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1. Detection of Gibberellin-Regulated Protein (Peamaclein) Sensitization among Italian Cypress Pollen-Sensitized Patients

Author

Asero, R, Abbadessa, S, Aruanno, A, Barilaro, G, Barzaghi, C, Bignardi, D, Bilò, M B, Borro, M, Bresciani, M, Busa, M, Buzzulini, F, Cavaliere, C, Cecchi, L, Ciccarelli, A, Cortellini, G, Cucinelli, F, Deleonardi, G, Emiliani, F, Farsi, A, Ferrarini, E, Franchini, M, Ingrassia, A, Lippolis, D, Losappio, L, Marra, A M, Martini, M, Masieri, S, Mauro, M, Mazzolini, M, Muratore, L, Murzilli, F, Nucera, E, Pastorello, E A, Pinter, E, Polillo, B R, Pravettoni, V, Quercia, O, Rizzi, A, Russello, M, Sacerdoti, C, Scala, E, Scala, G, Scarpa, A, Schroeder, J, Uasuf, G G, Villalta, D, Yang, B, Mistrello, G, Amato, S, Lidholm, J, Nucera, E (ORCID:0000-0002-0565-7680), Rizzi, A (ORCID:0000-0002-6795-746X), Asero, R, Abbadessa, S, Aruanno, A, Barilaro, G, Barzaghi, C, Bignardi, D, Bilò, M B, Borro, M, Bresciani, M, Busa, M, Buzzulini, F, Cavaliere, C, Cecchi, L, Ciccarelli, A, Cortellini, G, Cucinelli, F, Deleonardi, G, Emiliani, F, Farsi, A, Ferrarini, E, Franchini, M, Ingrassia, A, Lippolis, D, Losappio, L, Marra, A M, Martini, M, Masieri, S, Mauro, M, Mazzolini, M, Muratore, L, Murzilli, F, Nucera, E, Pastorello, E A, Pinter, E, Polillo, B R, Pravettoni, V, Quercia, O, Rizzi, A, Russello, M, Sacerdoti, C, Scala, E, Scala, G, Scarpa, A, Schroeder, J, Uasuf, G G, Villalta, D, Yang, B, Mistrello, G, Amato, S, Lidholm, J, Nucera, E (ORCID:0000-0002-0565-7680), and Rizzi, A (ORCID:0000-0002-6795-746X)

Abstract

Background: Peach gibberellin-regulated protein (peamaclein) has recently emerged as a relevant food allergen in cypress pollen-hypersensitive patients. Objective: We looked for mono-sensitization to peamaclein among Italian cypress-pollen allergic patients. Material and methods: 835 cypress pollen hypersensitive patients from 28 Italian allergy centers under went thorough interview for food-allergic reactions, and SPT with a commercial peach extracts containing peamaclein. In peach reactors, IgE to rPru p 3 was measured, and those scoring negative were enrolled as potentially mono-sensitized to peamaclein. IgE reactivity to rPru p 7 was evaluated by immunoblot and by an experimental ImmunoCAP with rPru p 7. Results: Peach SPT scored positive in 163 (19.5%) patients but 127 (77,9%) were excluded because Pru p 3 reactors. Twenty-four (14,7%, corresponding to 2.8% of the entire study population) were considered as potentially mono-sensitized to peamaclein. Their distribution did not show any geographic preference. Seventeen/24 (70,8%) had a history of food allergy, in most cases (n=15) to peach. Other offending foods included other Rosaceae, citrus fruits, fig, melon, tree nuts, and kiwi. On peach immunoblot, only 3/18 putative peamaclein allergic subjects reacted to a band at about 7kDa; 4 other patients reacted at about 50-60 kDa. Ten/18 (56%) scored positive for Pru p 7 on ImmunoCAP. Conclusion: Peamaclein allergy and sensitization prevalence seem rare in Italy. Most patients react to peach, albeit other Rosaceae fruits and several citrus fruits may also act as offending foods. Peach and cypress pollen probably share also cross-reacting allergens other than peamaclein.

