NUT Co Reactivity ‐ ACquiring Knowledge for Elimination Recommendations (NUT CRACKER) study

Abstract

The data presented here should assist in differentiating between allergic and tolerant patients, decrease the need for OFC, and allow for appropriate elimination recommendations.

Recent developments and highlights in food allergy

“…None of the patients with tree nut allergy had a co‐existing almond allergy despite 59% test positivity. The only almond‐allergic individual did not display tree nut allergies . This is in line with a recent single‐center report on 400 consecutive almond oral food challenges with a >80% chance of passing an oral food challenge despite a SPT >9 mm or sIgE >10 kU/l.…”

Component‐resolved diagnostics demonstrates that most peanut‐allergic individuals could potentially introduce tree nuts to their diet

“…We consider the available species‐specific tests, when negative, sufficient to rule out hazelnut, cashew and pistachio, walnut, Brazil nut, and sesame seed allergies in most cases. Species‐specific pecan sensitizations were assessed by analysing the cross‐reactive walnut allergens . The ISAC platform includes several important peanut, tree nut and seed allergens, although it would benefit from including hazelnut and cashew 2S albumins Cor a 14 and Ana o 3, which currently are available only in singleplex tests.…”

Selective nut‐eating in peanut or tree nut allergic children—How can molecular allergology help?

“…However, these modalities are limited by over‐reporting of allergic symptoms, false diagnosis, and positive tests related to cross‐reactivity to pollen or cross‐reactive carbohydrate determinants; all these factors might result a spuriously higher rate of reported allergy. More recently, the rate of challenge proven co‐existent peanut and tree nut allergy was cited as <30% . However, these studies were mainly conducted retrospectively, and/or only included a limited number of tree nuts .…”