Staff Publications

Staff Publications

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    'Staff publications' is the digital repository of Wageningen University & Research

    'Staff publications' contains references to publications authored by Wageningen University staff from 1976 onward.

    Publications authored by the staff of the Research Institutes are available from 1995 onwards.

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Gebakken insect kan allergie uitlokken
Ramaker, Rob ; Broekhoven, S. van - \ 2015
Resource: weekblad voor Wageningen UR 10 (2015)9. - p. 8 - 8.
insecten - insecten als voedsel - ongewoon voedsel - voedselallergieën - allergieën - voeding en gezondheid - insects - insects as food - unconventional foods - food allergies - allergies - nutrition and health
Mensen die allergisch zijn voor schaaldieren en huisstofmijt lopen kans ook te reageren op eetbare insecten, zelfs als deze zijn gebakken. Dit vraagt om voorzichtigheid nu het eten van insecten normaler wordt in het westen. Dat concludeert Sarah van Broekhoven in het proefschrift dat ze vandaag verdedigt.
Proficiency test for allergens in food 2014
Bremer, M.G.E.G. ; Alamenou, P. ; Elbers, I.J.W. - \ 2015
Wageningen : RIKILT Wageningen UR (RIKILT report 2015.002) - 38
graansoorten - zuigelingenvoedsel - allergenen - voedselallergieën - laboratoriumproeven - tests - cereals - infant foods - allergens - food allergies - laboratory tests
In the autumn of 2014 a proficiency test for allergens in baby cereal was organized by RIKILT, Wageningen UR. This PT-test enabled laboratories to evaluate their competence for the analysis of allergens in baby cereal. Both quantitative and qualitative methods were accepted. The proficiency test was carried out according to ISO/IEC 17043, however this specific test is not part of the accreditation.
Melkallergie - onderzoek aan Wageningen University
Savelkoul, H.F.J. - \ 2013
[S.l.] : YouTube
melkallergie - voedselallergieën - immuunsysteem - voeding en gezondheid - voedselintolerantie - stoornissen samenhangend met voedsel - voedingsonderzoek - milk allergy - food allergies - immune system - nutrition and health - food intolerance - food-related disorders - nutrition research
Prof. dr. ir. Huub Savelkoul, hoogleraar Celbiologie en Immunologie aan Wageningen University, legt de relatie tussen melkallergie en het immuunsysteem uit.
Species identification of gelatines in yoghurt and dairy desserts by UPLC-ESI-Q-TOF-MS
Nessen, M.A. ; Zoontjes, P.W. ; Wubs, K.L. ; Blokland, M.H. ; Alewijn, M. ; Ruth, S.M. van - \ 2012
analytische methoden - gelatine - yoghurt - desserts - voedselallergieën - analytical methods - gelatin - food allergies
Introduction: The use of unspecified gelatines in food products is a problem for people with specific diet wishes, such as people with an allergy, a specific religious background or a vegetarian diet. Accurate and truthful labelling of the source of gelatin is therefore needed and this requires a robust method that can identify and discriminate between the gelatines derived from different animal species. Methods: In this study a generic ultra performance liquid chromatography - electrospray - time of flight mass spectrometry (UPLC-ESI-QToF-MS) method for protein identification was used to identify gelatines in fruit yogurt and (dairy) desserts. The amino acid sequence of collagen differs between species, which allows identification of the source of the gelatin used in food products. Gelatin was extracted and enriched from the dairy products and subjected to trypsin digestion. After reversed solid phase extraction of the peptide mixture, samples were analysed by UPLC-ESI-QToF-MS/MS. Identification of the gelatines was done by data analysis using Mascot. Results: Fifteen yogurts, obtained from various retailers in the Netherlands, declared with and without gelatin, were analysed for gelatin content. It was found that six products did contain the gelatin as was declared on the product: two contained bovine gelatin, one contained porcine gelatin and three did not contain gelatin. Out of the nine products with unspecified gelatin, six contained gelatin from bovine source, two from porcine source and in one product no gelatin could be detected. Conclusion: This study shows the applicability of an LC-MS/MS method for the identification of gelatin from porcine or bovine source in dairy products. Further research on the gelatin extraction from different (processed) food products might allow extension of the method to other gelatin containing (food) products, such as different types of candy, (canned) meat products or pharmaceuticals, allowing accurate control of product authenticity.
Appels, appelallergie en Santana
Maas, Rien van der - \ 2011
apples - food allergies - breed differences - plant breeding - allergens - fruit growing
Interactions of lactobacilli with the host immune system
Meijerink, M. - \ 2011
Wageningen University. Promotor(en): Jerry Wells; Huub Savelkoul, co-promotor(en): J. Bilsen. - [S.l.] : S.n. - ISBN 9789461730442 - 223
probiotica - immunomodulerende eigenschappen - lactobacillus plantarum - spijsverteringskanaal - voedselallergieën - vaccinatie - probiotics - immunomodulatory properties - digestive tract - food allergies - vaccination

The aim of this thesis was to better understand the molecular mechanism of host res-ponses to probiotics. Probiotics can be used to stimulate or regulate immune responses in epithelial and immune cells of the intestinal mucosa and generate beneficial effects on the immune system. Carefully selected probiotics are able to steer the activity of the immune response in a predetermined manner by increasing or decreasing the activity of different aspects of the immune system (e.g. development and activity of T helper subsets). Beneficial effects of strains of probiotics have been established in the treatment and prevention of various intestinal disorders, including allergic diseases and diarrhea. However the precise molecular mechanisms and the strain dependent factors involved are poorly understood. Here in vitro molecular studies and in vivo mechanistic studies were combined in different mouse models to generate new insights into the beneficial mechanisms of selected lactobacilli and identify novel bacterial genes influencing the immune response. A further aim was to investigate the predictive value of in vitro immune assays for the effects of probiotics in vivo.

