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In adulthood, the importance of hazelnut sensitization to storage proteins, oleosin (Cor a 12), and Cor a 8 is diluted by the increased role of birch pollen cross-reactivity with Cor a 1. Cor a 8 sensitization in the Mediterranean is probably driven by diet in combination with pollen exposure. Hazelnut oleosin sensitization is prevalent across Europe; however, the clinical relevance remains to be established.

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A model combining CRD with clinical background and extract-based serology is superior to CRD alone in assessing the risk of severe reactions to hazelnut, particular in ruling out severe reactions.

BackgroundThe prevalence of peanut allergy has increased in developed countries, but little is known about developing countries with high peanut consumption and widespread parasitic infections.ObjectiveWe sought to investigate peanut allergy in Ghana.MethodsIn a cross-sectional survey among Ghanaian schoolchildren (n = 1604), data were collected on reported adverse reactions to peanut, peanut sensitization (serum specific IgE and skin reactivity), consumption patterns, and parasitic infections. In a subset (n = 43) IgE against Ara h 1, 2, 3, and 9 as well as cross-reactive carbohydrate determinants (CCDs) was measured by using ImmunoCAP. Cross-reactivity and biological activity were investigated by means of ImmunoCAP inhibition and basophil histamine release, respectively.ResultsAdverse reactions to peanut were reported in 1.5%, skin prick test reactivity in 2.0%, and IgE sensitization (≥0.35 kU/L) in 17.5% of participants. Moreover, 92.4% of those IgE sensitized to peanut (≥0.35 kU/L) had negative peanut skin prick test responses. Schistosoma haematobium infection was positively associated with IgE sensitization (adjusted odds ratio, 2.29; 95% CI, 1.37-3.86). In the subset IgE titers to Ara h 1, 2, 3, and 9 were low (<1.3 kU/L), except for 6 moderately strong reactions to Ara h 9. IgE against peanut was strongly correlated with IgE against CCDs (r = 0.89, P < .0001) and could be almost completely inhibited by CCDs, as well as S haematobium soluble egg antigen. Moreover, IgE to peanut showed poor biological activity.ConclusionsParasite-induced IgE against CCDs might account largely for high IgE levels to peanut in our study population of Ghanaian schoolchildren. No evidence of IgE-mediated peanut allergy was found.

Background The prevalence of food allergy (FA) among European school children is poorly defined. Estimates have commonly been based on parent‐reported symptoms. We aimed to estimate the frequency of FA and sensitization against food allergens in primary school children in eight European countries. Methods A follow‐up assessment at age 6‐10 years of a multicentre European birth cohort based was undertaken using an online parental questionnaire, clinical visits including structured interviews and skin prick tests (SPT). Children with suspected FA were scheduled for double‐blind, placebo‐controlled oral food challenges (DBPCFC). Results A total of 6105 children participated in this school‐age follow‐up (57.8% of 10 563 recruited at birth). For 982 of 6069 children (16.2%), parents reported adverse reactions after food consumption in the online questionnaire. Of 2288 children with parental face‐to‐face interviews and/or skin prick testing, 238 (10.4%) were eligible for a DBPCFC. Sixty‐three foods were challenge‐tested in 46 children. Twenty food challenges were positive in 17 children, including seven to hazelnut and three to peanut. Another seventy‐one children were estimated to suffer FA among those who were eligible but refused DBPCFC. This yielded prevalence estimates for FA in school age between 1.4% (88 related to all 6105 participants of this follow‐up) and 3.8% (88 related to 2289 with completed eligibility assessment). Interpretation In primary school children in eight European countries, the prevalence of FA was lower than expected even though parents of this cohort have become especially aware of allergic reactions to food. There was moderate variation between centres hampering valid regional comparisons.

1Background: Data is lacking regarding the prevalence of food sensitization and probable food allergy 2 among general population in India. We report the prevalence of sensitization and prevalence of 3 probable food allergy to 24 common foods among adults from general population in Karnataka, 4 South India. 5Methodology: The study was conducted in two stages; a screening study and a case-control study. 6 11,791 adults in age group 20-54 were randomly sampled from general population in South India 7 and answered a screening questionnaire. 588 subjects (236 cases and 352 controls) participated in 8 the case control study involving a detailed questionnaire and specific IgE estimation for 24 common 9 foods. 10Results: A high level of sensitization (26.5%) was observed to most of the foods in the general 11 population, higher than that observed among adults in Europe, except for those foods that cross 12 react with birch pollen. Most of the sensitization was observed in subjects who had total IgE above 13 the median IgE level. A high level of cross reactivity was observed among different pollens and foods 14 and among foods. The prevalence of probable food allergy (self-reports of adverse symptoms after 15 consumption of food and specific IgE to the same food) was 1.2%, which was mainly accounted for 16 cow's milk (0.5%) and apple (0.5%). 17Conclusion: Very high levels of sensitization was observed for most foods, including those not 18 commonly consumed in the general population. For the levels of sensitization, the prevalence of 19 probable food allergy was low. This disassociation needs to be further explored in future studies. 20

Nonwhite ethnicity: • In general a nonsignificant reduc on in food allergy in nonwhite EIG compared with nonwhite SIG Sensi zed: (IgE ≥0.1 kU/l to one or more foods) • EIG 19.2% versus SIG 34.2% developed any food allergy* Visible eczema: (moderate SCORAD 15 to <40) • EIG 22.6% versus SIG 46.7% developed any food allergy* • EIG 16.1% versus SIG 43.3% developed an egg allergy* Sensi zed: (IgE ≥0.1 kU/l to egg) • EIG 20.0% versus SIG 48.6% developed an egg allergy* *p<0.05 EIG: Early Introduc on Group SIG: Standard Introduc on Group Distribu on of enrollment (3 months of age) risk factors associated with a higher risk of developing a food allergy: Sensi za on (IgE ≥ 0.1 kU/l to one or more foods), visible eczema (any) at the clinic visit and nonwhite ethnicity (n=1170) Nonwhite Sensi zed