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Liu W, Yang Q, Wang Z, Wang J, Min F, Yuan J, Tong P, Li X, Wu Y, Gao J, Chen H. Quantitative food allergen risk assessment: Evolving concepts, modern approaches, and industry implications. Compr Rev Food Sci Food Saf 2025; 24:e70132. [PMID: 39929606 DOI: 10.1111/1541-4337.70132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2024] [Revised: 01/14/2025] [Accepted: 01/18/2025] [Indexed: 05/08/2025]
Abstract
Food safety is crucially linked to the food system, ensuring safe production, handling, and distribution to protect public health. Food allergy has been considered as a public health and food safety issue. Despite being widely regarded as a prevailing strategy for managing food allergies, strict food avoidance faces challenges due to allergen cross-contact in the food supply chain and the potential for inaccurate allergen labeling. Hence, a scientific approach to assess allergen risk in this context is imperative. In this review, a novel approach to managing food allergies, referred to as quantitative food allergen risk assessment, is presented. This discussion covered the evolving concepts and modern analytical approaches. Moreover, this review delves into the current application of quantitative food allergen risk assessment. Finally, a valuable tool for food allergen risk assessment in the food industry, Voluntary Incidental Trace Allergen Labelling (VITAL), was introduced. The establishment of a globally harmonized and standardized quantitative food allergen risk assessment framework could facilitate the promotion of international harmonization of allergen labeling, support food allergic consumers in making safe food choices, and safeguard the health of allergic individuals across various regions and ethnicities. The implementation of food allergen risk assessment could ensure both food supply chain safety and guide the establishment of acceptable allergen cross-contact levels, enhancing food safety and bolstering the integrity and sustainability of the food system.
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Affiliation(s)
- Wenfeng Liu
- State Key Laboratory of Food Science and Resources, Nanchang University, Nanchang, China
- China National Center for Food Safety Risk Assessment, Beijing, China
- School of Food Science and Technology, Nanchang University, Nanchang, China
- Sino-German Joint Research Institute, Nanchang University, Nanchang, China
| | - Qian Yang
- School of Food Science and Engineering, Hainan University, Haikou, China
| | - Zhongliang Wang
- State Key Laboratory of Food Science and Resources, Nanchang University, Nanchang, China
- School of Food Science and Technology, Nanchang University, Nanchang, China
- Sino-German Joint Research Institute, Nanchang University, Nanchang, China
| | - Jian Wang
- State Key Laboratory of Food Science and Resources, Nanchang University, Nanchang, China
- School of Food Science and Technology, Nanchang University, Nanchang, China
- Sino-German Joint Research Institute, Nanchang University, Nanchang, China
| | - Fangfang Min
- State Key Laboratory of Food Science and Resources, Nanchang University, Nanchang, China
- School of Food Science and Technology, Nanchang University, Nanchang, China
- Sino-German Joint Research Institute, Nanchang University, Nanchang, China
| | - Juanli Yuan
- State Key Laboratory of Food Science and Resources, Nanchang University, Nanchang, China
- School of Pharmacy, Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Ping Tong
- State Key Laboratory of Food Science and Resources, Nanchang University, Nanchang, China
- School of Food Science and Technology, Nanchang University, Nanchang, China
| | - Xin Li
- State Key Laboratory of Food Science and Resources, Nanchang University, Nanchang, China
- School of Food Science and Technology, Nanchang University, Nanchang, China
| | - Yong Wu
- School of Food Science and Technology, Nanchang University, Nanchang, China
- Sino-German Joint Research Institute, Nanchang University, Nanchang, China