Chapter 1and chapter 2 describe the current knowledge and understanding of the immunomodulatory effects of different probiotic species and strains on mucosal immune system, dendritic cells (DCs) and the adaptive immune system. The relevance and the implications of in vitro studies for clinical trials or mechanistic research in animal mo-dels are discussed.

Chapter 3and chapter 4 present new insights gained from research on the strain-dependent factors involved in probiotic immune modulation. Extensive variation was observed in the immune responses to 42 L. plantarum strains. These results were used to identify genetic loci that correlated with levels of induced cytokines (such as IL-10 or IL-12) following co-culture with DCs (chapter 3) or peripheral blood mononuclear cells (PBMCs) (chapter 4). This in silico “gene-trait matching” approach led to the identification of several candidate genes in the L. plantarum genome that might modulate the immune cytokine response to L. plantarum. Selective gene deletions mutants were constructed for the candidate genes in L. plantarum WCFS1 and compared to the wild-type strain in immune assays with PBMCs and DCs. The predicted phenotype of the genetic knock-out was confirmed for most of the candidate loci including genes encoding an N-acetyl-glucosamine/galactosamine phosphotransferase system, the LamBDCA quorum sensing system, a predicted transcriptional regulator gene (lp_2991) and components of the plantaricin (bacteriocin) biosynthesis and transport pathway. Transcriptome analysis and qPCR data showed that transcript level of gtcA3, which is predicted to be involved in the glycosylation of cell wall teichoic acids, was substantially increased in the lp_2991 deletion mutant (44- and 29-fold respectively).

In vitroassays for pre-screening of candidate probiotics would benefit from standar-dized methods and cryopreservation techniques for immature DCs (iDCs) or precursor monocytes. Literature on the effects of cryopreservation and thawing of monocytes or monocyte-derived iDCs suggested that this strategy might be useful although bacteria had not been previously used as a stimulus. Thus in chapter 5 we investigated the effects of cryopreservation and thawing of precursor monocytes and iDCs on the maturation and immune response of DCs to potential probiotic strains and bacterial TLR agonists. Surface markers CD83 and CD86 were expressed at similar levels on iDCs generated from cryopreserved or freshly isolated monocytes. Cryopreservation of iDCs led to slightly decreased expression of CD86 and CD83 compared to freshly generated iDCs prepared from unfrozen cells but this did not affect the capacity of DCs to acquire fully mature characteristics after stimulation. In contrast the cytokine response to lipoteichoic acid and bacterial stimulation was altered by cryopreservation of monocytes or iDCs, particularly for IL-12 which was decreased up to 250 fold or even not detected at all. Cryopreservation also decreased TNF-α and IL-1β production in stimulated iDCs but to a lesser extent than for IL-12, depending on the maturation factors used. The amounts of IL-10 produced by stimulated iDCs were increased up to 3.6 fold when iDCs were cryopreserved, but decreased up to 90 fold when generated from cryopreserved monocytes. Immature DCs are often used to investigate the immunomodulatory properties of probiotics and here we showed for the first time that cryopreserved monocytes and cryopreserved iDCs have a skewed cytokine response to microbial stimulation. Therefore we consider that standardization of probiotic screening assays by the use of cryopreservation methods is currently not applicable. The detailed method for generating human monocyte derived DC described in chapter 5 may however be useful for developing standardized immune assays.

In chapter 6 we screened the immunomodulatory properties of 28 commercially available bacterial strains in vitro using human PBMCs and investigated selected strains for their in vivo immunomodulatory potential in an established mouse peanut allergy model. The 28 probiotic strains induced highly variable cytokine profiles in PBMCs. L. salivarius HMI001 (HMI001), L. casei Shirota (LCS) and L. plantarum WCFS1 (WCFS1) were selected for further investigation due to their distinct patterns of IL-10, IL-12 and IFN-γ induction. Prophylactic treatment with both HMI001 and LCS attenuated the Th2 phenotype in the mouse model (reduced mast cell responses and ex vivo IL-4 and/or IL-5 production). In contrast, WCFS1 augmented the Th2 phenotype (increased mast cell and antibody responses and ex vivo IL-4 production). In vitro PBMC screening was useful in selecting strains with anti-inflammatory and Th1 skewing properties. In the case of HMI001 (inducing a high IL-10/IL-12 ratio) and LCS (inducing high amounts of IFN-γ and IL-12) partial protection was seen in a mouse peanut allergy model. However, certain strains may worsen the allergic reaction as shown in the case of WCFS1. This approach indicated that pre-selection of candidate probiotics using in vitro immune assays is useful for selecting strains for translational research in humans.

Probiotics have been shown to increase the efficacy of different vaccines and can be easily consumed in food, and therefore probiotics might be useful in the improvement of current mucosal vaccines. In chapter 7 we have investigated the mechanisms behind the effect of lactobacilli on humoral responses to an intranasal vaccine. In addition to L. rhamnosus GG we selected 6 strains of Lactobacillus plantarum which have strikingly different immunomodulatory properties in vitro and TLR-2/6 activating properties. This selection was based on the approach outlined in chapter 3 and chapter 4 examining the in vitro immune responses of human monocyte derived DCs and PBMCs to 42 different L. plantarum strains. First we established an influenza vaccination model in Balb/c mice that would be sensitive to immunomodulation by lactobacilli, which allowed potential up- and down-regulation by the lactobacilli of the immune response. Strain WCFS1, that induced the lowest IL-10 to IL-12 cytokine ratio in DC co-culture significantly increased vaccine-specific antibody responses to the intranasal vaccine compared to the vaccine control group. Several Lactobacillus strains appeared to increase delayed-type hypersensitivity responses after vaccination compared to the vaccine control group indicating increased Th1-mediated vaccine responses. For strain LMG18021 this was also reflected in the significantly higher vaccine-specific IgG2a to IgG1 antibody ratio. LMG18021, CIP104448 and CIP104450 which have the highest IL-10 to IL-12 ratios of the strains tested, significantly enhanced the ex vivo vaccine-specific induction of IL-10, IL-17A, IL-6 and IL-4 in MLN cells. B1839 which was included as negative control, as it was a low cytokine inducer, did not enhance the vaccine-specific antibody or immune response indicating that the immune-stimulatory properties are important in mediating effects on the vaccine response. Further research is needed to demonstrate that these effects on the vaccine response impact on protection from influenza challenge and to validate the immunomodulatory mechanisms involved. Nevertheless, the in vivo studies described in this thesis support other publications proposing that in vitro immune assays can be useful for predicting which candidate probiotic strains will be most effective in vivo.