Published
2020

2. EAACI Molecular Allergology User's Guide

Author

Matricardi, P. M., Kleine-Tebbe, J., Hoffmann, H. J., Valenta, R., Hilger, C., Hofmaier, S., Aalberse, R. C., Agache, I., Asero, R., Ballmer-Weber, B., Barber, D., Beyer, K., Biedermann, T., Bilò, M. B., Blank, S., Bohle, B., Bosshard, P. P., Breiteneder, H., Brough, H. A., Caraballo, L., Caubet, J. C., Crameri, R., Davies, J. M., Douladiris, N., Ebisawa, M., EIgenmann, P. A., Fernandez-Rivas, M., Ferreira, F., Gadermaier, G., Glatz, M., Hamilton, R. G., Hawranek, T., Hellings, P., Hoffmann-Sommergruber, K., Jakob, T., Jappe, U., Jutel, M., Kamath, S. D., Knol, E. F., Korosec, P., Kuehn, A., Lack, G., Lopata, A. L., Mäkelä, M., Morisset, M., Niederberger, V., Nowak-Węgrzyn, A. H., Papadopoulos, N. G., Pastorello, E. A., Pauli, G., Platts-Mills, T., Posa, D., Poulsen, L. K., Raulf, M., Sastre, J., Scala, E., Schmid, J. M., Schmid-Grendelmeier, P., van Hage, M., van Ree, R., Vieths, S., Weber, R., Wickman, M., Muraro, A., Ollert, M., Matricardi, P. M., Kleine-Tebbe, J., Hoffmann, H. J., Valenta, R., Hilger, C., Hofmaier, S., Aalberse, R. C., Agache, I., Asero, R., Ballmer-Weber, B., Barber, D., Beyer, K., Biedermann, T., Bilò, M. B., Blank, S., Bohle, B., Bosshard, P. P., Breiteneder, H., Brough, H. A., Caraballo, L., Caubet, J. C., Crameri, R., Davies, J. M., Douladiris, N., Ebisawa, M., EIgenmann, P. A., Fernandez-Rivas, M., Ferreira, F., Gadermaier, G., Glatz, M., Hamilton, R. G., Hawranek, T., Hellings, P., Hoffmann-Sommergruber, K., Jakob, T., Jappe, U., Jutel, M., Kamath, S. D., Knol, E. F., Korosec, P., Kuehn, A., Lack, G., Lopata, A. L., Mäkelä, M., Morisset, M., Niederberger, V., Nowak-Węgrzyn, A. H., Papadopoulos, N. G., Pastorello, E. A., Pauli, G., Platts-Mills, T., Posa, D., Poulsen, L. K., Raulf, M., Sastre, J., Scala, E., Schmid, J. M., Schmid-Grendelmeier, P., van Hage, M., van Ree, R., Vieths, S., Weber, R., Wickman, M., Muraro, A., and Ollert, M.

Published
2016

3. EAACI Molecular Allergology User's Guide

Author

Matricardi, P. M., Kleine-Tebbe, J., Hoffmann, H. J., Valenta, R., Hilger, C., Hofmaier, S., Aalberse, R. C., Agache, I., Asero, R., Ballmer-Weber, B., Barber, D., Beyer, K., Biedermann, T., Bilò, M. B., Blank, S., Bohle, B., Bosshard, P. P., Breiteneder, H., Brough, H. A., Caraballo, L., Caubet, J. C., Crameri, R., Davies, J. M., Douladiris, N., Ebisawa, M., EIgenmann, P. A., Fernandez-Rivas, M., Ferreira, F., Gadermaier, G., Glatz, M., Hamilton, R. G., Hawranek, T., Hellings, P., Hoffmann-Sommergruber, K., Jakob, T., Jappe, U., Jutel, M., Kamath, S. D., Knol, E. F., Korosec, P., Kuehn, A., Lack, G., Lopata, A. L., Mäkelä, M., Morisset, M., Niederberger, V., Nowak-Węgrzyn, A. H., Papadopoulos, N. G., Pastorello, E. A., Pauli, G., Platts-Mills, T., Posa, D., Poulsen, L. K., Raulf, M., Sastre, J., Scala, E., Schmid, J. M., Schmid-Grendelmeier, P., van Hage, M., van Ree, R., Vieths, S., Weber, R., Wickman, M., Muraro, A., Ollert, M., Matricardi, P. M., Kleine-Tebbe, J., Hoffmann, H. J., Valenta, R., Hilger, C., Hofmaier, S., Aalberse, R. C., Agache, I., Asero, R., Ballmer-Weber, B., Barber, D., Beyer, K., Biedermann, T., Bilò, M. B., Blank, S., Bohle, B., Bosshard, P. P., Breiteneder, H., Brough, H. A., Caraballo, L., Caubet, J. C., Crameri, R., Davies, J. M., Douladiris, N., Ebisawa, M., EIgenmann, P. A., Fernandez-Rivas, M., Ferreira, F., Gadermaier, G., Glatz, M., Hamilton, R. G., Hawranek, T., Hellings, P., Hoffmann-Sommergruber, K., Jakob, T., Jappe, U., Jutel, M., Kamath, S. D., Knol, E. F., Korosec, P., Kuehn, A., Lack, G., Lopata, A. L., Mäkelä, M., Morisset, M., Niederberger, V., Nowak-Węgrzyn, A. H., Papadopoulos, N. G., Pastorello, E. A., Pauli, G., Platts-Mills, T., Posa, D., Poulsen, L. K., Raulf, M., Sastre, J., Scala, E., Schmid, J. M., Schmid-Grendelmeier, P., van Hage, M., van Ree, R., Vieths, S., Weber, R., Wickman, M., Muraro, A., and Ollert, M.

