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1. EAACI guidelines on the diagnosis of IgE-mediated food allergy

Author: CTI Research, MS Dermatologie/Allergologie, Infection & Immunity, Santos, Alexandra F, Riggioni, Carmen, Agache, Ioana, Akdis, Cezmi A, Akdis, Mubeccel, Alvarez-Perea, Alberto, Alvaro-Lozano, Montserrat, Ballmer-Weber, Barbara, Barni, Simona, Beyer, Kirsten, Bindslev-Jensen, Carsten, Brough, Helen A, Buyuktiryaki, Betul, Chu, Derek, Del Giacco, Stefano, Dunn-Galvin, Audrey, Eberlein, Bernadette, Ebisawa, Motohiro, Eigenmann, Philippe, Eiwegger, Thomas, Feeney, Mary, Fernandez-Rivas, Montserrat, Fisher, Helen R, Fleischer, David M, Giovannini, Mattia, Gray, Claudia, Hoffmann-Sommergruber, Karin, Halken, Susanne, Hourihane, Jonathan O'B, Jones, Christina J, Jutel, Marek, Knol, Edward, Konstantinou, George N, Lack, Gideon, Lau, Susanne, Marques Mejias, Andreina, Marchisotto, Mary Jane, Meyer, Rosan, Mortz, Charlotte G, Moya, Beatriz, Muraro, Antonella, Nilsson, Caroline, Lopes de Oliveira, Lucila Camargo, O'Mahony, Liam, Papadopoulos, Nikolaos G, Perrett, Kirsten, Peters, Rachel L, Podesta, Marcia, Poulsen, Lars K, Roberts, Graham, Sampson, Hugh A, Schwarze, Jürgen, Smith, Peter, Tham, Elizabeth Huiwen, Untersmayr, Eva, Van Ree, Ronald, Venter, Carina, Vickery, Brian P, Vlieg-Boerstra, Berber, Werfel, Thomas, Worm, Margitta, Du Toit, George, Skypala, Isabel, CTI Research, MS Dermatologie/Allergologie, Infection & Immunity, Santos, Alexandra F, Riggioni, Carmen, Agache, Ioana, Akdis, Cezmi A, Akdis, Mubeccel, Alvarez-Perea, Alberto, Alvaro-Lozano, Montserrat, Ballmer-Weber, Barbara, Barni, Simona, Beyer, Kirsten, Bindslev-Jensen, Carsten, Brough, Helen A, Buyuktiryaki, Betul, Chu, Derek, Del Giacco, Stefano, Dunn-Galvin, Audrey, Eberlein, Bernadette, Ebisawa, Motohiro, Eigenmann, Philippe, Eiwegger, Thomas, Feeney, Mary, Fernandez-Rivas, Montserrat, Fisher, Helen R, Fleischer, David M, Giovannini, Mattia, Gray, Claudia, Hoffmann-Sommergruber, Karin, Halken, Susanne, Hourihane, Jonathan O'B, Jones, Christina J, Jutel, Marek, Knol, Edward, Konstantinou, George N, Lack, Gideon, Lau, Susanne, Marques Mejias, Andreina, Marchisotto, Mary Jane, Meyer, Rosan, Mortz, Charlotte G, Moya, Beatriz, Muraro, Antonella, Nilsson, Caroline, Lopes de Oliveira, Lucila Camargo, O'Mahony, Liam, Papadopoulos, Nikolaos G, Perrett, Kirsten, Peters, Rachel L, Podesta, Marcia, Poulsen, Lars K, Roberts, Graham, Sampson, Hugh A, Schwarze, Jürgen, Smith, Peter, Tham, Elizabeth Huiwen, Untersmayr, Eva, Van Ree, Ronald, Venter, Carina, Vickery, Brian P, Vlieg-Boerstra, Berber, Werfel, Thomas, Worm, Margitta, Du Toit, George, and Skypala, Isabel
Published: 2023

2. EAACI guidelines on the diagnosis of IgE‐mediated food allergy

Author: Santos, Alexandra F; https://orcid.org/0000-0002-7805-1436, Riggioni, Carmen; https://orcid.org/0000-0002-8745-0228, Agache, Ioana; https://orcid.org/0000-0001-7994-364X, Akdis, Cezmi A; https://orcid.org/0000-0001-8020-019X, Akdis, Mubeccel; https://orcid.org/0000-0003-0554-9943, Alvarez‐Perea, Alberto; https://orcid.org/0000-0001-7417-7309, Alvaro‐Lozano, Montserrat; https://orcid.org/0000-0002-5528-8043, Ballmer‐Weber, Barbara; https://orcid.org/0000-0002-4136-5036, Barni, Simona, Beyer, Kirsten, Bindslev‐Jensen, Carsten; https://orcid.org/0000-0002-8940-038X, Brough, Helen A; https://orcid.org/0000-0001-7203-0813, Buyuktiryaki, Betul, Chu, Derek, Del Giacco, Stefano; https://orcid.org/0000-0002-4517-1749, Dunn‐Galvin, Audrey; https://orcid.org/0000-0002-1540-3959, Eberlein, Bernadette; https://orcid.org/0000-0003-4509-6491, Ebisawa, Motohiro; https://orcid.org/0000-0003-4117-558X, Eigenmann, Philippe, Eiwegger, Thomas; https://orcid.org/0000-0002-2914-7829, Feeney, Mary; https://orcid.org/0000-0003-0594-7052, Fernandez‐Rivas, Montserrat; https://orcid.org/0000-0003-1748-2328, Fisher, Helen R; https://orcid.org/0000-0002-5958-4587, Fleischer, David M, Giovannini, Mattia; https://orcid.org/0000-0001-9568-6882, Gray, Claudia, Hoffmann‐Sommergruber, Karin; https://orcid.org/0000-0002-8830-058X, Halken, Susanne; https://orcid.org/0000-0003-0161-8278, Hourihane, Jonathan O’B, Jones, Christina J; https://orcid.org/0000-0003-3672-6631, et al, Santos, Alexandra F; https://orcid.org/0000-0002-7805-1436, Riggioni, Carmen; https://orcid.org/0000-0002-8745-0228, Agache, Ioana; https://orcid.org/0000-0001-7994-364X, Akdis, Cezmi A; https://orcid.org/0000-0001-8020-019X, Akdis, Mubeccel; https://orcid.org/0000-0003-0554-9943, Alvarez‐Perea, Alberto; https://orcid.org/0000-0001-7417-7309, Alvaro‐Lozano, Montserrat; https://orcid.org/0000-0002-5528-8043, Ballmer‐Weber, Barbara; https://orcid.org/0000-0002-4136-5036, Barni, Simona, Beyer, Kirsten, Bindslev‐Jensen, Carsten; https://orcid.org/0000-0002-8940-038X, Brough, Helen A; https://orcid.org/0000-0001-7203-0813, Buyuktiryaki, Betul, Chu, Derek, Del Giacco, Stefano; https://orcid.org/0000-0002-4517-1749, Dunn‐Galvin, Audrey; https://orcid.org/0000-0002-1540-3959, Eberlein, Bernadette; https://orcid.org/0000-0003-4509-6491, Ebisawa, Motohiro; https://orcid.org/0000-0003-4117-558X, Eigenmann, Philippe, Eiwegger, Thomas; https://orcid.org/0000-0002-2914-7829, Feeney, Mary; https://orcid.org/0000-0003-0594-7052, Fernandez‐Rivas, Montserrat; https://orcid.org/0000-0003-1748-2328, Fisher, Helen R; https://orcid.org/0000-0002-5958-4587, Fleischer, David M, Giovannini, Mattia; https://orcid.org/0000-0001-9568-6882, Gray, Claudia, Hoffmann‐Sommergruber, Karin; https://orcid.org/0000-0002-8830-058X, Halken, Susanne; https://orcid.org/0000-0003-0161-8278, Hourihane, Jonathan O’B, Jones, Christina J; https://orcid.org/0000-0003-3672-6631, and et al
Abstract: This European Academy of Allergy and Clinical Immunology guideline provides recommendations for diagnosing IgE‐mediated food allergy and was developed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Food allergy diagnosis starts with an allergy‐focused clinical history followed by tests to determine IgE sensitization, such as serum allergen‐specific IgE (sIgE) and skin prick test (SPT), and the basophil activation test (BAT), if available. Evidence for IgE sensitization should be sought for any suspected foods. The diagnosis of allergy to some foods, such as peanut and cashew nut, is well supported by SPT and serum sIgE, whereas there are less data and the performance of these tests is poorer for other foods, such as wheat and soya. The measurement of sIgE to allergen components such as Ara h 2 from peanut, Cor a 14 from hazelnut and Ana o 3 from cashew can be useful to further support the diagnosis, especially in pollen‐sensitized individuals. BAT to peanut and sesame can be used additionally. The reference standard for food allergy diagnosis is the oral food challenge (OFC). OFC should be performed in equivocal cases. For practical reasons, open challenges are suitable in most cases. Reassessment of food allergic children with allergy tests and/or OFCs periodically over time will enable reintroduction of food into the diet in the case of spontaneous acquisition of oral tolerance.
Published: 2023

3. EAACI guidelines on the diagnosis of IgE-mediated food allergy

Author: Santos, Alexandra F, Riggioni, Carmen, Agache, Ioana, Akdis, Cezmi A, Akdis, Mubeccel, Alvarez-Perea, Alberto, Alvaro-Lozano, Montserrat, Ballmer-Weber, Barbara, Barni, Simona, Beyer, Kirsten, Bindslev-Jensen, Carsten, Brough, Helen A, Buyuktiryaki, Betul, Chu, Derek, Del Giacco, Stefano, Dunn-Galvin, Audrey, Eberlein, Bernadette, Ebisawa, Motohiro, Eigenmann, Philippe, Eiwegger, Thomas, Feeney, Mary, Fernandez-Rivas, Montserrat, Fisher, Helen R, Fleischer, David M, Giovannini, Mattia, Gray, Claudia, Hoffmann-Sommergruber, Karin, Halken, Susanne, Hourihane, Jonathan O'B, Jones, Christina J, Jutel, Marek, Knol, Edward, Konstantinou, George N, Lack, Gideon, Lau, Susanne, Marques Mejias, Andreina, Marchisotto, Mary Jane, Meyer, Rosan, Mortz, Charlotte G, Moya, Beatriz, Muraro, Antonella, Nilsson, Caroline, Lopes de Oliveira, Lucila Camargo, O'Mahony, Liam, Papadopoulos, Nikolaos G, Perrett, Kirsten, Peters, Rachel L, Podesta, Marcia, Poulsen, Lars K, Roberts, Graham, Sampson, Hugh A, Schwarze, Jürgen, Smith, Peter, Tham, Elizabeth Huiwen, Untersmayr, Eva, Van Ree, Ronald, Venter, Carina, Vickery, Brian P, Vlieg-Boerstra, Berber, Werfel, Thomas, Worm, Margitta, Du Toit, George, Skypala, Isabel, Santos, Alexandra F, Riggioni, Carmen, Agache, Ioana, Akdis, Cezmi A, Akdis, Mubeccel, Alvarez-Perea, Alberto, Alvaro-Lozano, Montserrat, Ballmer-Weber, Barbara, Barni, Simona, Beyer, Kirsten, Bindslev-Jensen, Carsten, Brough, Helen A, Buyuktiryaki, Betul, Chu, Derek, Del Giacco, Stefano, Dunn-Galvin, Audrey, Eberlein, Bernadette, Ebisawa, Motohiro, Eigenmann, Philippe, Eiwegger, Thomas, Feeney, Mary, Fernandez-Rivas, Montserrat, Fisher, Helen R, Fleischer, David M, Giovannini, Mattia, Gray, Claudia, Hoffmann-Sommergruber, Karin, Halken, Susanne, Hourihane, Jonathan O'B, Jones, Christina J, Jutel, Marek, Knol, Edward, Konstantinou, George N, Lack, Gideon, Lau, Susanne, Marques Mejias, Andreina, Marchisotto, Mary Jane, Meyer, Rosan, Mortz, Charlotte G, Moya, Beatriz, Muraro, Antonella, Nilsson, Caroline, Lopes de Oliveira, Lucila Camargo, O'Mahony, Liam, Papadopoulos, Nikolaos G, Perrett, Kirsten, Peters, Rachel L, Podesta, Marcia, Poulsen, Lars K, Roberts, Graham, Sampson, Hugh A, Schwarze, Jürgen, Smith, Peter, Tham, Elizabeth Huiwen, Untersmayr, Eva, Van Ree, Ronald, Venter, Carina, Vickery, Brian P, Vlieg-Boerstra, Berber, Werfel, Thomas, Worm, Margitta, Du Toit, George, and Skypala, Isabel
Abstract: This European Academy of Allergy and Clinical Immunology guideline provides recommendations for diagnosing IgE-mediated food allergy and was developed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Food allergy diagnosis starts with an allergy-focused clinical history followed by tests to determine IgE sensitization, such as serum allergen-specific IgE (sIgE) and skin prick test (SPT), and the basophil activation test (BAT), if available. Evidence for IgE sensitization should be sought for any suspected foods. The diagnosis of allergy to some foods, such as peanut and cashew nut, is well supported by SPT and serum sIgE, whereas there are less data and the performance of these tests is poorer for other foods, such as wheat and soya. The measurement of sIgE to allergen components such as Ara h 2 from peanut, Cor a 14 from hazelnut and Ana o 3 from cashew can be useful to further support the diagnosis, especially in pollen-sensitized individuals. BAT to peanut and sesame can be used additionally. The reference standard for food allergy diagnosis is the oral food challenge (OFC). OFC should be performed in equivocal cases. For practical reasons, open challenges are suitable in most cases. Reassessment of food allergic children with allergy tests and/or OFCs periodically over time will enable reintroduction of food into the diet in the case of spontaneous acquisition of oral tolerance.
Published: 2023

4. EAACI guidelines on the diagnosis of IgE-mediated food allergy

Author: Santos, Alexandra F, Riggioni, Carmen, Agache, Ioana, Akdis, Cezmi A, Akdis, Mubeccel, Alvarez-Perea, Alberto, Alvaro-Lozano, Montserrat, Ballmer-Weber, Barbara, Barni, Simona, Beyer, Kirsten, Bindslev-Jensen, Carsten, Brough, Helen A, Buyuktiryaki, Betul, Chu, Derek, Del Giacco, Stefano, Dunn-Galvin, Audrey, Eberlein, Bernadette, Ebisawa, Motohiro, Eigenmann, Philippe, Eiwegger, Thomas, Feeney, Mary, Fernandez-Rivas, Montserrat, Fisher, Helen R, Fleischer, David M, Giovannini, Mattia, Gray, Claudia, Hoffmann-Sommergruber, Karin, Halken, Susanne, Hourihane, Jonathan O'B, Jones, Christina J, Jutel, Marek, Knol, Edward, Konstantinou, George N, Lack, Gideon, Lau, Susanne, Marques Mejias, Andreina, Marchisotto, Mary Jane, Meyer, Rosan, Mortz, Charlotte G, Moya, Beatriz, Muraro, Antonella, Nilsson, Caroline, Lopes de Oliveira, Lucila Camargo, O'Mahony, Liam, Papadopoulos, Nikolaos G, Perrett, Kirsten, Peters, Rachel L, Podesta, Marcia, Poulsen, Lars K, Roberts, Graham, Sampson, Hugh A, Schwarze, Jürgen, Smith, Peter, Tham, Elizabeth Huiwen, Untersmayr, Eva, Van Ree, Ronald, Venter, Carina, Vickery, Brian P, Vlieg-Boerstra, Berber, Werfel, Thomas, Worm, Margitta, Du Toit, George, Skypala, Isabel, Santos, Alexandra F, Riggioni, Carmen, Agache, Ioana, Akdis, Cezmi A, Akdis, Mubeccel, Alvarez-Perea, Alberto, Alvaro-Lozano, Montserrat, Ballmer-Weber, Barbara, Barni, Simona, Beyer, Kirsten, Bindslev-Jensen, Carsten, Brough, Helen A, Buyuktiryaki, Betul, Chu, Derek, Del Giacco, Stefano, Dunn-Galvin, Audrey, Eberlein, Bernadette, Ebisawa, Motohiro, Eigenmann, Philippe, Eiwegger, Thomas, Feeney, Mary, Fernandez-Rivas, Montserrat, Fisher, Helen R, Fleischer, David M, Giovannini, Mattia, Gray, Claudia, Hoffmann-Sommergruber, Karin, Halken, Susanne, Hourihane, Jonathan O'B, Jones, Christina J, Jutel, Marek, Knol, Edward, Konstantinou, George N, Lack, Gideon, Lau, Susanne, Marques Mejias, Andreina, Marchisotto, Mary Jane, Meyer, Rosan, Mortz, Charlotte G, Moya, Beatriz, Muraro, Antonella, Nilsson, Caroline, Lopes de Oliveira, Lucila Camargo, O'Mahony, Liam, Papadopoulos, Nikolaos G, Perrett, Kirsten, Peters, Rachel L, Podesta, Marcia, Poulsen, Lars K, Roberts, Graham, Sampson, Hugh A, Schwarze, Jürgen, Smith, Peter, Tham, Elizabeth Huiwen, Untersmayr, Eva, Van Ree, Ronald, Venter, Carina, Vickery, Brian P, Vlieg-Boerstra, Berber, Werfel, Thomas, Worm, Margitta, Du Toit, George, and Skypala, Isabel
Abstract: This European Academy of Allergy and Clinical Immunology guideline provides recommendations for diagnosing IgE-mediated food allergy and was developed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Food allergy diagnosis starts with an allergy-focused clinical history followed by tests to determine IgE sensitization, such as serum allergen-specific IgE (sIgE) and skin prick test (SPT), and the basophil activation test (BAT), if available. Evidence for IgE sensitization should be sought for any suspected foods. The diagnosis of allergy to some foods, such as peanut and cashew nut, is well supported by SPT and serum sIgE, whereas there are less data and the performance of these tests is poorer for other foods, such as wheat and soya. The measurement of sIgE to allergen components such as Ara h 2 from peanut, Cor a 14 from hazelnut and Ana o 3 from cashew can be useful to further support the diagnosis, especially in pollen-sensitized individuals. BAT to peanut and sesame can be used additionally. The reference standard for food allergy diagnosis is the oral food challenge (OFC). OFC should be performed in equivocal cases. For practical reasons, open challenges are suitable in most cases. Reassessment of food allergic children with allergy tests and/or OFCs periodically over time will enable reintroduction of food into the diet in the case of spontaneous acquisition of oral tolerance.
Published: 2023

5. Non-specific lipid-transfer proteins: Allergen structure and function, cross-reactivity, sensitization, and epidemiology

Author: Austrian Science Fund, Thermo Fisher Scientific, Ministerio de Economía y Competitividad (España), European Commission, Dutch Research Council, Skypala, Isabel J. [0000-0003-3629-4293], Asero, Ricardo [0000-0002-8277-1700], Barber, Domingo F. [0000-0001-8824-5405], Cecchi, Lorenzo [0000-0002-0658-2449], Díaz-Perales, Araceli [0000-0002-1093-3627], Hoffmann-Sommergruber, Karin [0000-0002-8830-058X], Pastorello, Elide A. [0000-0002-3753-1783], Swoboda, Inés [0000-0002-9164-1721], Bartra, Joan [0000-0001-7767-4730], Ebo, Didier G. [0000-0003-0672-7529], Faber, Margaretha [0000-0002-1277-5052], Fernández-Rivas, Montserrat [0000-0003-1748-2328], Gómez, Francesca [0000-0003-1607-6686], Konstantinopoulos, Anastasios P. [0000-0002-7060-653X], Luengo, Olga [0000-0002-8905-2776], van Ree, Ronald [0000-0003-0767-0894], Scala, Enrico [0000-0002-9391-9168], Till, Stephen J. [0000-0003-4518-3093], Skypala, Isabel J., Asero, Ricardo, Barber, Domingo F., Cecchi, Lorenzo, Díaz-Perales, Araceli, Hoffmann-Sommergruber, Karin, Pastorello, Elide A., Swoboda, Inés, Bartra, Joan, Ebo, Didier G., Faber, Margaretha, Fernández-Rivas, Montserrat, Gómez, Francesca, Konstantinopoulos, Anastasios P., Luengo, Olga, van Ree, Ronald, Scala, Enrico, Till, Stephen J., Austrian Science Fund, Thermo Fisher Scientific, Ministerio de Economía y Competitividad (España), European Commission, Dutch Research Council, Skypala, Isabel J. [0000-0003-3629-4293], Asero, Ricardo [0000-0002-8277-1700], Barber, Domingo F. [0000-0001-8824-5405], Cecchi, Lorenzo [0000-0002-0658-2449], Díaz-Perales, Araceli [0000-0002-1093-3627], Hoffmann-Sommergruber, Karin [0000-0002-8830-058X], Pastorello, Elide A. [0000-0002-3753-1783], Swoboda, Inés [0000-0002-9164-1721], Bartra, Joan [0000-0001-7767-4730], Ebo, Didier G. [0000-0003-0672-7529], Faber, Margaretha [0000-0002-1277-5052], Fernández-Rivas, Montserrat [0000-0003-1748-2328], Gómez, Francesca [0000-0003-1607-6686], Konstantinopoulos, Anastasios P. [0000-0002-7060-653X], Luengo, Olga [0000-0002-8905-2776], van Ree, Ronald [0000-0003-0767-0894], Scala, Enrico [0000-0002-9391-9168], Till, Stephen J. [0000-0003-4518-3093], Skypala, Isabel J., Asero, Ricardo, Barber, Domingo F., Cecchi, Lorenzo, Díaz-Perales, Araceli, Hoffmann-Sommergruber, Karin, Pastorello, Elide A., Swoboda, Inés, Bartra, Joan, Ebo, Didier G., Faber, Margaretha, Fernández-Rivas, Montserrat, Gómez, Francesca, Konstantinopoulos, Anastasios P., Luengo, Olga, van Ree, Ronald, Scala, Enrico, and Till, Stephen J.
Abstract: Discovered and described 40 years ago, non-specific lipid transfer proteins (nsLTP) are present in many plant species and play an important role protecting plants from stressors such as heat or drought. In the last 20 years, sensitization to nsLTP and consequent reactions to plant foods has become an increasing concern.
Published: 2021

6. Proposal of 0.5 mg of protein/100 g of processed food as threshold for voluntary declaration of food allergen traces in processed food-A first step in an initiative to better inform patients and avoid fatal allergic reactions : A GA(2)LEN position paper