Chapter 8 completes this thesis with an overview of the most important findings of this thesis and discusses possible research limitations and future research perspectives. We stress the importance of proper strain selection using in vitro assays, and the use of strategies to identify novel immunomodulatory factors. The results described in this thesis support the rationale of using in vitro co-culture assays for selection of candidate probiotics for in vivo animal experiments or human trials.

'Dieet oorzaak gedragsproblemen kinderen'
Savelkoul, H.F.J. - \ 2011
Kennis Online 8 (2011)okt. - p. 9 - 9.
gedragsstoornissen - kinderen - voedselallergieën - dieet - voeding en gezondheid - hyperactiviteit - voedselconsumptie - immuunsysteem - behaviour disorders - children - food allergies - diet - nutrition and health - hyperactivity - food consumption - immune system
Wat kinderen alles bij elkaar eten heeft invloed op autisme, ADHD en andere gedragsstoornissen. Dat zegt immunoloog Huub Savelkoul. Volgens Savelkoul hebben kinderen met gedragsproblemen vaker last van voedselallergie. Hij zoekt nu naar de oorzaak van dat verband.
Allergenicity in food allergy : influence of food processing and immunomodulation by lactic acid bacteria
Vissers, Y.M. - \ 2011
Wageningen University. Promotor(en): Harry Wichers; Huub Savelkoul, co-promotor(en): E.N.C. Mills. - [S.l.] : S.n. - ISBN 9789085859161 - 226
voedselallergieën - voedselverwerking - immunotherapie - aardnoten - melkzuurbacteriën - food allergies - food processing - immunotherapy - groundnuts - lactic acid bacteria


Allergic diseases such as allergic rhinitis, allergic asthma, atopic eczema and food allergy have become an increasing health problem world-wide, affecting between 20-30% of the total population. Peanut allergy (prevalence ~1%) is a common and persistent food allergy accounting for severe allergic reactions. Peanuts are often consumed after thermal processing (e.g. boiling, roasting) which can alter the protein structure and change its immunoreactivity and allergenicity. In vitro diagnostic testing, however, is generally performed using the native, unprocessed protein and more knowledge on the effect of processing on allergens is necessary to improve these diagnostic procedures. In addition, rationally designed processing could also lead to reduction of the allergen content in certain products and therefore be an effective food technological approach in allergy management. Another approach in allergy management is the use of immunomodulating foods, such as probiotics. There are indications that probiotics, e.g. specific lactic acid bacteria, could be beneficial for many conditions, including different clinical expressions of allergy.
Chapter 1 gives an overview of several aspects of allergy with a focus on food allergy. Firstly the basic mechanism and the involved immune cells are discussed, after which the prevalence of food allergy in the context of the EuroPrevall project is described. Different food allergens are discussed with an emphasis on the allergens from peanut and different methods are described to assess the potential allergenicity of proteins under widely used processing conditions, including heating and the Maillard reaction. Lastly, different methods to prevent or treat allergies are discussed with a special emphasis on immunomodulation by lactic acid bacteria. This introduction chapter is concluded with the research aim and thesis outline.

Section 1: Influence of processing on allergenicity of proteins
In our first study, described in Chapter 2, Ara h 2/6 was purified from raw peanut and heated in solution (boiling) in the presence or absence of glucose. Ara h 2 and 6 were also purified from roasted peanuts for comparison. Structural changes, the capacity to induce cell proliferation and cytokine production, and IgE-binding and IgE cross-linking capacity were evaluated. Although no effect of processing on T-cell reactivity was observed, heat-induced denaturation reduced the IgE-binding and cross-linking capacity. Interestingly, the soluble fraction of the Ara h 2/6 isolated from roasted peanuts retained the conformation and allergenic activity of the native protein.
In Chapter 3 similar methods were used to assess the effect of heating and glycation on Ara h 1. Heating in solution, irrespective of their level of glycation, resulted in formation of aggregates having reduced IgE-binding and cross-linking capacity, while T-cell reactivity was retained. The soluble fraction of Ara h 1 isolated from roasted peanuts appeared to be highly denatured, formed more globular and smaller aggregates, and showed no evidence of glycation. However, these smaller aggregates retained IgE-binding capacity, unlike the aggregates formed after heating and glycating purified Ara h 1. These results could account for observed differences between boiled and roasted peanuts and suggest that other modifications than the Maillard reaction affect the allergenicity of Ara h 1.
As peanuts are often consumed after roasting, the wet-thermal processing procedures, employed in the two previous described studies, were related to the effect of thermal treatment and Maillard reaction under low moisture conditions, which is described in Chapter 4. The extensive heating at low moisture resulted in hydrolysis of both Ara h 1 and Ara h 2/6. However, in contrast to Ara h 2/6, soluble Ara h 1 formed large aggregates. Thermally treated Ara h 2/6 had both a lower IgE-binding and degranulation capacity compared to the native form, and the presence of glucose during heating partly counteracted both the decrease in IgE-binding and degranulation capacity. The IgE-binding capacity of Ara h 1 was also decreased; however, the basophil degranulation capacity increased significantly. This demonstrates the importance of including degranulation assays in addition to IgE-binding assays, when assessing allergenic potency of allergens. In addition, we here propose a role for large aggregates in the increased IgE-cross-linking capacity of individual allergens.
Chapter 5 describes the effect of glycation on the immunoreactivity and basophil degranulation capacity of Cor a 11, the 7S globulin from hazelnut (and thus a homologue of Ara h 1). Three processing methods (heating at low moisture content at 37, 60 and 145°C) resulted in proteins with increasing degrees of glycation. Glycation at 37°C did not influence the specific IgG or IgE binding, while both were decreased after heating at 60°C and 145°C. However, heating at 145°C in the absence or presence of glucose resulting in the formation of aggregated structures, increased the basophil degranulation capacity of Cor a 11 using sera high in Cor a 11 specific IgE, but not when using sera from peanut allergic patients low in Cor a 11 specific IgE. Therefore, this study besides showing the importance of the use of a combination of tests also indicated the importance of using well-characterized sera as a source of IgE.
In Chapter 6 we focused on the clinical features of all our clinically well-defined peanut allergic patients of which immune cells and sera were used for the previously described studies. In addition, soy allergic patients were included and an extensive IgE profile was determined for all patients. Gly m 4 (Bet v 1 homologue from soy) sensitization was suggested to be an important indicator of severe soy allergy in the soy allergic patients, while in peanut allergic patients sensitization to allergens from soy and pea extract nor Gly m 5 and 6 was found to have a good diagnostic specificity. This is likely due to the presence of clinically non-relevant cross-reactivity between peanut-specific IgE and homologues soy and pea components.