Published
2016

4. EAACI Molecular Allergology User's Guide

Author

Matricardi, P. M., Kleine-Tebbe, J., Hoffmann, H. J., Valenta, R., Hilger, C., Hofmaier, S., Aalberse, R. C., Agache, I., Asero, R., Ballmer-Weber, B., Barber, D., Beyer, K., Biedermann, T., Bilò, M. B., Blank, S., Bohle, B., Bosshard, P. P., Breiteneder, H., Brough, H. A., Caraballo, L., Caubet, J. C., Crameri, R., Davies, J. M., Douladiris, N., Ebisawa, M., EIgenmann, P. A., Fernandez-Rivas, M., Ferreira, F., Gadermaier, G., Glatz, M., Hamilton, R. G., Hawranek, T., Hellings, P., Hoffmann-Sommergruber, K., Jakob, T., Jappe, U., Jutel, M., Kamath, S. D., Knol, E. F., Korosec, P., Kuehn, A., Lack, G., Lopata, A. L., Mäkelä, M., Morisset, M., Niederberger, V., Nowak-Węgrzyn, A. H., Papadopoulos, N. G., Pastorello, E. A., Pauli, G., Platts-Mills, T., Posa, D., Poulsen, L. K., Raulf, M., Sastre, J., Scala, E., Schmid, J. M., Schmid-Grendelmeier, P., van Hage, M., van Ree, R., Vieths, S., Weber, R., Wickman, M., Muraro, A., Ollert, M., Matricardi, P. M., Kleine-Tebbe, J., Hoffmann, H. J., Valenta, R., Hilger, C., Hofmaier, S., Aalberse, R. C., Agache, I., Asero, R., Ballmer-Weber, B., Barber, D., Beyer, K., Biedermann, T., Bilò, M. B., Blank, S., Bohle, B., Bosshard, P. P., Breiteneder, H., Brough, H. A., Caraballo, L., Caubet, J. C., Crameri, R., Davies, J. M., Douladiris, N., Ebisawa, M., EIgenmann, P. A., Fernandez-Rivas, M., Ferreira, F., Gadermaier, G., Glatz, M., Hamilton, R. G., Hawranek, T., Hellings, P., Hoffmann-Sommergruber, K., Jakob, T., Jappe, U., Jutel, M., Kamath, S. D., Knol, E. F., Korosec, P., Kuehn, A., Lack, G., Lopata, A. L., Mäkelä, M., Morisset, M., Niederberger, V., Nowak-Węgrzyn, A. H., Papadopoulos, N. G., Pastorello, E. A., Pauli, G., Platts-Mills, T., Posa, D., Poulsen, L. K., Raulf, M., Sastre, J., Scala, E., Schmid, J. M., Schmid-Grendelmeier, P., van Hage, M., van Ree, R., Vieths, S., Weber, R., Wickman, M., Muraro, A., and Ollert, M.

