Why Celiac Disease Is Different from a Food Allergy
Celiac disease causes gluten-triggered autoimmune damage to the small intestine, a different immune process from the reactions behind food allergy.
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Food Allergy
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A food allergy is an adverse health effect caused by a specific immune response that occurs reproducibly after exposure to a particular food. The substances that trigger these reactions are called food allergens and are usually proteins. Food allergy can involve different immune mechanisms, including immunoglobulin E, or IgE-mediated reactions, as well as forms that do not depend on IgE .1
In IgE-mediated food allergy, the immune system produces IgE antibodies that recognize a particular food allergen. When that allergen is encountered again, it can activate mast cells and basophils, causing the release of substances that produce allergic symptoms. Reactions may affect the skin, gastrointestinal tract, respiratory system, or cardiovascular system, and severe systemic reactions can develop into anaphylaxis .1
Food allergy is not the same as allergic sensitization. A person can have detectable food-specific IgE or a positive skin-prick test without developing symptoms after exposure to the food. Diagnosis therefore requires interpreting evidence of sensitization together with the clinical history and, when necessary, an oral food challenge, which is a reference standard for establishing clinical food allergy .1,2
Food allergy is also distinct from food intolerance. Both can cause adverse reactions after eating, but food allergy involves a specific immune response. Food intolerances arise through non-immune mechanisms, such as impaired lactose digestion in lactose intolerance .1
References
- Boyce JA, Assa’ad A, Burks AW, Jones SM, Sampson HA, Wood RA Guidelines for the Diagnosis and Management of Food Allergy in the United States: Report of the NIAID-Sponsored Expert Panel. Journal of Allergy and Clinical Immunology. 2010. About this source DOI
- Alexandra F. Santos, Carmen Riggioni, Ioana Agache, Cezmi A. Akdis, Mubeccel Akdis, Alberto Alvarez‐Perea, Montserrat Alvaro‐Lozano, Barbara Ballmer‐Weber, Simona Barni, Kirsten Beyer, Carsten Bindslev‐Jensen, Helen A. Brough, Betul Buyuktiryaki, Derek Chu, Stefano Del Giacco, Audrey Dunn‐Galvin, Bernadette Eberlein, Motohiro Ebisawa, Philippe Eigenmann, Thomas Eiwegger, Mary Feeney, Montserrat Fernandez‐Rivas, Helen R. Fisher, David M. Fleischer, Mattia Giovannini, Claudia Gray, Karin Hoffmann‐Sommergruber, Susanne Halken, Jonathan O’B. Hourihane, Christina J. Jones, Marek Jutel, Edward Knol, George N. Konstantinou, Gideon Lack, Susanne Lau, Andreina Marques Mejias, Mary Jane Marchisotto, Rosan Meyer, Charlotte G. Mortz, Beatriz Moya, Antonella Muraro, Caroline Nilsson, Lucila Camargo Lopes de Oliveira, Liam O’Mahony, Nikolaos G. Papadopoulos, Kirsten Perrett, Rachel L. Peters, Marcia Podesta, Lars K. Poulsen, Graham Roberts, Hugh A. Sampson, Jürgen Schwarze, Peter Smith, Elizabeth Huiwen Tham, Eva Untersmayr, Ronald Van Ree, Carina Venter, Brian P. Vickery, Berber Vlieg‐Boerstra, Thomas Werfel, Margitta Worm, George Du Toit, Isabel Skypala EAACI guidelines on the diagnosis of IgE ‐mediated food allergy. Allergy. 2023. About this source DOI
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