Author: Zuberbier, Torsten, Doerr, Tamara, Aberer, Werner, Alvaro, Montserrat, Angier, Elizabeth, Arasi, Stefania, Arshad, Hasan, Ballmer-Weber, Barbara, Bartra, Joan, Beck, Lisa, Begin, Philippe, Bindslev-Jensen, Carsten, Bislimovska, Jovanka, Bousquet, Jean, Brockow, Knut, Bush, Andrew, Cianferoni, Antonella, Cork, Michael J., Custovic, Adnan, Darsow, Ulf, Jong, Nicolette, Deleanu, Diana, Del Giacco, Stefano, Deschildre, Antoine, Galvin, Audrey Dunn, Ebisawa, Motohiro, Fernandez-Rivas, Montserrat, Ferrer, Marta, Fiocchi, Alessandro, van Wijk, Roy Gerth, Gotua, Maia, Grimshaw, Kate, Gruenhagen, Josefine, Heffler, Enrico, Hide, Michihiro, Hoffmann-Sommergruber, Karin, Incorvaia, Cristoforo, Janson, Christer, John, Swen Malte, Jones, Carla, Jutel, Marek, Katoh, Norito, Kendziora, Benjamin, Kinaciyan, Tamar, Knol, Edward, Kurbacheva, Oksana, Lau, Susanne, Loh, Richard, Lombardi, Carlo, Makela, Mika, Marchisotto, Mary Jane, Makris, Michael, Maurer, Marcus, Meyer, Rosan, Mijakoski, Dragan, Minov, Jordan, Mullol, Joaquim, Nilsson, Caroline, Nowak-Wegrzyn, Anna, Nwaru, Bright, I, Odemyr, Mikela, Pajno, Giovanni Battista, Paudel, Sushil, Papadopoulos, Nikolaos G., Renz, Harald, Ricci, Giampaolo, Ring, Johannes, Rogala, Barbara, Sampson, Hugh, Senna, Gianenrico, Sitkauskiene, Brigita, Smith, Peter Kenneth, Stevanovic, Katarina, Stoleski, Sasho, Szajewska, Hania, Tanaka, Akio, Todo-Bom, Ana, Topal, Fatih Alexander, Valovirta, Erkka, Van Ree, Ronald, Venter, Carina, Woehrl, Stefan, Wong, Gary W. K., Zhao, Zuotao, Worm, Margitta, Zuberbier, Torsten, Doerr, Tamara, Aberer, Werner, Alvaro, Montserrat, Angier, Elizabeth, Arasi, Stefania, Arshad, Hasan, Ballmer-Weber, Barbara, Bartra, Joan, Beck, Lisa, Begin, Philippe, Bindslev-Jensen, Carsten, Bislimovska, Jovanka, Bousquet, Jean, Brockow, Knut, Bush, Andrew, Cianferoni, Antonella, Cork, Michael J., Custovic, Adnan, Darsow, Ulf, Jong, Nicolette, Deleanu, Diana, Del Giacco, Stefano, Deschildre, Antoine, Galvin, Audrey Dunn, Ebisawa, Motohiro, Fernandez-Rivas, Montserrat, Ferrer, Marta, Fiocchi, Alessandro, van Wijk, Roy Gerth, Gotua, Maia, Grimshaw, Kate, Gruenhagen, Josefine, Heffler, Enrico, Hide, Michihiro, Hoffmann-Sommergruber, Karin, Incorvaia, Cristoforo, Janson, Christer, John, Swen Malte, Jones, Carla, Jutel, Marek, Katoh, Norito, Kendziora, Benjamin, Kinaciyan, Tamar, Knol, Edward, Kurbacheva, Oksana, Lau, Susanne, Loh, Richard, Lombardi, Carlo, Makela, Mika, Marchisotto, Mary Jane, Makris, Michael, Maurer, Marcus, Meyer, Rosan, Mijakoski, Dragan, Minov, Jordan, Mullol, Joaquim, Nilsson, Caroline, Nowak-Wegrzyn, Anna, Nwaru, Bright, I, Odemyr, Mikela, Pajno, Giovanni Battista, Paudel, Sushil, Papadopoulos, Nikolaos G., Renz, Harald, Ricci, Giampaolo, Ring, Johannes, Rogala, Barbara, Sampson, Hugh, Senna, Gianenrico, Sitkauskiene, Brigita, Smith, Peter Kenneth, Stevanovic, Katarina, Stoleski, Sasho, Szajewska, Hania, Tanaka, Akio, Todo-Bom, Ana, Topal, Fatih Alexander, Valovirta, Erkka, Van Ree, Ronald, Venter, Carina, Woehrl, Stefan, Wong, Gary W. K., Zhao, Zuotao, and Worm, Margitta
Abstract: Background Food anaphylaxis is commonly elicited by unintentional ingestion of foods containing the allergen above the tolerance threshold level of the individual. While labeling the 14 main allergens used as ingredients in food products is mandatory in the EU, there is no legal definition of declaring potential contaminants. Precautionary allergen labeling such as "may contain traces of" is often used. However, this is unsatisfactory for consumers as they get no information if the contamination is below their personal threshold. In discussions with the food industry and technologists, it was suggested to use a voluntary declaration indicating that all declared contaminants are below a threshold of 0.5 mg protein per 100 g of food. This concentration is known to be below the threshold of most patients, and it can be technically guaranteed in most food production. However, it was also important to assess that in case of accidental ingestion of contaminants below this threshold by highly allergic patients, no fatal anaphylactic reaction could occur. Therefore, we performed a systematic review to assess whether a fatal reaction to 5mg of protein or less has been reported, assuming that a maximum portion size of 1kg of a processed food exceeds any meal and thus gives a sufficient safety margin. Methods MEDLINE and EMBASE were searched until 24 January 2021 for provocation studies and case reports in which one of the 14 major food allergens was reported to elicit fatal or life-threatening anaphylactic reactions and assessed if these occurred below the ingestion of 5mg of protein. A Delphi process was performed to obtain an expert consensus on the results. Results In the 210 studies included, in our search, no reports of fatal anaphylactic reactions reported below 5 mg protein ingested were identified. However, in provocation studies and case reports, severe reactions below 5 mg were reported for the following allergens: eggs, fish, lupin, milk, nuts, peanuts, soy, and se
Published: 2022
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7. Proposal of 0.5 mg of protein/100 g of processed food as threshold for voluntary declaration of food allergen traces in processed food-A first step in an initiative to better inform patients and avoid fatal allergic reactions : A GA(2)LEN position paper

Author: Zuberbier, Torsten, Doerr, Tamara, Aberer, Werner, Alvaro, Montserrat, Angier, Elizabeth, Arasi, Stefania, Arshad, Hasan, Ballmer-Weber, Barbara, Bartra, Joan, Beck, Lisa, Begin, Philippe, Bindslev-Jensen, Carsten, Bislimovska, Jovanka, Bousquet, Jean, Brockow, Knut, Bush, Andrew, Cianferoni, Antonella, Cork, Michael J., Custovic, Adnan, Darsow, Ulf, Jong, Nicolette, Deleanu, Diana, Del Giacco, Stefano, Deschildre, Antoine, Galvin, Audrey Dunn, Ebisawa, Motohiro, Fernandez-Rivas, Montserrat, Ferrer, Marta, Fiocchi, Alessandro, van Wijk, Roy Gerth, Gotua, Maia, Grimshaw, Kate, Gruenhagen, Josefine, Heffler, Enrico, Hide, Michihiro, Hoffmann-Sommergruber, Karin, Incorvaia, Cristoforo, Janson, Christer, John, Swen Malte, Jones, Carla, Jutel, Marek, Katoh, Norito, Kendziora, Benjamin, Kinaciyan, Tamar, Knol, Edward, Kurbacheva, Oksana, Lau, Susanne, Loh, Richard, Lombardi, Carlo, Makela, Mika, Marchisotto, Mary Jane, Makris, Michael, Maurer, Marcus, Meyer, Rosan, Mijakoski, Dragan, Minov, Jordan, Mullol, Joaquim, Nilsson, Caroline, Nowak-Wegrzyn, Anna, Nwaru, Bright, I, Odemyr, Mikela, Pajno, Giovanni Battista, Paudel, Sushil, Papadopoulos, Nikolaos G., Renz, Harald, Ricci, Giampaolo, Ring, Johannes, Rogala, Barbara, Sampson, Hugh, Senna, Gianenrico, Sitkauskiene, Brigita, Smith, Peter Kenneth, Stevanovic, Katarina, Stoleski, Sasho, Szajewska, Hania, Tanaka, Akio, Todo-Bom, Ana, Topal, Fatih Alexander, Valovirta, Erkka, Van Ree, Ronald, Venter, Carina, Woehrl, Stefan, Wong, Gary W. K., Zhao, Zuotao, Worm, Margitta, Zuberbier, Torsten, Doerr, Tamara, Aberer, Werner, Alvaro, Montserrat, Angier, Elizabeth, Arasi, Stefania, Arshad, Hasan, Ballmer-Weber, Barbara, Bartra, Joan, Beck, Lisa, Begin, Philippe, Bindslev-Jensen, Carsten, Bislimovska, Jovanka, Bousquet, Jean, Brockow, Knut, Bush, Andrew, Cianferoni, Antonella, Cork, Michael J., Custovic, Adnan, Darsow, Ulf, Jong, Nicolette, Deleanu, Diana, Del Giacco, Stefano, Deschildre, Antoine, Galvin, Audrey Dunn, Ebisawa, Motohiro, Fernandez-Rivas, Montserrat, Ferrer, Marta, Fiocchi, Alessandro, van Wijk, Roy Gerth, Gotua, Maia, Grimshaw, Kate, Gruenhagen, Josefine, Heffler, Enrico, Hide, Michihiro, Hoffmann-Sommergruber, Karin, Incorvaia, Cristoforo, Janson, Christer, John, Swen Malte, Jones, Carla, Jutel, Marek, Katoh, Norito, Kendziora, Benjamin, Kinaciyan, Tamar, Knol, Edward, Kurbacheva, Oksana, Lau, Susanne, Loh, Richard, Lombardi, Carlo, Makela, Mika, Marchisotto, Mary Jane, Makris, Michael, Maurer, Marcus, Meyer, Rosan, Mijakoski, Dragan, Minov, Jordan, Mullol, Joaquim, Nilsson, Caroline, Nowak-Wegrzyn, Anna, Nwaru, Bright, I, Odemyr, Mikela, Pajno, Giovanni Battista, Paudel, Sushil, Papadopoulos, Nikolaos G., Renz, Harald, Ricci, Giampaolo, Ring, Johannes, Rogala, Barbara, Sampson, Hugh, Senna, Gianenrico, Sitkauskiene, Brigita, Smith, Peter Kenneth, Stevanovic, Katarina, Stoleski, Sasho, Szajewska, Hania, Tanaka, Akio, Todo-Bom, Ana, Topal, Fatih Alexander, Valovirta, Erkka, Van Ree, Ronald, Venter, Carina, Woehrl, Stefan, Wong, Gary W. K., Zhao, Zuotao, and Worm, Margitta
Abstract: Background Food anaphylaxis is commonly elicited by unintentional ingestion of foods containing the allergen above the tolerance threshold level of the individual. While labeling the 14 main allergens used as ingredients in food products is mandatory in the EU, there is no legal definition of declaring potential contaminants. Precautionary allergen labeling such as "may contain traces of" is often used. However, this is unsatisfactory for consumers as they get no information if the contamination is below their personal threshold. In discussions with the food industry and technologists, it was suggested to use a voluntary declaration indicating that all declared contaminants are below a threshold of 0.5 mg protein per 100 g of food. This concentration is known to be below the threshold of most patients, and it can be technically guaranteed in most food production. However, it was also important to assess that in case of accidental ingestion of contaminants below this threshold by highly allergic patients, no fatal anaphylactic reaction could occur. Therefore, we performed a systematic review to assess whether a fatal reaction to 5mg of protein or less has been reported, assuming that a maximum portion size of 1kg of a processed food exceeds any meal and thus gives a sufficient safety margin. Methods MEDLINE and EMBASE were searched until 24 January 2021 for provocation studies and case reports in which one of the 14 major food allergens was reported to elicit fatal or life-threatening anaphylactic reactions and assessed if these occurred below the ingestion of 5mg of protein. A Delphi process was performed to obtain an expert consensus on the results. Results In the 210 studies included, in our search, no reports of fatal anaphylactic reactions reported below 5 mg protein ingested were identified. However, in provocation studies and case reports, severe reactions below 5 mg were reported for the following allergens: eggs, fish, lupin, milk, nuts, peanuts, soy, and se
Published: 2022
Full Text: View/download PDF

8. Proposal of 0.5 mg of protein/100 g of processed food as threshold for voluntary declaration of food allergen traces in processed food-A first step in an initiative to better inform patients and avoid fatal allergic reactions : A GA(2)LEN position paper

Author: Zuberbier, Torsten, Doerr, Tamara, Aberer, Werner, Alvaro, Montserrat, Angier, Elizabeth, Arasi, Stefania, Arshad, Hasan, Ballmer-Weber, Barbara, Bartra, Joan, Beck, Lisa, Begin, Philippe, Bindslev-Jensen, Carsten, Bislimovska, Jovanka, Bousquet, Jean, Brockow, Knut, Bush, Andrew, Cianferoni, Antonella, Cork, Michael J., Custovic, Adnan, Darsow, Ulf, Jong, Nicolette, Deleanu, Diana, Del Giacco, Stefano, Deschildre, Antoine, Galvin, Audrey Dunn, Ebisawa, Motohiro, Fernandez-Rivas, Montserrat, Ferrer, Marta, Fiocchi, Alessandro, van Wijk, Roy Gerth, Gotua, Maia, Grimshaw, Kate, Gruenhagen, Josefine, Heffler, Enrico, Hide, Michihiro, Hoffmann-Sommergruber, Karin, Incorvaia, Cristoforo, Janson, Christer, John, Swen Malte, Jones, Carla, Jutel, Marek, Katoh, Norito, Kendziora, Benjamin, Kinaciyan, Tamar, Knol, Edward, Kurbacheva, Oksana, Lau, Susanne, Loh, Richard, Lombardi, Carlo, Makela, Mika, Marchisotto, Mary Jane, Makris, Michael, Maurer, Marcus, Meyer, Rosan, Mijakoski, Dragan, Minov, Jordan, Mullol, Joaquim, Nilsson, Caroline, Nowak-Wegrzyn, Anna, Nwaru, Bright, I, Odemyr, Mikela, Pajno, Giovanni Battista, Paudel, Sushil, Papadopoulos, Nikolaos G., Renz, Harald, Ricci, Giampaolo, Ring, Johannes, Rogala, Barbara, Sampson, Hugh, Senna, Gianenrico, Sitkauskiene, Brigita, Smith, Peter Kenneth, Stevanovic, Katarina, Stoleski, Sasho, Szajewska, Hania, Tanaka, Akio, Todo-Bom, Ana, Topal, Fatih Alexander, Valovirta, Erkka, Van Ree, Ronald, Venter, Carina, Woehrl, Stefan, Wong, Gary W. K., Zhao, Zuotao, Worm, Margitta, Zuberbier, Torsten, Doerr, Tamara, Aberer, Werner, Alvaro, Montserrat, Angier, Elizabeth, Arasi, Stefania, Arshad, Hasan, Ballmer-Weber, Barbara, Bartra, Joan, Beck, Lisa, Begin, Philippe, Bindslev-Jensen, Carsten, Bislimovska, Jovanka, Bousquet, Jean, Brockow, Knut, Bush, Andrew, Cianferoni, Antonella, Cork, Michael J., Custovic, Adnan, Darsow, Ulf, Jong, Nicolette, Deleanu, Diana, Del Giacco, Stefano, Deschildre, Antoine, Galvin, Audrey Dunn, Ebisawa, Motohiro, Fernandez-Rivas, Montserrat, Ferrer, Marta, Fiocchi, Alessandro, van Wijk, Roy Gerth, Gotua, Maia, Grimshaw, Kate, Gruenhagen, Josefine, Heffler, Enrico, Hide, Michihiro, Hoffmann-Sommergruber, Karin, Incorvaia, Cristoforo, Janson, Christer, John, Swen Malte, Jones, Carla, Jutel, Marek, Katoh, Norito, Kendziora, Benjamin, Kinaciyan, Tamar, Knol, Edward, Kurbacheva, Oksana, Lau, Susanne, Loh, Richard, Lombardi, Carlo, Makela, Mika, Marchisotto, Mary Jane, Makris, Michael, Maurer, Marcus, Meyer, Rosan, Mijakoski, Dragan, Minov, Jordan, Mullol, Joaquim, Nilsson, Caroline, Nowak-Wegrzyn, Anna, Nwaru, Bright, I, Odemyr, Mikela, Pajno, Giovanni Battista, Paudel, Sushil, Papadopoulos, Nikolaos G., Renz, Harald, Ricci, Giampaolo, Ring, Johannes, Rogala, Barbara, Sampson, Hugh, Senna, Gianenrico, Sitkauskiene, Brigita, Smith, Peter Kenneth, Stevanovic, Katarina, Stoleski, Sasho, Szajewska, Hania, Tanaka, Akio, Todo-Bom, Ana, Topal, Fatih Alexander, Valovirta, Erkka, Van Ree, Ronald, Venter, Carina, Woehrl, Stefan, Wong, Gary W. K., Zhao, Zuotao, and Worm, Margitta
Abstract: Background Food anaphylaxis is commonly elicited by unintentional ingestion of foods containing the allergen above the tolerance threshold level of the individual. While labeling the 14 main allergens used as ingredients in food products is mandatory in the EU, there is no legal definition of declaring potential contaminants. Precautionary allergen labeling such as "may contain traces of" is often used. However, this is unsatisfactory for consumers as they get no information if the contamination is below their personal threshold. In discussions with the food industry and technologists, it was suggested to use a voluntary declaration indicating that all declared contaminants are below a threshold of 0.5 mg protein per 100 g of food. This concentration is known to be below the threshold of most patients, and it can be technically guaranteed in most food production. However, it was also important to assess that in case of accidental ingestion of contaminants below this threshold by highly allergic patients, no fatal anaphylactic reaction could occur. Therefore, we performed a systematic review to assess whether a fatal reaction to 5mg of protein or less has been reported, assuming that a maximum portion size of 1kg of a processed food exceeds any meal and thus gives a sufficient safety margin. Methods MEDLINE and EMBASE were searched until 24 January 2021 for provocation studies and case reports in which one of the 14 major food allergens was reported to elicit fatal or life-threatening anaphylactic reactions and assessed if these occurred below the ingestion of 5mg of protein. A Delphi process was performed to obtain an expert consensus on the results. Results In the 210 studies included, in our search, no reports of fatal anaphylactic reactions reported below 5 mg protein ingested were identified. However, in provocation studies and case reports, severe reactions below 5 mg were reported for the following allergens: eggs, fish, lupin, milk, nuts, peanuts, soy, and se
Published: 2022
Full Text: View/download PDF

9. Proposal of 0.5 mg of protein/100 g of processed food as threshold for voluntary declaration of food allergen traces in processed food-A first step in an initiative to better inform patients and avoid fatal allergic reactions : A GA(2)LEN position paper

Author: Zuberbier, Torsten, Doerr, Tamara, Aberer, Werner, Alvaro, Montserrat, Angier, Elizabeth, Arasi, Stefania, Arshad, Hasan, Ballmer-Weber, Barbara, Bartra, Joan, Beck, Lisa, Begin, Philippe, Bindslev-Jensen, Carsten, Bislimovska, Jovanka, Bousquet, Jean, Brockow, Knut, Bush, Andrew, Cianferoni, Antonella, Cork, Michael J., Custovic, Adnan, Darsow, Ulf, Jong, Nicolette, Deleanu, Diana, Del Giacco, Stefano, Deschildre, Antoine, Galvin, Audrey Dunn, Ebisawa, Motohiro, Fernandez-Rivas, Montserrat, Ferrer, Marta, Fiocchi, Alessandro, van Wijk, Roy Gerth, Gotua, Maia, Grimshaw, Kate, Gruenhagen, Josefine, Heffler, Enrico, Hide, Michihiro, Hoffmann-Sommergruber, Karin, Incorvaia, Cristoforo, Janson, Christer, John, Swen Malte, Jones, Carla, Jutel, Marek, Katoh, Norito, Kendziora, Benjamin, Kinaciyan, Tamar, Knol, Edward, Kurbacheva, Oksana, Lau, Susanne, Loh, Richard, Lombardi, Carlo, Makela, Mika, Marchisotto, Mary Jane, Makris, Michael, Maurer, Marcus, Meyer, Rosan, Mijakoski, Dragan, Minov, Jordan, Mullol, Joaquim, Nilsson, Caroline, Nowak-Wegrzyn, Anna, Nwaru, Bright, I, Odemyr, Mikela, Pajno, Giovanni Battista, Paudel, Sushil, Papadopoulos, Nikolaos G., Renz, Harald, Ricci, Giampaolo, Ring, Johannes, Rogala, Barbara, Sampson, Hugh, Senna, Gianenrico, Sitkauskiene, Brigita, Smith, Peter Kenneth, Stevanovic, Katarina, Stoleski, Sasho, Szajewska, Hania, Tanaka, Akio, Todo-Bom, Ana, Topal, Fatih Alexander, Valovirta, Erkka, Van Ree, Ronald, Venter, Carina, Woehrl, Stefan, Wong, Gary W. K., Zhao, Zuotao, Worm, Margitta, Zuberbier, Torsten, Doerr, Tamara, Aberer, Werner, Alvaro, Montserrat, Angier, Elizabeth, Arasi, Stefania, Arshad, Hasan, Ballmer-Weber, Barbara, Bartra, Joan, Beck, Lisa, Begin, Philippe, Bindslev-Jensen, Carsten, Bislimovska, Jovanka, Bousquet, Jean, Brockow, Knut, Bush, Andrew, Cianferoni, Antonella, Cork, Michael J., Custovic, Adnan, Darsow, Ulf, Jong, Nicolette, Deleanu, Diana, Del Giacco, Stefano, Deschildre, Antoine, Galvin, Audrey Dunn, Ebisawa, Motohiro, Fernandez-Rivas, Montserrat, Ferrer, Marta, Fiocchi, Alessandro, van Wijk, Roy Gerth, Gotua, Maia, Grimshaw, Kate, Gruenhagen, Josefine, Heffler, Enrico, Hide, Michihiro, Hoffmann-Sommergruber, Karin, Incorvaia, Cristoforo, Janson, Christer, John, Swen Malte, Jones, Carla, Jutel, Marek, Katoh, Norito, Kendziora, Benjamin, Kinaciyan, Tamar, Knol, Edward, Kurbacheva, Oksana, Lau, Susanne, Loh, Richard, Lombardi, Carlo, Makela, Mika, Marchisotto, Mary Jane, Makris, Michael, Maurer, Marcus, Meyer, Rosan, Mijakoski, Dragan, Minov, Jordan, Mullol, Joaquim, Nilsson, Caroline, Nowak-Wegrzyn, Anna, Nwaru, Bright, I, Odemyr, Mikela, Pajno, Giovanni Battista, Paudel, Sushil, Papadopoulos, Nikolaos G., Renz, Harald, Ricci, Giampaolo, Ring, Johannes, Rogala, Barbara, Sampson, Hugh, Senna, Gianenrico, Sitkauskiene, Brigita, Smith, Peter Kenneth, Stevanovic, Katarina, Stoleski, Sasho, Szajewska, Hania, Tanaka, Akio, Todo-Bom, Ana, Topal, Fatih Alexander, Valovirta, Erkka, Van Ree, Ronald, Venter, Carina, Woehrl, Stefan, Wong, Gary W. K., Zhao, Zuotao, and Worm, Margitta
Abstract: Background Food anaphylaxis is commonly elicited by unintentional ingestion of foods containing the allergen above the tolerance threshold level of the individual. While labeling the 14 main allergens used as ingredients in food products is mandatory in the EU, there is no legal definition of declaring potential contaminants. Precautionary allergen labeling such as "may contain traces of" is often used. However, this is unsatisfactory for consumers as they get no information if the contamination is below their personal threshold. In discussions with the food industry and technologists, it was suggested to use a voluntary declaration indicating that all declared contaminants are below a threshold of 0.5 mg protein per 100 g of food. This concentration is known to be below the threshold of most patients, and it can be technically guaranteed in most food production. However, it was also important to assess that in case of accidental ingestion of contaminants below this threshold by highly allergic patients, no fatal anaphylactic reaction could occur. Therefore, we performed a systematic review to assess whether a fatal reaction to 5mg of protein or less has been reported, assuming that a maximum portion size of 1kg of a processed food exceeds any meal and thus gives a sufficient safety margin. Methods MEDLINE and EMBASE were searched until 24 January 2021 for provocation studies and case reports in which one of the 14 major food allergens was reported to elicit fatal or life-threatening anaphylactic reactions and assessed if these occurred below the ingestion of 5mg of protein. A Delphi process was performed to obtain an expert consensus on the results. Results In the 210 studies included, in our search, no reports of fatal anaphylactic reactions reported below 5 mg protein ingested were identified. However, in provocation studies and case reports, severe reactions below 5 mg were reported for the following allergens: eggs, fish, lupin, milk, nuts, peanuts, soy, and se
Published: 2022
Full Text: View/download PDF