Section 2: Immunomodulation by Lactobacillus strains
In the first in vitro study, described in Chapter 7, initially 51 Lactobacillus strains were screened of which 8 were selected and tested for their immunomodulating effects on peripheral blood mononuclear cells (PBMC) of healthy donors. All tested Lactobacillus strains were capable of inducing the production of IL-1β, IL-10, IFN-γ and TNF-α. Clear strain-specific effects were observed with L. plantarum strains showing significantly higher induction capacity of IFN-γ, IL-12 and TNF-α compared with L. acidophilus strains. We therefore concluded that especially L. plantarum strains are promising candidates in IgE-mediated allergy by their stimulation potential of the T-cell response toward a putative Th1 response.
As healthy subjects, in contrast to allergic individuals, are assumed to finely regulate the Th1/Th2 balance by inducing sufficient Treg cell activity, immunomodulatory effects of six selected Lactobacillus strains were investigated on PBMC of pollen-allergic patients in Chapter 8. All strains could modulate PBMC to induce innate cytokine production and in addition, all strains had the ability to repress IL-13 production. Again a differential effect on IFN-γ and IL-12 induction was observed. In addition, one strain could extensively suppress proliferation induced by anti-CD3/anti-CD28 stimulation. Specific strains that were able to suppress the Th2 cytokine induction and induce Th1 cytokines might be beneficial for allergic patients.
Effects found in vitro cannot directly be extrapolated to in vivo and therefore, in Chapter 9, we performed an in vivo screening including five Lactobacillus strains. Blood samples were collected before and after a 4-week intervention with probiotics from all 62 birch-pollen-allergic patients included. Four strains caused a decrease in birch-pollen-specific IgE and for one specific strain this coincided with significant decreases in IL-5 and IL-13 and an increase in IL-10 production by anti-CD3/anti-CD28 stimulated PBMC cultures and might therefore have the potential to alleviate seasonal allergy symptoms.
The last chapter, Chapter 10, gives an overview of the most important results of this thesis and discusses the research limitations and future research perspectives. We hypothesize the role of protein aggregation in allergenicity and we elaborate on the importance of a proper stepwise approach to realize selection of a proper lactic acid strain for in vivo human testing.
In conclusion, this thesis showed that processing effects can have profound and specific effects on the structure and the allergenicity of relevant allergens. However, to test putative effects on allergenicity, IgE-binding tests only are not sufficient and mediator release assays are important to include, particularly when testing aggregated proteins. These results might have consequences for the proper diagnosis of food allergy in daily practice. Finally, as effects of lactic acid bacteria are strain specific, a proper pre-selection of candidate strains is important to choose the most promising strains for clinical testing. In our in vivo screening, one strain, L. plantarum CBS125632, was found to be promising because of its desired immunomodulatory activity to test in a follow-up trial to reduce symptoms of birch-pollen allergy.

