Tartrazine exclusion for allergic asthma

 

Abstract

Background

Tartrazine is the best known and one of the most commonly used food additives. Food colorants are also used in many medications as well as foods. There has been conflicting evidence as to whether tartrazine causes exacerbations of asthma with some studies finding a positive association especially in individuals with cross-sensitivity to aspirin.

Objectives

To assess the overall effect of tartrazine (exclusion or challenge) in the management of asthma.

Search methods

A search was carried out on the Cochrane Airways Group Specialised Register. Bibliographies of each RCT was searched for additional papers. Authors of identified RCTs were contacted for further information. Searches are updated annually and are current as of February 2006.

Selection criteria

RCTs of oral administration of tartrazine (as a challenge) versus placebo or dietary avoidance of tartrazine versus normal diet were considered. Studies which focused upon allergic asthma, were also included. Studies of tartrazine exclusion for other allergic conditions such as hay fever, allergic rhinitis and eczema were only considered if the results for subjects with asthma were separately identified. Trials could be in either adults or children with asthma or allergic asthma (e.g. sensitivity to aspirin or food items known to contain tartrazine).

Data collection and analysis

Study quality was assessed and data abstracted by two reviewers independently. Outcomes were analysed using RevMan 4.1.1.

Main results

Ninety abstracts were found, of which 18 were potentially relevant. Six met the inclusion criteria, but only three presented results in a format that permitted analysis and none could be combined in a meta-analysis. In none of the studies did tartrazine challenge or avoidance in diet significantly alter asthma outcomes.

Authors' conclusions

Due to the paucity of available evidence, it is not possible to provide firm conclusions as to the effects of tartrazine on asthma control. However, the six RCTs that could be included in this review all arrived at the same conclusion. Routine tartrazine exclusion may not benefit most patients, except those very few individuals with proven sensitivity.

 

Plain language summary

Tartrazine exclusion for allergic asthma

Tartrazine is the best known and one of the most commonly used food additives. Food colorants are also used in many medications as well as foods. There is no evidence that tartrazine makes asthma worse or avoiding it makes asthma patients any better.

 

摘要

背景

排除Tartrazine對於過敏性氣喘的影響

Tartrazine為一種廣為人知,且最常使用的食品添加物. 食品色素也使用於許多藥物以及食物中. 關於Tartrazine是否加劇氣喘, 部份研究顯示, Tartrazine與氣喘惡化可能有正相關, 尤其是對於阿斯匹靈較為敏感的氣喘患者而言,其相關性更高. 但是目前尚有許多爭議.

目標

本次文獻回顧的主要目的在於評估tartrazine對於處理氣喘的整體影響(排除或質疑).

搜尋策略

於考科藍 Airways Group Specialised Register進行搜尋,並 搜尋每一個隨機對照試驗(RCT)的參考書目,以尋找更多相關論文. 同時也連絡已確認的隨機對照試驗作者,以取得更進一步的資訊. 需要進一步的資料則連絡的作者. 每年更新相關文獻搜尋,最近一次搜尋更新為2006年2月.

選擇標準

有關口服tartrazine(作為質疑)對照安慰劑的隨機對照試驗或飲食中避面添加tartrazine對照正常飲食的試驗均被考慮納入. 焦點著重於於過敏性氣喘的研究也被納入. 排除花粉症,過敏性鼻炎及濕疹等其他過敏情況的tartrazine研究,若氣喘受試者的結果獨立分開,則可納入. 試驗選擇包括 患有氣喘或過敏性氣喘(對有添加tartrazine的阿斯匹靈或食物敏感)的成人或小孩的研究.

資料收集與分析

由兩位審核者獨立評估研究品質及收集資料. 使用RevMan 4.1.1.分析結果.

主要結論

共計搜尋90篇摘要,其中18篇可能有相關性.6篇符合納入標準,但僅3篇有分析的結果,沒有一篇摘要有交叉分析的結果. 並無摘要顯示使用tartrazine或避免在食物中添加tartrazine,會明顯影響氣喘.

作者結論

由於缺少足夠的證據,因此,不可能對於tartrazine控制氣喘的效用下一確切的結論. 然而,回顧6篇隨機對照試驗均有相同的結論. 常規性排除tartrazine的使用,對於大多數的病患可能沒有益處,除了少數被證實具有敏感性的病患.

翻譯人

本摘要由國泰綜合醫院劉怡敏翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

Tartrazine是眾所皆知且最常用的一種食品添加劑. 在很多藥品和食物均使用食物色素. 並無證據顯示tartrazine會使氣喘惡化或讓氣喘病況好轉.