10. Protocol for a systematic review of the diagnostic test accuracy of tests for IgE-mediated food allergy

Author: Genuneit, Jon, Jayasinghe, Sashini, Riggioni, Carmen, Peters, Rachel Louise, Chu, Derek K., Munblit, Daniel, Boyle, Robert J., Du Toit, George, Skypala, Isabel, Santos, Alexandra F., Akdis, Cezmi A., Alvarez-Perea, Alberto, Lozano, Montserrat Alvaro, Asero, Riccardo, Ballmer-Weber, Barbara, Barber, Domingo, Barni, Simona, Pajno, Giovanni Battista, Beyer, Kirsten, Bindslev-Jensen, Carsten, Brough, Helen, Buyuktiryaki, Betul, de Oliveira, Lucila Camargo Lopes, Cianferoni, Antonella, Chinthrajah, R. Sharon, Parker, Sean N., Giacco, Stefano Del, DunnGalvin, Audrey, Eberlein, Bernadette, Ebisawa, Motohiro, Eigenmann, Philippe, Eiwegger, Thomas, Faber, Margaretha, Fernandez-Rivas, Montserrat, Feeney, Mary, Fisher, Helen, Giovannini, Mattia, Halken, Susanne, Hoffmann-Sommergruber, Karin, Jaumdally, Hannah, Jones, Christina J., Knibb, Rebecca, Knol, Edward, Konstantinou, George N., Krawiec, Marta, Lau, Susanne, Mayorga, Lina, Marques-Mejias, M. Andreina, Meyer, Rosan, Moya, Beatriz, the EAACI Food Allergy Guidelines Expert Group, the EAACI Resear, Genuneit, Jon, Jayasinghe, Sashini, Riggioni, Carmen, Peters, Rachel Louise, Chu, Derek K., Munblit, Daniel, Boyle, Robert J., Du Toit, George, Skypala, Isabel, Santos, Alexandra F., Akdis, Cezmi A., Alvarez-Perea, Alberto, Lozano, Montserrat Alvaro, Asero, Riccardo, Ballmer-Weber, Barbara, Barber, Domingo, Barni, Simona, Pajno, Giovanni Battista, Beyer, Kirsten, Bindslev-Jensen, Carsten, Brough, Helen, Buyuktiryaki, Betul, de Oliveira, Lucila Camargo Lopes, Cianferoni, Antonella, Chinthrajah, R. Sharon, Parker, Sean N., Giacco, Stefano Del, DunnGalvin, Audrey, Eberlein, Bernadette, Ebisawa, Motohiro, Eigenmann, Philippe, Eiwegger, Thomas, Faber, Margaretha, Fernandez-Rivas, Montserrat, Feeney, Mary, Fisher, Helen, Giovannini, Mattia, Halken, Susanne, Hoffmann-Sommergruber, Karin, Jaumdally, Hannah, Jones, Christina J., Knibb, Rebecca, Knol, Edward, Konstantinou, George N., Krawiec, Marta, Lau, Susanne, Mayorga, Lina, Marques-Mejias, M. Andreina, Meyer, Rosan, Moya, Beatriz, and the EAACI Food Allergy Guidelines Expert Group, the EAACI Resear
Abstract: Background: The European Academy of Allergy and Clinical Immunology (EAACI) is in the process of updating the guidelines on the diagnosis and management of food allergy. The existing guidelines are based on a systematic review of the literature until 30 September 2012. Therefore, a new systematic review must be undertaken to inform the new guidelines. This systematic review aims to assess the accuracy of index tests to support the diagnosis of IgE-mediated food allergy. Methods: The databases Cochrane CENTRAL (Trials), MEDLINE (OVID) and Embase (OVID) will be searched for diagnostic test accuracy studies from 1 October 2012 to 30 June 2021. Inclusion and exclusion criteria will be used to select appropriate studies. Data from these studies will be extracted and tabulated, and then reviewed for risk of bias and applicability using the QUADAS-2 tool. All evaluations will be done in duplicate. Studies with a high risk of bias and low applicability will be excluded. Meta-analysis will be performed if there are three or more studies of the same index test and food. Results: A protocol for the systematic review and meta-analyses is presented and was registered using Prospero prior to commencing the literature search. Discussion: Oral food challenges are the reference standard for diagnosis but involve considerable risks and resources. This protocol for systematic review aims to assess the accuracy of various tests to diagnose food allergy, which can be useful in both clinical and research settings.
Published: 2022

11. Protocol for a systematic review of the diagnostic test accuracy of tests for IgE-mediated food allergy

Author: Genuneit, Jon, Jayasinghe, Sashini, Riggioni, Carmen, Peters, Rachel Louise, Chu, Derek K., Munblit, Daniel, Boyle, Robert J., Du Toit, George, Skypala, Isabel, Santos, Alexandra F., Akdis, Cezmi A., Alvarez-Perea, Alberto, Lozano, Montserrat Alvaro, Asero, Riccardo, Ballmer-Weber, Barbara, Barber, Domingo, Barni, Simona, Pajno, Giovanni Battista, Beyer, Kirsten, Bindslev-Jensen, Carsten, Brough, Helen, Buyuktiryaki, Betul, de Oliveira, Lucila Camargo Lopes, Cianferoni, Antonella, Chinthrajah, R. Sharon, Parker, Sean N., Giacco, Stefano Del, DunnGalvin, Audrey, Eberlein, Bernadette, Ebisawa, Motohiro, Eigenmann, Philippe, Eiwegger, Thomas, Faber, Margaretha, Fernandez-Rivas, Montserrat, Feeney, Mary, Fisher, Helen, Giovannini, Mattia, Halken, Susanne, Hoffmann-Sommergruber, Karin, Jaumdally, Hannah, Jones, Christina J., Knibb, Rebecca, Knol, Edward, Konstantinou, George N., Krawiec, Marta, Lau, Susanne, Mayorga, Lina, Marques-Mejias, M. Andreina, Meyer, Rosan, Moya, Beatriz, the EAACI Food Allergy Guidelines Expert Group, the EAACI Resear, Genuneit, Jon, Jayasinghe, Sashini, Riggioni, Carmen, Peters, Rachel Louise, Chu, Derek K., Munblit, Daniel, Boyle, Robert J., Du Toit, George, Skypala, Isabel, Santos, Alexandra F., Akdis, Cezmi A., Alvarez-Perea, Alberto, Lozano, Montserrat Alvaro, Asero, Riccardo, Ballmer-Weber, Barbara, Barber, Domingo, Barni, Simona, Pajno, Giovanni Battista, Beyer, Kirsten, Bindslev-Jensen, Carsten, Brough, Helen, Buyuktiryaki, Betul, de Oliveira, Lucila Camargo Lopes, Cianferoni, Antonella, Chinthrajah, R. Sharon, Parker, Sean N., Giacco, Stefano Del, DunnGalvin, Audrey, Eberlein, Bernadette, Ebisawa, Motohiro, Eigenmann, Philippe, Eiwegger, Thomas, Faber, Margaretha, Fernandez-Rivas, Montserrat, Feeney, Mary, Fisher, Helen, Giovannini, Mattia, Halken, Susanne, Hoffmann-Sommergruber, Karin, Jaumdally, Hannah, Jones, Christina J., Knibb, Rebecca, Knol, Edward, Konstantinou, George N., Krawiec, Marta, Lau, Susanne, Mayorga, Lina, Marques-Mejias, M. Andreina, Meyer, Rosan, Moya, Beatriz, and the EAACI Food Allergy Guidelines Expert Group, the EAACI Resear
Abstract: Background: The European Academy of Allergy and Clinical Immunology (EAACI) is in the process of updating the guidelines on the diagnosis and management of food allergy. The existing guidelines are based on a systematic review of the literature until 30 September 2012. Therefore, a new systematic review must be undertaken to inform the new guidelines. This systematic review aims to assess the accuracy of index tests to support the diagnosis of IgE-mediated food allergy. Methods: The databases Cochrane CENTRAL (Trials), MEDLINE (OVID) and Embase (OVID) will be searched for diagnostic test accuracy studies from 1 October 2012 to 30 June 2021. Inclusion and exclusion criteria will be used to select appropriate studies. Data from these studies will be extracted and tabulated, and then reviewed for risk of bias and applicability using the QUADAS-2 tool. All evaluations will be done in duplicate. Studies with a high risk of bias and low applicability will be excluded. Meta-analysis will be performed if there are three or more studies of the same index test and food. Results: A protocol for the systematic review and meta-analyses is presented and was registered using Prospero prior to commencing the literature search. Discussion: Oral food challenges are the reference standard for diagnosis but involve considerable risks and resources. This protocol for systematic review aims to assess the accuracy of various tests to diagnose food allergy, which can be useful in both clinical and research settings.
Published: 2022

12. Development and validation of the Food Allergy Severity Score

Author: Fernández-Rivas, Montserrat, Gómez García, Ismael, Gonzalo-Fernández, Alejandro, Fuentes Ferrer, Manuel, Dölle-Bierke, Sabine, Marco-Martín, Guadalupe, Ballmer-Weber, Barbara K, Asero, Riccardo, Belohlavkova, Simona, Beyer, Kirsten, de Blay, Frédéric, Clausen, Michael, Datema, Mareen R, Dubakiene, Ruta, Grimshaw, Kate E C, Hoffmann-Sommergruber, Karin, Hourihane, Jonathan O'B, Jedrzejczak-Czechowicz, Monika, Knulst, André C, Kralimarkova, Tanya, Le, Thuy-My, Papadopoulos, Nikolaos G, Popov, Todor A, Poulsen, Lars K, Purohit, Ashok, Seneviratne, Suranjith L, Simpson, Angela, Sinaniotis, Atanasios, Turkalji, Mirjana, Vázquez-Cortés, Sonia, Vera-Berrios, Rosialzira N, Muraro, Antonella, Worm, Margitta, Roberts, Graham, van Ree, Ronald, Fernández-Pérez, Cristina, Turner, Paul J, Mills, Elizabeth N Clare, Fernández-Rivas, Montserrat, Gómez García, Ismael, Gonzalo-Fernández, Alejandro, Fuentes Ferrer, Manuel, Dölle-Bierke, Sabine, Marco-Martín, Guadalupe, Ballmer-Weber, Barbara K, Asero, Riccardo, Belohlavkova, Simona, Beyer, Kirsten, de Blay, Frédéric, Clausen, Michael, Datema, Mareen R, Dubakiene, Ruta, Grimshaw, Kate E C, Hoffmann-Sommergruber, Karin, Hourihane, Jonathan O'B, Jedrzejczak-Czechowicz, Monika, Knulst, André C, Kralimarkova, Tanya, Le, Thuy-My, Papadopoulos, Nikolaos G, Popov, Todor A, Poulsen, Lars K, Purohit, Ashok, Seneviratne, Suranjith L, Simpson, Angela, Sinaniotis, Atanasios, Turkalji, Mirjana, Vázquez-Cortés, Sonia, Vera-Berrios, Rosialzira N, Muraro, Antonella, Worm, Margitta, Roberts, Graham, van Ree, Ronald, Fernández-Pérez, Cristina, Turner, Paul J, and Mills, Elizabeth N Clare
Abstract: BACKGROUND: The heterogeneity and lack of validation of existing severity scores for food allergic reactions limit standardization of case management and research advances. We aimed to develop and validate a severity score for food allergic reactions.METHODS: Following a multidisciplinary experts consensus, it was decided to develop a food allergy severity score (FASS) with ordinal (oFASS) and numerical (nFASS) formats. oFASS with 3 and 5 grades were generated through expert consensus, and nFASS by mathematical modeling. Evaluation was performed in the EuroPrevall outpatient clinic cohort (8232 food reactions) by logistic regression with request of emergency care and medications used as outcomes. Discrimination, classification, and calibration were calculated. Bootstrapping internal validation was followed by external validation (logistic regression) in 5 cohorts (3622 food reactions). Correlation of nFASS with the severity classification done by expert allergy clinicians by Best-Worst Scaling of 32 food reactions was calculated.RESULTS: oFASS and nFASS map consistently, with nFASS having greater granularity. With the outcomes emergency care, adrenaline and critical medical treatment, oFASS and nFASS had a good discrimination (receiver operating characteristic area under the curve [ROC-AUC]>0.80), classification (sensitivity 0.87-0.92, specificity 0.73-0.78), and calibration. Bootstrapping over ROC-AUC showed negligible biases (1.0 × 10-6 -1.23 × 10-3 ). In external validation, nFASS performed best with higher ROC-AUC. nFASS was strongly correlated (R 0.89) to best-worst scoring of 334 expert clinicians.CONCLUSION: FASS is a validated and reliable method to measure severity of food allergic reactions. The ordinal and numerical versions that map onto each other are suitable for use by different stakeholders in different settings.
Published: 2022

13. Proposal of 0.5 mg of protein/100 g of processed food as threshold for voluntary declaration of food allergen traces in processed food—A first step in an initiative to better inform patients and avoid fatal allergic reactions:A GA²LEN position paper

Author: Zuberbier, Torsten, Dörr, Tamara, Aberer, Werner, Alvaro, Montserrat, Angier, Elizabeth, Arasi, Stefania, Arshad, Hasan, Ballmer-Weber, Barbara, Bartra, Joan, Beck, Lisa, Bégin, Philippe, Bindslev-Jensen, Carsten, Bislimovska, Jovanka, Bousquet, Jean, Brockow, Knut, Bush, Andrew, Cianferoni, Antonella, Cork, Michael J., Custovic, Adnan, Darsow, Ulf, de Jong, Nicolette, Deleanu, Diana, Del Giacco, Stefano, Deschildre, Antoine, Dunn Galvin, Audrey, Ebisawa, Motohiro, Fernández-Rivas, Montserrat, Ferrer, Marta, Fiocchi, Alessandro, Gerth van Wijk, Roy, Gotua, Maia, Grimshaw, Kate, Grünhagen, Josefine, Heffler, Enrico, Hide, Michihiro, Hoffmann-Sommergruber, Karin, Incorvaia, Cristoforo, Janson, Christer, Malte John, Swen, Jones, Carla, Jutel, Marek, Katoh, Norito, Kendziora, Benjamin, Kinaciyan, Tamar, Knol, Edward, Kurbacheva, Oksana, Lau, Susanne, Loh, Richard, Lombardi, Carlo, Mäkelä, Mika, Marchisotto, Mary Jane, Makris, Michael, Maurer, Marcus, Meyer, Rosan, Mijakoski, Dragan, Minov, Jordan, Mullol, Joaquim, Nilsson, Caroline, Nowak–Wegrzyn, Anna, Nwaru, Bright I., Odemyr, Mikela, Pajno, Giovanni Battista, Paudel, Sushil, Papadopoulos, Nikolaos G., Renz, Harald, Ricci, Giampaolo, Ring, Johannes, Rogala, Barbara, Sampson, Hugh, Senna, Gianenrico, Sitkauskiene, Brigita, Smith, Peter Kenneth, Stevanovic, Katarina, Stoleski, Sasho, Szajewska, Hania, Tanaka, Akio, Todo-Bom, Ana, Topal, Fatih Alexander, Valovirta, Erkka, Van Ree, Ronald, Venter, Carina, Wöhrl, Stefan, Wong, Gary W.K., Zhao, Zuotao, Worm, Margitta, Zuberbier, Torsten, Dörr, Tamara, Aberer, Werner, Alvaro, Montserrat, Angier, Elizabeth, Arasi, Stefania, Arshad, Hasan, Ballmer-Weber, Barbara, Bartra, Joan, Beck, Lisa, Bégin, Philippe, Bindslev-Jensen, Carsten, Bislimovska, Jovanka, Bousquet, Jean, Brockow, Knut, Bush, Andrew, Cianferoni, Antonella, Cork, Michael J., Custovic, Adnan, Darsow, Ulf, de Jong, Nicolette, Deleanu, Diana, Del Giacco, Stefano, Deschildre, Antoine, Dunn Galvin, Audrey, Ebisawa, Motohiro, Fernández-Rivas, Montserrat, Ferrer, Marta, Fiocchi, Alessandro, Gerth van Wijk, Roy, Gotua, Maia, Grimshaw, Kate, Grünhagen, Josefine, Heffler, Enrico, Hide, Michihiro, Hoffmann-Sommergruber, Karin, Incorvaia, Cristoforo, Janson, Christer, Malte John, Swen, Jones, Carla, Jutel, Marek, Katoh, Norito, Kendziora, Benjamin, Kinaciyan, Tamar, Knol, Edward, Kurbacheva, Oksana, Lau, Susanne, Loh, Richard, Lombardi, Carlo, Mäkelä, Mika, Marchisotto, Mary Jane, Makris, Michael, Maurer, Marcus, Meyer, Rosan, Mijakoski, Dragan, Minov, Jordan, Mullol, Joaquim, Nilsson, Caroline, Nowak–Wegrzyn, Anna, Nwaru, Bright I., Odemyr, Mikela, Pajno, Giovanni Battista, Paudel, Sushil, Papadopoulos, Nikolaos G., Renz, Harald, Ricci, Giampaolo, Ring, Johannes, Rogala, Barbara, Sampson, Hugh, Senna, Gianenrico, Sitkauskiene, Brigita, Smith, Peter Kenneth, Stevanovic, Katarina, Stoleski, Sasho, Szajewska, Hania, Tanaka, Akio, Todo-Bom, Ana, Topal, Fatih Alexander, Valovirta, Erkka, Van Ree, Ronald, Venter, Carina, Wöhrl, Stefan, Wong, Gary W.K., Zhao, Zuotao, and Worm, Margitta
Abstract: Background: Food anaphylaxis is commonly elicited by unintentional ingestion of foods containing the allergen above the tolerance threshold level of the individual. While labeling the 14 main allergens used as ingredients in food products is mandatory in the EU, there is no legal definition of declaring potential contaminants. Precautionary allergen labeling such as “may contain traces of” is often used. However, this is unsatisfactory for consumers as they get no information if the contamination is below their personal threshold. In discussions with the food industry and technologists, it was suggested to use a voluntary declaration indicating that all declared contaminants are below a threshold of 0.5 mg protein per 100 g of food. This concentration is known to be below the threshold of most patients, and it can be technically guaranteed in most food production. However, it was also important to assess that in case of accidental ingestion of contaminants below this threshold by highly allergic patients, no fatal anaphylactic reaction could occur. Therefore, we performed a systematic review to assess whether a fatal reaction to 5mg of protein or less has been reported, assuming that a maximum portion size of 1kg of a processed food exceeds any meal and thus gives a sufficient safety margin. Methods: MEDLINE and EMBASE were searched until 24 January 2021 for provocation studies and case reports in which one of the 14 major food allergens was reported to elicit fatal or life-threatening anaphylactic reactions and assessed if these occurred below the ingestion of 5mg of protein. A Delphi process was performed to obtain an expert consensus on the results. Results: In the 210 studies included, in our search, no reports of fatal anaphylactic reactions reported below 5 mg protein ingested were identified. However, in provocation studies and case reports, severe reactions below 5 mg were reported for the following allergens: eggs, fish, lupin, milk, nuts, peanuts, soy
Published: 2022