| | - Jinyan Gao
- School of Food Science and Technology, Nanchang University, Nanchang, China
| | - Hongbing Chen
- State Key Laboratory of Food Science and Resources, Nanchang University, Nanchang, China
- Sino-German Joint Research Institute, Nanchang University, Nanchang, China
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Zhang RWY, Yuan DD, Yang X, Yang YB, Li FP, Chen XY, Wang K, Liu J, Yu LN, Hu ZG. Detection of egg white allergy in children by specific IgE microarray chemiluminescence immunoassay. Clin Chim Acta 2025; 565:119966. [PMID: 39278524 DOI: 10.1016/j.cca.2024.119966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2024] [Revised: 08/29/2024] [Accepted: 09/10/2024] [Indexed: 09/18/2024]
Abstract
BACKGROUND Allergen testing has emerged as a pivotal component in prevention and treatment strategies for allergic diseases among children and the utilization of specific IgE (sIgE) through a fully automated chemiluminescent microarray immunoassay (CLMIA) has emerged as a promising trend in the simultaneous detection of multiple allergenic components of children. METHODS The accuracy and reliability of CLMIA were verified using children's serum samples that concentrated on allergens. the allergens. The clinical diagnostic practicability of CLMIA was assessed through comprehensive evaluations including measurements of the limit of detection (LOD), intra-batch, and inter-batch precision, linearity analysis, the cross-contamination rate, and the concordance rate with the Phadia system. RESULTS After the optimization process of CLMIA, the LODs for allergens were calculated to be below 0.01 kU/L, demonstrating the high sensitivity of CLMIA. All components exhibited good linearity within the range of 0.1-100.0 kU/L and the coefficient of determinations (R2 > 0.99). The data of intra-batch precision (<10 %) and inter-batch data (<15 %) illustrated the high reproducibility of CLMIA. The cross-contamination rates for allergens (<0.5 %) showed the high accuracy of CLMIA without interfering. The positive concordance rate between CLMIA and the Phadia system exceeds 90 % with a good negative concordance rate (>85 %) and the Kappa coefficients (>0.8), suggesting the close alignment of CLMIA and the Phadia system and showing the satisfactory clinical potential of CLMIA in children's allergy disease. CONCLUSIONS The application of CLMIA has been promising in allergen testing, especially for detecting multiple allergenic components in children.
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Affiliation(s)
- Ren-Wei-Yang Zhang
- Department of Medical Laboratory, Affiliated Children's Hospital of Jiangnan University, Qingyang Road 299, Wuxi, Jiangsu, 214023, China
| | - Dan-Dan Yuan
- Department of Medical Laboratory, Affiliated Children's Hospital of Jiangnan University, Qingyang Road 299, Wuxi, Jiangsu, 214023, China
| | - Xue Yang
- Department of Medical Laboratory, Affiliated Children's Hospital of Jiangnan University, Qingyang Road 299, Wuxi, Jiangsu, 214023, China
| | - Yong-Bing Yang
- Department of Medical Laboratory, Affiliated Children's Hospital of Jiangnan University, Qingyang Road 299, Wuxi, Jiangsu, 214023, China
| | - Fa-Ping Li
- Department of Medical Laboratory, Affiliated Children's Hospital of Jiangnan University, Qingyang Road 299, Wuxi, Jiangsu, 214023, China
| | - Xu-Yang Chen
- Department of Medical Laboratory, Affiliated Children's Hospital of Jiangnan University, Qingyang Road 299, Wuxi, Jiangsu, 214023, China
| | - Kai Wang
- Department of Medical Laboratory, Affiliated Children's Hospital of Jiangnan University, Qingyang Road 299, Wuxi, Jiangsu, 214023, China.
| | - Jie Liu
- Department of Respiratory and Critical Care Medicine, Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, Jiangsu, 214023, China.
| | - Li-Na Yu
- Jiangsu Sunlant Bioengineering Co., Ltd, Wuxi, Jiangsu, 214038, China.
| | - Zhi-Gang Hu
- Department of Medical Laboratory, Affiliated Children's Hospital of Jiangnan University, Qingyang Road 299, Wuxi, Jiangsu, 214023, China.
