Pollen food syndrome: Update on the allergens

Hofmann, Alison; Burks, A. Wesley

doi:10.1007/s11882-008-0080-0

Cited by 62 publications

(34 citation statements)

References 24 publications

(41 reference statements)

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“…24,25 Postprandial syndromes, such as pollenfood syndrome and scombroidosis, also need to be considered, as do excess endogenous histamine syndromes, such as mastocytosis; flush syndromes, including perimenopausal flushing; nonorganic diseases, such as vocal cord dysfunction; and other diagnostic entities, some of which are rarely encountered (Table VI). [24][25][26]32,33,[63][64][65][66][67][68]109,110 The differential diagnosis is age related to some extent. In infants foreign body aspiration, congenital malformations of the respiratory or gastrointestinal tracts, and apparent life-threatening event/sudden infant death syndrome need to be considered.…”

Section: Clinical Diagnosis Of Anaphylaxismentioning

confidence: 99%

Anaphylaxis

Simons

2010

Journal of Allergy and Clinical Immunology

385

380

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Anaphylaxis occurs commonly in community settings. The rate of occurrence is increasing, especially in young people. Understanding potential triggers, mechanisms, and patient-specific risk factors for severity and fatality is the key to performing appropriate risk assessment in those who have previously experienced an acute anaphylactic episode. The diagnosis of anaphylaxis is based primarily on clinical criteria and is valid even if the results of laboratory tests, such as serum total tryptase levels, are within normal limits. Positive skin test results or increased serum specific IgE levels to potential triggering allergens confirm sensitization but do not confirm the diagnosis of anaphylaxis because asymptomatic sensitization is common in the general population. Important patient-related risk factors for severity and fatality include age, concomitant diseases, and concurrent medications, as well as other less well-defined factors, such as defects in mediator degradation pathways, fever, acute infection, menses, emotional stress, and disruption of routine. Prevention of anaphylaxis depends primarily on optimal management of patient-related risk factors, strict avoidance of confirmed relevant allergen or other triggers, and, where indicated, immunomodulation (eg, subcutaneous venom immunotherapy to prevent Hymenoptera sting-triggered anaphylaxis, an underused, potentially curative treatment). The benefits and risks of immunomodulation to prevent food-triggered anaphylaxis are still being defined. Epinephrine (adrenaline) is the medication of first choice in the treatment of anaphylaxis. All patients at risk for recurrence in the community should be equipped with 1 or more epinephrine autoinjectors; a written, personalized anaphylaxis emergency action plan; and up-to-date medical identification. Improvements in the design of epinephrine autoinjectors will help to optimize ease of use and safety. Randomized controlled trials of pharmacologic agents, such as antihistamines and glucocorticoids, are needed to strengthen the evidence base for treatment of acute anaphylactic episodes.

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Section: Clinical Diagnosis Of Anaphylaxismentioning

confidence: 99%

Anaphylaxis

Simons

2010

Journal of Allergy and Clinical Immunology

385

380

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“…1a). Class 2 fruit allergies are also called the pollen food syndrome [23]. They usually involve labile allergens and therefore sensitization is only possible through the respiratory passages.…”

Section: Main Types Of Fruit Allergy and Disease Determinantsmentioning

confidence: 99%

Identification of European Allergy Patterns to the Allergen Families PR-10, LTP, and Profilin from Rosaceae Fruits