14. Managing food allergy:GA2LEN guideline 2022

Author: Muraro, Antonella, de Silva, Debra, Halken, Susanne, Worm, Margitta, Khaleva, Ekaterina, Arasi, Stefania, Dunn-Galvin, Audrey, Nwaru, Bright I., De Jong, Nicolette W., Rodríguez Del Río, Pablo, Turner, Paul J., Smith, Pete, Begin, Philippe, Angier, Elizabeth, Arshad, Hasan, Ballmer-Weber, Barbara, Beyer, Kirsten, Bindslev-Jensen, Carsten, Cianferoni, Antonella, Demoulin, Céline, Deschildre, Antoine, Ebisawa, Motohiro, Fernandez-Rivas, Maria Montserrat, Fiocchi, Alessandro, Flokstra-de Blok, Bertine, Gerdts, Jennifer, Gradman, Josefine, Grimshaw, Kate, Jones, Carla, Lau, Susanne, Loh, Richard, Alvaro Lozano, Montserrat, Makela, Mika, Marchisotto, Mary Jane, Meyer, Rosan, Mills, Clare, Nilsson, Caroline, Nowak-Wegrzyn, Anna, Nurmatov, Ulugbek, Pajno, Giovanni, Podestà, Marcia, Poulsen, Lars K., Sampson, Hugh A., Sanchez, Angel, Schnadt, Sabine, Szajewska, Hania, Van Ree, Ronald, Venter, Carina, Vlieg-Boerstra, Berber, Warner, Amena, Zuberbier, Torsten, Roberts, Graham, Muraro, Antonella, de Silva, Debra, Halken, Susanne, Worm, Margitta, Khaleva, Ekaterina, Arasi, Stefania, Dunn-Galvin, Audrey, Nwaru, Bright I., De Jong, Nicolette W., Rodríguez Del Río, Pablo, Turner, Paul J., Smith, Pete, Begin, Philippe, Angier, Elizabeth, Arshad, Hasan, Ballmer-Weber, Barbara, Beyer, Kirsten, Bindslev-Jensen, Carsten, Cianferoni, Antonella, Demoulin, Céline, Deschildre, Antoine, Ebisawa, Motohiro, Fernandez-Rivas, Maria Montserrat, Fiocchi, Alessandro, Flokstra-de Blok, Bertine, Gerdts, Jennifer, Gradman, Josefine, Grimshaw, Kate, Jones, Carla, Lau, Susanne, Loh, Richard, Alvaro Lozano, Montserrat, Makela, Mika, Marchisotto, Mary Jane, Meyer, Rosan, Mills, Clare, Nilsson, Caroline, Nowak-Wegrzyn, Anna, Nurmatov, Ulugbek, Pajno, Giovanni, Podestà, Marcia, Poulsen, Lars K., Sampson, Hugh A., Sanchez, Angel, Schnadt, Sabine, Szajewska, Hania, Van Ree, Ronald, Venter, Carina, Vlieg-Boerstra, Berber, Warner, Amena, Zuberbier, Torsten, and Roberts, Graham
Abstract: Food allergy affects approximately 2–4% of children and adults. This guideline provides recommendations for managing food allergy from the Global Allergy and Asthma European Network (GA2LEN). A multidisciplinary international Task Force developed the guideline using the Appraisal of Guidelines for Research and Evaluation (AGREE) II framework and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. We reviewed the latest available evidence as of April 2021 (161 studies) and created recommendations by balancing benefits, harms, feasibility, and patient and clinician experiences. We suggest that people diagnosed with food allergy avoid triggering allergens (low certainty evidence). We suggest that infants with cow's milk allergy who need a breastmilk alternative use either hypoallergenic extensively hydrolyzed cow's milk formula or an amino acid-based formula (moderate certainty). For selected children with peanut allergy, we recommend oral immunotherapy (high certainty), though epicutaneous immunotherapy might be considered depending on individual preferences and availability (moderate certainty). We suggest considering oral immunotherapy for children with persistent severe hen's egg or cow's milk allergy (moderate certainty). There are significant gaps in evidence about safety and effectiveness of the various strategies. Research is needed to determine the best approaches to education, how to predict the risk of severe reactions, whether immunotherapy is cost-effective and whether biological therapies are effective alone or combined with allergen immunotherapy.
Published: 2022

15. Proposal of 0.5 mg of protein/100 g of processed food as threshold for voluntary declaration of food allergen traces in processed food-A first step in an initiative to better inform patients and avoid fatal allergic reactions : A GA(2)LEN position paper

Author: Zuberbier, Torsten, Doerr, Tamara, Aberer, Werner, Alvaro, Montserrat, Angier, Elizabeth, Arasi, Stefania, Arshad, Hasan, Ballmer-Weber, Barbara, Bartra, Joan, Beck, Lisa, Begin, Philippe, Bindslev-Jensen, Carsten, Bislimovska, Jovanka, Bousquet, Jean, Brockow, Knut, Bush, Andrew, Cianferoni, Antonella, Cork, Michael J., Custovic, Adnan, Darsow, Ulf, Jong, Nicolette, Deleanu, Diana, Del Giacco, Stefano, Deschildre, Antoine, Galvin, Audrey Dunn, Ebisawa, Motohiro, Fernandez-Rivas, Montserrat, Ferrer, Marta, Fiocchi, Alessandro, van Wijk, Roy Gerth, Gotua, Maia, Grimshaw, Kate, Gruenhagen, Josefine, Heffler, Enrico, Hide, Michihiro, Hoffmann-Sommergruber, Karin, Incorvaia, Cristoforo, Janson, Christer, John, Swen Malte, Jones, Carla, Jutel, Marek, Katoh, Norito, Kendziora, Benjamin, Kinaciyan, Tamar, Knol, Edward, Kurbacheva, Oksana, Lau, Susanne, Loh, Richard, Lombardi, Carlo, Makela, Mika, Marchisotto, Mary Jane, Makris, Michael, Maurer, Marcus, Meyer, Rosan, Mijakoski, Dragan, Minov, Jordan, Mullol, Joaquim, Nilsson, Caroline, Nowak-Wegrzyn, Anna, Nwaru, Bright, I, Odemyr, Mikela, Pajno, Giovanni Battista, Paudel, Sushil, Papadopoulos, Nikolaos G., Renz, Harald, Ricci, Giampaolo, Ring, Johannes, Rogala, Barbara, Sampson, Hugh, Senna, Gianenrico, Sitkauskiene, Brigita, Smith, Peter Kenneth, Stevanovic, Katarina, Stoleski, Sasho, Szajewska, Hania, Tanaka, Akio, Todo-Bom, Ana, Topal, Fatih Alexander, Valovirta, Erkka, Van Ree, Ronald, Venter, Carina, Woehrl, Stefan, Wong, Gary W. K., Zhao, Zuotao, Worm, Margitta, Zuberbier, Torsten, Doerr, Tamara, Aberer, Werner, Alvaro, Montserrat, Angier, Elizabeth, Arasi, Stefania, Arshad, Hasan, Ballmer-Weber, Barbara, Bartra, Joan, Beck, Lisa, Begin, Philippe, Bindslev-Jensen, Carsten, Bislimovska, Jovanka, Bousquet, Jean, Brockow, Knut, Bush, Andrew, Cianferoni, Antonella, Cork, Michael J., Custovic, Adnan, Darsow, Ulf, Jong, Nicolette, Deleanu, Diana, Del Giacco, Stefano, Deschildre, Antoine, Galvin, Audrey Dunn, Ebisawa, Motohiro, Fernandez-Rivas, Montserrat, Ferrer, Marta, Fiocchi, Alessandro, van Wijk, Roy Gerth, Gotua, Maia, Grimshaw, Kate, Gruenhagen, Josefine, Heffler, Enrico, Hide, Michihiro, Hoffmann-Sommergruber, Karin, Incorvaia, Cristoforo, Janson, Christer, John, Swen Malte, Jones, Carla, Jutel, Marek, Katoh, Norito, Kendziora, Benjamin, Kinaciyan, Tamar, Knol, Edward, Kurbacheva, Oksana, Lau, Susanne, Loh, Richard, Lombardi, Carlo, Makela, Mika, Marchisotto, Mary Jane, Makris, Michael, Maurer, Marcus, Meyer, Rosan, Mijakoski, Dragan, Minov, Jordan, Mullol, Joaquim, Nilsson, Caroline, Nowak-Wegrzyn, Anna, Nwaru, Bright, I, Odemyr, Mikela, Pajno, Giovanni Battista, Paudel, Sushil, Papadopoulos, Nikolaos G., Renz, Harald, Ricci, Giampaolo, Ring, Johannes, Rogala, Barbara, Sampson, Hugh, Senna, Gianenrico, Sitkauskiene, Brigita, Smith, Peter Kenneth, Stevanovic, Katarina, Stoleski, Sasho, Szajewska, Hania, Tanaka, Akio, Todo-Bom, Ana, Topal, Fatih Alexander, Valovirta, Erkka, Van Ree, Ronald, Venter, Carina, Woehrl, Stefan, Wong, Gary W. K., Zhao, Zuotao, and Worm, Margitta
Abstract: Background Food anaphylaxis is commonly elicited by unintentional ingestion of foods containing the allergen above the tolerance threshold level of the individual. While labeling the 14 main allergens used as ingredients in food products is mandatory in the EU, there is no legal definition of declaring potential contaminants. Precautionary allergen labeling such as "may contain traces of" is often used. However, this is unsatisfactory for consumers as they get no information if the contamination is below their personal threshold. In discussions with the food industry and technologists, it was suggested to use a voluntary declaration indicating that all declared contaminants are below a threshold of 0.5 mg protein per 100 g of food. This concentration is known to be below the threshold of most patients, and it can be technically guaranteed in most food production. However, it was also important to assess that in case of accidental ingestion of contaminants below this threshold by highly allergic patients, no fatal anaphylactic reaction could occur. Therefore, we performed a systematic review to assess whether a fatal reaction to 5mg of protein or less has been reported, assuming that a maximum portion size of 1kg of a processed food exceeds any meal and thus gives a sufficient safety margin. Methods MEDLINE and EMBASE were searched until 24 January 2021 for provocation studies and case reports in which one of the 14 major food allergens was reported to elicit fatal or life-threatening anaphylactic reactions and assessed if these occurred below the ingestion of 5mg of protein. A Delphi process was performed to obtain an expert consensus on the results. Results In the 210 studies included, in our search, no reports of fatal anaphylactic reactions reported below 5 mg protein ingested were identified. However, in provocation studies and case reports, severe reactions below 5 mg were reported for the following allergens: eggs, fish, lupin, milk, nuts, peanuts, soy, and se
Published: 2022
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16. Development and validation of the Food Allergy Severity Score

Author: Fernández-Rivas, Montserrat, Gómez García, Ismael, Gonzalo-Fernández, Alejandro, Fuentes Ferrer, Manuel, Dölle-Bierke, Sabine, Marco-Martín, Guadalupe, Ballmer-Weber, Barbara K, Asero, Riccardo, Belohlavkova, Simona, Beyer, Kirsten, de Blay, Frédéric, Clausen, Michael, Datema, Mareen R, Dubakiene, Ruta, Grimshaw, Kate E C, Hoffmann-Sommergruber, Karin, Hourihane, Jonathan O'B, Jedrzejczak-Czechowicz, Monika, Knulst, André C, Kralimarkova, Tanya, Le, Thuy-My, Papadopoulos, Nikolaos G, Popov, Todor A, Poulsen, Lars K, Purohit, Ashok, Seneviratne, Suranjith L, Simpson, Angela, Sinaniotis, Atanasios, Turkalji, Mirjana, Vázquez-Cortés, Sonia, Vera-Berrios, Rosialzira N, Muraro, Antonella, Worm, Margitta, Roberts, Graham, van Ree, Ronald, Fernández-Pérez, Cristina, Turner, Paul J, Mills, Elizabeth N Clare, Fernández-Rivas, Montserrat, Gómez García, Ismael, Gonzalo-Fernández, Alejandro, Fuentes Ferrer, Manuel, Dölle-Bierke, Sabine, Marco-Martín, Guadalupe, Ballmer-Weber, Barbara K, Asero, Riccardo, Belohlavkova, Simona, Beyer, Kirsten, de Blay, Frédéric, Clausen, Michael, Datema, Mareen R, Dubakiene, Ruta, Grimshaw, Kate E C, Hoffmann-Sommergruber, Karin, Hourihane, Jonathan O'B, Jedrzejczak-Czechowicz, Monika, Knulst, André C, Kralimarkova, Tanya, Le, Thuy-My, Papadopoulos, Nikolaos G, Popov, Todor A, Poulsen, Lars K, Purohit, Ashok, Seneviratne, Suranjith L, Simpson, Angela, Sinaniotis, Atanasios, Turkalji, Mirjana, Vázquez-Cortés, Sonia, Vera-Berrios, Rosialzira N, Muraro, Antonella, Worm, Margitta, Roberts, Graham, van Ree, Ronald, Fernández-Pérez, Cristina, Turner, Paul J, and Mills, Elizabeth N Clare
Abstract: BACKGROUND: The heterogeneity and lack of validation of existing severity scores for food allergic reactions limit standardization of case management and research advances. We aimed to develop and validate a severity score for food allergic reactions.METHODS: Following a multidisciplinary experts consensus, it was decided to develop a food allergy severity score (FASS) with ordinal (oFASS) and numerical (nFASS) formats. oFASS with 3 and 5 grades were generated through expert consensus, and nFASS by mathematical modeling. Evaluation was performed in the EuroPrevall outpatient clinic cohort (8232 food reactions) by logistic regression with request of emergency care and medications used as outcomes. Discrimination, classification, and calibration were calculated. Bootstrapping internal validation was followed by external validation (logistic regression) in 5 cohorts (3622 food reactions). Correlation of nFASS with the severity classification done by expert allergy clinicians by Best-Worst Scaling of 32 food reactions was calculated.RESULTS: oFASS and nFASS map consistently, with nFASS having greater granularity. With the outcomes emergency care, adrenaline and critical medical treatment, oFASS and nFASS had a good discrimination (receiver operating characteristic area under the curve [ROC-AUC]>0.80), classification (sensitivity 0.87-0.92, specificity 0.73-0.78), and calibration. Bootstrapping over ROC-AUC showed negligible biases (1.0 × 10-6 -1.23 × 10-3 ). In external validation, nFASS performed best with higher ROC-AUC. nFASS was strongly correlated (R 0.89) to best-worst scoring of 334 expert clinicians.CONCLUSION: FASS is a validated and reliable method to measure severity of food allergic reactions. The ordinal and numerical versions that map onto each other are suitable for use by different stakeholders in different settings.
Published: 2022

17. EAACI guideline:Anaphylaxis (2021 update)

Author: Muraro, Antonella, Worm, Margitta, Alviani, Cherry, Cardona, Victoria, DunnGalvin, Audrey, Garvey, Lene H., Riggioni, Carmen, Silva, Debra de, Angier, Elizabeth, Arasi, Stefania, Bellou, Abdelouahab, Beyer, Kirsten, Bijlhout, Diola, Bilò, M. Beatrice, Bindslev-Jensen, Carsten, Brockow, Knut, Fernandez-Rivas, Montserrat, Halken, Susanne, Jensen, Britt, Khaleva, Ekaterina, Michaelis, Louise J., Elberink, Hanneke N. G. Oude, Regent, Lynne, Sanchez, Angel, Vlieg-Boerstra, Berber J., Roberts, Graham, Muraro, Antonella, Worm, Margitta, Alviani, Cherry, Cardona, Victoria, DunnGalvin, Audrey, Garvey, Lene H., Riggioni, Carmen, Silva, Debra de, Angier, Elizabeth, Arasi, Stefania, Bellou, Abdelouahab, Beyer, Kirsten, Bijlhout, Diola, Bilò, M. Beatrice, Bindslev-Jensen, Carsten, Brockow, Knut, Fernandez-Rivas, Montserrat, Halken, Susanne, Jensen, Britt, Khaleva, Ekaterina, Michaelis, Louise J., Elberink, Hanneke N. G. Oude, Regent, Lynne, Sanchez, Angel, Vlieg-Boerstra, Berber J., and Roberts, Graham
Abstract: Anaphylaxis is a clinical emergency which all healthcare professionals need to be able to recognise and manage. The European Academy of Allergy and Clinical Immunology Anaphylaxis multidisciplinary Task Force has updated the 2014 guideline. The guideline was developed using the AGREE II framework and the GRADE approach. The evidence was systematically reviewed and recommendations were created by weighing up benefits and harms. The guideline was peer-reviewed by external experts and reviewed in a public consultation. The use of clinical criteria to identify anaphylaxis is suggested with blood sampling for the later measurement of tryptase. The prompt use of intramuscular adrenaline as first line management is recommended with the availability of adrenaline autoinjectors to patients in the community. Pharmacokinetic data should be provided for adrenaline autoinjector devices. Structured, comprehensive training for people at risk of anaphylaxis is recommended. Simulation training and visual prompts for healthcare professionals are suggested to improve the management of anaphylaxis. It is suggested that school policies reflect anaphylaxis guidelines. The evidence for the management of anaphylaxis remains mostly at a very low level. There is an urgent need to prioritise clinical trials with the potential to improve the management of patients at risk of anaphylaxis., Anaphylaxis is a clinical emergency which all healthcare professionals need to be able to recognize and manage. The European Academy of Allergy and Clinical Immunology Anaphylaxis multidisciplinary Task Force has updated the 2014 guideline. The guideline was developed using the AGREE II framework and the GRADE approach. The evidence was systematically reviewed and recommendations were created by weighing up benefits and harms. The guideline was peer-reviewed by external experts and reviewed in a public consultation. The use of clinical criteria to identify anaphylaxis is suggested with blood sampling for the later measurement of tryptase. The prompt use of intramuscular adrenaline as first-line management is recommended with the availability of adrenaline autoinjectors to patients in the community. Pharmacokinetic data should be provided for adrenaline autoinjector devices. Structured, comprehensive training for people at risk of anaphylaxis is recommended. Simulation training and visual prompts for healthcare professionals are suggested to improve the management of anaphylaxis. It is suggested that school policies reflect anaphylaxis guidelines. The evidence for the management of anaphylaxis remains mostly at a very low level. There is an urgent need to prioritize clinical trials with the potential to improve the management of patients at risk of anaphylaxis.
Published: 2022

18. EAACI guideline:Anaphylaxis (2021 update)

Author: Muraro, Antonella, Worm, Margitta, Alviani, Cherry, Cardona, Victoria, DunnGalvin, Audrey, Garvey, Lene H., Riggioni, Carmen, Silva, Debra de, Angier, Elizabeth, Arasi, Stefania, Bellou, Abdelouahab, Beyer, Kirsten, Bijlhout, Diola, Bilò, M. Beatrice, Bindslev-Jensen, Carsten, Brockow, Knut, Fernandez-Rivas, Montserrat, Halken, Susanne, Jensen, Britt, Khaleva, Ekaterina, Michaelis, Louise J., Elberink, Hanneke N. G. Oude, Regent, Lynne, Sanchez, Angel, Vlieg-Boerstra, Berber J., Roberts, Graham, Muraro, Antonella, Worm, Margitta, Alviani, Cherry, Cardona, Victoria, DunnGalvin, Audrey, Garvey, Lene H., Riggioni, Carmen, Silva, Debra de, Angier, Elizabeth, Arasi, Stefania, Bellou, Abdelouahab, Beyer, Kirsten, Bijlhout, Diola, Bilò, M. Beatrice, Bindslev-Jensen, Carsten, Brockow, Knut, Fernandez-Rivas, Montserrat, Halken, Susanne, Jensen, Britt, Khaleva, Ekaterina, Michaelis, Louise J., Elberink, Hanneke N. G. Oude, Regent, Lynne, Sanchez, Angel, Vlieg-Boerstra, Berber J., and Roberts, Graham
Abstract: Anaphylaxis is a clinical emergency which all healthcare professionals need to be able to recognise and manage. The European Academy of Allergy and Clinical Immunology Anaphylaxis multidisciplinary Task Force has updated the 2014 guideline. The guideline was developed using the AGREE II framework and the GRADE approach. The evidence was systematically reviewed and recommendations were created by weighing up benefits and harms. The guideline was peer-reviewed by external experts and reviewed in a public consultation. The use of clinical criteria to identify anaphylaxis is suggested with blood sampling for the later measurement of tryptase. The prompt use of intramuscular adrenaline as first line management is recommended with the availability of adrenaline autoinjectors to patients in the community. Pharmacokinetic data should be provided for adrenaline autoinjector devices. Structured, comprehensive training for people at risk of anaphylaxis is recommended. Simulation training and visual prompts for healthcare professionals are suggested to improve the management of anaphylaxis. It is suggested that school policies reflect anaphylaxis guidelines. The evidence for the management of anaphylaxis remains mostly at a very low level. There is an urgent need to prioritise clinical trials with the potential to improve the management of patients at risk of anaphylaxis., Anaphylaxis is a clinical emergency which all healthcare professionals need to be able to recognize and manage. The European Academy of Allergy and Clinical Immunology Anaphylaxis multidisciplinary Task Force has updated the 2014 guideline. The guideline was developed using the AGREE II framework and the GRADE approach. The evidence was systematically reviewed and recommendations were created by weighing up benefits and harms. The guideline was peer-reviewed by external experts and reviewed in a public consultation. The use of clinical criteria to identify anaphylaxis is suggested with blood sampling for the later measurement of tryptase. The prompt use of intramuscular adrenaline as first-line management is recommended with the availability of adrenaline autoinjectors to patients in the community. Pharmacokinetic data should be provided for adrenaline autoinjector devices. Structured, comprehensive training for people at risk of anaphylaxis is recommended. Simulation training and visual prompts for healthcare professionals are suggested to improve the management of anaphylaxis. It is suggested that school policies reflect anaphylaxis guidelines. The evidence for the management of anaphylaxis remains mostly at a very low level. There is an urgent need to prioritize clinical trials with the potential to improve the management of patients at risk of anaphylaxis.
Published: 2022

19. Allergen immunotherapy and/or biologicals for IgE-mediated food allergy:A systematic review and meta-analysis

Author: de Silva, Debra, Rodríguez del Río, Pablo, de Jong, Nicolette W., Khaleva, Ekaterina, Singh, Chris, Nowak-Wegrzyn, Anna, Muraro, Antonella, Begin, Philippe, Pajno, Giovanni, Fiocchi, Alessandro, Sanchez, Angel, Jones, Carla, Nilsson, Caroline, Bindslev-Jensen, Carsten, Wong, Gary, Sampson, Hugh, Beyer, Kirsten, Marchisotto, Mary Jane, Fernandez Rivas, Montserrat, Meyer, Rosan, Lau, Susanne, Nurmatov, Ulugbek, de Silva, Debra, Rodríguez del Río, Pablo, de Jong, Nicolette W., Khaleva, Ekaterina, Singh, Chris, Nowak-Wegrzyn, Anna, Muraro, Antonella, Begin, Philippe, Pajno, Giovanni, Fiocchi, Alessandro, Sanchez, Angel, Jones, Carla, Nilsson, Caroline, Bindslev-Jensen, Carsten, Wong, Gary, Sampson, Hugh, Beyer, Kirsten, Marchisotto, Mary Jane, Fernandez Rivas, Montserrat, Meyer, Rosan, Lau, Susanne, and Nurmatov, Ulugbek
Abstract: Background: There is substantial interest in immunotherapy and biologicals in IgE-mediated food allergy. Methods: We searched six databases for randomized controlled trials about immunotherapy alone or with biologicals or biological monotherapy in food allergy confirmed by oral food challenge. We pooled the data using random-effects meta-analysis. Results: We included 36 trials about immunotherapy with 2126 mainly child participants. Oral immunotherapy increased tolerance whilst on therapy for peanut; cow's milk and hen's egg allergy. The number needed to treat to increase tolerance to a single dose of 300 mg or 1000 mg peanut protein was 2. Oral immunotherapy did not increase adverse reactions or severe reactions in peanut allergy, but may increase (mild) adverse reactions in cow's milk and hen's egg allergy. Epicutaneous immunotherapy increased tolerance whilst on therapy for peanut. Results were unclear for other allergies and administration routes. There were too few trials of biologicals alone (3) or with immunotherapy (1) to draw conclusions. Conclusions: Oral immunotherapy improves tolerance whilst on therapy and is probably safe in peanut, cow's milk and hen's egg allergy. More research is needed about quality of life, cost and biologicals.
Published: 2022

