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Biomedical subjects

M Martín Esteban

Publications and source records attributed to M Martín Esteban.

At least 19 recordsLinked to original sources
PubMed2006

Palatability of hydrolysates and Other substitution formulas for cow's milk-allergic children: a comparative study of taste, smell, and texture evaluated by healthy volunteers.

BACKGROUND: Hydrolyzed formulas used to feed infants with cow's milk-allergy can be classified as soy based, extensively hydrolyzed (casein, whey and mixed), and amino-acid based. Their unsatisfactory taste is reported by parents and physicians. OBJECTIVE: The aim of this study was to ascertain the palatability of these formulas in a double-blind taste test. MATERIALS AND METHODS: Fifty healthy volunteers performed a randomized-order double-blind test with 12 different milks. The taste, smell, smell, and texture of each formula were evaluated o n scales ranging from 1 (worst) t o 5 (best). The Pearson correlation coefficient between the peptide weight of each formula and the score obtained for each evaluated attribute was calculated. RESULTS: The soy formulas and rice formula had the best taste scores, followed by the whey hydrolysates; the mixed hydrolysates and the casein hydrolysates had the lowest taste scores. Individually the most palatable formula was mixed hydrolysate 1, by total score. We found a statistically significant correlation between peptide weight, reflecting the degree of hydrolysis of each formula, and the scores obtained for taste, texture, and overall palatability. CONCLUSION: The palatability of formulas is determined by the amount of bitter peptides obtained through hydrolysis. Flavorings and sweeteners may also contribute to palatability. Further studies are needed in order to determine how to modify the organoleptic properties of these products with the purpose of improving their palatability.

Adult↗
PubMed2003

[Incidence of allergy to cow's milk protein in the first year of life and its effect on consumption of hydrolyzed formulae].

OBJECTIVES: The aims of this study were to determine the incidence of allergy to cow's milk protein in infants and the cost of treatment with hydrolyzed formulae in the Autonomous Community of Madrid. PATIENTS AND METHODS: Infants with suspected adverse reaction to cow's milk protein born between March 1, 2000 and February 28, 2001 within the catchment area covered by the pediatric services of Hospital La Paz were studied. The diagnostic algorithm of allergy to cow's milk protein of our department was used. The theoretical consumption of hydrolyzed formulae in the treatment of allergic infants was calculated and extrapolated to the Community of Madrid. RESULTS: There were 5367 live births in the above-mentioned catchment area. Adverse reaction to cow's milk protein was suspected in 185 infants. Allergy to cow's milk protein was confirmed in 101 (54 %). The incidence of allergy to cow's milk protein was 101/5356 (1.9 %). In the same period there were 57 078 live births in the Autonomous Community of Madrid. The number of infants that might be allergic in one year would be 1084. The cost of hydrolyzed formulae per infant and year would be 1,585.72 Euros. Thus, the cost of hydrolyzed formulae in the 1084 allergic infants would be 1,718,922.9 Euros; in the 923 in whom allergy was ruled out, the cost would be 1,463,621.8 Euros. CONCLUSIONS: The incidence of allergy to cow's milk protein in the first year of life is at least 1.9 %. The correct diagnosis allows us to rule out allergy to cow's milk protein in almost half of the cases, thus avoiding the use of unnecessary substitutive diets involving a high cost.

Algorithms↗
PubMed1997

Peculiarities of egg allergy in children with bird protein sensitization.

BACKGROUND: Hen's egg is frequently implicated in food allergy in children. Sometimes this allergy is associated with bird protein sensitization. OBJECTIVE: A study was conducted to establish the possible role of bird protein sensitization in the clinical picture and evolution of egg allergy in patients with both egg and bird sensitization. METHODS: Epidemiologic and clinical characteristics and the results of allergic study of 27 patients with both egg and bird allergy were compared with those of a control group of 19 egg-allergic patients without bird protein sensitization. All patients were evaluated clinically each year during the 4 years subsequent to the beginning of the study or until clinical tolerance to egg was achieved. RESULTS: Patients with bird sensitization had more frequent digestive and respiratory symptoms related to egg ingestion compared with the control group. At the end of follow-up. 15% of the bird sensitized patients and 58% of the controls tolerated egg. Egg yolk sensitization was the major sensitization in bird-sensitized patients. CONCLUSION: It is necessary to exclude sensitization to bird proteins in egg-allergic patients, mainly when they show respiratory or digestive symptoms after egg ingestion, the egg allergy persists over a long period of time or egg yolk sensitization is strong.

Allergens↗
PubMed1992

Fish allergy: evaluation of the importance of cross-reactivity.