Published
2016

5. EAACI Molecular Allergology User's Guide

Author

MS Dermatologie/Allergologie, CDL Celdiagnostiek, Infection & Immunity, Matricardi, P. M., Kleine-Tebbe, J., Hoffmann, H. J., Valenta, R., Hilger, C., Hofmaier, S., Aalberse, R. C., Agache, I., Asero, R., Ballmer-Weber, B., Barber, D., Beyer, K., Biedermann, T., Bilò, M. B., Blank, S., Bohle, B., Bosshard, P. P., Breiteneder, H., Brough, H. A., Caraballo, L., Caubet, J. C., Crameri, R., Davies, J. M., Douladiris, N., Ebisawa, M., EIgenmann, P. A., Fernandez-Rivas, M., Ferreira, F., Gadermaier, G., Glatz, M., Hamilton, R. G., Hawranek, T., Hellings, P., Hoffmann-Sommergruber, K., Jakob, T., Jappe, U., Jutel, M., Kamath, S. D., Knol, E. F., Korosec, P., Kuehn, A., Lack, G., Lopata, A. L., Mäkelä, M., Morisset, M., Niederberger, V., Nowak-Węgrzyn, A. H., Papadopoulos, N. G., Pastorello, E. A., Pauli, G., Platts-Mills, T., Posa, D., Poulsen, L. K., Raulf, M., Sastre, J., Scala, E., Schmid, J. M., Schmid-Grendelmeier, P., van Hage, M., van Ree, R., Vieths, S., Weber, R., Wickman, M., Muraro, A., Ollert, M., MS Dermatologie/Allergologie, CDL Celdiagnostiek, Infection & Immunity, Matricardi, P. M., Kleine-Tebbe, J., Hoffmann, H. J., Valenta, R., Hilger, C., Hofmaier, S., Aalberse, R. C., Agache, I., Asero, R., Ballmer-Weber, B., Barber, D., Beyer, K., Biedermann, T., Bilò, M. B., Blank, S., Bohle, B., Bosshard, P. P., Breiteneder, H., Brough, H. A., Caraballo, L., Caubet, J. C., Crameri, R., Davies, J. M., Douladiris, N., Ebisawa, M., EIgenmann, P. A., Fernandez-Rivas, M., Ferreira, F., Gadermaier, G., Glatz, M., Hamilton, R. G., Hawranek, T., Hellings, P., Hoffmann-Sommergruber, K., Jakob, T., Jappe, U., Jutel, M., Kamath, S. D., Knol, E. F., Korosec, P., Kuehn, A., Lack, G., Lopata, A. L., Mäkelä, M., Morisset, M., Niederberger, V., Nowak-Węgrzyn, A. H., Papadopoulos, N. G., Pastorello, E. A., Pauli, G., Platts-Mills, T., Posa, D., Poulsen, L. K., Raulf, M., Sastre, J., Scala, E., Schmid, J. M., Schmid-Grendelmeier, P., van Hage, M., van Ree, R., Vieths, S., Weber, R., Wickman, M., Muraro, A., and Ollert, M.

Published
2016

6. EAACI molecular allergology user's guide

Author

Matricardi, P M, Kleine-Tebbe, J, Hoffmann, H.J., Valenta, R, Hilger, C, Hofmaier, S, Aalberse, R C, Agache, I, Asero, R, Ballmer-Weber, B, Barber, D, Beyer, K, Biedermann, T, Bilò, M B, Blank, S, Bohle, B, Bosshard, P P, Breiteneder, H, Brough, H A, Caraballo, L, Caubet, J C, Crameri, R, Davies, J M, Douladiris, N, Ebisawa, M, EIgenmann, P A, Fernandez-Rivas, M, Ferreira, F, Gadermaier, G, Glatz, M, Hamilton, R G, Hawranek, T, Hellings, P, Hoffmann-Sommergruber, K, Jakob, T, Jappe, U, Jutel, M, Kamath, S D, Knol, E F, Korosec, P, Kuehn, A, Lack, G, Lopata, A L, Mäkelä, M, Morisset, M, Niederberger, V, Nowak-Węgrzyn, A H, Papadopoulos, N G, Pastorello, E A, Pauli, G, Platts-Mills, T, Posa, D, Poulsen, L. K., Raulf, M, Sastre, J, Scala, E, Schmid, J M, Schmid-Grendelmeier, P, van Hage, M, van Ree, R, Vieths, S, Weber, R, Wickman, M, Muraro, A, Ollert, M., Matricardi, P M, Kleine-Tebbe, J, Hoffmann, H.J., Valenta, R, Hilger, C, Hofmaier, S, Aalberse, R C, Agache, I, Asero, R, Ballmer-Weber, B, Barber, D, Beyer, K, Biedermann, T, Bilò, M B, Blank, S, Bohle, B, Bosshard, P P, Breiteneder, H, Brough, H A, Caraballo, L, Caubet, J C, Crameri, R, Davies, J M, Douladiris, N, Ebisawa, M, EIgenmann, P A, Fernandez-Rivas, M, Ferreira, F, Gadermaier, G, Glatz, M, Hamilton, R G, Hawranek, T, Hellings, P, Hoffmann-Sommergruber, K, Jakob, T, Jappe, U, Jutel, M, Kamath, S D, Knol, E F, Korosec, P, Kuehn, A, Lack, G, Lopata, A L, Mäkelä, M, Morisset, M, Niederberger, V, Nowak-Węgrzyn, A H, Papadopoulos, N G, Pastorello, E A, Pauli, G, Platts-Mills, T, Posa, D, Poulsen, L. K., Raulf, M, Sastre, J, Scala, E, Schmid, J M, Schmid-Grendelmeier, P, van Hage, M, van Ree, R, Vieths, S, Weber, R, Wickman, M, Muraro, A, and Ollert, M.