20. Proposal of 0.5 mg of protein/100 g of processed food as threshold for voluntary declaration of food allergen traces in processed food—A first step in an initiative to better inform patients and avoid fatal allergic reactions: A GA²LEN position paper

Author: CTI Research, MS Dermatologie/Allergologie, Infection & Immunity, Zuberbier, Torsten, Dörr, Tamara, Aberer, Werner, Alvaro, Montserrat, Angier, Elizabeth, Arasi, Stefania, Arshad, Hasan, Ballmer-Weber, Barbara, Bartra, Joan, Beck, Lisa, Bégin, Philippe, Bindslev-Jensen, Carsten, Bislimovska, Jovanka, Bousquet, Jean, Brockow, Knut, Bush, Andrew, Cianferoni, Antonella, Cork, Michael J, Custovic, Adnan, Darsow, Ulf, de Jong, Nicolette, Deleanu, Diana, Del Giacco, Stefano, Deschildre, Antoine, Dunn Galvin, Audrey, Ebisawa, Motohiro, Fernández-Rivas, Montserrat, Ferrer, Marta, Fiocchi, Alessandro, Gerth van Wijk, Roy, Gotua, Maia, Grimshaw, Kate, Grünhagen, Josefine, Heffler, Enrico, Hide, Michihiro, Hoffmann-Sommergruber, Karin, Incorvaia, Cristoforo, Janson, Christer, Malte John, Swen, Jones, Carla, Jutel, Marek, Katoh, Norito, Kendziora, Benjamin, Kinaciyan, Tamar, Knol, Edward, Kurbacheva, Oksana, Lau, Susanne, Loh, Richard, Lombardi, Carlo, Mäkelä, Mika, Marchisotto, Mary Jane, Makris, Michael, Maurer, Marcus, Meyer, Rosan, Mijakoski, Dragan, Minov, Jordan, Mullol, Joaquim, Nilsson, Caroline, Nowak-Wegrzyn, Anna, Nwaru, Bright I, Odemyr, Mikela, Pajno, Giovanni Battista, Paudel, Sushil, Papadopoulos, Nikolaos G, Renz, Harald, Ricci, Giampaolo, Ring, Johannes, Rogala, Barbara, Sampson, Hugh, Senna, Gianenrico, Sitkauskiene, Brigita, Smith, Peter Kenneth, Stevanovic, Katarina, Stoleski, Sasho, Szajewska, Hania, Tanaka, Akio, Todo-Bom, Ana, Topal, Fatih Alexander, Valovirta, Erkka, Van Ree, Ronald, Venter, Carina, Wöhrl, Stefan, Wong, Gary W K, Zhao, Zuotao, Worm, Margitta, CTI Research, MS Dermatologie/Allergologie, Infection & Immunity, Zuberbier, Torsten, Dörr, Tamara, Aberer, Werner, Alvaro, Montserrat, Angier, Elizabeth, Arasi, Stefania, Arshad, Hasan, Ballmer-Weber, Barbara, Bartra, Joan, Beck, Lisa, Bégin, Philippe, Bindslev-Jensen, Carsten, Bislimovska, Jovanka, Bousquet, Jean, Brockow, Knut, Bush, Andrew, Cianferoni, Antonella, Cork, Michael J, Custovic, Adnan, Darsow, Ulf, de Jong, Nicolette, Deleanu, Diana, Del Giacco, Stefano, Deschildre, Antoine, Dunn Galvin, Audrey, Ebisawa, Motohiro, Fernández-Rivas, Montserrat, Ferrer, Marta, Fiocchi, Alessandro, Gerth van Wijk, Roy, Gotua, Maia, Grimshaw, Kate, Grünhagen, Josefine, Heffler, Enrico, Hide, Michihiro, Hoffmann-Sommergruber, Karin, Incorvaia, Cristoforo, Janson, Christer, Malte John, Swen, Jones, Carla, Jutel, Marek, Katoh, Norito, Kendziora, Benjamin, Kinaciyan, Tamar, Knol, Edward, Kurbacheva, Oksana, Lau, Susanne, Loh, Richard, Lombardi, Carlo, Mäkelä, Mika, Marchisotto, Mary Jane, Makris, Michael, Maurer, Marcus, Meyer, Rosan, Mijakoski, Dragan, Minov, Jordan, Mullol, Joaquim, Nilsson, Caroline, Nowak-Wegrzyn, Anna, Nwaru, Bright I, Odemyr, Mikela, Pajno, Giovanni Battista, Paudel, Sushil, Papadopoulos, Nikolaos G, Renz, Harald, Ricci, Giampaolo, Ring, Johannes, Rogala, Barbara, Sampson, Hugh, Senna, Gianenrico, Sitkauskiene, Brigita, Smith, Peter Kenneth, Stevanovic, Katarina, Stoleski, Sasho, Szajewska, Hania, Tanaka, Akio, Todo-Bom, Ana, Topal, Fatih Alexander, Valovirta, Erkka, Van Ree, Ronald, Venter, Carina, Wöhrl, Stefan, Wong, Gary W K, Zhao, Zuotao, and Worm, Margitta
Published: 2022

21. Development and validation of the Food Allergy Severity Score

Author: MS Dermatologie/Allergologie, Infection & Immunity, Fernández-Rivas, Montserrat, Gómez García, Ismael, Gonzalo-Fernández, Alejandro, Fuentes Ferrer, Manuel, Dölle-Bierke, Sabine, Marco-Martín, Guadalupe, Ballmer-Weber, Barbara K., Asero, Riccardo, Belohlavkova, Simona, Beyer, Kirsten, de Blay, Frédéric, Clausen, Michael, Datema, Mareen R., Dubakiene, Ruta, Grimshaw, Kate E.C., Hoffmann-Sommergruber, Karin, Hourihane, Jonathan O.B., Jedrzejczak-Czechowicz, Monika, Knulst, André C., Kralimarkova, Tanya, Le, Thuy My, Papadopoulos, Nikolaos G., Popov, Todor A., Poulsen, Lars K., Purohit, Ashok, Seneviratne, Suranjith L., Simpson, Angela, Sinaniotis, Atanasios, Turkalji, Mirjana, Vázquez-Cortés, Sonia, Vera-Berrios, Rosialzira N., Muraro, Antonella, Worm, Margitta, Roberts, Graham, van Ree, Ronald, Fernández-Pérez, Cristina, Turner, Paul J., Mills, Elizabeth N.Clare, MS Dermatologie/Allergologie, Infection & Immunity, Fernández-Rivas, Montserrat, Gómez García, Ismael, Gonzalo-Fernández, Alejandro, Fuentes Ferrer, Manuel, Dölle-Bierke, Sabine, Marco-Martín, Guadalupe, Ballmer-Weber, Barbara K., Asero, Riccardo, Belohlavkova, Simona, Beyer, Kirsten, de Blay, Frédéric, Clausen, Michael, Datema, Mareen R., Dubakiene, Ruta, Grimshaw, Kate E.C., Hoffmann-Sommergruber, Karin, Hourihane, Jonathan O.B., Jedrzejczak-Czechowicz, Monika, Knulst, André C., Kralimarkova, Tanya, Le, Thuy My, Papadopoulos, Nikolaos G., Popov, Todor A., Poulsen, Lars K., Purohit, Ashok, Seneviratne, Suranjith L., Simpson, Angela, Sinaniotis, Atanasios, Turkalji, Mirjana, Vázquez-Cortés, Sonia, Vera-Berrios, Rosialzira N., Muraro, Antonella, Worm, Margitta, Roberts, Graham, van Ree, Ronald, Fernández-Pérez, Cristina, Turner, Paul J., and Mills, Elizabeth N.Clare
Published: 2022

22. Proposal of 0.5 mg of protein/100 g of processed food as threshold for voluntary declaration of food allergen traces in processed food—A first step in an initiative to better inform patients and avoid fatal allergic reactions: A GA²LEN position paper

Author: Zuberbier, Torsten; https://orcid.org/0000-0002-1466-8875, Dörr, Tamara, Aberer, Werner, Alvaro, Montserrat; https://orcid.org/0000-0002-5528-8043, Angier, Elizabeth, Arasi, Stefania; https://orcid.org/0000-0002-8135-0568, Arshad, Hasan; https://orcid.org/0000-0001-5988-235X, Ballmer-Weber, Barbara; https://orcid.org/0000-0002-4136-5036, Bartra, Joan; https://orcid.org/0000-0001-7767-4730, Beck, Lisa; https://orcid.org/0000-0002-8452-667X, Bégin, Philippe; https://orcid.org/0000-0002-9089-4604, Bindslev‐Jensen, Carsten; https://orcid.org/0000-0002-8940-038X, Bislimovska, Jovanka, Bousquet, Jean; https://orcid.org/0000-0002-4061-4766, Brockow, Knut; https://orcid.org/0000-0002-2775-3681, Bush, Andrew; https://orcid.org/0000-0001-6756-9822, Cianferoni, Antonella; https://orcid.org/0000-0002-2966-2564, Cork, Michael J; https://orcid.org/0000-0003-4428-2428, Custovic, Adnan; https://orcid.org/0000-0001-5218-7071, Darsow, Ulf, de Jong, Nicolette, Deleanu, Diana, Del Giacco, Stefano; https://orcid.org/0000-0002-4517-1749, Deschildre, Antoine; https://orcid.org/0000-0003-2006-7221, Dunn Galvin, Audrey, Ebisawa, Motohiro; https://orcid.org/0000-0003-4117-558X, Fernández‐Rivas, Montserrat; https://orcid.org/0000-0003-1748-2328, Ferrer, Marta; https://orcid.org/0000-0001-8495-1302, Fiocchi, Alessandro; https://orcid.org/0000-0002-2549-0523, Gerth van Wijk, Roy; https://orcid.org/0000-0002-9608-8742, et al, Zuberbier, Torsten; https://orcid.org/0000-0002-1466-8875, Dörr, Tamara, Aberer, Werner, Alvaro, Montserrat; https://orcid.org/0000-0002-5528-8043, Angier, Elizabeth, Arasi, Stefania; https://orcid.org/0000-0002-8135-0568, Arshad, Hasan; https://orcid.org/0000-0001-5988-235X, Ballmer-Weber, Barbara; https://orcid.org/0000-0002-4136-5036, Bartra, Joan; https://orcid.org/0000-0001-7767-4730, Beck, Lisa; https://orcid.org/0000-0002-8452-667X, Bégin, Philippe; https://orcid.org/0000-0002-9089-4604, Bindslev‐Jensen, Carsten; https://orcid.org/0000-0002-8940-038X, Bislimovska, Jovanka, Bousquet, Jean; https://orcid.org/0000-0002-4061-4766, Brockow, Knut; https://orcid.org/0000-0002-2775-3681, Bush, Andrew; https://orcid.org/0000-0001-6756-9822, Cianferoni, Antonella; https://orcid.org/0000-0002-2966-2564, Cork, Michael J; https://orcid.org/0000-0003-4428-2428, Custovic, Adnan; https://orcid.org/0000-0001-5218-7071, Darsow, Ulf, de Jong, Nicolette, Deleanu, Diana, Del Giacco, Stefano; https://orcid.org/0000-0002-4517-1749, Deschildre, Antoine; https://orcid.org/0000-0003-2006-7221, Dunn Galvin, Audrey, Ebisawa, Motohiro; https://orcid.org/0000-0003-4117-558X, Fernández‐Rivas, Montserrat; https://orcid.org/0000-0003-1748-2328, Ferrer, Marta; https://orcid.org/0000-0001-8495-1302, Fiocchi, Alessandro; https://orcid.org/0000-0002-2549-0523, Gerth van Wijk, Roy; https://orcid.org/0000-0002-9608-8742, and et al
Published: 2022

23. Development and validation of the Food Allergy Severity Score

Author: Fernández‐Rivas, Montserrat; https://orcid.org/0000-0003-1748-2328, Gómez García, Ismael; https://orcid.org/0000-0001-9756-2373, Gonzalo‐Fernández, Alejandro; https://orcid.org/0000-0002-5835-1896, Fuentes Ferrer, Manuel; https://orcid.org/0000-0002-5177-1441, Dölle‐Bierke, Sabine; https://orcid.org/0000-0002-3339-0709, Marco‐Martín, Guadalupe; https://orcid.org/0000-0003-1754-3274, Ballmer-Weber, Barbara K; https://orcid.org/0000-0002-4136-5036, et al, Fernández‐Rivas, Montserrat; https://orcid.org/0000-0003-1748-2328, Gómez García, Ismael; https://orcid.org/0000-0001-9756-2373, Gonzalo‐Fernández, Alejandro; https://orcid.org/0000-0002-5835-1896, Fuentes Ferrer, Manuel; https://orcid.org/0000-0002-5177-1441, Dölle‐Bierke, Sabine; https://orcid.org/0000-0002-3339-0709, Marco‐Martín, Guadalupe; https://orcid.org/0000-0003-1754-3274, Ballmer-Weber, Barbara K; https://orcid.org/0000-0002-4136-5036, and et al
Abstract: Background The heterogeneity and lack of validation of existing severity scores for food allergic reactions limit standardization of case management and research advances. We aimed to develop and validate a severity score for food allergic reactions. Methods Following a multidisciplinary experts consensus, it was decided to develop a food allergy severity score (FASS) with ordinal (oFASS) and numerical (nFASS) formats. oFASS with 3 and 5 grades were generated through expert consensus, and nFASS by mathematical modeling. Evaluation was performed in the EuroPrevall outpatient clinic cohort (8232 food reactions) by logistic regression with request of emergency care and medications used as outcomes. Discrimination, classification, and calibration were calculated. Bootstrapping internal validation was followed by external validation (logistic regression) in 5 cohorts (3622 food reactions). Correlation of nFASS with the severity classification done by expert allergy clinicians by Best-Worst Scaling of 32 food reactions was calculated. Results oFASS and nFASS map consistently, with nFASS having greater granularity. With the outcomes emergency care, adrenaline and critical medical treatment, oFASS and nFASS had a good discrimination (receiver operating characteristic area under the curve [ROC-AUC]>0.80), classification (sensitivity 0.87–0.92, specificity 0.73–0.78), and calibration. Bootstrapping over ROC-AUC showed negligible biases (1.0 × 10−6–1.23 × 10−3). In external validation, nFASS performed best with higher ROC-AUC. nFASS was strongly correlated (R 0.89) to best-worst scoring of 334 expert clinicians. Conclusion FASS is a validated and reliable method to measure severity of food allergic reactions. The ordinal and numerical versions that map onto each other are suitable for use by different stakeholders in different settings.
Published: 2022

24. Non-specific lipid-transfer proteins : Allergen structure and function, cross-reactivity, sensitization, and epidemiology

Author: Skypala, Isabel, Asero, Riccardo, Barber, Domingo, Cecchi, Lorenzo, Díaz-Perales, Araceli, Hoffmann-Sommergruber, Karin, Pastorello, Elide A., Swoboda, Ines, Bartra, Joan, Ebo, Didier, Faber, Margaretha A., Fernández-Rivas, Montserrat, Gomez, Francesca, Konstantinopoulos, Anastasios. P., Luengo Sánchez, Olga, van Ree, Ronald, Scala, Enrico, Till, Stephen J., Universitat Autònoma de Barcelona, Skypala, Isabel, Asero, Riccardo, Barber, Domingo, Cecchi, Lorenzo, Díaz-Perales, Araceli, Hoffmann-Sommergruber, Karin, Pastorello, Elide A., Swoboda, Ines, Bartra, Joan, Ebo, Didier, Faber, Margaretha A., Fernández-Rivas, Montserrat, Gomez, Francesca, Konstantinopoulos, Anastasios. P., Luengo Sánchez, Olga, van Ree, Ronald, Scala, Enrico, Till, Stephen J., and Universitat Autònoma de Barcelona
Abstract: Discovered and described 40 years ago, non-specific lipid transfer proteins (nsLTP) are present in many plant species and play an important role protecting plants from stressors such as heat or drought. In the last 20 years, sensitization to nsLTP and consequent reactions to plant foods has become an increasing concern. The aim of this paper is to review the evidence for the structure and function of nsLTP allergens, and cross-reactivity, sensitization, and epidemiology of nsLTP allergy. A Task Force, supported by the European Academy of Allergy & Clinical Immunology (EAACI), reviewed current evidence and provide a signpost for future research. The search terms for this paper were "Non-specific Lipid Transfer Proteins", "LTP syndrome", "Pru p 3", "plant food allergy", "pollen-food syndrome". Most nsLTP allergens have a highly conserved structure stabilised by 4-disulphide bridges. Studies on the peach nsLTP, Pru p 3, demonstrate that nsLTPs are very cross-reactive, with the four major IgE epitopes of Pru p 3 being shared by nsLTP from other botanically related fruits. These nsLTP allergens are to varying degrees resistant to heat and digestion, and sensitization may occur through the oral, inhaled or cutaneous routes. In some populations, Pru p 3 is the primary and sole sensitizing allergen, but many are poly-sensitised both to botanically un-related nsLTP in foods, and non-food sources of nsLTP such as Cannabis sativa, Platanus acerifolia, (plane tree), Ambrosia artemisiifolia (ragweed) and Artemisia vulgaris (mugwort). Initially, nsLTP sensitization appeared to be limited to Mediterranean countries, however more recent studies suggest clinically relevant sensitization occurs in North Atlantic regions and also countries in Northern Europe, with nsLTP sensitisation profiles being broadly similar. These robust allergens have the potential to sensitize and provoke symptoms to a large number of plant foods, including those which are raw, cooked or processed. It is unkn
Published: 2021

25. Diagnosing, managing and preventing anaphylaxis:Systematic review

Author: de Silva, Debra, Singh, Chris, Muraro, Antonella, Worm, Margitta, Alviani, Cherry, Cardona, Victoria, DunnGlvin, Audrey, Garvey, Lene Heise, Riggioni, Carmen, Angier, Elizabeth, Arasi, Stefania, Bellou, Abdelouahab, Beyer, Kirsten, Bijlhout, Diola, Bilo, M. Beatrice, Brockow, Knut, Fernandez-Rivas, Montserrat, Halken, Susanne, Jensen, Britt, Khaleva, Ekaterina, Michaelis, Louise J., Oude Elberink, Hanneke, Regent, Lynne, Sanchez, Angel, Vlieg-Boerstra, Berber, Roberts, Graham, de Silva, Debra, Singh, Chris, Muraro, Antonella, Worm, Margitta, Alviani, Cherry, Cardona, Victoria, DunnGlvin, Audrey, Garvey, Lene Heise, Riggioni, Carmen, Angier, Elizabeth, Arasi, Stefania, Bellou, Abdelouahab, Beyer, Kirsten, Bijlhout, Diola, Bilo, M. Beatrice, Brockow, Knut, Fernandez-Rivas, Montserrat, Halken, Susanne, Jensen, Britt, Khaleva, Ekaterina, Michaelis, Louise J., Oude Elberink, Hanneke, Regent, Lynne, Sanchez, Angel, Vlieg-Boerstra, Berber, and Roberts, Graham
Abstract: Background This systematic review used the GRADE approach to compile evidence to inform the European Academy of Allergy and Clinical Immunology's (EAACI) anaphylaxis guideline. Methods We searched five bibliographic databases from 1946 to 20 April 2020 for studies about the diagnosis, management and prevention of anaphylaxis. We included 50 studies with 18 449 participants: 29 randomized controlled trials, seven controlled clinical trials, seven consecutive case series and seven case-control studies. Findings were summarized narratively because studies were too heterogeneous to conduct meta-analysis. Results It is unclear whether the NIAID/FAAN criteria or Brighton case definition are valid for immediately diagnosing anaphylaxis due to the very low certainty of evidence. There was also insufficient evidence about the impact of most anaphylaxis management and prevention strategies. Adrenaline is regularly used for first-line emergency management of anaphylaxis but little robust research has assessed its effectiveness. Newer models of adrenaline autoinjectors may slightly increase the proportion of people correctly using the devices and reduce time to administration. Face-to-face training for laypeople may slightly improve anaphylaxis knowledge and competence in using autoinjectors. We searched for but found little or no comparative effectiveness evidence about strategies such as fluid replacement, oxygen, glucocorticosteroids, methylxanthines, bronchodilators, management plans, food labels, drug labels and similar. Conclusions Anaphylaxis is a potentially life-threatening condition but, due to practical and ethical challenges, there is a paucity of robust evidence about how to diagnose and manage it.
Published: 2021