Fish constitute one of the most important groups of allergens in the induction of immediate (type I) food hypersensitivity. In our environment, fish allergy is present in 22% of all patients with a diagnosis of food hypersensitivity. We studied the allergenic significance of the fish species considered most representative because of their greater consumption in our environment (flatfishes: Pleuronectiformes such as sole, whiff, and witch; Gadiformes such as hake; and Scombriformes such as albacore) or because of the results of previous studies of Gadiformes such as cod. Through the use of isoelectric focusing and sodium dodecyl sulfate-polyacrylamide gel electrophoresis immunoblotting, we have observed that several allergens common to all these species are able to bind specific IgE from the sera of sensitized patients. This allergenic community has been confirmed by radioallergosorbent inhibition. Another group of species-specific allergens focuses in the regions at about pH 5 and with molecular weights less than 14 kilodaltons; these allergens correspond to sarcoplasmic parvoalbumins. From the results observed, which have been confirmed by various procedures and techniques, we conclude that hake is the fish with the capability to induce the strongest IgE response, followed by whiff; the witch seems to be the least allergenic of all flatfishes. Among all species studied, albacore was the least allergenic. These results may be considered when one introduces supplementary feeding with fish in infants, most particularly in infants at high risk for atopy.

Cross Reactions↗
PubMed1992

Possible consequences of elimination diets in asymptomatic immediate hypersensitivity to fish.

The natural history of IgE antibodies to food without related symptoms is unknown. We have followed the progress of 7 children with various atopic diseases and asymptomatic immediate hypersensitivity to fish, treated with elimination diet in spite of full alimentary tolerance. During the diet period, between 24 and 113 months, all 7 patients presented immediate symptoms upon accidental exposure to or challenge tests with fish (skin symptoms in all 7 cases, digestive in 5, respiratory in 4, and anaphylaxis in 2), which differed from those related to atopic diseases previously present. The levels of fish-specific IgE (prick test, RAST) remained unchanged or were increased. These findings suggest that during elimination diet, and perhaps due to minimal and hidden contact with the allergen, the patients' degree of sensitization may increase, turning an asymptomatic into a symptomatic immediate hypersensitivity.

Allergens↗
PubMed1991

Egg protein sensitization in patients with bird feather allergy.

We have studied the hypersensitivity to hen's egg protein and chicken meat in 25 adults with a previous diagnosis of bronchial asthma and rhinoconjunctivitis due to bird feather sensitization. Seventeen of the 25 reported good tolerance to the ingestion of egg and chicken meat. The skin tests were negative to both antigens in 15 of them, and positive for egg in two. All 17 patients had negative RAST to chicken meat and egg protein. The remaining eight patients had intolerance to egg, and three of them also to chicken meat ingestion; in seven of the eight cases allergic to egg, the alimentary intolerance began after the clinical symptoms of bird feather sensitization. In all eight cases the skin tests were positive to egg yolk, and in five of them also to egg white and chicken meat. These patients evidenced specific serum IgE antibodies to egg yolk, four of them to egg white, and seven to chicken meat. These results demonstrate the high frequency (32%) of the association of sensitization to egg proteins, particularly egg yolk, in a selected population of patients with known allergy to bird feathers, thus suggesting that in some patients feather sensitization could trigger or somehow facilitate the later sensitization to egg yolk proteins.

Adult↗
PubMed1987

[Food allergy in children. I. Clinical aspects and diagnosis].

Two hundred and thirty children with suspected food allergy have been reviewed retrospectively. One hundred and nine fulfilled the following three selection criteria: suggestive anamnesis, presence of specific IgE antibodies (in serum or by skin prick test), and having been reassessed at least once. The major clinical data analyzed were: age of onset, sensitising foods, symptomatology and diagnostic procedures. The results show a mean age of onset for food allergy of 11.5 months, with variations related to the sensitizing food, cow's milk allergy being the earliest in onset time. The most frequent sensitizing foods in this group of patients were eggs, fish and cow's milk. The skin and the gastrointestinal tract have been the most affected shock organs, both together or isolated; respiratory symptoms were an uncommon finding and their isolated presentation as the sole manifestation of food allergy exceptional. The skin prick tests were positive in 99.2 percent of the sensitizations and in 84 percent high levels of specific IgE antibodies were found. Food allergy seems to be a common situation in children, clinical symptomatology is similar to that of the other atopic diseases and the diagnosis is based on the demonstration of specific IgE antibodies against the sensitizing foods.

Age Factors↗
PubMed1987

[Food allergy in children. II. Prognostic factors and long-term development].