Abstract

The availability of allergen molecules ('components') from several protein families has advanced our understanding of immunoglobulin E (IgE)-mediated responses and enabled 'component-resolved diagnosis' (CRD). The European Academy of Allergy and Clinical Immunology (EAACI) Molecular Allergology User's Guide (MAUG) provides comprehensive information on important allergens and describes the diagnostic options using CRD. Part A of the EAACI MAUG introduces allergen molecules, families, composition of extracts, databases, and diagnostic IgE, skin, and basophil tests. Singleplex and multiplex IgE assays with components improve both sensitivity for low-abundance allergens and analytical specificity; IgE to individual allergens can yield information on clinical risks and distinguish cross-reactivity from true primary sensitization. Part B discusses the clinical and molecular aspects of IgE-mediated allergies to foods (including nuts, seeds, legumes, fruits, vegetables, cereal grains, milk, egg, meat, fish, and shellfish), inhalants (pollen, mold spores, mites, and animal dander), and Hymenoptera venom. Diagnostic algorithms and short case histories provide useful information for the clinical workup of allergic individuals targeted for CRD. Part C covers protein families containing ubiquitous, highly cross-reactive panallergens from plant (lipid transfer proteins, polcalcins, PR-10, profilins) and animal sources (lipocalins, parvalbumins, serum albumins, tropomyosins) and explains their diagnostic and clinical utility. Part D lists 100 important allergen molecules. In conclusion, IgE-mediated reactions and allergic diseases, including allergic rhinoconjunctivitis, asthma, food reactions, and insect sting reactions, are discussed from a novel molecular perspective. The EAACI MAUG documents the rapid progression of molecular allergology from basic research to its integration into clinical practice, a quantum leap in the management of allergic patients.

Published
2016

7. Management of anaphylaxis:a systematic review

Author

Dhami, S, Panesar, S S, Roberts, G, Muraro, A, Worm, M, Bilò, M B, Cardona, V, Dubois, A E J, DunnGalvin, A, Eigenmann, P, Fernandez-Rivas, M, Halken, S, Lack, G, Niggemann, B, Rueff, F, Santos, A F, Vlieg-Boerstra, B, Zolkipli, Z Q, Sheikh, A, Poulsen, Lars K., Dhami, S, Panesar, S S, Roberts, G, Muraro, A, Worm, M, Bilò, M B, Cardona, V, Dubois, A E J, DunnGalvin, A, Eigenmann, P, Fernandez-Rivas, M, Halken, S, Lack, G, Niggemann, B, Rueff, F, Santos, A F, Vlieg-Boerstra, B, Zolkipli, Z Q, Sheikh, A, and Poulsen, Lars K.

Abstract

To establish the effectiveness of interventions for the acute and long-term management of anaphylaxis, seven databases were searched for systematic reviews, randomized controlled trials, quasi-randomized controlled trials, controlled clinical trials, controlled before-after studies and interrupted time series and - only in relation to adrenaline - case series investigating the effectiveness of interventions in managing anaphylaxis. Fifty-five studies satisfied the inclusion criteria. We found no robust studies investigating the effectiveness of adrenaline (epinephrine), H1-antihistamines, systemic glucocorticosteroids or methylxanthines to manage anaphylaxis. There was evidence regarding the optimum route, site and dose of administration of adrenaline from trials studying people with a history of anaphylaxis. This suggested that administration of intramuscular adrenaline into the middle of vastus lateralis muscle is the optimum treatment. Furthermore, fatality register studies have suggested that a failure or delay in administration of adrenaline may increase the risk of death. The main long-term management interventions studied were anaphylaxis management plans and allergen-specific immunotherapy. Management plans may reduce the risk of further reactions, but these studies were at high risk of bias. Venom immunotherapy may reduce the incidence of systemic reactions in those with a history of venom-triggered anaphylaxis.

