Tree nut allergy: a systematic review

Chu, Derek K.

doi:10.1097/mop.0000000000001180

Cited by 6 publications

(3 citation statements)

References 66 publications

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“…Although there are recent reviews on the management and diagnosis of tree nut allergy, 8,9,[41][42][43] this is the first systematic review thoroughly investigating the available information on therapeutic options for the desensitization of patients with IgE-mediated tree nut allergy, other than peanut. Studies addressing the management of tree nut allergy, which did not fulfill the prespecified inclusion criteria of this review, can be found in the Supplementary information.…”

Section: Strengths and Weaknessesmentioning

confidence: 99%

Current options in the management of tree nut allergy: A systematic review and narrative synthesis

Pasioti,

Xepapadaki,

Mathioudakis

et al. 2024

Pediatric Allergy Immunology

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Tree nut allergy is a lifelong and potentially life‐threatening condition. The standard of care is strictly avoiding the culprit nut and treating accidental reactions symptomatically. To evaluate potential therapeutic options for desensitizing patients with IgE‐mediated tree nut allergy, we systematically searched three bibliographic databases for studies published until January 2024. We looked for active treatments of IgE‐mediated allergy to tree nuts (walnut, hazelnut, pistachio, cashew, almond, pecan, macadamia nut, and brazil nut). We focused on allergen‐specific immunotherapy (AIT) using oral (OIT), sublingual (SLIT), epicutaneous (EPIT), or subcutaneous (SCIT) delivery, or other disease‐modifying treatments. We found 19 studies that met our criteria: 3 studies investigated sublingual immunotherapy, 5 studied oral immunotherapy to a single tree nut, and 6 used multi‐food oral immunotherapy with or without omalizumab. The remaining studies investigated the effectiveness of monoclonal antibodies or IgE‐immunoadsorption in multi‐food allergic patients, including patients with tree nut allergy. The heterogeneity of the studies prevented pooling and meta‐analysis. Oral immunotherapy, single or multi‐nut, with or without omalizumab, was the most studied approach and appears effective in conferring protection from accidental exposures. Omalizumab monotherapy is the only approved alternative management for reducing allergic reactions that may occur with accidental exposure.image

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Section: Strengths and Weaknessesmentioning

confidence: 99%

Current options in the management of tree nut allergy: A systematic review and narrative synthesis

Pasioti,

Xepapadaki,

Mathioudakis

et al. 2024

Pediatric Allergy Immunology

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show abstract

“…Although there are recent reviews on the management and diagnosis of tree nut allergy 5,6,[37][38][39] this is the first systematic review thoroughly investigating the available information on therapeutic options for the desensitization of patients with IgE-mediated tree nut allergy, other than peanut. Studies addressing the management of tree nut allergy which did not fulfill the prespecified inclusion criteria of this review can be found in Supplementary text.…”

Section: Strengths and Weaknessesmentioning

confidence: 99%

Current options in the management of tree nut allergy. A systematic review and narrative synthesis.

Pasioti,

Xepapadaki,

Mathioudakis

et al. 2023

Preprint

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Background: Tree nut allergy is usually life-long and potentially life-threatening. Standard of care consists of strict avoidance of the culprit nut and symptomatic treatment of accidental reactions. Objective: To evaluate the potential therapeutic options for desensitization of patients with IgE-mediated tree nut allergy, focusing on, but not limited to, immunotherapy. Methods: We systematically searched three bibliographic databases for studies published until July 2022 for active treatments of IgE-mediated allergy to tree nuts (walnut, hazelnut, pistachio, cashew, and almond) with allergen-specific immunotherapy (AIT) using oral (OIT), sublingual (SLIT), epicutaneous (EPIT) or subcutaneous (SCIT) delivery, or with other disease-modifying treatments. Results: We included 17 studies (three randomized, double-blinded, placebo-controlled, five quasi-experimental prospective cohorts, five prospective cohorts, two retrospective cohorts, and two case reports. Three studies investigated sublingual immunotherapy, five investigated oral immunotherapy to a single tree nut, and six used multi-food oral immunotherapy with (four) or without (two) omalizumab. The remaining studies investigated the effectiveness of monoclonal antibodies in multi-food allergic patients, including patients with a tree nut allergy. The heterogeneity of the studies prevented pooling and meta-analysis. Conclusion: Even though strict avoidance remains the standard of care for patients with tree nut allergy, alternative approaches have been tested in clinical trials and real-life studies. These new concepts require further investigation with more well-designed studies including well-characterized nut allergic patients before implementing them in daily clinical practice.

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“…Sensitization to peanut allergens Ara h 5 and Ara h 8, belonging to the PR10 protein family and profilin, respectively usually induces symptoms belonging to the oral allergy syndrome. In contrast, Ara h 1, Ara h 2, and Ara h 3, belonging to the seed storage proteins, tend to induce more severe and systemic reactions (16,18,19).…”

Section: Introductionmentioning

confidence: 99%

Molecular allergology and its application in prevention, diagnosis and therapy

Podzhilkova,

Nagl,

Hoffmann-Sommergruber

2023

Front. Allergy

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Allergic diseases represent a relevant global health problem, affecting adults and children and posing a significant burden for health care systems. In addition, the disease is still under-recognized and harmonized diagnostic tools and management plans for patients are still lacking. In this review the most important aspects of the diagnosis of allergic diseases are summarized and the contribution of Molecular allergology to this area is highlighted.

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Tree nut allergy: a systematic review

Cited by 6 publications

References 66 publications

Current options in the management of tree nut allergy: A systematic review and narrative synthesis

Current options in the management of tree nut allergy: A systematic review and narrative synthesis

Current options in the management of tree nut allergy. A systematic review and narrative synthesis.

Molecular allergology and its application in prevention, diagnosis and therapy

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