Different kinetics of mediator release can be detected during allergic reactions after oral provocation (double blind placebo-controlled food challenge)

Food allergy is a rare disease and initiated by an abnormal immune response towards nutritive antigens. In gastrointestinal food allergy, reactions are generated in the gut, but may engender extraintestinal manifestations. It usually is an immediate type-I reaction and involves IgE, mast cells and eosinophils. These cells release their mediators upon antigen contact provoking intestinal and extraintestinal symptoms. Other types of allergic reactions (type II-IV) seem to play a minor role. Diagnosis is made by positive skin or RAST tests and a clinically reproducible reaction towards an antigen in a blinded challenge test. To clarify the role of mast cells and eosinophils in food allergy, their mediators were followed during standardised double-blind placebo-controlled food challenges (DBPCFC) in allergic individuals.