Component-Resolved Diagnosis in Food Allergies

Calamelli, Elisabetta; Liotti, Lucia; Beghetti, Isadora; Piccinno, Valentina; Serra, Laura; Bottau, Paolo

doi:10.3390/medicina55080498

Cited by 42 publications

(30 citation statements)

References 138 publications

(204 reference statements)

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“…Children with prolonged egg allergy have elevated IgE levels against the sequential epitopes Gald1 and Gald2. These children do not tolerate even cooked egg [78][79][80][81].…”

Section: Fa Diagnosticsmentioning

confidence: 97%

New Perspectives in Food Allergy

Martinis

Sirufo

Suppa

et al. 2020

IJMS

164

130

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The improvement of the knowledge of the pathophysiological mechanisms underlying the tolerance and sensitization to food antigens has recently led to a radical change in the clinical approach to food allergies. Epidemiological studies show a global increase in the prevalence of food allergy all over the world and manifestations of food allergy appear increasingly frequent also in elderly subjects. Environmental and nutritional changes have partly changed the epidemiology of allergic reactions to foods and new food allergic syndromes have emerged in recent years. The deepening of the study of the intestinal microbiota has highlighted important mechanisms of immunological adaptation of the mucosal immune system to food antigens, leading to a revolution in the concept of immunological tolerance. As a consequence, new prevention models and innovative therapeutic strategies aimed at a personalized approach to the patient affected by food allergy are emerging. This review focuses on these new perspectives and their practical implications in the management of food allergy, providing an updated view of this complex pathology.

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“…Children with prolonged egg allergy have elevated IgE levels against the sequential epitopes Gald1 and Gald2. These children do not tolerate even cooked egg [78][79][80][81].…”

Section: Fa Diagnosticsmentioning

confidence: 97%

New Perspectives in Food Allergy

Martinis

Sirufo

Suppa

et al. 2020

IJMS

164

130

View full text Add to dashboard Cite

show abstract

“…CRD level of sensitivity and specificity is still less accurate compared to the OFC and is expensive if compared to both SPT and extract based sIgE. Additionally, only few relevant allergens have been currently included among the available commercial diagnostic tests ( Table 1 ) [ 1 , 34 , 35 ]. The majority of molecules considered as food allergens are biochemically classified as proteins or glycoproteins that are naturally present in foods [ 35 ].…”

Section: Diagnosis Of Hazelnut Allergymentioning

confidence: 99%

Hazelnut Allergy

Calamelli¹,

Trozzo

Blasi

et al. 2021

Medicina

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Background and Objectives: Hazelnuts are frequently involved in IgE-mediated reactions and represent the main culprit of nut allergy in Europe. The clinical presentation varies from mild symptoms limited to the oropharynx [oral allergy syndrome (OAS)], due to the cross-reaction with homologues in pollen allergens and more severe events caused by the primary sensitization to highly stable molecules contained in hazelnuts. The aim of this review is to summarize the most relevant concepts in the field of hazelnut allergy and to provide a practical approach useful in the clinical practice Materials and Methods: References were identified by PubMed searches dating from January 2000 up to November 2020 using the search terms: “component resolved diagnosis” and “Hazelnut allergy. Results: The storage proteins Cor a 9 and Cor a 14 resulted highly specific for primary hazelnut allergy and strongly associated with severe reactions, while the cross reactive Cor a 1, an homolog of the birch Bet v1, were related to OAS. Any cut-off has shown a specificity and sensitivity pattern as high as to replace the oral food challenge (OFC), which still remains the gold standard in the diagnosis of hazelnut allergy. To date there is still no definitive treatment. Hazelnut free-diet and treatment of symptoms with emergency management, including the prescription of auto-injective epinephrine, still represent the main approach. Oral allergen immunotherapy (AIT) appears a promising therapeutic strategy and the definition of individual clinical threshold would be useful for sensitized individuals, caregivers, and physicians to reduce social limitation, anxiety, and better manage food allergy. Conclusions: An accurate diagnostic work-up including clinical history, in vivo and in vitro test including component resolved diagnosis and OFC are essential to confirm the diagnosis, to assess the risk of a severe reaction, and to prescribe an adequate diet and treatment.

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“…The current lack of relevant allergen variants needed for diagnostics assays leads to lower levels of specificity and sensitivity than that of OFC. Consequently, OFC remains the gold standard in food allergy diagnosis, limiting the progress of MA [93]. Despite some disadvantages and discrepancies, the capability to use small amounts of patient serum to isolate cross-reactive allergens and detect unknown or potentially harmful allergens are greatly benefiting allergy diagnoses, especially in patients with allergy-like symptoms (e.g.…”

Section: Molecular-based Allergymentioning

confidence: 99%

Egg Allergy: Diagnosis and Immunotherapy

Dona

Suphioglu

2020

IJMS

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Hypersensitivity or an allergy to chicken egg proteins is a predominant symptomatic condition affecting 1 in 20 children in Australia; however, an effective form of therapy has not yet been found. This occurs as the immune system of the allergic individual overreacts when in contact with egg allergens (egg proteins), triggering a complex immune response. The subsequent instantaneous inflammatory immune response is characterized by the excessive production of immunoglobulin E (IgE) antibody against the allergen, T-cell mediators and inflammation. Current allergen-specific approaches to egg allergy diagnosis and treatment lack consistency and therefore pose safety concerns among anaphylactic patients. Immunotherapy has thus far been found to be the most efficient way to treat and relieve symptoms, this includes oral immunotherapy (OIT) and sublingual immunotherapy (SLIT). A major limitation in immunotherapy, however, is the difficulty in preparing effective and safe extracts from natural allergen sources. Advances in molecular techniques allow for the production of safe and standardized recombinant and hypoallergenic egg variants by targeting the IgE-binding epitopes responsible for clinical allergic symptoms. Site-directed mutagenesis can be performed to create such safe hypoallergens for their potential use in future methods of immunotherapy, providing a feasible standardized therapeutic approach to target egg allergies safely.

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Component-Resolved Diagnosis in Food Allergies

Cited by 42 publications

References 138 publications

New Perspectives in Food Allergy

New Perspectives in Food Allergy

Hazelnut Allergy

Egg Allergy: Diagnosis and Immunotherapy

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