Published
2014

8. The epidemiology of anaphylaxis in Europe:a systematic review

Author

Panesar, S S, Javad, S, de Silva, D, Nwaru, B I, Hickstein, L, Muraro, A, Roberts, G, Worm, M, Bilò, M B, Cardona, V, Dubois, A E J, Dunn Galvin, A, Eigenmann, P, Fernandez-Rivas, M, Halken, S, Lack, G, Niggemann, B, Santos, A F, Vlieg-Boerstra, B J, Zolkipli, Z Q, Sheikh, A, Poulsen, Lars K., Panesar, S S, Javad, S, de Silva, D, Nwaru, B I, Hickstein, L, Muraro, A, Roberts, G, Worm, M, Bilò, M B, Cardona, V, Dubois, A E J, Dunn Galvin, A, Eigenmann, P, Fernandez-Rivas, M, Halken, S, Lack, G, Niggemann, B, Santos, A F, Vlieg-Boerstra, B J, Zolkipli, Z Q, Sheikh, A, and Poulsen, Lars K.

Abstract

BACKGROUND: Anaphylaxis is an acute, potentially fatal, multi-organ system, allergic reaction caused by the release of chemical mediators from mast cells and basophils. Uncertainty exists around epidemiological measures of incidence and prevalence, risk factors, risk of recurrence, and death due to anaphylaxis. This systematic review aimed to (1) understand and describe the epidemiology of anaphylaxis and (2) describe how these characteristics vary by person, place, and time.METHODS: Using a highly sensitive search strategy, we identified systematic reviews of epidemiological studies, descriptive and analytical epidemiological investigations, and studies involving analysis of routine data.RESULTS: Our searches identified a total of 5,843 potentially eligible studies, of which 49 satisfied our inclusion criteria. Of these, three were suitable for pooled estimates of prevalence. The incidence rates for all-cause anaphylaxis ranged from 1.5 to 7.9 per 100,000 person-years. These data indicated that an estimated 0.3% (95% CI 0.1-0.5) of the population experience anaphylaxis at some point in their lives. Food, drugs, stinging insects, and latex were the most commonly identified triggers.CONCLUSIONS: Anaphylaxis is a common problem, affecting an estimated 1 in 300 of the European population at some time in their lives. Future research needs to focus on better understanding of the trends across Europe and identifying those most likely to experience fatal reactions.

Published
2013

9. The epidemiology of anaphylaxis in Europe:a systematic review

Author

Panesar, S S, Javad, S, de Silva, D, Nwaru, B I, Hickstein, L, Muraro, A, Roberts, G, Worm, M, Bilò, M B, Cardona, V, Dubois, A E J, Dunn Galvin, A, Eigenmann, P, Fernandez-Rivas, M, Halken, S, Lack, G, Niggemann, B, Santos, A F, Vlieg-Boerstra, B J, Zolkipli, Z Q, Sheikh, A, Poulsen, Lars K., Panesar, S S, Javad, S, de Silva, D, Nwaru, B I, Hickstein, L, Muraro, A, Roberts, G, Worm, M, Bilò, M B, Cardona, V, Dubois, A E J, Dunn Galvin, A, Eigenmann, P, Fernandez-Rivas, M, Halken, S, Lack, G, Niggemann, B, Santos, A F, Vlieg-Boerstra, B J, Zolkipli, Z Q, Sheikh, A, and Poulsen, Lars K.

Abstract

BACKGROUND: Anaphylaxis is an acute, potentially fatal, multi-organ system, allergic reaction caused by the release of chemical mediators from mast cells and basophils. Uncertainty exists around epidemiological measures of incidence and prevalence, risk factors, risk of recurrence, and death due to anaphylaxis. This systematic review aimed to (1) understand and describe the epidemiology of anaphylaxis and (2) describe how these characteristics vary by person, place, and time.METHODS: Using a highly sensitive search strategy, we identified systematic reviews of epidemiological studies, descriptive and analytical epidemiological investigations, and studies involving analysis of routine data.RESULTS: Our searches identified a total of 5,843 potentially eligible studies, of which 49 satisfied our inclusion criteria. Of these, three were suitable for pooled estimates of prevalence. The incidence rates for all-cause anaphylaxis ranged from 1.5 to 7.9 per 100,000 person-years. These data indicated that an estimated 0.3% (95% CI 0.1-0.5) of the population experience anaphylaxis at some point in their lives. Food, drugs, stinging insects, and latex were the most commonly identified triggers.CONCLUSIONS: Anaphylaxis is a common problem, affecting an estimated 1 in 300 of the European population at some time in their lives. Future research needs to focus on better understanding of the trends across Europe and identifying those most likely to experience fatal reactions.

Published
2013

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