1. Allergens May be I am allergic to flowers

2.  Are harmful antigen-specific immune responses, occur when individual who has been primed by an innocuous antigen subsequently encounters the same antigen, produced tissue injury and dysfunction.  Types of hypersensitivity ： I 、 II 、 III 、 IV  Allergy is one of four forms of hypersensitivity and is called type I (or immediate) hypersensitivity. Hypersensitive Reactions

3. Allergy is a disorder of the immune system that occur to normally harmless environmental substances known as allergens. It is characterized by excessive activation of certain white blood cells called mast cells and basophils by a type of antibody known as IgE, resulting in an extreme inflammatory response.IgE An antigen reacts with cell fixed antibody (Ig E) leading to release of soluble molecules An antigen (allergen) soluble molecules (mediators)

4. Allergens Sulfonamide drugs Penicillins salicylate

5. 3 The process and mechanism of Type I hypersensitivity 1) Priming stage ： last more than half a year 2) Activating stage ： Crosslinkage Enzyme reaction Degranulation of mast cell, basophil 3) Effect stage ： Immediate/early phase response: Mediated by histamine Start within seconds Last several hours Late-phase response ： Mediated by new-synthesized lipid mediators Take up 8-12hours to develop Last several days

7. Allergen Primary Individual Generation IgE Adhesion IgE binds to the Fc  RI on mast cell and basophil Secondary Allergen binds to the IgE on primed target cell Crosslikage of Fc  RI Degranulate and release the biological mediators Preformed granule mediators New generated mediators HistamineBradykininLeukotrienesPAF Prostaglandin D2 Dilate capillaries,increase permeability, increase mucus secretion, contract smooth muscle Systemic anaphylaxis SkinRespiratory tractDegist tract Mechanism of type I hypersensitivity

8. Allergy symptoms depend on route of allergen entry Dust or pollen are airborne particles. In these cases, symptoms arise in areas in contact with air, such as eyes, nose and lungs. For instance, allergic rhinitis, also known as hay fever, causes irritation of the nose, sneezing, and itching and redness of the eyes. Inhaled allergens can also lead to asthmatic symptoms, caused by narrowing of the airways (bronchoconstriction) and increased production of mucus in the lungs, shortness of breath (dyspnea), coughing and wheezing

9. Symptoms of food allergy include abdominal pain, bloating, vomiting, diarrhea, itchy skin, and swelling of the skin during hives. Food allergies rarely cause respiratory (asthmatic) reactions, or rhinitis. Substances that come into contact with the skin, such as latex, are also common causes of allergic reactions, known as contact dermatitis or eczema. Skin allergies frequently cause rashes, or swelling and inflammation within the skin.latexcontact dermatitis

10. Insect stings, antibiotics, and certain medicines produce a systemic allergic response that is also called anaphylaxis; multiple organ systems can be affected, including the digestive system, the respiratory system, and the circulatory system. Depending of the rate of severity, it can cause cutaneous reactions, bronchoconstriction, edema, hypotension, coma, and even death. This type of reaction can be triggered suddenly, or the onset can be delayed. The severity of this type of allergic response often requires injections of epinephrine, sometimes through a device known as the EpiPen or Twinject auto-injector. epinephrine EpiPenTwinject

11. Atopy * Local form of type I hypersensitivity * Exposure to certain allergens that induce production of specific Ig E * Allergens : Inhalants:dust mite faeces, tree or pollens, mould spor. Ingestants: milk, egg, fish, choclate Contactants: wool, nylon, animal fur Drugs: penicillin, salicylates, anesthesia insect venom * There is a strong familial predisposition to atopic allergy * The predisposition is genetically determined

12. Therapy of type I hypersensitivity 1. Allergen avoidance : Atopy patch test 2. Desensitivity therapy / Hyposensitization : 1) Allogenic serum desensitivity therapy: 2) Specific allergen desensitivity therapy Repeated injection small amounts of allergen, IgG+allergen Neutralizing antibody, Blocking antibody 3. Drug therapy ： 1) Stabilization of triggering cells stabilize the membrane, inhibit mast cell degranulation 2) Mediator antagonism Antihistamine Bradykinin antagonism 3) Improve the responsibility of target organs