26. Management of anaphylaxis due to COVID-19 vaccines in the elderly

Author: Bousquet, Jean, Agache, Ioana, Blain, Hubert, Jutel, Marek, Ventura, Maria Teresa, Worm, Margitta, Del Giacco, Stefano, Benetos, Athanasios, Bilo, Beatrice Maria, Czarlewski, Wienczyslawa, Abdul Latiff, Amir Hamzah, Al-Ahmad, Mona, Angier, Elizabeth, Annesi-Maesano, Isabella, Atanaskovic-Markovic, Marina, Bachert, Claus, Barbaud, Annick, Bedbrook, Anna, Bennoor, Kazi S., Berghea, Elena Camelia, Bindslev-Jensen, Carsten, Bonini, Sergio, Bosnic-Anticevich, Sinthia, Brockow, Knut, Brussino, Luisa, Camargos, Paulo, Canonica, G. Walter, Cardona, Victoria, Carreiro-Martins, Pedro, Carriazo, Ana, Casale, Thomas, Caubet, Jean Christoph, Cecchi, Lorenzo, Cherubini, Antonio, Christoff, George, Chu, Derek K., Cruz, Alvaro A., Dokic, Dejan, El-Gamal, Yehia, Ebisawa, Motohiro, Eberlein, Bernadette, Farrell, John, Fernandez-Rivas, Montserrat, Fokkens, Wytske J., Fonseca, Joao A., Gao, Yadong, Gavazzi, Gaëtan, Gawlik, Radoslaw, Gelincik, Asli, Gemicioğlu, Bilun, Gotua, Maia, Guérin, Olivier, Haahtela, Tari, Hoffmann-Sommergruber, Karin, Hoffmann, Hans Jürgen, Hofmann, Maja, Hrubisko, Martin, Illario, Maddalena, Irani, Carla, Ispayeva, Zhanat, Ivancevich, Juan Carlos, Julge, Kaja, Kaidashev, Igor, Khaitov, Musa, Knol, Edward, Kraxner, Helga, Kuna, Piotr, Kvedariene, Violeta, Lauerma, Antti, Le, Lan T.T., Le Moing, Vincent, Levin, Michael, Louis, Renaud, Lourenco, Olga, Mahler, Vera, Martin, Finbarr C., Matucci, Andrea, Milenkovic, Branislava, Miot, Stéphanie, Montella, Emma, Morais-Almeida, Mario, Mortz, Charlotte G., Mullol, Joaquim, Namazova-Baranova, Leyla, Neffen, Hugo, Nekam, Kristof, Niedoszytko, Marek, Odemyr, Mikaëla, O’Hehir, Robyn E., Okamoto, Yoshitaka, Ollert, Markus, Palomares, Oscar, Papadopoulos, Nikolaos G., Panzner, Petr, Passalacqua, Giovanni, Patella, Vincenzo, Petrovic, Mirko, Pfaar, Oliver, Pham-Thi, Nhân, Plavec, Davor, Popov, Todor A., Recto, Marysia T., Regateiro, Frederico S., Reynes, Jacques, Roller-Winsberger, Regina E., Rolland, Yves, Romano, Antonino, Rondon, Carmen, Rottem, Menachem, Rouadi, Philip W., Salles, Nathalie, Samolinski, Boleslaw, Santos, Alexandra F., S Sarquis, Faradiba, Sastre, Joaquin, M. G. A. Schols, Jos, Scichilone, Nicola, Sediva, Anna, Shamji, Mohamed H., Sheikh, Aziz, Skypala, Isabel, Smolinska, Sylwia, Sokolowska, Milena, Sousa-Pinto, Bernardo, Sova, Milan, Stelmach, Rafael, Sturm, Gunter, Suppli Ulrik, Charlotte, Todo-Bom, Ana Maria, Toppila-Salmi, Sanna, Tsiligianni, Ioanna, Torres, Maria, Untersmayr, Eva, Urrutia Pereira, Marilyn, Valiulis, Arunas, Vitte, Joana, Vultaggio, Alessandra, Wallace, Dana, Walusiak-Skorupa, Jolanta, Wang, De Yun, Waserman, Susan, Yorgancioglu, Arzu, Yusuf, Osman M., Zernotti, Mario, Zidarn, Mihaela, Chivato, Tomas, Akdis, Cezmi A., Zuberbier, Torsten, Klimek, Ludger, Bousquet, Jean, Agache, Ioana, Blain, Hubert, Jutel, Marek, Ventura, Maria Teresa, Worm, Margitta, Del Giacco, Stefano, Benetos, Athanasios, Bilo, Beatrice Maria, Czarlewski, Wienczyslawa, Abdul Latiff, Amir Hamzah, Al-Ahmad, Mona, Angier, Elizabeth, Annesi-Maesano, Isabella, Atanaskovic-Markovic, Marina, Bachert, Claus, Barbaud, Annick, Bedbrook, Anna, Bennoor, Kazi S., Berghea, Elena Camelia, Bindslev-Jensen, Carsten, Bonini, Sergio, Bosnic-Anticevich, Sinthia, Brockow, Knut, Brussino, Luisa, Camargos, Paulo, Canonica, G. Walter, Cardona, Victoria, Carreiro-Martins, Pedro, Carriazo, Ana, Casale, Thomas, Caubet, Jean Christoph, Cecchi, Lorenzo, Cherubini, Antonio, Christoff, George, Chu, Derek K., Cruz, Alvaro A., Dokic, Dejan, El-Gamal, Yehia, Ebisawa, Motohiro, Eberlein, Bernadette, Farrell, John, Fernandez-Rivas, Montserrat, Fokkens, Wytske J., Fonseca, Joao A., Gao, Yadong, Gavazzi, Gaëtan, Gawlik, Radoslaw, Gelincik, Asli, Gemicioğlu, Bilun, Gotua, Maia, Guérin, Olivier, Haahtela, Tari, Hoffmann-Sommergruber, Karin, Hoffmann, Hans Jürgen, Hofmann, Maja, Hrubisko, Martin, Illario, Maddalena, Irani, Carla, Ispayeva, Zhanat, Ivancevich, Juan Carlos, Julge, Kaja, Kaidashev, Igor, Khaitov, Musa, Knol, Edward, Kraxner, Helga, Kuna, Piotr, Kvedariene, Violeta, Lauerma, Antti, Le, Lan T.T., Le Moing, Vincent, Levin, Michael, Louis, Renaud, Lourenco, Olga, Mahler, Vera, Martin, Finbarr C., Matucci, Andrea, Milenkovic, Branislava, Miot, Stéphanie, Montella, Emma, Morais-Almeida, Mario, Mortz, Charlotte G., Mullol, Joaquim, Namazova-Baranova, Leyla, Neffen, Hugo, Nekam, Kristof, Niedoszytko, Marek, Odemyr, Mikaëla, O’Hehir, Robyn E., Okamoto, Yoshitaka, Ollert, Markus, Palomares, Oscar, Papadopoulos, Nikolaos G., Panzner, Petr, Passalacqua, Giovanni, Patella, Vincenzo, Petrovic, Mirko, Pfaar, Oliver, Pham-Thi, Nhân, Plavec, Davor, Popov, Todor A., Recto, Marysia T., Regateiro, Frederico S., Reynes, Jacques, Roller-Winsberger, Regina E., Rolland, Yves, Romano, Antonino, Rondon, Carmen, Rottem, Menachem, Rouadi, Philip W., Salles, Nathalie, Samolinski, Boleslaw, Santos, Alexandra F., S Sarquis, Faradiba, Sastre, Joaquin, M. G. A. Schols, Jos, Scichilone, Nicola, Sediva, Anna, Shamji, Mohamed H., Sheikh, Aziz, Skypala, Isabel, Smolinska, Sylwia, Sokolowska, Milena, Sousa-Pinto, Bernardo, Sova, Milan, Stelmach, Rafael, Sturm, Gunter, Suppli Ulrik, Charlotte, Todo-Bom, Ana Maria, Toppila-Salmi, Sanna, Tsiligianni, Ioanna, Torres, Maria, Untersmayr, Eva, Urrutia Pereira, Marilyn, Valiulis, Arunas, Vitte, Joana, Vultaggio, Alessandra, Wallace, Dana, Walusiak-Skorupa, Jolanta, Wang, De Yun, Waserman, Susan, Yorgancioglu, Arzu, Yusuf, Osman M., Zernotti, Mario, Zidarn, Mihaela, Chivato, Tomas, Akdis, Cezmi A., Zuberbier, Torsten, and Klimek, Ludger
Abstract: Older adults, especially men and/or those with diabetes, hypertension, and/or obesity, are prone to severe COVID-19. In some countries, older adults, particularly those residing in nursing homes, have been prioritized to receive COVID-19 vaccines due to high risk of death. In very rare instances, the COVID-19 vaccines can induce anaphylaxis, and the management of anaphylaxis in older people should be considered carefully. An ARIA-EAACI-EuGMS (Allergic Rhinitis and its Impact on Asthma, European Academy of Allergy and Clinical Immunology, and European Geriatric Medicine Society) Working Group has proposed some recommendations for older adults receiving the COVID-19 vaccines. Anaphylaxis to COVID-19 vaccines is extremely rare (from 1 per 100,000 to 5 per million injections). Symptoms are similar in younger and older adults but they tend to be more severe in the older patients. Adrenaline is the mainstay treatment and should be readily available. A flowchart is proposed to manage anaphylaxis in the older patients.
Published: 2021

27. Diagnosing, managing and preventing anaphylaxis:Systematic review

Author: de Silva, Debra, Singh, Chris, Muraro, Antonella, Worm, Margitta, Alviani, Cherry, Cardona, Victoria, DunnGlvin, Audrey, Garvey, Lene Heise, Riggioni, Carmen, Angier, Elizabeth, Arasi, Stefania, Bellou, Abdelouahab, Beyer, Kirsten, Bijlhout, Diola, Bilo, M. Beatrice, Brockow, Knut, Fernandez-Rivas, Montserrat, Halken, Susanne, Jensen, Britt, Khaleva, Ekaterina, Michaelis, Louise J., Oude Elberink, Hanneke, Regent, Lynne, Sanchez, Angel, Vlieg-Boerstra, Berber, Roberts, Graham, de Silva, Debra, Singh, Chris, Muraro, Antonella, Worm, Margitta, Alviani, Cherry, Cardona, Victoria, DunnGlvin, Audrey, Garvey, Lene Heise, Riggioni, Carmen, Angier, Elizabeth, Arasi, Stefania, Bellou, Abdelouahab, Beyer, Kirsten, Bijlhout, Diola, Bilo, M. Beatrice, Brockow, Knut, Fernandez-Rivas, Montserrat, Halken, Susanne, Jensen, Britt, Khaleva, Ekaterina, Michaelis, Louise J., Oude Elberink, Hanneke, Regent, Lynne, Sanchez, Angel, Vlieg-Boerstra, Berber, and Roberts, Graham
Abstract: Background This systematic review used the GRADE approach to compile evidence to inform the European Academy of Allergy and Clinical Immunology's (EAACI) anaphylaxis guideline. Methods We searched five bibliographic databases from 1946 to 20 April 2020 for studies about the diagnosis, management and prevention of anaphylaxis. We included 50 studies with 18 449 participants: 29 randomized controlled trials, seven controlled clinical trials, seven consecutive case series and seven case-control studies. Findings were summarized narratively because studies were too heterogeneous to conduct meta-analysis. Results It is unclear whether the NIAID/FAAN criteria or Brighton case definition are valid for immediately diagnosing anaphylaxis due to the very low certainty of evidence. There was also insufficient evidence about the impact of most anaphylaxis management and prevention strategies. Adrenaline is regularly used for first-line emergency management of anaphylaxis but little robust research has assessed its effectiveness. Newer models of adrenaline autoinjectors may slightly increase the proportion of people correctly using the devices and reduce time to administration. Face-to-face training for laypeople may slightly improve anaphylaxis knowledge and competence in using autoinjectors. We searched for but found little or no comparative effectiveness evidence about strategies such as fluid replacement, oxygen, glucocorticosteroids, methylxanthines, bronchodilators, management plans, food labels, drug labels and similar. Conclusions Anaphylaxis is a potentially life-threatening condition but, due to practical and ethical challenges, there is a paucity of robust evidence about how to diagnose and manage it.
Published: 2021

28. Management of anaphylaxis due to COVID-19 vaccines in the elderly

Author: Bousquet, Jean, Agache, Ioana, Blain, Hubert, Jutel, Marek, Ventura, Maria Teresa, Worm, Margitta, Del Giacco, Stefano, Benetos, Athanasios, Bilo, Beatrice Maria, Czarlewski, Wienczyslawa, Abdul Latiff, Amir Hamzah, Al-Ahmad, Mona, Angier, Elizabeth, Annesi-Maesano, Isabella, Atanaskovic-Markovic, Marina, Bachert, Claus, Barbaud, Annick, Bedbrook, Anna, Bennoor, Kazi S., Berghea, Elena Camelia, Bindslev-Jensen, Carsten, Bonini, Sergio, Bosnic-Anticevich, Sinthia, Brockow, Knut, Brussino, Luisa, Camargos, Paulo, Canonica, G. Walter, Cardona, Victoria, Carreiro-Martins, Pedro, Carriazo, Ana, Casale, Thomas, Caubet, Jean Christoph, Cecchi, Lorenzo, Cherubini, Antonio, Christoff, George, Chu, Derek K., Cruz, Alvaro A., Dokic, Dejan, El-Gamal, Yehia, Ebisawa, Motohiro, Eberlein, Bernadette, Farrell, John, Fernandez-Rivas, Montserrat, Fokkens, Wytske J., Fonseca, Joao A., Gao, Yadong, Gavazzi, Gaëtan, Gawlik, Radoslaw, Gelincik, Asli, Gemicioğlu, Bilun, Gotua, Maia, Guérin, Olivier, Haahtela, Tari, Hoffmann-Sommergruber, Karin, Hoffmann, Hans Jürgen, Hofmann, Maja, Hrubisko, Martin, Illario, Maddalena, Irani, Carla, Ispayeva, Zhanat, Ivancevich, Juan Carlos, Julge, Kaja, Kaidashev, Igor, Khaitov, Musa, Knol, Edward, Kraxner, Helga, Kuna, Piotr, Kvedariene, Violeta, Lauerma, Antti, Le, Lan T.T., Le Moing, Vincent, Levin, Michael, Louis, Renaud, Lourenco, Olga, Mahler, Vera, Martin, Finbarr C., Matucci, Andrea, Milenkovic, Branislava, Miot, Stéphanie, Montella, Emma, Morais-Almeida, Mario, Mortz, Charlotte G., Mullol, Joaquim, Namazova-Baranova, Leyla, Neffen, Hugo, Nekam, Kristof, Niedoszytko, Marek, Odemyr, Mikaëla, O’Hehir, Robyn E., Okamoto, Yoshitaka, Ollert, Markus, Palomares, Oscar, Papadopoulos, Nikolaos G., Panzner, Petr, Passalacqua, Giovanni, Patella, Vincenzo, Petrovic, Mirko, Pfaar, Oliver, Pham-Thi, Nhân, Plavec, Davor, Popov, Todor A., Recto, Marysia T., Regateiro, Frederico S., Reynes, Jacques, Roller-Winsberger, Regina E., Rolland, Yves, Romano, Antonino, Rondon, Carmen, Rottem, Menachem, Rouadi, Philip W., Salles, Nathalie, Samolinski, Boleslaw, Santos, Alexandra F., S Sarquis, Faradiba, Sastre, Joaquin, M. G. A. Schols, Jos, Scichilone, Nicola, Sediva, Anna, Shamji, Mohamed H., Sheikh, Aziz, Skypala, Isabel, Smolinska, Sylwia, Sokolowska, Milena, Sousa-Pinto, Bernardo, Sova, Milan, Stelmach, Rafael, Sturm, Gunter, Suppli Ulrik, Charlotte, Todo-Bom, Ana Maria, Toppila-Salmi, Sanna, Tsiligianni, Ioanna, Torres, Maria, Untersmayr, Eva, Urrutia Pereira, Marilyn, Valiulis, Arunas, Vitte, Joana, Vultaggio, Alessandra, Wallace, Dana, Walusiak-Skorupa, Jolanta, Wang, De Yun, Waserman, Susan, Yorgancioglu, Arzu, Yusuf, Osman M., Zernotti, Mario, Zidarn, Mihaela, Chivato, Tomas, Akdis, Cezmi A., Zuberbier, Torsten, Klimek, Ludger, Bousquet, Jean, Agache, Ioana, Blain, Hubert, Jutel, Marek, Ventura, Maria Teresa, Worm, Margitta, Del Giacco, Stefano, Benetos, Athanasios, Bilo, Beatrice Maria, Czarlewski, Wienczyslawa, Abdul Latiff, Amir Hamzah, Al-Ahmad, Mona, Angier, Elizabeth, Annesi-Maesano, Isabella, Atanaskovic-Markovic, Marina, Bachert, Claus, Barbaud, Annick, Bedbrook, Anna, Bennoor, Kazi S., Berghea, Elena Camelia, Bindslev-Jensen, Carsten, Bonini, Sergio, Bosnic-Anticevich, Sinthia, Brockow, Knut, Brussino, Luisa, Camargos, Paulo, Canonica, G. Walter, Cardona, Victoria, Carreiro-Martins, Pedro, Carriazo, Ana, Casale, Thomas, Caubet, Jean Christoph, Cecchi, Lorenzo, Cherubini, Antonio, Christoff, George, Chu, Derek K., Cruz, Alvaro A., Dokic, Dejan, El-Gamal, Yehia, Ebisawa, Motohiro, Eberlein, Bernadette, Farrell, John, Fernandez-Rivas, Montserrat, Fokkens, Wytske J., Fonseca, Joao A., Gao, Yadong, Gavazzi, Gaëtan, Gawlik, Radoslaw, Gelincik, Asli, Gemicioğlu, Bilun, Gotua, Maia, Guérin, Olivier, Haahtela, Tari, Hoffmann-Sommergruber, Karin, Hoffmann, Hans Jürgen, Hofmann, Maja, Hrubisko, Martin, Illario, Maddalena, Irani, Carla, Ispayeva, Zhanat, Ivancevich, Juan Carlos, Julge, Kaja, Kaidashev, Igor, Khaitov, Musa, Knol, Edward, Kraxner, Helga, Kuna, Piotr, Kvedariene, Violeta, Lauerma, Antti, Le, Lan T.T., Le Moing, Vincent, Levin, Michael, Louis, Renaud, Lourenco, Olga, Mahler, Vera, Martin, Finbarr C., Matucci, Andrea, Milenkovic, Branislava, Miot, Stéphanie, Montella, Emma, Morais-Almeida, Mario, Mortz, Charlotte G., Mullol, Joaquim, Namazova-Baranova, Leyla, Neffen, Hugo, Nekam, Kristof, Niedoszytko, Marek, Odemyr, Mikaëla, O’Hehir, Robyn E., Okamoto, Yoshitaka, Ollert, Markus, Palomares, Oscar, Papadopoulos, Nikolaos G., Panzner, Petr, Passalacqua, Giovanni, Patella, Vincenzo, Petrovic, Mirko, Pfaar, Oliver, Pham-Thi, Nhân, Plavec, Davor, Popov, Todor A., Recto, Marysia T., Regateiro, Frederico S., Reynes, Jacques, Roller-Winsberger, Regina E., Rolland, Yves, Romano, Antonino, Rondon, Carmen, Rottem, Menachem, Rouadi, Philip W., Salles, Nathalie, Samolinski, Boleslaw, Santos, Alexandra F., S Sarquis, Faradiba, Sastre, Joaquin, M. G. A. Schols, Jos, Scichilone, Nicola, Sediva, Anna, Shamji, Mohamed H., Sheikh, Aziz, Skypala, Isabel, Smolinska, Sylwia, Sokolowska, Milena, Sousa-Pinto, Bernardo, Sova, Milan, Stelmach, Rafael, Sturm, Gunter, Suppli Ulrik, Charlotte, Todo-Bom, Ana Maria, Toppila-Salmi, Sanna, Tsiligianni, Ioanna, Torres, Maria, Untersmayr, Eva, Urrutia Pereira, Marilyn, Valiulis, Arunas, Vitte, Joana, Vultaggio, Alessandra, Wallace, Dana, Walusiak-Skorupa, Jolanta, Wang, De Yun, Waserman, Susan, Yorgancioglu, Arzu, Yusuf, Osman M., Zernotti, Mario, Zidarn, Mihaela, Chivato, Tomas, Akdis, Cezmi A., Zuberbier, Torsten, and Klimek, Ludger
Abstract: Older adults, especially men and/or those with diabetes, hypertension, and/or obesity, are prone to severe COVID-19. In some countries, older adults, particularly those residing in nursing homes, have been prioritized to receive COVID-19 vaccines due to high risk of death. In very rare instances, the COVID-19 vaccines can induce anaphylaxis, and the management of anaphylaxis in older people should be considered carefully. An ARIA-EAACI-EuGMS (Allergic Rhinitis and its Impact on Asthma, European Academy of Allergy and Clinical Immunology, and European Geriatric Medicine Society) Working Group has proposed some recommendations for older adults receiving the COVID-19 vaccines. Anaphylaxis to COVID-19 vaccines is extremely rare (from 1 per 100,000 to 5 per million injections). Symptoms are similar in younger and older adults but they tend to be more severe in the older patients. Adrenaline is the mainstay treatment and should be readily available. A flowchart is proposed to manage anaphylaxis in the older patients.
Published: 2021

29. Predicting food allergy: The value of patient history reinforced

Author: Lyons, Sarah A; https://orcid.org/0000-0001-7128-2699, Knulst, André C, Burney, Peter G J, Fernandez-Rivas, Montserrat, Ballmer-Weber, Barbara K, Barreales, Laura, Bieli, Christian, Clausen, Michael, Dubakiene, Ruta, Fernandez-Perez, Cristina, Jedrzejczak-Czechowicz, Monika, Kowalski, Marek L; https://orcid.org/0000-0002-8442-2774, Kummeling, Ischa, Kralimarkova, Tanya, Mustakov, Tihomir B, van Os-Medendorp, Harmieke, Papadopoulos, Nikolaos G, Popov, Todor A, Potts, James, Versteeg, Serge A, Xepapadaki, Paraskevi; https://orcid.org/0000-0001-9204-1923, Welsing, Paco M J, Mills, Clare, van Ree, Ronald, Le, Thuy-My, Lyons, Sarah A; https://orcid.org/0000-0001-7128-2699, Knulst, André C, Burney, Peter G J, Fernandez-Rivas, Montserrat, Ballmer-Weber, Barbara K, Barreales, Laura, Bieli, Christian, Clausen, Michael, Dubakiene, Ruta, Fernandez-Perez, Cristina, Jedrzejczak-Czechowicz, Monika, Kowalski, Marek L; https://orcid.org/0000-0002-8442-2774, Kummeling, Ischa, Kralimarkova, Tanya, Mustakov, Tihomir B, van Os-Medendorp, Harmieke, Papadopoulos, Nikolaos G, Popov, Todor A, Potts, James, Versteeg, Serge A, Xepapadaki, Paraskevi; https://orcid.org/0000-0001-9204-1923, Welsing, Paco M J, Mills, Clare, van Ree, Ronald, and Le, Thuy-My
Abstract: BACKGROUND: EAACI guidelines emphasize the importance of patient history in diagnosing food allergy (FA) and the need for studies investigating its value using standardized allergy-focused questionnaires. OBJECTIVE: To determine the contribution of reaction characteristics, allergic comorbidities and demographics to prediction of FA in individuals experiencing food-related adverse reactions. METHODS: Adult and school-age participants in the standardized EuroPrevall population surveys, with self-reported FA, were included. Penalized multivariable regression was used to assess the association of patient history determinants with "probable" FA, defined as a food-specific case history supported by relevant IgE sensitization. RESULTS: In adults (N = 844), reproducibility of reaction (OR 1.35 [95% CI 1.29-1.41]), oral allergy symptoms (OAS) (4.46 [4.19-4.75]), allergic rhinitis (AR) comorbidity (2.82 [2.68-2.95]), asthma comorbidity (1.38 [1.30-1.46]) and male sex (1.50 [1.41-1.59]) were positively associated with probable FA. Gastrointestinal symptoms (0.88 [0.85-0.91]) made probable FA less likely. The AUC of a model combining all selected predictors was 0.85 after cross-validation. In children (N = 670), OAS (2.26 [2.09-2.44]) and AR comorbidity (1.47 [CI 1.39-1.55]) contributed most to prediction of probable FA, with a combined cross-validation-based AUC of 0.73. When focusing on plant foods, the dominant source of FA in adults, the pediatric model also included gastrointestinal symptoms (inverse association), and the AUC increased to 0.81. CONCLUSIONS: In both adults and school-age children from the general population, reporting of OAS and of AR comorbidity appear to be the strongest predictors of probable FA. Patient history particularly allows for good discrimination between presence and absence of probable plant FA.
Published: 2021