The evolution of 109 allergic children with 129 IgE-mediated food sensitizations has been evaluated. The follow-up period was from nine months to 14 years. The period up to clinical tolerance was analyzed, together with the influence of two possible prognostic factors: specific IgE antibody levels at the beginning of symptomatology and the sensitizing food. Moreover, when clinical tolerance was achieved, the presence of specific IgE antibodies was again assessed. Probability estimations indicated that 30% of food-allergic children become clinically tolerant before 3 years of evolution, 40% before 6 years, 50% before 9 years and 53% before 12 years. Onset of clinical tolerance varies in dependence with the offending food: clinical tolerance to cow's milk seems to be far earlier and easier to reach than those to egg and fish (p less than 0.001, at 9 years' evolution); allergy to egg disappears also earlier and easier than fish allergy (p less than 0.01). Levels of specific IgE antibodies at the onset of the disease show significant difference (p less than 0.01) between the patients which will become tolerant and those with persistence of clinical sensitivity, being higher in the last group. However, a high number of patients who become clinically tolerant (67.5%) remained positive at skin prick testing or had elevated specific IgE serum antibodies against the offending food.

Animals↗
PubMed1985

[Behavior of immunoglobulin E in primary immunodeficiencies].

The complexity of IgE synthesis and regulation is expressed in the IgE serum levels of 81 patients with primary immunodeficiency diseases. IgE serum levels were often elevated in patients with partial cellular deficiency and also in some with predominantly antibody defect, as isolated IgA and IgM deficiency. The lowest levels were found in the wider spectrum immunodeficiencies, such as the X-linked agammaglobulinemia and severe combined immunodeficiency. Due to the heterogeneity and variability of the immunological defects, even in these well defined immunodeficiency diseases, it is very difficult to establish a typical feature of IgE serum levels in these conditions.

Dysgammaglobulinemia↗
PubMed1983

[Food hypersensitivity in infants].

In a group of 41 infants with immediate, IgE mediated, food hypersensitivity, food anamnesis was specific in 60 per 100 and food challenge positive in 29 out of 34 times. Total serum IgE levels were raised in 80 per 100. In 26 instances symptoms appeared with the first food intake (15 cases) or there was sensitization before ingestion (11 cases); all but three were breast fed. Moreover, breast feeding in patients of the whole group had higher prevalence (p less than 0,001) than in a non-sensitized control group. These results suggest that food hypersensitivity in infants occurs very often without previous antigen intake and it is not always followed by clinical intolerance. Breast milk and/or transplacental antigen passage are probably important ways of sensitization. If so, it seems that minute quantities of antigen may be more fit for sensitization, provided the possible genetic high responsiveness for IgE synthesis in those infants.

Animals↗
PubMedDate not supplied

[The allergenic significance of legumes].

Leguminous are a cheap source of protein that are cultivated practically throughout the world. They are the main source of food in developing countries. In the Mediterranean area and Middle East, the most commonly consumed legumes are lentils and chickpea. In the United States, United Kingdom and south-east Asia, the major legumes involved in food allergy are considered to be peanut and soy bean, respectively. The clinical manifestations of the allergy to legumes are similar for all legumes and range from oral allergy syndrome, urticaria, angioedema, rhinitis and asthmatic crises to anaphylaxis and even death. Legumes have a high degree of immunological cross-reactivity. Severals authors have described cross-reactivity among different legumes and between legumes and various vegetables. The allergenicity of legumes is mainly is mainly related to allergens from the storage proteins of seeds. Vicilins from this group of proteins could be an important common allergen in clinical allergy to legumes. Profilins are considered to be a cause of cross-reactivity among fruits, vegetables and some pollens and are believed to be a panallergen. Other panallergens of increasing importance are lipid transfer proteins. Few studies have assessed the long-term clinical course of allergy to legumes. Novel therapeutic agents are being investigated for the treatment of peanut allergy and these could be applied to other legumes.

Adolescent↗
PubMedDate not supplied

[Anisakis and anisakiosis].

The nematode Anisakis simplex (AS) is a world wide distributed parasite that infects consumers of raw or undercoocked parasitized fish. The clinical manifestation of Anisakiosis depend on the site in the digestive tract in which larva lodges. The symptoms develops as a result of the inflammation when the larvae penetrates the gastric mucous. Most of asymptomatic subjects show high levels of specific IgE to AS. Diagnosis of AS allergy is not simple, due to cross-reactivity with other allergens. In childhood is more difficult to make a right diagnosis than in adult population. Most of positive prick test to AS correspond to children with positive prick tests to other allergens. Cross-reactivity between this parasite and other parasites with a higher prevalence in childhood, is the cause of a false diagnosis. The secretor-excretory antigen shows a better specificity, recognizing the true parasitized patients. This antigen could be used as indicator of parasitization. To follow prevention rules AS, avoid consumption of raw fish unless frozen for 48 hours or ingestion of fresh fish always cooked for more than 20 minutes at least at 60 C.

Animals↗