13. Diagnosis Blood testing This kind of testing measures a "total IgE level Skin testing preferred over blood allergy tests because it is more sensitive and specific, simpler to use, and less expensive. also known as "puncture testing" and "prick testing" due to the series of tiny puncture or pricks made into the patient's skin. Small amounts of suspected allergens and/or their extracts (pollen, grass, mite proteins, peanut extract, etc.) are introduced to sites on the skin marked with pen or dye. If a serious life threatening anaphylactic reaction has brought a patient in for evaluation, some allergists will prefer an initial blood test prior to performing the skin prick test. Skin tests may not be an option if the patient has widespread skin disease or has taken antihistamines sometime the last several days.antihistamines

14. Food allergy The common allergens are: peanut egg milk fish crustaceans soy gluten Wheat sesame tree nuts walnuts, almonds, cashews, pistachios Food allergy symptoms can include one or more of the following: Hives, rash, tingling of the mouth or throat, abdominal cramps, vomiting, diarrhea, swelling of the face or tongue, or difficulty breathing. People with the same food allergy may have different reactions. Food allergies can be fatal

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16. Peanut Allergies: Hidden Ingredients Arachis oil Ground nuts, ground peanuts Imitation walnuts or almonds Mixed nuts* Mixed nut butters Nut butters* Nut extracts* Nut flavorings* Peanuts Peanut butter Peanut butter chips Peanut extract Peanut flavoring* Peanut flour Peanut oil Ground nut oil Peanut syrup Satay sauce* * May contain peanuts

17. Tree Nut: Hidden Ingredients Almonds Brazil nuts Cashews Chestnuts Filberts/hazelnuts Gianduja* Hickory nuts Macadamia nuts Marzipan/almond paste Nougat Nu-Nuts ® artificial nuts Nut butters (cashew butter) Nut milks (almond milk) Nut oil Nut paste (almond paste) Pecans (Mashuga nuts) Pine nuts Pistachios Pralines Pure almond or other nut extract Walnuts * Gianduja is a creamy mixture of chocolate and chopped nuts found in premium or imported chocolate

18. Wheat Allergy – Hidden Ingredients Bleached all-purpose flour Bran Bread, bread crumbs Bulgur wheat, Durum wheat Cake and pastry flour Cereal extracts, cereal binder, cereal filler, cereal protein Cracker meal Cream of Wheat ® Malt-O-Meal ® Couscous Durum Enriched flour, bread flour (white or wheat) Farina Flour, granary flour Gliadin Gluten Grain-based coffee substitutes Graham cracker, graham flour Hydrolyzed protein Hydrolyzed vegetable protein Instant soup stock Modified food starch MSG (Monosodium glutamate) Pasta, noodles Puddings, wheat thickeners Soy sauce Spelt, Triticale

19. Wheat Allergy – Hidden Ingredients Vegetable starch Vitamin E pills (some) Wheat flour and wheat bran Wheat germ, wheat starch Wheat gluten, gluten flour Wheat semolina, semolina flour White (grain) vinegar PLEASE NOTE: Stabilizers, spices and emulsifiers can also indicate the presence of wheat Some alcoholic beverages (beer, whisky and gin) may cause allergic reactions in individuals with wheat allergies. Oats, barley, rye, triticale, and spelt may also cause problems for people with gluten sensitivity. Buckwheat is an herb and does not contain gluten. www.gluten.net

20. Egg Allergy – Hidden Ingredients Albumin Apovitellin Batter Cholesterol-free eggs Custard Dried egg Egg, egg glazes Eggnog Egg noodles Egg white solids Egg yolks Globulin Lecithin (could be derived from soy) Livetin Lysozyme Marzipan Mayonnaise Meringue Mouse Ovalbumin Ovamucoid/ovamucin Ovovitellin/vitellin Powdered or liquid eggs Pudding Quiche Simplesse Souffle

21. Milk Allergy: Hidden Ingredients Bechamel sauce Butter, butter solids Butter fat Butter flavor Buttermilk Casein Caseinates Cheese (any kind) Cottage cheese Cream Curds Custard Dried milk solids Evaporated milk Ghee Half-and-half High protein flour Ice cream, ice milk Lactate solids Lactoglobulin, lactalbumin Lactose Malted milk Margarine Milk (any kind, except soy) Milk protein Milk solids Non-fat dry milk Nougat Pudding Rennet Sodium casein Sour or whipping cream Whey Yogurt (any kind, except soy)