Andersen

Hall

Dragsted

2009

Clinic Rev Allerg Immunol

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High fruit intakes are associated with significant health benefits but fruit allergy sufferers may be discouraged from eating fruit due to the symptoms they experience. Knowledge about allergens involved in fruit allergy and the frequent cross-reactions to other allergens is essential to (a) design the best strategy for fruit allergy testing (b) prescribe optimal avoidance diets, and (c) design technological solutions for development of hypoallergenic fruits. The objective of this review was to investigate whether some characteristic disease entities could be identified in Europe for allergy to Rosaceae fruits. Five allergy patterns were found involving the allergen families PR-10, LTP, and profilin. In the Western Mediterranean area allergies to Rosaceae fruits are caused by monosensitization to LTP, monosensitization to profilin, or co-sensitization to both these allergens. On the contrary, monosensitization to PR-10 and, to a lesser degree, co-sensitization to profilin and PR-10 is dominant in Northern and Central Europe. LTP sensitization is present both in pollinosis and non-pollinosis patients and is associated with peach allergy in particular. The disease pattern for patients sensitized to profilin is characterized by several concomitant allergies including grass and other pollens, Rosaceae and non-Rosaceae fruits. Finally, PR-10 sensitization is primarily associated to concomitant birch pollen and apple allergy.

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“…Adolescent and adult patients, however, mainly acquire food allergy via primary sensitization to inhalant allergens on the basis of cross-reactivity between proteins in inhalant sources and in food. This type of food allergy is frequently mediated by sensitization to broadly represented allergens, or so-called panallergens (type 2) [3,[23][24][25]. In this group of reactions, the presence of IgE antibodies cannot be demonstrated by conventional methods.…”

Section: Foods Involvedmentioning

confidence: 99%

Doing the Food Allergy Diagnosis

Alej¹,

MedinaHern²,

ez³

et al. 2017

Otolaryngol (Sunnyvale)

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Most people can eat a variety of foods without problems. However, in a small percentage of the population, certain foods can cause adverse reactions, from which the origin should be investigated: Perhaps food poisoning, a psychological aversion to a food, an intolerance to an ingredient in a meal or a true food allergy. Diagnosis of food allergy requires a combination of a detailed medical history, laboratory data and in many cases, an oral food challenge, which is confirmatory of either tolerance or an adverse food reaction (allergy or non-allergic). The cornerstone of food allergy management is the elimination of the allergen involved, however the allergen elimination process could predispose patients, especially children to inadequate diets and cause nutritional deficiencies thus eliminating diets should be done in the most specific way possible. Keywords: Food allergy, Allergy; Patient; Children DefinitionAdverse reactions to food may be due to intolerance, toxicity or immunological mechanisms. Food allergy is defined as an adverse immune response that occurs reproducibly on exposure to a given food. This is different from food intolerance, which refers to a nonimmunological adverse reaction to food [1][2][3][4]. Food allergy is the result of an immune response, which may be mediated by IgE (type I) and non-IgE mediated (type II, III, IV or mixed hypersensitivity); and which occurs by sensitization to food allergens [5][6][7][8]. Food Allergy EpidemiologyFood allergy is common, in developed countries, the prevalence of food allergy has increased over the last two or three decades, with no universal theory to explain this phenomenon and no interventions appear to curtail a similar increase in developing countries. The prevalence of food allergy seems to vary greatly with age. Currently estimated to affect between 2 and 8% of the world's population. The prevalence of food allergy is highest in infants and toddlers; affecting 6% to 8% of children and can be both life-impacting and lifethreatening [1][2][3]8,9].2.5% of infants suffer from milk allergy and up to 10% of 1-yearolds suffer from allergies to food, including cow's milk, egg, nuts, soya, wheat and fish/shellfish [2,10]. Some children may "outgrow" their symptoms of allergy, but for others, the food allergies may be lifelong. Because reported cases increase each year, food allergy should be considered a public health problem. In fact, some authors have described it as "the second wave" of the allergic epidemic [8].Cross-reactivity between different species of foods in allergic patients is also common. Dietary avoidance is currently the most essential component in the management of food allergy. However, it may not be beneficial for children during periods of active growth, as it can limit their intake of nutrients from different foods. Conflicting information regarding cross-reactivity often leads to an inconsistent understanding of food allergies among physicians and other health care givers which lead to disparate recommendations and confusion...

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Pollen food syndrome: Update on the allergens

Cited by 62 publications

References 24 publications

Anaphylaxis

Anaphylaxis

Identification of European Allergy Patterns to the Allergen Families PR-10, LTP, and Profilin from Rosaceae Fruits

Doing the Food Allergy Diagnosis

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