Iedereen eet en drinkt elke dag voedsel met E-nummers
Hartemink, R. - \ 2010
Over gevoelig heden : kwartaalblad van de Stichting Voedselallergie 26 (2010)4. - ISSN 0928-9127 - p. 22 - 24.
voedseladditieven - voedselallergieën - voedselintolerantie - stoornissen samenhangend met voedsel - toevoegingen - etiketteren van voedingsmiddelen - voedselsamenstelling - voeding en gezondheid - food additives - food allergies - food intolerance - food-related disorders - additives - nutrition labeling - food composition - nutrition and health
Soms krijgen mensen met overgevoeligheidsklachten het advies om alle E-nummers in levensmiddelen te mijden. Dat kan helemaal niet! 'Als je dat wilt doen, hou je een dieet over van water, zout en suiker', aldus levensmiddelentechnoloog dr. ir. Ralf Hartemink van Wageningen Universiteit. Dit artikel is een bewerking van zijn lezing tijdens de LustrumDag.
De meeste vragen gaan over E-nummers en voedselallergie
Hartemink, R. - \ 2010
Over gevoelig heden : kwartaalblad van de Stichting Voedselallergie 26 (2010)1. - ISSN 0928-9127 - p. 16 - 17.
voedselallergieën - allergenen - vragenlijsten - voeding en gezondheid - etiketteren van voedingsmiddelen - voedingsinformatie - food allergies - allergens - questionnaires - nutrition and health - nutrition labeling - nutrition information
De informatiesite Food-info.net begon heel bescheiden in 1999 als een simpele vraag-antwoordlijst met circa dertig vragen over voeding op de server van de Wageningse universiteit. Inmiddels is het een uitgebreide site in 27 talen, die meer dan 300 duizend bezoekers per maand trekt. De website geeft informatie over de productiewijze van voeding, ingrediënten en additieven (E-nummers), voedselveiligheid en allergenen. Een blik achter de schermen.
De allergoloog en de appelveredelaar
Schots, Arjen - \ 2010
food allergies - food intolerance - food-related disorders - food consumption - immune system - plant breeding - allergens - pollen allergy
The impact of food allergy on household level
Voordouw, J. - \ 2010
Wageningen University. Promotor(en): Lynn Frewer; Gerrit Antonides, co-promotor(en): J.R. Cornelisse-Vermaat. - [S.l.] : S.n. - ISBN 9789085857150 - 158
voedselallergieën - overgevoeligheid - kosten - kosten van de gezondheidszorg - sociaal welzijn - etiketteren van voedingsmiddelen - welzijn - food allergies - hypersensitivity - costs - health care costs - social welfare - nutrition labeling - well-being
Adverse reactions to food can be caused by food hypersensitivity. Prominent examples include food allergy or food intolerance. Patients suffering from food hypersensitivity have inappropriate autoimmune system reactions to potentially harmless food components. Symptoms can vary from uncomfortable skin rashes to cardiovascular problems such as anaphylactic shock. To date, no general cure is available. As a consequence, the management of food allergy consists of allergen avoidance, which may cause negative consequences in terms of patient anxiety and their experience of quality of life. Furthermore, implementation of dietary restrictions can have a negative effect on the quality of life and economic functioning of not only the food allergic patient but also their family members.
An important issue in the assessment of the impact of food hypersensitivity and food allergy is the assessment of the economic costs that accrue to afflicted consumers. This information will contribute to the prioritising of healthcare resources, as well as developing effective policies to insure consumer protection. It is also important to evaluate whether wellbeing and welfare are affected. If this is indeed the case, a question arises as how to best manage dietary avoidance strategies. The aim of the research reported in this thesis is to provide information salient to the assessment of the impact of food hypersensitivity and allergy on households with respect to costs (time and money), welfare, well-being, and information search strategies.
A systematic review of the existing literature revealed that researchers had not yet developed and validated an instrument to measure the individual and household costs of food hypersensitivity and/ or allergy. This thesis describes the development of the “household costs of food allergy” questionnaire and the exploratory analyses applied to validate the instrument. Thereafter, the “household costs of food allergy” questionnaire was used on a large sample of clinician-diagnosed food hypersensitive patients to confirm these cost effects. This study was part of an epidemiological study to investigate the prevalence of food allergy and food intolerance in four European countries, data were collected in The Netherlands, Poland, Spain and the United Kingdom. The respondents in this study were either diagnosed with food allergy or food intolerance. For the purposes of this discussion, the term food hypersensitivity will be used to indicate both diseases. Contrary to expectation, households with food hypersensitive respondents had significantly lower direct and indirect costs across all countries compared to households without food hypersensitive members. In addition, no differences in welfare between food hypersensitive respondents and respondents asymptomatic to foods were found. However, adult food hypersensitive respondents and their spouses reported significantly less happiness than respondents, or their spouses, who were asymptomatic. Thus, the results presented in this thesis do not support the commonly held belief of clinical researcher and patient organisations that all food allergies incur high costs to the individual.
Given that an individual’s experience of quality of life is negatively impacted by food hypersensitivity, it is feasible that this might be improved by the implementation of more effective management strategies. As the primary viable management strategy involves avoidance of problematic foods, facilitating consumer choice in the retail environment may optimise risk management. The labelling preferences of food allergic consumers were investigated in two European countries, The Netherlands and Greece. At the time the research was conducted, food legislation had been developed to facilitate management of food allergens in order to protect food allergic consumers, rather than food intolerant consumers. For this reason, the research was confined to the study of the information needs of food allergic patients, and how this related to the current legislative situation. The research utilised ethnographic interviews with food allergic consumers during the course of shopping in a supermarket. The results suggest that current labelling practice is perceived to be inadequate for food allergic consumers if safe food choices are to be made. This is due to inappropriate use of fonts, colours with low contrasts and inconsistencies in the different languages, application of precautionary labelling, and lack of European and international harmonisation in labelling legislation. Based on these results, new information scenarios, such as uniform labelling, information booklet and ICT solutions, were developed and tested through an online survey. The results were used to develop prototype information delivery tools. An experiment was conducted to understand if the information delivery was in fact optimal, and to confirm if the additional attributes of the prototype tools were sufficient to facilitate allergen avoidance. The results suggested that the label should show the percentages of the allergens in the food product, as well as provide specific details about allergy management in the food chain, and use standardised symbols and standardised location of allergy information on the package. Additional visual and auditory warnings were also treated as being important for the ICT driven information delivery approaches, the results indicated that ICT methods are not appropriate replacements for effective food labelling on packaging, but may be used to supplement information provided by labels.
To conclude, this thesis provides insight in the financial impact of food hypersensitivity, as well as the welfare and well-being. The “household costs of food allergy” questionnaire can be used by regulators and policy makers to prioritise healthcare resources, as well as to test the effectiveness of policy interventions. Limitations in current risk management strategies based on consumer information were also identified. The results of the consumer preferences studies can be used by policy makers and food industry to optimise the information delivery to food allergic consumers and therewith improve their quality of life. The combination of economic research and consumer research is relevant to investigate the dynamic impact of food allergy on individuals and their families.