22. Soy Allergy: Hidden Ingredients Edamame soy bean Hydrolyzed soy protein Lecithin Miso Modified food starch Natto Shoyu sauce Soy albumin Soy beans (curds, granules) Soy concentrate Soy cheese Soy flour Soy grits Soy meat, soy meal Soy milk, soy ice cream Soy nuts Soy oil Soy protein concentrate Soy protein isolate Soy sauce Soy sprouts Soy yogurt Tamari Tempeh Textured soy protein (TSP) Textured vegetable protein (TVP) Tofu

23. Soy Allergy: Hidden Ingredients The following are label ingredients that may contain the presence of soy protein: Hydrolyzed plant protein Hydrolyzed vegetable protein Natural flavoring Many gluten free products contain soy. Check the label. Vegetable broth Vegetable gum Vegetable starch

24. Fish/Shellfish Allergy: Hidden Ingredients Albone Clams (cherrystone, littleneck, pismo, quahog) Cockle (periwinkle, sea urchin) Crab Crawfish (crayfish, ecrevisse) Fish oil capsules Fish broth or stock Lobster (langouste, langoustine, coral, tomalley) Mollusks Parvalbumin is the protein in fish that is known to provoke allergic reactions. Mussels Worcestershire sauce (may contain anchovies) Octopus Oysters Prawns Scallops Scampi Shrimp Snail Squid (calamari) Sushi

25. Fish/Shellfish Allergy: Hidden Ingredients The following ingredients may indicate the presence of shellfish protein: Bouillabaisse Fish stock Seafood flavoring (crab or clam extract) Surimi

26. Corn Allergy: Hidden Ingredients Baking powder* Cereals Confectioner’s (powdered) sugar Corn – ANYTHING! Dextrin or maltodextrin Dextrose, glucose, or fructose Golden syrup (treacle) Glucona delta lactone High-fructose corn syrup Hominy, grits Invert sugar, invert syrup Malt, malt syrup, malt extract Modified food starch (may be corn) Mono- and diglycerides Monosodium glutamate (MSG) Polenta Sorbitol Starch, food starch Sucrose (may derive from corn) Vanilla extract Vegetable oil (may be corn) Xanthan gum Zein (protein from corn, sometimes used in time-released medications) *Do not confuse with baking soda. Baking powder contains a mixture of leavening agents and a moisture-absorber such as cornstarch. Substitutions for Corn Featherweight Baking Powder or Arrowroot

27. Latex Allergies Banana Avocado Chestnut Hazel Nut Kiwi Melons Passion Fruit Fig Tomato Carrot Celery Papaya Potato Pineapple Mango Peach Proteins found in these items have a similar chemical composition to latex and a reaction may occur from consuming these foods:

28. Substitutions for Wheat Products Rice flour Tapioca flour Cornstarch Potato Starch Flour Soy bean flour Arrowroot Cornmeal Corn flour Gluten Free Mix 6 cups of rice flour, 2 cups of potato starch flour, 1 cup of tapioca flour. Combine, store in a cool, dry place for use as needed. Makes 9 cups.

29. Milk Substitutions Baked goods containing soy, rice or almond milks Cornstarch puddings made with fruit juice Frozen tofu desserts Milk-free margarine (parve), salad dressings (almond milk) Milk-free sherbets, ices and sorbets (Alpine Ice) Milk-free or soy milk shakes Nut, soy or rice milks Soy cheese and soy yogurt Some non-dairy creamers

30. Egg Substitutions For each egg, try one of the following: 1 packet of plain gelatin mixed with 2 tbsp warm water. Mix into other ingredients immediately before it thickens. 1 tsp. baking powder, 2 tbsp. Vinegar 1 tsp. yeast dissolved in ¼ cup warm water 1 tbsp. apricot puree 1 ½ tbsp. water, 1½ tbsp. cooking oil, & 1 tsp. baking powder Egg Replacer, such as Ener-G® 1/2 tbsp. powder and 2 tbsp. water