Position paper of the EAACI: food allergy due to immunological cross‐reactions with common inhalant allergens |
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| Authors: | T. Werfel R. Asero B. K. Ballmer‐Weber K. Beyer E. Enrique A. C. Knulst A. Mari A. Muraro M. Ollert L. K. Poulsen S. Vieths M. Worm K. Hoffmann‐Sommergruber |
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| Affiliation: | 1. Department of Dermatology and Allergy, Hannover Medical University, Hannover, Germany;2. Ambulatorio di Allergologia, Clinica San Carlo, Paderno Dugnano, Milan, Italy;3. Allergy Unit, Department of Dermatology, University Hospital Zürich, Zürich, Switzerland;4. Division of Paediatric Pneumology and Immunology, Charité University Hospital, Berlin, Germany;5. Allergy Division, Hospital General de Castellón, Castellón, Spain;6. Department of Dermatology/Allergology, University Medical Center Utrecht, Utrecht, The Netherlands;7. Associated Center for Molecular Allergology (CAAM), Latina, Italy;8. The Referral Centre for Food Allergy Diagnosis and Treatment Veneto Region, Department of Mother and Child Health, University of Padua, Padua, Italy;9. Department of Infection and Immunity, Luxembourg Institute of Health, Esch‐sur‐Alzette, Luxembourg and Department of Dermatology and Allergy, Biederstein, Technische Universit?t München (TUM), Munich, Germany;10. Allergy Clinic Copenhagen University Hospital at Gentofte, Copenhagen, Denmark;11. Division of Allergology, Paul‐Ehrlich Institute, Langen, Germany;12. Department of Dermatology and Allergy, of Charité ‐ Universit?tsmedizin Berlin, Berlin, Germany;13. Department of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria |
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| Abstract: | In older children, adolescents, and adults, a substantial part of all IgE‐mediated food allergies is caused by cross‐reacting allergenic structures shared by inhalants and foods. IgE stimulated by a cross‐reactive inhalant allergen can result in diverse patterns of allergic reactions to various foods. Local, mild, or severe systemic reactions may occur already after the first consumption of a food containing a cross‐reactive allergen. In clinical practice, clinically relevant sensitizations are elucidated by skin prick testing or by the determination of specific IgE in vitro. Component‐resolved diagnosis may help to reach a diagnosis and may predict the risk of a systemic reaction. Allergy needs to be confirmed in cases of unclear history by oral challenge tests. The therapeutic potential of allergen immunotherapy with inhalant allergens in pollen‐related food allergy is not clear, and more placebo‐controlled studies are needed. As we are facing an increasing incidence of pollen allergies, a shift in sensitization patterns and changes in nutritional habits, and the occurrence of new, so far unknown allergies due to cross‐reactions are expected. |
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| Keywords: | inhalant allergens cross‐reactive food allergy IgE sensitization |
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