30. Walnut Allergy across Europe: Distribution of Allergen Sensitization Patterns and Prediction of Severity

Author: MS Dermatologie/Allergologie, Infection & Immunity, DIGD-Onderzoek, Lyons, S A, Datema, M R, Le, T T M, Asero, R, Barreales, L, Belohlavkova, S, de Blay, F, Clausen, M, Dubakiene, R, Fernández-Perez, C, Fritsche, P, Gislason, D, Hoffmann-Sommergruber, K, Jedrzejczak-Czechowicz, M, Jongejan, L, Kowalski, M L, Kralimarkova, T, Lidholm, J, Papadopoulos, N G, Pontoppidan, B, Popov, T A, Del Prado, N, Purohit, A, Reig, I, Seneviratne, S L, Sinaniotis, A, Vassilopoulou, E, Versteeg, S A, Vieths, S, Zwinderman, A H, Welsing, P M J, Mills, E N C, Ballmer-Weber, Barbara, Knulst, A C, Fernández-Rivas, Montserrat, Van Ree, Ronald, MS Dermatologie/Allergologie, Infection & Immunity, DIGD-Onderzoek, Lyons, S A, Datema, M R, Le, T T M, Asero, R, Barreales, L, Belohlavkova, S, de Blay, F, Clausen, M, Dubakiene, R, Fernández-Perez, C, Fritsche, P, Gislason, D, Hoffmann-Sommergruber, K, Jedrzejczak-Czechowicz, M, Jongejan, L, Kowalski, M L, Kralimarkova, T, Lidholm, J, Papadopoulos, N G, Pontoppidan, B, Popov, T A, Del Prado, N, Purohit, A, Reig, I, Seneviratne, S L, Sinaniotis, A, Vassilopoulou, E, Versteeg, S A, Vieths, S, Zwinderman, A H, Welsing, P M J, Mills, E N C, Ballmer-Weber, Barbara, Knulst, A C, Fernández-Rivas, Montserrat, and Van Ree, Ronald
Published: 2021

31. Predicting food allergy: the value of patient history reinforced

Author: MS Dermatologie/Allergologie, Infection & Immunity, Afdeling Dermatologie/Allergologie, Lab Reumatologie/Klinische Immunologie, Regenerative Medicine and Stem Cells, JC onderzoeksprogramma Methodologie, Lyons, Sarah A, Knulst, André C, Burney, Peter G J, Fernandez-Rivas, Montserrat, Ballmer-Weber, Barbara K, Barreales, Laura, Bieli, Christian, Clausen, Michael, Dubakiene, Ruta, Fernandez-Perez, Cristina, Jedrzejczak-Czechowicz, Monika, Kowalski, Marek L, Kummeling, Ischa, Kralimarkova, Tanya, Mustakov, Tihomir B, van Os-Medendorp, Harmieke, Papadopoulos, Nikolaos G, Popov, Todor A, Potts, James, Versteeg, Serge A, Xepapadaki, Paraskevi, Welsing, Paco M J, Mills, E N Clare, van Ree, Ronald, Le, Thuy-My, MS Dermatologie/Allergologie, Infection & Immunity, Afdeling Dermatologie/Allergologie, Lab Reumatologie/Klinische Immunologie, Regenerative Medicine and Stem Cells, JC onderzoeksprogramma Methodologie, Lyons, Sarah A, Knulst, André C, Burney, Peter G J, Fernandez-Rivas, Montserrat, Ballmer-Weber, Barbara K, Barreales, Laura, Bieli, Christian, Clausen, Michael, Dubakiene, Ruta, Fernandez-Perez, Cristina, Jedrzejczak-Czechowicz, Monika, Kowalski, Marek L, Kummeling, Ischa, Kralimarkova, Tanya, Mustakov, Tihomir B, van Os-Medendorp, Harmieke, Papadopoulos, Nikolaos G, Popov, Todor A, Potts, James, Versteeg, Serge A, Xepapadaki, Paraskevi, Welsing, Paco M J, Mills, E N Clare, van Ree, Ronald, and Le, Thuy-My
Published: 2021

32. Secondary prevention measures in anaphylaxis patients: Data from the anaphylaxis registry

Author: Kraft, Magdalena; https://orcid.org/0000-0002-2770-9947, Knop, Macarena Pia, Renaudin, Jean-Marie, Scherer Hofmeier, Kathrin, Pföhler, Claudia, Bilò, Maria Beatrice, Lang, Roland, Treudler, Regina, Wagner, Nicola, Spindler, Thomas, Hourihane, Jonathan O'B, Maris, Ioana, Koehli, Alice, Bauer, Andrea, Lange, Lars; https://orcid.org/0000-0003-1104-5848, Müller, Sabine, Papadopoulos, Nikolaos G, Wedi, Bettina; https://orcid.org/0000-0002-9868-6308, Moeser, Anne, Ensina, Luis F, Fernandez-Rivas, Montserrat, Cichocka-Jarosz, Ewa, Christoff, George, Garcia, Blanca E, Poziomkowska-Gęsicka, Iwona, Cardona, Victoria; https://orcid.org/0000-0003-2197-9767, Mustakov, Tihomir B, Rabe, Uta, Mahler, Vera, Grabenhenrich, Linus, et al, Kraft, Magdalena; https://orcid.org/0000-0002-2770-9947, Knop, Macarena Pia, Renaudin, Jean-Marie, Scherer Hofmeier, Kathrin, Pföhler, Claudia, Bilò, Maria Beatrice, Lang, Roland, Treudler, Regina, Wagner, Nicola, Spindler, Thomas, Hourihane, Jonathan O'B, Maris, Ioana, Koehli, Alice, Bauer, Andrea, Lange, Lars; https://orcid.org/0000-0003-1104-5848, Müller, Sabine, Papadopoulos, Nikolaos G, Wedi, Bettina; https://orcid.org/0000-0002-9868-6308, Moeser, Anne, Ensina, Luis F, Fernandez-Rivas, Montserrat, Cichocka-Jarosz, Ewa, Christoff, George, Garcia, Blanca E, Poziomkowska-Gęsicka, Iwona, Cardona, Victoria; https://orcid.org/0000-0003-2197-9767, Mustakov, Tihomir B, Rabe, Uta, Mahler, Vera, Grabenhenrich, Linus, and et al
Abstract: BACKGROUND Patients with a history of anaphylaxis are at risk of future anaphylactic reactions. Thus, secondary prevention measures are recommended for these patients to prevent or attenuate the next reaction. METHODS Data from the Anaphylaxis Registry were analyzed to identify secondary prevention measures offered to patients who experienced anaphylaxis. Our analysis included 7788 cases from 10 European countries and Brazil. RESULTS The secondary prevention measures offered varied across the elicitors. A remarkable discrepancy was observed between prevention measures offered in specialized allergy centers (84% of patients were prescribed adrenaline autoinjectors following EAACI guidelines) and outside the centers: Here, EAACI guideline adherence was only 37%. In the multivariate analysis, the elicitor of the reaction, age of the patient, mastocytosis as comorbidity, severity of the reaction, and reimbursement/availability of the autoinjector influence physician's decision to prescribe one. CONCLUSIONS Based on the low implementation of guidelines concerning secondary prevention measures outside of specialized allergy centers, our findings highlight the importance of these specialized centers and the requirement of better education for primary healthcare and emergency physicians.
Published: 2020

33. APPEAL‐1: A pan‐European survey of patient/caregiver perceptions of peanut allergy management

Author: Blümchen, Katharina, DunnGalvin, Audrey, Timmermans, Frans, Regent, Lynne, Schnadt, Sabine, Podestà, Marcia, Sánchez, Angel, Couratier, Pascale, Feeney, Mary, Hjorth, Betina, Patel, Ram, Lush, Tessa, Ryan, Robert, Vereda, Andrea, Fisher, Helen R., Fernández‐Rivas, Montserrat, Blümchen, Katharina, DunnGalvin, Audrey, Timmermans, Frans, Regent, Lynne, Schnadt, Sabine, Podestà, Marcia, Sánchez, Angel, Couratier, Pascale, Feeney, Mary, Hjorth, Betina, Patel, Ram, Lush, Tessa, Ryan, Robert, Vereda, Andrea, Fisher, Helen R., and Fernández‐Rivas, Montserrat
Abstract: Background: Peanut allergy (PA) is associated with marked quality‐of‐life (QoL) impairment. However, data are lacking on the experience and impact of living with PA from the perspectives of persons with PA (PwPA) and their caregivers. Allergy to Peanuts imPacting Emotions And Life study 1 (APPEAL‐1) was a pan‐European survey investigating these perspectives. This first of two articles reports clinical characteristics of PwPA and PA management practices. Methods: APPEAL‐1 was a quantitative, online survey conducted in eight European countries, developed by eight representatives of patient advocacy groups and five healthcare professionals and researchers. Eligible participants included adults with PA and parents/caregivers of PwPA who responded by self‐report and provided proxy‐report for the PwPA under their care. Data were summarized using nonweighted descriptive statistics. Results: Of 1846 completed/analysed questionnaires, 528 were from adults with PA (self‐report); 437 by proxy for children with PA (34 aged 0‐3 years, 287 aged 4‐12 years, 116 aged 13‐17 years) and 881 from parents/caregivers (self‐report). Of PwPA (N = 965), 95% reported diagnosis by healthcare professionals, mostly by clinical history and peanut‐specific allergy testing. Rates of allergic rhinitis, asthma and other food allergies in PwPA were 50%, 42% and 79%, respectively. Only 31% of PwPA received HCP advice/support following their worst allergic reaction, and 28% had not been prescribed an adrenaline auto‐injector. Results were similar by country but varied by age group. Conclusions: The APPEAL‐1 findings contribute to greater understanding of PA impact on PwPA, caregivers and family members and the need for improved PA management across Europe.
Published: 2020

34. Prevalence of food sensitization and food allergy in children across Europe

Author: Lyons, Sarah A, Clausen, Michael, Knulst, André C, Ballmer-Weber, Barbara K, Fernandez-Rivas, Montserrat, Barreales, Laura, Bieli, Christian, Dubakiene, Ruta, Fernandez-Perez, Cristina, Jedrzejczak-Czechowicz, Monika, Kowalski, Marek L, Kralimarkova, Tanya, Kummeling, Ischa, Mustakov, Tihomir B, Papadopoulos, Nikolaos G, Popov, Todor A, Xepapadaki, Paraskevi, Welsing, Paco M J, Potts, James, Mills, E N Clare, van Ree, Ronald, Burney, Peter G J, Le, Thuy-My, Lyons, Sarah A, Clausen, Michael, Knulst, André C, Ballmer-Weber, Barbara K, Fernandez-Rivas, Montserrat, Barreales, Laura, Bieli, Christian, Dubakiene, Ruta, Fernandez-Perez, Cristina, Jedrzejczak-Czechowicz, Monika, Kowalski, Marek L, Kralimarkova, Tanya, Kummeling, Ischa, Mustakov, Tihomir B, Papadopoulos, Nikolaos G, Popov, Todor A, Xepapadaki, Paraskevi, Welsing, Paco M J, Potts, James, Mills, E N Clare, van Ree, Ronald, Burney, Peter G J, and Le, Thuy-My
Abstract: BACKGROUND: For adults, prevalence estimates of food sensitization (FS) and food allergy (FA) have been obtained in a standardized manner across Europe. For children, such estimates are lacking. OBJECTIVES: To determine the prevalence of self-reported FA, FS, probable FA (symptoms plus IgE sensitization), and challenge-confirmed FA in European school-age children. METHODS: Data on self-reported FA were collected through a screening questionnaire sent to a random sample of the general population of 7- to 10-year-old children in 8 European centers in phase I of the EuroPrevall study. Data on FS and probable FA were obtained in phase II, comprising an extensive questionnaire on reactions to 24 commonly implicated foods, and serology testing. Food challenge was performed in phase III. RESULTS: Prevalence (95% CI) of self-reported FA ranged from 6.5% (5.4-7.6) in Athens to 24.6% (22.8-26.5) in Lodz; prevalence of FS ranged from 11.0% (9.7-12.3) in Reykjavik to 28.7% (26.9-30.6) in Zurich; and prevalence of probable FA ranged from 1.9% (0.8-3.5) in Reykjavik to 5.6% (3.6-8.1) in Lodz. In all centers, most food-sensitized subjects had primary (non-cross-reactive) FS. However, FS due to birch pollen related cross-reactivity was also common in Central-Northern Europe. Probable FA to milk and egg occurred frequently throughout Europe; to fish and shrimp mainly in the Mediterranean and Reykjavik. Peach, kiwi, and peanut were prominent sources of plant FA in most countries, along with notably hazelnut, apple, carrot, and celery in Central-Northern Europe and lentils and walnut in the Mediterranean. CONCLUSIONS: There are large geograhical differences in the prevalence of FS and FA in school-age children across Europe. Both primary and cross-reactive FS and FA occur frequently.
Published: 2020

35. Predictors of food sensitization in children and adults across Europe

Author: Lyons, Sarah A, Knulst, André C, Burney, Peter G J, Fernández-Rivas, Montserrat, Ballmer-Weber, Barbara K, Barreales, Laura, Bieli, Christian, Clausen, Michael, Dubakiene, Ruta, Fernández-Perez, Cristina, Jedrzejczak-Czechowicz, Monika, Kowalski, Marek L, Kummeling, Ischa, Mustakov, Tihomir B, van Os-Medendorp, Harmieke, Papadopoulos, Nikolaos G, Popov, Todor A, Potts, James, Xepapadaki, Paraskevi, Welsing, Paco M J, Mills, E N Clare, van Ree, Ronald, Le, Thuy-My, Lyons, Sarah A, Knulst, André C, Burney, Peter G J, Fernández-Rivas, Montserrat, Ballmer-Weber, Barbara K, Barreales, Laura, Bieli, Christian, Clausen, Michael, Dubakiene, Ruta, Fernández-Perez, Cristina, Jedrzejczak-Czechowicz, Monika, Kowalski, Marek L, Kummeling, Ischa, Mustakov, Tihomir B, van Os-Medendorp, Harmieke, Papadopoulos, Nikolaos G, Popov, Todor A, Potts, James, Xepapadaki, Paraskevi, Welsing, Paco M J, Mills, E N Clare, van Ree, Ronald, and Le, Thuy-My
Abstract: BACKGROUND: The geographical variation and temporal increase in the prevalence of food sensitization (FS) suggest environmental influences. OBJECTIVE: To investigate how environment, infant diet, and demographic characteristics, are associated with FS in children and adults, focusing on early-life exposures. METHODS: Data on childhood and adult environmental exposures (including, among others, sibship size, daycare, pets, farm environment, and smoking), infant diet (including breastfeeding and timing of introduction to infant formula and solids), and demographic characteristics were collected from 2196 school-age children and 2185 adults completing an extensive questionnaire and blood sampling in the cross-sectional pan-European EuroPrevall project. Multivariable logistic regression was applied to determine associations between the predictor variables and sensitization to foods commonly implicated in food allergy (specific IgE ≥0.35 kU$_{A}$/L). Secondary outcomes were inhalant sensitization and primary (non-cross-reactive) FS. RESULTS: Dog ownership in early childhood was inversely associated with childhood FS (odds ratio, 0.65; 95% CI, 0.48-0.90), as was higher gestational age at delivery (odds ratio, 0.93 [95% CI, 0.87-0.99] per week increase in age). Lower age and male sex were associated with a higher prevalence of adult FS (odds ratio, 0.97 [95% CI, 0.96-0.98] per year increase in age, and 1.39 [95% CI, 1.12-1.71] for male sex). No statistically significant associations were found between other evaluated environmental determinants and childhood or adult FS, nor between infant diet and childhood FS, although early introduction of solids did show a trend toward prevention of FS. CONCLUSIONS: Dog ownership seems to protect against childhood FS, but independent effects of other currently conceived environmental and infant dietary determinants on FS in childhood or adulthood could not be confirmed.
Published: 2020

36. Prevalence of Food Sensitization and Food Allergy in Children across Europe

Author: MS Dermatologie/Allergologie, Infection & Immunity, DIGD-Onderzoek, Lyons, Sarah A, Clausen, Michael, Knulst, André C, Ballmer-Weber, Barbara K, Fernandez-Rivas, Montserrat, Barreales, Laura, Bieli, Christian, Dubakiene, Ruta, Fernandez-Perez, Cristina, Jedrzejczak-Czechowicz, Monika, Kowalski, Marek L, Kralimarkova, Tanya, Kummeling, Ischa, Mustakov, Tihomir B, Papadopoulos, Nikolaos G, Popov, Todor A, Xepapadaki, Paraskevi, Welsing, Paco M J, Potts, James, Mills, E N Clare, van Ree, Ronald, Burney, Peter G J, Le, Thuy-My, MS Dermatologie/Allergologie, Infection & Immunity, DIGD-Onderzoek, Lyons, Sarah A, Clausen, Michael, Knulst, André C, Ballmer-Weber, Barbara K, Fernandez-Rivas, Montserrat, Barreales, Laura, Bieli, Christian, Dubakiene, Ruta, Fernandez-Perez, Cristina, Jedrzejczak-Czechowicz, Monika, Kowalski, Marek L, Kralimarkova, Tanya, Kummeling, Ischa, Mustakov, Tihomir B, Papadopoulos, Nikolaos G, Popov, Todor A, Xepapadaki, Paraskevi, Welsing, Paco M J, Potts, James, Mills, E N Clare, van Ree, Ronald, Burney, Peter G J, and Le, Thuy-My
Published: 2020

37. Predictors of Food Sensitization in Children and Adults across Europe

Author: MS Dermatologie/Allergologie, Infection & Immunity, Afdeling Dermatologie/Allergologie, DIGD-Onderzoek, Lyons, Sarah A, Knulst, André C, Burney, Peter G J, Fernández-Rivas, Montserrat, Ballmer-Weber, Barbara K, Barreales, Laura, Bieli, Christian, Clausen, Michael, Dubakiene, Ruta, Fernández-Perez, Cristina, Jedrzejczak-Czechowicz, Monika, Kowalski, Marek L, Kummeling, Ischa, Mustakov, Tihomir B, van Os-Medendorp, Harmieke, Papadopoulos, Nikolaos G, Popov, Todor A, Potts, James, Xepapadaki, Paraskevi, Welsing, Paco M J, Mills, E N Clare, van Ree, Ronald, Le, Thuy-My, MS Dermatologie/Allergologie, Infection & Immunity, Afdeling Dermatologie/Allergologie, DIGD-Onderzoek, Lyons, Sarah A, Knulst, André C, Burney, Peter G J, Fernández-Rivas, Montserrat, Ballmer-Weber, Barbara K, Barreales, Laura, Bieli, Christian, Clausen, Michael, Dubakiene, Ruta, Fernández-Perez, Cristina, Jedrzejczak-Czechowicz, Monika, Kowalski, Marek L, Kummeling, Ischa, Mustakov, Tihomir B, van Os-Medendorp, Harmieke, Papadopoulos, Nikolaos G, Popov, Todor A, Potts, James, Xepapadaki, Paraskevi, Welsing, Paco M J, Mills, E N Clare, van Ree, Ronald, and Le, Thuy-My
Published: 2020

38. Deriving individual threshold doses from clinical food challenge data for population risk assessment of food allergens

Author: Westerhout, Joost, Baumert, Joseph L., Blom, W. Marty, Allen, Katrina J., Ballmer-Weber, Barbara, Crevel, René W.R., Dubois, Anthony E.J., Fernández-Rivas, Montserrat, Greenhawt, Matthew J., Hourihane, Jonathan O.B., Koplin, Jennifer J., Kruizinga, Astrid G., Le, Thuy My, Sampson, Hugh A., Shreffler, Wayne G., Turner, Paul J., Taylor, Steve L., Houben, Geert F., Remington, Benjamin C., Westerhout, Joost, Baumert, Joseph L., Blom, W. Marty, Allen, Katrina J., Ballmer-Weber, Barbara, Crevel, René W.R., Dubois, Anthony E.J., Fernández-Rivas, Montserrat, Greenhawt, Matthew J., Hourihane, Jonathan O.B., Koplin, Jennifer J., Kruizinga, Astrid G., Le, Thuy My, Sampson, Hugh A., Shreffler, Wayne G., Turner, Paul J., Taylor, Steve L., Houben, Geert F., and Remington, Benjamin C.
Published: 2019

39. Identifying and managing patients at risk of severe allergic reactions to food:report from two iFAAM workshops

Author: Roberts, Graham, Allen, Katie, Ballmer-Weber, Barbara, Clark, Andrew, Crevel, Rene, Dunn Galvin, Audrey, Fernandez-Rivas, Montserrat, Grimshaw, Kate E C, Hourihane, Jonathan O'B, Poulsen, Lars K, van Ree, Ronald, Regent, Lynn, Remington, Ben, Schnadt, Sabine, Turner, Paul J, Mills, E N Clare, Roberts, Graham, Allen, Katie, Ballmer-Weber, Barbara, Clark, Andrew, Crevel, Rene, Dunn Galvin, Audrey, Fernandez-Rivas, Montserrat, Grimshaw, Kate E C, Hourihane, Jonathan O'B, Poulsen, Lars K, van Ree, Ronald, Regent, Lynn, Remington, Ben, Schnadt, Sabine, Turner, Paul J, and Mills, E N Clare
Abstract: Food allergy affects a small but important number of children and adults. Much of the morbidity associated with food allergy is driven by the fear of a severe reaction, and fatalities continue to occur. Foods are the commonest cause of anaphylaxis. One of the aims of the European Union funded Integrated Approaches to Food Allergen and Allergy Risk Management (iFAAM) project was to improve the identification and management of children and adults at risk of experiencing a severe reaction. A number of interconnected studies within the project have focused on quantifying the severity of allergic reactions; the impact of food matrix, immunological factors on severity of reactions; the impact of co-factors such as medications on the severity of reactions; utilising single dose challenges to understand threshold and severity of reactions; and community studies to understand the experience of patients suffering real-life allergic reactions to food. Associated studies have examined population thresholds, and co-factors such as exercise and stress. This paper summarises two workshops focused on the severity of allergic reactions to food. It outlines the related studies being undertaken in the project indicating how they are likely to impact on our ability to identify individuals at risk of severe reactions and improve their management.
Published: 2019

