Adult IgE-mediated food allergy is on the rise: A review of phenotypes, pathophysiologic mechanisms, diagnosis, and advances in management

Unhapipatpong, Chanita; Julanon, Narachai; Krikeerati, Thanachit; Vichara-Anont, Irin; Sompornrattanaphan, Mongkhon

doi:10.12932/ap-101122-1499

Cited by 7 publications

(5 citation statements)

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“…Regional variations in fruit allergy prevalence are likely influenced by dietary habits, local fruit varieties, and patterns of allergen sensitization [2,37]. Furthermore, determining the accurate prevalence of fruit allergies in the general population poses challenges due to the gold-standard diagnostic method for food allergies being the oral food challenge (OFC), which is impractical for the general population.…”

Section: Global Prevalence Of Fruit Allergymentioning

confidence: 99%

“…The general concept for managing food allergies encompasses four key components: (1) allergen avoidance, including consideration of cross-reactivity; (2) carrying prefilled epinephrine syringes/autoinjectors; (3) possessing an action plan; (4) and accessing advanced treatment for food allergies [2]. There is no evidence-based advice about fruit avoidance.…”

Section: Managementmentioning

confidence: 99%

“…They can be found in an array of products including juices, pastries, sweets, preserves, and even as components in various recipes. Even without heat processing or pasteurization, merely cutting a fruit like an apple could cause the oxidative breakdown of its allergenic substances [1,2].…”

Section: Introductionmentioning

confidence: 99%

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Revisiting Fruit Allergy: Prevalence across the Globe, Diagnosis, and Current Management

Krikeerati,

Rodsaward,

Nawiboonwong

et al. 2023

Foods

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Fruit allergies manifest with a diverse array of clinical presentations, ranging from localized contact allergies and oral allergy syndrome to the potential for severe systemic reactions including anaphylaxis. The scope of population-level prevalence studies remains limited, largely derived from single-center or hospital-based investigations. In this comprehensive review, we conducted a systematic literature search spanning the years 2009 to 2023, with full acknowledgment of potential analytical biases, to provide a global overview of fruit allergy prevalence. The primary mechanistic underpinning of fruit allergies stems from cross-reactivity between aeroallergens and food allergens, a consequence of structurally similar epitopes—a phenomenon recognized as pollen food allergy syndrome (PFAS). In the era of molecular allergology, numerous studies have dissected allergen components with substantial clinical relevance. Within this review, we explore important allergenic molecules found in plant-based foods, scrutinize pertinent cross-reactivity patterns, and offer insights into management recommendations. Additionally, we compare guideline recommendations to enhance clinical understanding and inform decision making.

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Section: Global Prevalence Of Fruit Allergymentioning

confidence: 99%

Section: Managementmentioning

confidence: 99%

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Revisiting Fruit Allergy: Prevalence across the Globe, Diagnosis, and Current Management

Krikeerati,

Rodsaward,

Nawiboonwong

et al. 2023

Foods

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“…Food allergy is a complex immune-mediated disorder characterized by adverse reactions to specific food antigens. It affects a significant proportion of the global population and poses a substantial public health burden [ 1 , 2 ]. The etiology of food allergies is believed to involve a combination of genetic and environmental factors [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

HLA variants and their association with IgE-Mediated banana allergy: A cross-sectional study

Vichara-anont,

Lumkul,

Taratikhundej

et al. 2024

Heliyon

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“…Prick-to-prick tests (PTP) using fresh plant food are often considered superior to extract-based skin tests due to their higher sensitivity. When combined with a convincing medical history, a positive PTP to a specific fruit can confirm a plant food allergy [ 18 ]. Given the significant cross-reactivity among plant allergens, the clinical relevance of sensitization often requires confirmation through oral food challenges (OFC).…”

Section: Introductionmentioning

confidence: 99%

Not Just a Banana: The Extent of Fruit Cross-Reactivity and Reaction Severity in Adults with Banana Allergy

Julanon

Thiravetyan

Unhapipatpong

et al. 2023

Foods

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This cross-sectional study aimed to investigate the prevalence and clinical characteristics of cross-reactivity and co-allergy to other plant foods among adult patients with IgE-mediated banana allergy in Thailand. A structured questionnaire was used to assess clinical reactivity, and cross-reactivity diagnoses were based on reactions occurring within 2 years of banana allergy onset, within 3 h of intake, and confirmed by allergists. Among the 133 participants, the most commonly associated plant foods with clinical reactions were kiwi (83.5%), avocado (71.1%), persimmon (58.8%), grapes (44.0%), and durian (43.6%). Notably, 26.5% of the reported reactions to other plant foods were classified as severe. These findings highlight the common occurrence of cross-reactivity/co-allergy to other plant foods in banana-allergic patients, with a significant proportion experiencing severe reactions. Travelers to tropical regions should be aware of this risk and advised to avoid specific banana cultivars and plant foods with reported high cross-reactivity. The inclusion of self-injectable epinephrine in the management plan for patients with primary banana allergy should be considered due to the substantial proportion of reported severe reactions and the wide range of clinical cross-reactivity and co-allergy observed.

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Adult IgE-mediated food allergy is on the rise: A review of phenotypes, pathophysiologic mechanisms, diagnosis, and advances in management

Cited by 7 publications

References 0 publications

Revisiting Fruit Allergy: Prevalence across the Globe, Diagnosis, and Current Management

Revisiting Fruit Allergy: Prevalence across the Globe, Diagnosis, and Current Management

HLA variants and their association with IgE-Mediated banana allergy: A cross-sectional study

Not Just a Banana: The Extent of Fruit Cross-Reactivity and Reaction Severity in Adults with Banana Allergy

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