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Bellia C, Sardina DS, Scazzone C, Lio D, Scola L, Uasuf CG. Diagnostic Accuracy of Lipid Transfer Proteins (LTPs) Specific IgE Assay in Food Allergy: A Systematic Review. Int J Mol Sci 2024; 25:12925. [PMID: 39684636 PMCID: PMC11641413 DOI: 10.3390/ijms252312925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2024] [Revised: 11/05/2024] [Accepted: 11/23/2024] [Indexed: 12/18/2024] Open
Abstract
The aim of this systematic review was to evaluate the diagnostic accuracy of molecular-based LTPs serum sIgE for the diagnosis of food allergies in patients with suspected allergy to one of the LTPs-containing foods. Cohort, prospective or retrospective cross-sectional studies were considered for inclusion in this review. Oral food challenge (both open and double-blind placebo-controlled) was the reference standard for the diagnosis. PubMed (MEDLINE), Web of Science, Scopus, and ClinicalTrial.org were searched for relevant papers. The risk of bias was assigned by the QUADAS-2 tool. Data were reported as the sensitivity and specificity. The study protocol was registered in the PROSPERO database (CRD42022321985). Fifteen articles, including 2395 individuals, were included. The sensitivity of Ara h 9 for peanut allergy diagnosis ranged from 6 to 61%; the specificity ranged from 57 to 100%. The Cor a 8 sensitivity ranged from 11 to 43%, with the specificity ranging from 59 to 94%. Ara h 9 and Cor a 8 serum sIgE may be useful for confirming the diagnosis of peanut and hazelnut allergy in symptomatic patients, although the diagnostic accuracy is limited by the low sensitivity. More investigation on other LTPs and in adult populations may be important to define the clinical role of this test in food allergy diagnostics.
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Affiliation(s)
- Chiara Bellia
- Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy; (C.B.); (C.S.); (L.S.)
- Transfusion Medicine Unit, University Hospital “Paolo Giaccone”, 90127 Palermo, Italy
| | - Davide Stefano Sardina
- Institute of Translational Pharmacology (IFT), National Research Council (CNR), 90146 Palermo, Italy;
| | - Concetta Scazzone
- Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy; (C.B.); (C.S.); (L.S.)
| | - Domenico Lio
- University Research Centre “Migrate”, University of Palermo, 90100 Palermo, Italy;
| | - Letizia Scola
- Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy; (C.B.); (C.S.); (L.S.)
- Transfusion Medicine Unit, University Hospital “Paolo Giaccone”, 90127 Palermo, Italy
| | - Carina Gabriela Uasuf
- Institute of Translational Pharmacology (IFT), National Research Council (CNR), 90146 Palermo, Italy;
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Al Ghamdi A, Abrams EM, Carr S, Hanna MA, Herman SM, Lavine E, Kim H, Vander Leek TK, Mack DP. Canadian Society of Allergy and Clinical Immunology position statement: panel testing for food allergies. ALLERGY, ASTHMA, AND CLINICAL IMMUNOLOGY : OFFICIAL JOURNAL OF THE CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY 2024; 20:61. [PMID: 39614376 DOI: 10.1186/s13223-024-00937-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2024] [Accepted: 11/21/2024] [Indexed: 12/01/2024]
Abstract
This position statement addresses the critical concerns and recommended practices surrounding the use of panel food testing for diagnosing food allergies. Food allergies are a significant public health concern, and the misdiagnosis of food allergies remains a prevalent concern, made worse by the ongoing use of panel food testing. The practice of screening patients for multiple food allergens, regardless of clinical relevance, is commonly referred to as "panel food testing." Fundamentally, a panel food test is not simply a single test; a panel food test is a series of several distinct tests for multiple foods, each with its own variable predictive value. These tests have not been adequately validated as screening tests and carry a considerable false positive rate. The resulting false diagnoses lead to unnecessary dietary restrictions, increased healthcare costs, and significant psychosocial distress for patients and their families.
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Affiliation(s)
- Abdulrahman Al Ghamdi
- Division of Allergy and Immunology, Department of Pediatrics, University of Toronto, Toronto, Canada
- Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Elissa M Abrams
- Department of Pediatrics, Section of Allergy and Clinical Immunology, University of Manitoba, Winnipeg, Canada
- Department of Pediatrics, Division of Allergy, University of British Columbia, Vancouver, Canada
| | - Stuart Carr
- Snö Asthma & Allergy, Abu Dhabi, United Arab Emirates
| | | | - Sari M Herman
- Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Elana Lavine
- Department of Pediatrics, University of Toronto & Humber River Hospital, Toronto, ON, Canada
| | - Harold Kim
- Western University, London, ON, Canada
- Canada and McMaster University, Hamilton, ON, Canada
| | - Timothy K Vander Leek
- Department of Pediatrics, Stollery Children's Hospital, University of Alberta, Edmonton, AB, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - Douglas P Mack
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada.