40. Deriving individual threshold doses from clinical food challenge data for population risk assessment of food allergens

Author: Westerhout, Joost, Baumert, Joseph L., Blom, W. Marty, Allen, Katrina J., Ballmer-Weber, Barbara, Crevel, René W.R., Dubois, Anthony E.J., Fernández-Rivas, Montserrat, Greenhawt, Matthew J., Hourihane, Jonathan O.B., Koplin, Jennifer J., Kruizinga, Astrid G., Le, Thuy My, Sampson, Hugh A., Shreffler, Wayne G., Turner, Paul J., Taylor, Steve L., Houben, Geert F., Remington, Benjamin C., Westerhout, Joost, Baumert, Joseph L., Blom, W. Marty, Allen, Katrina J., Ballmer-Weber, Barbara, Crevel, René W.R., Dubois, Anthony E.J., Fernández-Rivas, Montserrat, Greenhawt, Matthew J., Hourihane, Jonathan O.B., Koplin, Jennifer J., Kruizinga, Astrid G., Le, Thuy My, Sampson, Hugh A., Shreffler, Wayne G., Turner, Paul J., Taylor, Steve L., Houben, Geert F., and Remington, Benjamin C.
Published: 2019

41. EAACI Guidelines on Allergen Immunotherapy: House dust mite-driven allergic asthma

Author: Agache, Ioana, Lau, Susanne, Akdis, Cezmi A., Smolinska, Sylwia, Bonini, Matteo, Cavkaytar, Ozlem, Flood, Breda, Gajdanowicz, Pawe, Izuhara, Kenji, Kalayci, Omer, Mosges, Ralph, Palomares, Oscar, Papadopoulos, Nikolaos G., Sokolowska, Milena, Angier, Elisabeth, Fernandez-Rivas, Montserrat, Pajno, Giovanni, Pfaar, Oliver, Roberts, Graham C., Ryan, Dermot, Sturm, Gunter J., van Ree, Ronald, Varga, Eva M., van Wijk, Roy Gerth, Yepes-Nunez, Juan Jose, Jutel, Marek, Agache, Ioana, Lau, Susanne, Akdis, Cezmi A., Smolinska, Sylwia, Bonini, Matteo, Cavkaytar, Ozlem, Flood, Breda, Gajdanowicz, Pawe, Izuhara, Kenji, Kalayci, Omer, Mosges, Ralph, Palomares, Oscar, Papadopoulos, Nikolaos G., Sokolowska, Milena, Angier, Elisabeth, Fernandez-Rivas, Montserrat, Pajno, Giovanni, Pfaar, Oliver, Roberts, Graham C., Ryan, Dermot, Sturm, Gunter J., van Ree, Ronald, Varga, Eva M., van Wijk, Roy Gerth, Yepes-Nunez, Juan Jose, and Jutel, Marek
Abstract: Allergen immunotherapy (AIT) has been in use for the treatment of allergic disease for more than 100 years. Asthma treatment relies mainly on corticosteroids and other controllers recommended to achieve and maintain asthma control, prevent exacerbations, and improve quality of life. AIT is underused in asthma, both in children and in adults. Notably, patients with allergic asthma not adequately controlled on pharmacotherapy (including biologics) represent an unmet health need. The European Academy of Allergy and Clinical Immunology has developed a clinical practice guideline providing evidence-based recommendations for the use of house dust mites (HDM) AIT as add-on treatment for HDM-driven allergic asthma. This guideline was developed by a multi-disciplinary working group using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. HDM AIT was separately evaluated by route of administration and children and adults: subcutaneous (SCIT) and sublingual AIT (SLIT), drops, and tablets. Recommendations were formulated for each. The important prerequisites for successful treatment with HDM AIT are (a) selection of patients most likely to respond to AIT and (b) use of allergen extracts and desensitization protocols of proven efficacy. To date, only AIT with HDM SLIT-tablet has demonstrated a robust effect in adults for critical end points (exacerbations, asthma control, and safety). Thus, it is recommended as an add-on to regular asthma therapy for adults with controlled or partially controlled HDM-driven allergic asthma (conditional recommendation, moderate-quality evidence). HDM SCIT is recommended for adults and children, and SLIT drops are recommended for children with controlled HDM-driven allergic asthma as the add-on to regular asthma therapy to decrease symptoms and medication needs (conditional recommendation, low-quality evidence).
Published: 2019

42. Deriving individual threshold doses from clinical food challenge data for population risk assessment of food allergens

Author: Westerhout, Joost, Baumert, Joseph L., Blom, W. Marty, Allen, Katrina J., Ballmer-Weber, Barbara, Crevel, René W.R., Dubois, Anthony E.J., Fernández-Rivas, Montserrat, Greenhawt, Matthew J., Hourihane, Jonathan O.B., Koplin, Jennifer J., Kruizinga, Astrid G., Le, Thuy My, Sampson, Hugh A., Shreffler, Wayne G., Turner, Paul J., Taylor, Steve L., Houben, Geert F., Remington, Benjamin C., Westerhout, Joost, Baumert, Joseph L., Blom, W. Marty, Allen, Katrina J., Ballmer-Weber, Barbara, Crevel, René W.R., Dubois, Anthony E.J., Fernández-Rivas, Montserrat, Greenhawt, Matthew J., Hourihane, Jonathan O.B., Koplin, Jennifer J., Kruizinga, Astrid G., Le, Thuy My, Sampson, Hugh A., Shreffler, Wayne G., Turner, Paul J., Taylor, Steve L., Houben, Geert F., and Remington, Benjamin C.
Published: 2019

43. Guía de actuación en anafilaxia en Latinoamérica. Galaxia-Latam

Author: Cardona, Victoria, Álvarez Perea, Alberto, Ansotegui Zubeldia, Ignacio Javier, Arias Cruz, Alfredo, Ivancevich, Juan Carlos, González Díaz, Sandra Nora, Latour Staffeld, Patricia, Sánchez Borges, Mario, Serrano, Carlos D., Solé, Dirceu, Tanno, Luciana Kase, Cabañes Higuero, Nieves, Chivato, Tomás, De la Hoz, Belén, Fernández Rivas, Montserrat, Gangoiti, Iker, Guardia Martínez, Pedro, Herranz Sanz, Miguel Ángel, Juliá Benito, Juan Carlos, Lobera Labairu, Teófilo, Praena Crespo, Manuel, Prieto Romo, José Ignacio, Sánchez Salguero, Carlos, Sánchez González, José Ignacio, Uixera Marzal, Sonia, Vega, Arantza, Villarroel, Pedro, Jares, Edgardo José, Cardona, Victoria, Álvarez Perea, Alberto, Ansotegui Zubeldia, Ignacio Javier, Arias Cruz, Alfredo, Ivancevich, Juan Carlos, González Díaz, Sandra Nora, Latour Staffeld, Patricia, Sánchez Borges, Mario, Serrano, Carlos D., Solé, Dirceu, Tanno, Luciana Kase, Cabañes Higuero, Nieves, Chivato, Tomás, De la Hoz, Belén, Fernández Rivas, Montserrat, Gangoiti, Iker, Guardia Martínez, Pedro, Herranz Sanz, Miguel Ángel, Juliá Benito, Juan Carlos, Lobera Labairu, Teófilo, Praena Crespo, Manuel, Prieto Romo, José Ignacio, Sánchez Salguero, Carlos, Sánchez González, José Ignacio, Uixera Marzal, Sonia, Vega, Arantza, Villarroel, Pedro, and Jares, Edgardo José
Published: 2019

44. Deriving individual threshold doses from clinical food challenge data for population risk assessment of food allergens

Author: MS Dermatologie/Allergologie, Infection & Immunity, Westerhout, Joost, Baumert, Joseph L., Blom, W. Marty, Allen, Katrina J., Ballmer-Weber, Barbara, Crevel, René W.R., Dubois, Anthony E.J., Fernández-Rivas, Montserrat, Greenhawt, Matthew J., Hourihane, Jonathan O.B., Koplin, Jennifer J., Kruizinga, Astrid G., Le, Thuy My, Sampson, Hugh A., Shreffler, Wayne G., Turner, Paul J., Taylor, Steve L., Houben, Geert F., Remington, Benjamin C., MS Dermatologie/Allergologie, Infection & Immunity, Westerhout, Joost, Baumert, Joseph L., Blom, W. Marty, Allen, Katrina J., Ballmer-Weber, Barbara, Crevel, René W.R., Dubois, Anthony E.J., Fernández-Rivas, Montserrat, Greenhawt, Matthew J., Hourihane, Jonathan O.B., Koplin, Jennifer J., Kruizinga, Astrid G., Le, Thuy My, Sampson, Hugh A., Shreffler, Wayne G., Turner, Paul J., Taylor, Steve L., Houben, Geert F., and Remington, Benjamin C.
Published: 2019

45. EAACI Guidelines on Allergen Immunotherapy: House dust mite-driven allergic asthma

Author: Agache, Ioana, Lau, Susanne, Akdis, Cezmi A., Smolinska, Sylwia, Bonini, Matteo, Cavkaytar, Ozlem, Flood, Breda, Gajdanowicz, Pawe, Izuhara, Kenji, Kalayci, Omer, Mosges, Ralph, Palomares, Oscar, Papadopoulos, Nikolaos G., Sokolowska, Milena, Angier, Elisabeth, Fernandez-Rivas, Montserrat, Pajno, Giovanni, Pfaar, Oliver, Roberts, Graham C., Ryan, Dermot, Sturm, Gunter J., van Ree, Ronald, Varga, Eva M., van Wijk, Roy Gerth, Yepes-Nunez, Juan Jose, Jutel, Marek, Agache, Ioana, Lau, Susanne, Akdis, Cezmi A., Smolinska, Sylwia, Bonini, Matteo, Cavkaytar, Ozlem, Flood, Breda, Gajdanowicz, Pawe, Izuhara, Kenji, Kalayci, Omer, Mosges, Ralph, Palomares, Oscar, Papadopoulos, Nikolaos G., Sokolowska, Milena, Angier, Elisabeth, Fernandez-Rivas, Montserrat, Pajno, Giovanni, Pfaar, Oliver, Roberts, Graham C., Ryan, Dermot, Sturm, Gunter J., van Ree, Ronald, Varga, Eva M., van Wijk, Roy Gerth, Yepes-Nunez, Juan Jose, and Jutel, Marek
Abstract: Allergen immunotherapy (AIT) has been in use for the treatment of allergic disease for more than 100 years. Asthma treatment relies mainly on corticosteroids and other controllers recommended to achieve and maintain asthma control, prevent exacerbations, and improve quality of life. AIT is underused in asthma, both in children and in adults. Notably, patients with allergic asthma not adequately controlled on pharmacotherapy (including biologics) represent an unmet health need. The European Academy of Allergy and Clinical Immunology has developed a clinical practice guideline providing evidence-based recommendations for the use of house dust mites (HDM) AIT as add-on treatment for HDM-driven allergic asthma. This guideline was developed by a multi-disciplinary working group using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. HDM AIT was separately evaluated by route of administration and children and adults: subcutaneous (SCIT) and sublingual AIT (SLIT), drops, and tablets. Recommendations were formulated for each. The important prerequisites for successful treatment with HDM AIT are (a) selection of patients most likely to respond to AIT and (b) use of allergen extracts and desensitization protocols of proven efficacy. To date, only AIT with HDM SLIT-tablet has demonstrated a robust effect in adults for critical end points (exacerbations, asthma control, and safety). Thus, it is recommended as an add-on to regular asthma therapy for adults with controlled or partially controlled HDM-driven allergic asthma (conditional recommendation, moderate-quality evidence). HDM SCIT is recommended for adults and children, and SLIT drops are recommended for children with controlled HDM-driven allergic asthma as the add-on to regular asthma therapy to decrease symptoms and medication needs (conditional recommendation, low-quality evidence).
Published: 2019

46. Identifying and managing patients at risk of severe allergic reactions to food:report from two iFAAM workshops

Author: Roberts, Graham, Allen, Katie, Ballmer-Weber, Barbara, Clark, Andrew, Crevel, Rene, Dunn Galvin, Audrey, Fernandez-Rivas, Montserrat, Grimshaw, Kate E C, Hourihane, Jonathan O'B, Poulsen, Lars K, van Ree, Ronald, Regent, Lynn, Remington, Ben, Schnadt, Sabine, Turner, Paul J, Mills, E N Clare, Roberts, Graham, Allen, Katie, Ballmer-Weber, Barbara, Clark, Andrew, Crevel, Rene, Dunn Galvin, Audrey, Fernandez-Rivas, Montserrat, Grimshaw, Kate E C, Hourihane, Jonathan O'B, Poulsen, Lars K, van Ree, Ronald, Regent, Lynn, Remington, Ben, Schnadt, Sabine, Turner, Paul J, and Mills, E N Clare
Abstract: Food allergy affects a small but important number of children and adults. Much of the morbidity associated with food allergy is driven by the fear of a severe reaction, and fatalities continue to occur. Foods are the commonest cause of anaphylaxis. One of the aims of the European Union funded Integrated Approaches to Food Allergen and Allergy Risk Management (iFAAM) project was to improve the identification and management of children and adults at risk of experiencing a severe reaction. A number of interconnected studies within the project have focused on quantifying the severity of allergic reactions; the impact of food matrix, immunological factors on severity of reactions; the impact of co-factors such as medications on the severity of reactions; utilising single dose challenges to understand threshold and severity of reactions; and community studies to understand the experience of patients suffering real-life allergic reactions to food. Associated studies have examined population thresholds, and co-factors such as exercise and stress. This paper summarises two workshops focused on the severity of allergic reactions to food. It outlines the related studies being undertaken in the project indicating how they are likely to impact on our ability to identify individuals at risk of severe reactions and improve their management.
Published: 2019

47. Rational Design, Structure-Activity Relationship, and Immunogenicity of Hypoallergenic Pru p 3 Variants

Author: Eichhorn, Stephanie, Hörschläger, Angelika, Steiner, Markus, Laimer, Josef, Jensen, Bettina M, Versteeg, Serge A, Pablos, Isabel, Briza, Peter, Jongejan, Laurian, Rigby, Neil, Asturias, Juan A, Portolés, Antonio, Fernandez-Rivas, Montserrat, Papadopoulos, Nikolaos G, Mari, Adriano, Poulsen, Lars K, Lackner, Peter, van Ree, Ronald, Ferreira, Fatima, Gadermaier, Gabriele, Eichhorn, Stephanie, Hörschläger, Angelika, Steiner, Markus, Laimer, Josef, Jensen, Bettina M, Versteeg, Serge A, Pablos, Isabel, Briza, Peter, Jongejan, Laurian, Rigby, Neil, Asturias, Juan A, Portolés, Antonio, Fernandez-Rivas, Montserrat, Papadopoulos, Nikolaos G, Mari, Adriano, Poulsen, Lars K, Lackner, Peter, van Ree, Ronald, Ferreira, Fatima, and Gadermaier, Gabriele
Abstract: SCOPE: Allergies to lipid transfer proteins involve severe adverse reactions; thus, effective and sustainable therapies are desired. Previous attempts disrupting disulfide bonds failed to maintain immunogenicity; thus, the aim is to design novel hypoallergenic Pru p 3 variants and evaluate the applicability for treatment of peach allergy.METHODS AND RESULTS: Pru p 3 proline variant (PV) designed using in silico mutagenesis, cysteine variant (CV), and wild-type Pru p 3 (WT) are purified from Escherichia coli. Variants display homogenous and stable protein conformations with an altered secondary structure in circular dichroism. PV shows enhanced long-term storage capacities compared to CV similar to the highly stable WT. Using sera of 33 peach allergic patients, IgE-binding activity is reduced by 97% (PV) and 71% (CV) compared to WT. Both molecules show strong hypoallergenicity in Pru p 3 ImmunoCAP cross-inhibition and histamine release assays. Immunogenicity of PV is demonstrated with a phosphate-based adjuvant formulation in a mouse model.CONCLUSIONS: An in silico approach is used to generate a PV without targeting disulfide bonds, T cell epitopes, or previously reported IgE epitopes of Pru p 3. PV is strongly hypoallergenic while structurally stable and immunogenic, thus representing a promising candidate for peach allergen immunotherapy.
Published: 2019

48. Guía de actuación en anafilaxia en Latinoamérica. Galaxia-Latam

Author: Cardona, Victoria, Alvarez Perea, Alberto, Ansotegui Zubeldia, Ignacio Javier, Arias Cruz, Alfredo, Ivancevich, Juan Carlos, González Díaz, Sandra Nora, Latour Staffeld, Patricia, Sánchez Borges, Mario, Serrano, Carlos D., Solé, Dirceu, Tanno, Luciana Kase, Cabañes Higuero, Nieves, Chivato, Tomás, De la Hoz, Belén, Fernández Rivas, Montserrat, Gangoiti, Iker, Guardia Martínez, Pedro, Herranz Sanz, Miguel Ángel, Juliá Benito, Juan Carlos, Lobera Labairu, Teófilo, Praena Crespo, Manuel, Prieto Romo, José Ignacio, Sánchez Salguero, Carlos, Sánchez González, José Ignacio, Uixera Marzal, Sonia, Vega, Arantza, Villarroel, Pedro, Jares, Edgardo José, Cardona, Victoria, Alvarez Perea, Alberto, Ansotegui Zubeldia, Ignacio Javier, Arias Cruz, Alfredo, Ivancevich, Juan Carlos, González Díaz, Sandra Nora, Latour Staffeld, Patricia, Sánchez Borges, Mario, Serrano, Carlos D., Solé, Dirceu, Tanno, Luciana Kase, Cabañes Higuero, Nieves, Chivato, Tomás, De la Hoz, Belén, Fernández Rivas, Montserrat, Gangoiti, Iker, Guardia Martínez, Pedro, Herranz Sanz, Miguel Ángel, Juliá Benito, Juan Carlos, Lobera Labairu, Teófilo, Praena Crespo, Manuel, Prieto Romo, José Ignacio, Sánchez Salguero, Carlos, Sánchez González, José Ignacio, Uixera Marzal, Sonia, Vega, Arantza, Villarroel, Pedro, and Jares, Edgardo José
Published: 2019

49. Rational Design, Structure-Activity Relationship, and Immunogenicity of Hypoallergenic Pru p 3 Variants

Author: Eichhorn, Stephanie, Hörschläger, Angelika, Steiner, Markus, Laimer, Josef, Jensen, Bettina M, Versteeg, Serge A, Pablos, Isabel, Briza, Peter, Jongejan, Laurian, Rigby, Neil, Asturias, Juan A, Portolés, Antonio, Fernandez-Rivas, Montserrat, Papadopoulos, Nikolaos G, Mari, Adriano, Poulsen, Lars K, Lackner, Peter, van Ree, Ronald, Ferreira, Fatima, Gadermaier, Gabriele, Eichhorn, Stephanie, Hörschläger, Angelika, Steiner, Markus, Laimer, Josef, Jensen, Bettina M, Versteeg, Serge A, Pablos, Isabel, Briza, Peter, Jongejan, Laurian, Rigby, Neil, Asturias, Juan A, Portolés, Antonio, Fernandez-Rivas, Montserrat, Papadopoulos, Nikolaos G, Mari, Adriano, Poulsen, Lars K, Lackner, Peter, van Ree, Ronald, Ferreira, Fatima, and Gadermaier, Gabriele
Abstract: SCOPE: Allergies to lipid transfer proteins involve severe adverse reactions; thus, effective and sustainable therapies are desired. Previous attempts disrupting disulfide bonds failed to maintain immunogenicity; thus, the aim is to design novel hypoallergenic Pru p 3 variants and evaluate the applicability for treatment of peach allergy.METHODS AND RESULTS: Pru p 3 proline variant (PV) designed using in silico mutagenesis, cysteine variant (CV), and wild-type Pru p 3 (WT) are purified from Escherichia coli. Variants display homogenous and stable protein conformations with an altered secondary structure in circular dichroism. PV shows enhanced long-term storage capacities compared to CV similar to the highly stable WT. Using sera of 33 peach allergic patients, IgE-binding activity is reduced by 97% (PV) and 71% (CV) compared to WT. Both molecules show strong hypoallergenicity in Pru p 3 ImmunoCAP cross-inhibition and histamine release assays. Immunogenicity of PV is demonstrated with a phosphate-based adjuvant formulation in a mouse model.CONCLUSIONS: An in silico approach is used to generate a PV without targeting disulfide bonds, T cell epitopes, or previously reported IgE epitopes of Pru p 3. PV is strongly hypoallergenic while structurally stable and immunogenic, thus representing a promising candidate for peach allergen immunotherapy.
Published: 2019

50. Guía de actuación en anafilaxia en Latinoamérica. Galaxia-Latam

Author: Cardona, Victoria, Alvarez Perea, Alberto, Ansotegui Zubeldia, Ignacio Javier, Arias Cruz, Alfredo, Ivancevich, Juan Carlos, González Díaz, Sandra Nora, Latour Staffeld, Patricia, Sánchez Borges, Mario, Serrano, Carlos D., Solé, Dirceu, Tanno, Luciana Kase, Cabañes Higuero, Nieves, Chivato, Tomás, De la Hoz, Belén, Fernández Rivas, Montserrat, Gangoiti, Iker, Guardia Martínez, Pedro, Herranz Sanz, Miguel Ángel, Juliá Benito, Juan Carlos, Lobera Labairu, Teófilo, Praena Crespo, Manuel, Prieto Romo, José Ignacio, Sánchez Salguero, Carlos, Sánchez González, José Ignacio, Uixera Marzal, Sonia, Vega, Arantza, Villarroel, Pedro, Jares, Edgardo José, Cardona, Victoria, Alvarez Perea, Alberto, Ansotegui Zubeldia, Ignacio Javier, Arias Cruz, Alfredo, Ivancevich, Juan Carlos, González Díaz, Sandra Nora, Latour Staffeld, Patricia, Sánchez Borges, Mario, Serrano, Carlos D., Solé, Dirceu, Tanno, Luciana Kase, Cabañes Higuero, Nieves, Chivato, Tomás, De la Hoz, Belén, Fernández Rivas, Montserrat, Gangoiti, Iker, Guardia Martínez, Pedro, Herranz Sanz, Miguel Ángel, Juliá Benito, Juan Carlos, Lobera Labairu, Teófilo, Praena Crespo, Manuel, Prieto Romo, José Ignacio, Sánchez Salguero, Carlos, Sánchez González, José Ignacio, Uixera Marzal, Sonia, Vega, Arantza, Villarroel, Pedro, and Jares, Edgardo José
Published: 2019

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