Smaak van morgen/onderdeel fruit : systeeminnovaties met winst voor milieu en markt
Maas, M.P. van der; Dubbeldam, R. - \ 2010
Randwijk : Praktijkonderzoek Plant & Omgeving, Sector Fruit - 23
fruitteelt - bedrijfssystemen - milieueffect - voedselallergieën - appels - oppervlaktewater - ziekteresistentie - gewasbescherming - smaak - nederland - belevingswaarde - multifunctionele landbouw - fruit growing - farming systems - environmental impact - food allergies - apples - surface water - disease resistance - plant protection - taste - netherlands - experiential value - multifunctional agriculture
Toekomstverkenningen en systeeminnovaties betreffende de projecten; Nutriënten Waterproof: Innovatie Schone Sloot, Topsoil+ Smaak van Morgen: Santana voor mensen met voedselallergie, Ziekteresistente rassen met marktpotentie, Open Boomgaard en Fruitteelt en beleving
Chemical and Biological Properties of Food Allergens
Jedrychowski, L. ; Wichers, H.J. - \ 2009
Boca Raton : CRC Press (Chemical and functional properties of food components ) - ISBN 9781420058550 - 447
voedselallergieën - allergenen - voedsel - overgevoeligheid - food allergies - allergens - food - hypersensitivity
This book provides epidemiological data on food allergens and information on the incidence of food allergies. It discusses the link between hypersensitivity and immune system health and covers methods used for assays on allergenic components, animal models for allergen analysis, and clinical methods for diagnosis. Furthermore, it highlights future trends in applying recombinant food allergens.
Novel foods and food allergies : an exploratory study of novel foods as allergy management strategy
Putten, M.C. van - \ 2009
Wageningen University. Promotor(en): Lynn Frewer; Bart Gremmen, co-promotor(en): Harry Wichers; Luud Gilissen. - Wageningen : Wageningen University - ISBN 9789085854494 - 125
voedselallergieën - nieuwe voedingsmiddelen - houding van consumenten - voedselintolerantie - aanvaardbaarheid - consumenten - bedrijfsvoering - controle - kwaliteit van het leven - food allergies - novel foods - consumer attitudes - food intolerance - acceptability - consumers - management - control - quality of life
Food allergy represents an increasing concern to society. It is defined as an inappropriate immunological reaction to normally harmless food components and affects 5-8% of children and 1-2% of adults. Since at the time of writing no cure for food allergy exists, food allergic consumers need to avoid all problematic foods and ingredients, which may have a negative impact on the quality of life and economic functioning of food allergic consumers and their families. Food allergies may also result in substantial costs for society overall in terms of health care costs and absenteeism.
Novel foods are continuously being developed and introduced onto the European market. The novelty of a food can be the result of: (1) genetic modification (GM) of the food itself, or its production using genetically modified organisms, (2) the application of novel processing techniques, or (3) the food in question having no prior history of consumption in general, or in a specific region or country. One potential benefit of novel foods is that of hypoallergenicity, although there is the potential risk that new proteins are introduced into the human food chain together with the novel foods.
The aim of the research presented in this thesis is to investigate whether novel foods can be used as part of an allergy management strategy. The issues associated with novel foods and food allergy are identified and insight is gained in stakeholder and consumer attitudes towards the application of novel foods as allergy management strategy. In addition, the existing novel food legislation regarding novel foods is reviewed with respect to risks (and benefits) of novel foods associated with food allergy.
The results show that that although hypoallergenic novel foods can have some positive contribution to food allergy management, their influence remains limited because many other factors other than the available foods cause the food allergy problems.
Overall, this research contributes to a better understanding of the impact of food allergy on daily lives of food allergic consumers and shows that although hypoallergenic novel foods can facilitate allergen avoidance, their influence remains limited because many other factors, such as the recognition of their allergy by their social environment cause the food allergy problems. Nevertheless, considering that the food allergy management options are limited, the contribution that hypoallergenic novel foods, which can be replacement for allergenic foods may be valuable for consumers who are allergic to foods that are easy to recognise and avoid.

Stability of the Bet v 1 cross-reactive allergens Api g 1 and Dau c 1 : a biophysical approach
Bollen, M.A. - \ 2009
Wageningen University. Promotor(en): Tiny van Boekel; Huub Savelkoul; Harry Wichers, co-promotor(en): Hans Helsper. - [S.l.] : S.n. - ISBN 9789085853763 - 160
allergenen - voedselallergieën - kruisreactie - betula - daucus carota - penen - selderij - apium graveolens - hooikoorts - allergens - food allergies - cross reaction - carrots - celery - pollen allergy
The allergen Bet v 1 is known as the primary sensitizer for birch pollen-related food allergy and is responsible for IgE cross-reactivity to pathogenesis-related 10 (PR-10) proteins from, in particular, fruits from the Rosaceae and vegetables from the Apiaceae families. The allergenic potential of PR-10 proteins is mainly characterized for specific recombinantly produced isoforms, which are used for research and diagnostic purposes. However, in natural food sources these allergens are often present as isoform mixtures. The first aim of this research was to purify and characterize PR-10 allergens as natural isoform mixtures to determine whether differences could be observed between natural and recombinant allergens and between plant families. The second aim was to find a relationship between the physico-chemical stability of PR-10 proteins and structural characteristics to explain differences in IgE binding potential and cross-reactivity. The PR-10 allergens Bet v 1 from birch, Api g 1 from celery, and Dau c 1 from carrot were purified under mild conditions following a standardized protocol. Different allergen isoforms were determined and circular dichorism (CD) analyses of the allergen mixtures showed a similar secondary structure composition as observed for other PR-10 proteins. The allergen mixtures and recombinant allergens were characterized by stability studies to pH, temperature and denaturant where CD was used to detect structural changes. Minor differences were observed in stability between natural isoform mixtures and between the recombinant isoforms, although recombinant Dau c 1 was likely destabilized by its attached His-tag. A general trend was observed for allergen stability, structural differences and their relationship to the IgE binding capacity in aqueous solutions. The allergenic potential decreases in the following order: Bet v 1, the primary allergen of birch pollen-related allergies, Mal d 1, Api g 1 and Dau c 1, in accordance with their amino acid sequence identity. Bet v 1 cross-reactive IgE antibodies preferably bind to the charged and polar residues of Mal d 1 for which the positive charge can be increased by the physiological pH of fruit. Api g 1 appears to be more stable than Dau c 1 as the result of a tighter hydrophobic packing. However, the thermodynamic stability of Api g 1 is similar to that of Bet v 1, but the higher proportion of hydrophobic residues and the reduced proportion of charged residues are responsible for the lower IgE binding capacity. Furthermore, the IgE binding capacity is not severely affected, as long as the protein is able to refold. The implications of these findings are discussed in the context of the development of allergic symptoms upon exposure to these PR-10 proteins.

