluations. Am J Chin Med 1975;3:263–70.

144. Lai X. Observation on the curative effect of acupuncture on type I allergic diseases. J Tradit Chin Med 1993;13:243–8.

145. Wolkenstein E, Horak F. [Protective effect of acupuncture on allergen provoked rhinitis]. Wien Med Wochenschr 1998;148:450–3 [in German].

146. Miller JB. A double-blind study of food extract injection therapy: a preliminary report. Ann Allerg 1977:185–91.

147. Hosen H. Provocative testing for food allergy diagnosis. J Asthma Res 1976:45–51.

148. Rea WJ, Podell RN, Williams ML, et al. Elimination of oral food challenge reaction by injection of food extracts. A double-blind evaluation. Arch Otolaryngol 1984;110:248–52.

149. King WP, Fadal RG, Ward WA, et al. Provocation-neutralization: a two-part study. Part II. Subcutaneous neutralization therapy: a multi-center study. Otolaryngol Head Neck Surg 1988;99:272–7.

150. Jewett DL, Fein G, Greenberg MH. A double-blind study of symptom provocation to determine food sensitivity. New Engl J Med 1990;323:429–33.

151. Morris DL. Use of sublingual antigen in diagnosis and treatment of food allergy. Ann Allergy 1969;27:289–94.

152. Scadding GK, Brostoff J. Low dose sublingual therapy in patients with allergic rhinitis due to house dust mite. Clin Allergy 1986;16:483–91.

153. Tari MG, Mancino M, Monti G. Efficacy of sublingual immunotherapy in patients with rhinitis and asthma due to house dust mite. A double-blind study. Allergol Immunopathol (Madr) 1990;18:277–84.

154. Bousquet J, Scheinmann P, Guinnepain MT, et al. Sublingual-swallow immunotherapy (SLIT) in patients with asthma due to house-dust mites: a double-blind, placebo-controlled study. Allergy 1999;54:249–60.

155. Mungan D, Misirligil Z, Gurbuz L. Comparison of the efficacy of subcutaneous and sublingual immunotherapy in mite-sensitive patients with rhinitis and asthma—a placebo controlled study. Ann Allergy Asthma Immunol 1999;82:485–90.

156. Urbanek R, Gehl R. Efficacy of oral hyposensitization treatment in house dust mite allergy. Monatsschr Kinderheilkd 1982;130:150–2 [in German].

157. Guez S, Vatrinet C, Fadel R, Andre C. House-dust-mite sublingual-swallow immunotherapy (SLIT) in perennial rhinitis: a double-blind, placebo-controlled study. Allergy 2000;55:369–75.

158. Mastrandrea F, Serio G, Minelli M, et al. Specific sublingual immunotherapy in atopic dermatitis. Results of a 6-year follow-up of 35 consecutive patients. Allergol Immunopathol (Madr) 2000;28:54–62.

159. Passalacqua G, Albano M, Riccio A, et al. Clinical and immunologic effects of a rush sublingual immunotherapy to Parietaria species: A double-blind, placebo-controlled trial. J Allergy Clin Immunol 1999;104:964–8.

160. Pradalier A, Basset D, Claudel A, et al. Sublingual-swallow immunotherapy (SLIT) with a standardized five-grass-pollen extract (drops and sublingual tablets) versus placebo in seasonal rhinitis. Allergy 1999;54:819–28.

161. Sabbah A. Specific immunotherapy using allergens apropos of specific immunotherapy by the sublingual route. Allerg Immunol (Paris) 1998;30:221–8 [review; in French].

162. Patriarca C, Romano A, Venuti A, et al. Oral specific hyposensitization in the management of patients allergic to food. Allergol Immunopathol (Madr) 1984;12:275–81.

163. Patriarca G, Schiavino D, Nucera E, et al. Food allergy in children: results of a standardized protocol for oral desensitization. Hepatogastroenterology 1998;45:52–8.

164. Am Academy of Allergy. Position statements: controversial techniques. J Allergy Clin Immunol 1981:333–8.

165. Gleich G, Yunginger J. The radioallergosorbent test: its present place and likely future in the practice of allergy. Adv Asthma Allergy 1975(Spring):1.

166. Wraith DG. Recognition of food-allergic patients and their allergens by the RAST technique and clinical investigation. Clin Allergy 1979:25–36.

167. Lieberman P, et al. Controlled study of the cytotoxic food test. JAMA 1975:728–30.

168. Miller JB. A double-blind study of food extract injection therapy: a preliminary report. Ann Allerg 1977:185–91.

169. Hosen H. Provocative testing for food allergy diagnosis. J Asthma Res 1976:45–51.

170. Morris DL. Use of sublingual antigen in diagnosis and treatment of food allergy. Ann Allergy 1969;27:289–94.

171. Lehman CW. A double-blind study of sublingual provocative food testing: a study of its efficacy. Ann Allergy 1980;45:144–9.

172. Mandell M. Dr. Mandell’s 5-Day Allergy Relief System. Pocket Books, New York, 1979.

173. Tsuei JJ, Lehman CW, Lam FMK, et al. A food allergy study using the EAV acupuncture technique. Am J Acupuncture 1984;12:105–16.

174. Krop J, Swierczek J, Wood A. Comparison of ecological testing with the Vega test method in identifying sensitivities to chemicals, foods and inhalents. Am J Acupuncture 1985;13:253–9.

La información que se presenta en Aisle7 tiene carácter meramente informativo. Está basada en estudios científicos (ya sea en humanos, animales o in vitro), en experiencia clínica o en el uso tradicional, como se cita en cada artículo específico. Los resultados que se mencionan podrían no presentarse necesariamente en todas las personas. Muchas de las enfermedades que se describen pueden tratarse también con medicamentos, ya sea que requieran receta o no. En caso de tener algún problema de salud y antes de utilizar cualquiera de los suplementos o de hacer algún cambio en los medicamentos que se le hayan recetado, consulte a su médico o a su farmacéutico. La información está vigente hasta febrero de 2010.