Hazelnut allergy: A double-blind, placebo-controlled food challenge multicenter study

Standardization of food challenges in patients with immediate reactions to foods – position paper from the European Academy of Allergology and Clinical Immunology

“…In cases of classical type 1 patients presenting objective signs a protocol using one active and one placebo is normally sufficient due to the low frequency of reactions to placebo in these patients (38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49). In more dubious cases and especially in cases patients presenting with subjective signs only a protocol with repeated challenges should be applied, either using three plus three challenges or three plus two challenges (50)(51)(52)(53).…”

Opinion of the Scientific Panel on Dietetic products, nutrition and allergies [NDA] on a request from the Commission relating to the evaluation of allergenic foods for labelling purposes

“…The most important gastrointestinal manifestation of nut allergy is the oral allergy syndrome, which has been confirmed by DBPCFC (Wensing et al, 2002b;Ortolani et al, 2000). Dermatitis can be elicited by cashew nut (Diogenes et al, 1996;Hamilton and Zug, 1998;Rosen and Fordice, 1994;Marks et al, 1984).…”

“…Cor a 1.04 is expressed in at least four sub-isoforms, which show different allergenic properties: the isoform Cor a 1.0404 is less allergenic, maybe because of the lack of a conformational epitope. By studying the IgE reactivity of the sera of patients with oral allergy syndrome, as diagnosed by DBPCFC in the study by Ortolani et al (2000), Pastorello et al (2002a) provided evidence that the 18 kDa protein was the major hazelnut allergen, as it was bound by IgE from 63 out of 65 DBPCFC positive patients. This protein was destroyed by heating and lost its allergenicity in roasted hazelnut.…”

“…Local oral symptoms are most commonly experienced while the more severe forms are rare (Rodríguez et al, 2000;Ortolani et al, 2000;Ballmer-Weber et al, 2000 and.…”

Food allergy: A clinician’s criteria for including sera in a serum bank

“…For example, for patients with pollen-related (class II) food allergy, the SPT and in vitro IgE testing is much less sensitive, especially when performed with a commercially available food extract. For tests performed with commercially available extracts from celery, carrot, cherry or hazelnut, the sensitivity of SPT and CAP-FEIA were 20-65% or 4-87%, respectively , [Ballmer-Weber et al, 2001], [Ballmer-Weber et al, 2002] and [Ortolani et al, 2000]). Due to the high rate of false negative results and the low negative predictive value of these tests, they cannot be reliably excluding food allergy in that group of patients.…”