Allergische consument is tevreden met Santana
Maas, M.P. van der; Schenk, M.F. - \ 2008
Over gevoelig heden : kwartaalblad van de Stichting Voedselallergie 24 (2008)4. - ISSN 0928-9127 - p. 9 - 11.
voedselallergieën - allergenen - appels - veredelde rassen - voedselintolerantie - stoornissen samenhangend met voedsel - voeding en gezondheid - consumenten - food allergies - allergens - apples - improved varieties - food intolerance - food-related disorders - nutrition and health - consumers
Nederland had twee jaar geleden de primeur: Santana, een hyperallergeen appelras voor mensen met appelallergie. Wageningen UR heeft de ervaringen van de consumenten over 2006 en 2007 onderzocht. De vermindering van de allergische reactie is ongeveer volgens verwachting en de tevredenheid blijkt hoog te zijn
Allergie@WUR en het ACW
Savelkoul, Huub - \ 2008
allergies - prevention - hypersensitivity - health - risk factors - food allergies - allergens
Klant wil duidelijker etiket : Onderzoek naar voorkeur voedselallergische consument voor etikettering
Voordouw, J. ; Cornelisse-Vermaat, J.R. - \ 2008
Over gevoelig heden : kwartaalblad van de Stichting Voedselallergie 24 (2008)1. - ISSN 0928-9127 - p. 4 - 6.
voedselallergieën - consumenten - etiketteren van voedingsmiddelen - voeding en gezondheid - stoornissen samenhangend met voedsel - allergenen - food allergies - consumers - nutrition labeling - nutrition and health - food-related disorders - allergens
De voedselallergische consument is niet tevreden over de informatie op het etiket en wenst een zo volledig mogelijke ingrediëntenlijst. Dat blijkt uit een studie van de Wageningse onderzoekers Judith Cornelisse- Vermaat en Jantine Voordouw in samenwerking met Griekse collega's. Dit artikel is een bewerking van de lezing van Judith Cornelisse tijdens de Nationale Voedselallergiedag november 2010.
Birch pollen allergy: molecular characterization and hypoallergenic products
Schenk, M.F. - \ 2008
Wageningen University. Promotor(en): Evert Jacobsen; Lynn Frewer, co-promotor(en): Rene Smulders; Luud Gilissen. - [S.l.] : S.n. - ISBN 9789085048732 - 192
betula - allergieën - allergenen - appels - voedselallergieën - diëten - transgene planten - houding van consumenten - cultivars - plantenveredeling - selectie - ige - dna-sequencing - genetische variatie - hooikoorts - moleculaire veredeling - allergies - allergens - apples - food allergies - diets - transgenic plants - consumer attitudes - plant breeding - selection - dna sequencing - genetic variation - pollen allergy - molecular breeding
Allergic diseases, such as hay fever and food allergy, affect a substantial part of the population in westernized countries. Pollen of the European white birch (Betula pendula) is a considerable cause of hay fever (seasonal allergic rhinitis) in northern and central Europe. The major birch pollen allergen is Bet ν 1, which is the conventional allergen name for the birch pollen proteins of a large group of proteins otherwise known as PR-10 proteins. Individuals that suffer from birch pollen allergy are particularly prone to develop Oral Allergy Syndrome (OAS) due to the occurrence of an IgE-mediated cross-reaction between Bet ν 1 and PR-10 proteins in various plant foods. The high prevalence of apple allergy among hay fever sufferers is a good example of OAS. Allergic diseases can be severe for patients and have considerable medical and economical costs as well. Consequently, prevention of birch pollen allergy and OAS would contribute to an improvement of the quality of life of many patients. This thesis examines the feasibility of strategies that are directed towards development of hypoallergenic (= having a reduced allergenicity) birch trees or plant foods in order to alleviate Bet ν 1 [PR-10]- associated complaints.
When the development of hypoallergenic products involves application of genetic modification (GM), societal concerns about this technology should be taken into account. The attitude towards hypoallergenic products developed by GM was examined in the survey that is described in Chapter 2. This study differentiated between patients and non-patients. Attitude towards GM was measured for two applications directed against hay fever (hypoallergenic birch and grass) and one application directed against food allergy (hypoallergenic apple). Attitude was described in terms of two constructs that were labelled as 'benefits' and 'rejection factors'. Hay fever sufferers perceived greater 'benefits' associated with application of GM to develop hypoallergenic birch trees as compared to non-sufferers. The perceived 'benefits' increased with a higher self-reported impact of hay fever on quality of life. No attitudinal differences were observed between sufferers and non-sufferers for the attitudinal construct 'rejection factors'. Furthermore, the impact of perceived 'benefits' on acceptance of GM was larger than the impact of 'rejection factors'.
The perceptions of 'benefits' were further explored in Chapter 3. Here, the attitude towards hypoallergenic apples was examined in a survey in which consumers rate a set of apple profiles that varied in the breeding method that was applied during development (GM vs. traditional breeding), in pesticide usage, and in the degree of allergenicity. Acceptance of hypoallergenic apples was high among all consumers, also when GM was involved in their development. Acceptance of hypoallergenic products was higher among consumers with an apple allergy, presumably because they find a personal 'benefit' associated with these products. Novel GM products that are recognised as beneficial by some consumers may consequently experience an increased acceptance. However, both Chapter 2 and 3 indicated a clear consumer preference for
traditional breeding over breeding by GM for the development of hypoallergenic birch trees or food products. Approaches which focus on traditional breeding should thus be explored first.
Chapter 3 also evaluated appreciation of the hypoallergenic apple cultivar Santana, which was introduced in shops in a large-scale sales pilot labelled as 'suitable for individuals suffering from mild apple allergy' in 2006. A survey among consumers that bought the Santana measured the self-reported response to this apple. Almost half (42%) of the apple allergic consumers had no allergic reaction at all after eating the Santana. Most (96%) consumers who did experience an allergic reaction reported the symptoms as minor. The self-reported severity of the apple allergy, the occurrence of other fruit allergies, and age were associated with the occurrence of an allergic reaction to the Santana. Overall, the Santana was valued positively by the majority of apple allergic consumers, regardless of whether these consumers could eat the apple without experiencing an allergic reaction. Development of hypoallergenic foods such as Santana may therefore contribute to food allergy management, although variation among individual consumers in the allergic response to hypoallergenic products should be taken into account when developing and marketing such products.
