Assessment of the risk of foodallergy from mealworm consumption

A lot of research is being done into the development and applicability to the
food market of insect protein. This is an investment in a sustainable food
market. Mealworm seems a good candidate. The introduction of new proteins comes
with safety issues. One of the biggest risks is allerginicity. In theory every
protein, allso new proteins in food can cause allergic reactions.
A pilot study shows crossreactivity between proteins in mealworm and
crustaceans and house dust mite. These results ask for a more elaborate study
into the sensibilisation potential of the proteins.

- Establashing the percentage of patients within a population allergic to house
dust mite and/or crustaceans, that can get an allergic reaction from consuming
mealworm.
- Establashing the risk of sensitization and allergy by handling mealworms and
the change of (cross)allergy with crustaceans.

Part one:establashing the percentage of patients, within a crustacean and / or
house dust mite allergic population, that can get an allergic reaction when
consuming mealworm
1) Selection of patients with crustacean and / or house dust mite allergy
2) Visit 1: history, blood collection and skin prick test
3) Visit 2 and 3: foodchalenge with mealworm, unrecognisable

Part two: establashing the risk of an allergic reaction when consuming mealworm
or shrimp, in individuals that have symptoms after contact with mealworm.
1) Recrutement of individuals that have symptoms after contact with mealworms
2) Visit 1: history and blood collection. this can be done at the place of work
3) Visit 2: blood collection and skin prick test at UMC Utrecht
4) Visit 3 and 4: foodchalenge with mealworm, unrecognisable
5) Visit 5: foodchalenge with shrimp

food provocation

A first visit of 1 hour and a second visit with a chalenge of two times 9 hours
for patients.
For individuals that have symptoms after contact with mealworms, first visit 30
minutes, at a location of choice, second 1 hour, possibly a third , forth and
fifth visit, thirth and fourth of 9 hours each, fifth of 6 hours.
The risk of blood collection and intraveneus dripp (during food challenge) is a
slight pain and the possibility of a bruise. Skin prick test is a safe test and
is routinely done in the outpatient clinic. In most cases, the participant will
get a weal (looks like a mosquito bite). The itching disappears after 15-30
minutes and the weal itself after 2-3 hours.
Food chalenge (selection of 15 patients and 5 patients) is done routinely at
our daycare-facility. Our experiance shows us that most reactions seen are
mild, a severe reaction is vary rare. Before the chalenge starts the
participant will get an intraveneus dripp, to make sure mediation can be given
quickly if nessessary. Allso the participant is under costant observation of
trained nurses, under supervision of a mediacal doctor, up to five hours after
the chalenge.