A prerequisite for designing strategies for selection and breeding of hypoallergenic birch trees is knowledge on diversity of Bet ν 1 genes and on allergenicity of the protein variants (=isoforms) that are encoded by these genes. Chapter 4 describes a study on the variation of Bet ν 1 isoforms in .the most common birch species in Europe, Betula pendula. PR-10 sequences from three B. pendula cultivars were amplified, cloned and sequenced. Forty-four unique PR-10 sequences were recovered from B. pendula and these were assigned to thirteen putative genes based on sequence identity and intron length. Information on gene transcription was inferred from a comparison with existing mRNA sequences and suggested that seven of these genes are transcribed in pollen. Bet ν 1 isoforms are known to vary in IgE-reactivity. The study in Chapter 4 showed that isoforms with high and low IgE-reactivity are encoded by different genes. Thus, one birch pollen grain has the genetic background to produce a mixture of isoforms with varying IgE-reactivity. The sequence of one of the isoforms with a high IgE-reactivity was present in all examined B. pendula trees. The search for hypoallergenic birch trees was, therefore, expanded to other Betula species.
The selection of a representative set of species which cover variation among Betula species requires knowledge on phylogenetic relationships within the genus Betula. Chapter 5 describes a study on the reconstruction of the phylogeny of this genus using multilocus data from AFLP markers. The taxonomy of the genus Betula is complicated by the occurrence of parallel evolution of morphological traits, of polyploidisation events, and of extensive hybridisation among species. A large number of polymorphic AFLP markers (321 variable bands) were produced in 107 Betula accessions from 23 species and 11 hybrids. The analysis identified four distinct groups within the
genus. These groups are partly in disagreement with the traditional, but disputed, division of the genus. The majority of the species and all hybrids fell within subgenus Betula and are thus closely related to B. pendula. Subgenus Chamaebetula and part of the Neurobetula species should be merged with subgenus Betula. Apart from subgenus Betula, the subgenera Betulenta, Betulaster, and the remaining part of Neurobetula formed distinct and well-supported groups and should thus be maintained. The results from the AFLP study are to a large extent congruent with results from previous studies that made use of molecular (sequence) data.
The allergenic potency of Betula species other than B. pendula is described in Chapter 6 in which the PR-10 genes from eight birch species are cloned and sequenced. These species represent the various groups that were previously identified in the genus Betula. In total, 134 unique PR-10 sequences were recovered, including both sequences with a full open reading frame and pseudogenes. Sequences were attributed to putative genes, which could, in turn, be subdivided into seven subfamilies. Five subfamilies were common to all birch species. Q-TOF LC-MSE was applied to detect peptide fragments of Bet ν 1 that are unique for particular isoforms, in order to identify which PR-10 genes are expressed in pollen. The relative abundance of individual isoforms in the pollen proteome was also determined by Q-TOF LC-MSE. Each of the five examined birch species expressed a mixture of isoforms with at least 4-5 different isoforms. Both isoforms with a high and low IgE-reactivity were abundant in the Bet ν 1 mixture of B. pendula. The other birch species lacked Bet ν 1 isoforms that are similar to known isoforms with a low IgE-reactivity, but isoforms that are similar to known isoforms with a high IgE-reactivity were abundant in all species except B. lenta.
In Chapter 7, the antigenic and allergenic profiles of pollen extracts from twenty-four different birch trees were determined by SDS-PAGE and Western blotting. Fifteen different Betula species were examined, covering all previously identified subgenera/groups in the genus Betula. The major birch allergen Bet ν 1 was an abundant protein in all examined pollen extracts. Immune-reactivity of the extracts was tested using a pool of sera that were obtained from birch pollen allergic patients. A strong 17 kDa band, representing Bet ν 1, was recognized by the serum pool in all pollen extracts. The degree of immune-reactivity correlated well with the total amount of Bet ν 1 in the extract, which varied from 44% to 61% of the total protein content. Pollen extracts from different birch trees varied in the total protein content, presumably the result of variation in pollen quality due to pollen rupture and varying hydration during the extraction. Bet ν 1 isoforms in the pollen of eleven Betula species were subsequently digested with trypsin and the resulting fragments were analyzed and quantified by Q-TOF LC-MSE. Peptides that contained amino acid residues that are associated with high IgE-reactivity were detected in all examined species, and were abundant as well. Differences between Betula species in the relative presence of these amino acid residues were small. As a consequence, differences in allergenicity between birch trees
are probably far too small to have clinical relevance, implying that all examined Betula species will be highly allergenic.
The research presented here did not identify any birch trees in which Bet ν 1 variants with a high IgE-reactivity are reduced in abundance or are absent. Development of hypoallergenic birch trees thus must rely on other approaches, such as selection or introduction of male sterility (trees that do not produce male catkins were observed during the study), or the application of RNAi to silence the Bet ν 1 genes in pollen. Also, the conducted research showed that acceptance of hypoallergenic GM products is quite high, particularly for allergic sufferers who were allergic to the product being modified. This supports the hypothesis that consumer attitude towards GM is partly driven by recognition of specific and personally relevant benefits. The hypoallergenic apple cultivar Santana, which was developed by selection and not by GM, was well received by allergic consumers, indicating that there is a market for hypoallergenic products.

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