- Halton Pediatric Allergy, 5500 North Service Road, Suite 106, Burlington, ON, L7L 6W6, Canada.
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Mousavi Khaneghah A, Mostashari P. Decoding food reactions: a detailed exploration of food allergies vs. intolerances and sensitivities. Crit Rev Food Sci Nutr 2024; 65:2669-2713. [PMID: 38747015 DOI: 10.1080/10408398.2024.2349740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2025]
Abstract
The food matrix is a complex system encompassing all constituent elements in food production. It influences the digestibility of these elements through direct interactions and affects the digestive environment. Furthermore, the gastrointestinal system possesses precise mechanisms that efficiently process dietary components into essential nutrients, effectively preventing the onset of abnormal immune responses or dysfunctional host reactions in most instances. However, the incidence of adverse food reactions is constantly increasing, and evidence indicates that this process is environmental. Adverse reactions can be categorized as toxic or nontoxic. Toxic reactions are dose-dependent and can result from natural compounds, processing-induced substances, or contaminants. Nontoxic reactions like food intolerance and hypersensitivity depend on individual susceptibility and evoke specific pathological and physiological responses. This review aims to elucidate the mechanisms underlying the occurrence of immune- (food allergies and sensitivities) and non-immune-mediated (food intolerance) reactions, emphasizing the fundamental distinctions between these two categories. Enhanced comprehension and distinction of these mechanisms will significantly contribute to advancing preventive and therapeutic approaches and establishing guidelines for food labeling concerning immune-mediated reactions.
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Affiliation(s)
| | - Parisa Mostashari
- Department of Food Science and Technology, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Food Science and Technology, Faculty of Pharmacy, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
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Parrish CP. A review of food allergy panels and their consequences. Ann Allergy Asthma Immunol 2023; 131:421-426. [PMID: 37098403 DOI: 10.1016/j.anai.2023.04.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 03/28/2023] [Accepted: 04/10/2023] [Indexed: 04/27/2023]
Abstract
Serum immunoglobulin E (IgE) assays to food specific IgE (s-IgE) are useful tools for the confirmation of clinical suspicion of food allergy. However, the specificity of these assays is poor given that sensitization is much more common than clinical food allergy. Therefore, the use of broad panels to assess sensitization to multiple foods often leads to overdiagnosis and unnecessary food avoidance. Unintended consequences that may occur as a result include physical harm, psychological harm, financial cost, opportunity cost, and even worsening of existing health care disparities. Although current guidelines recommend against the use of s-IgE food panel testing, these tests are widely available and frequently used. To limit the negative impacts of s-IgE food panel testing, further work is needed to effectively spread the message that these food panels may cause unintended harm to patients and families.
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Affiliation(s)
- Christopher P Parrish
- Division of Allergy and Immunology, Departments of Pediatrics and Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.
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Bourgoin P, Busnel JM. Promises and Remaining Challenges for Further Integration of Basophil Activation Test in Allergy-Related Research and Clinical Practice. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:3000-3007. [PMID: 37634807 DOI: 10.1016/j.jaip.2023.08.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 08/21/2023] [Accepted: 08/21/2023] [Indexed: 08/29/2023]
Abstract
More than 20 years after having been initially proposed, the relevance and usefulness of basophil activation test (BAT) for the field of allergy research and testing were demonstrated on many occasions. Leveraging the fully open format of a flexible, whole blood-based functional assay, BAT has been shown to be equally important for fundamental research, clinical research, and diagnosis. Regardless of whether the focus of a study is on the characterization of the allergenic moiety, on the patient side, or on the study of the fundamental processes involved in the allergic disease or its treatment, BAT enables the gathering of very important insights. In spite of this, its full capabilities have yet to be leveraged. Various bottlenecks, including but not limited to assay logistics, robustness, flow cytometry access, and/or expertise, have indeed been limiting its development beyond experts and long-term users. Now, various initiatives, aiming at resolving these bottlenecks, have been launched. If successful, a broader use of BAT could then be contemplated. In such a situation, its more thorough integration in clinical practice has the potential to significantly change the allergic patient's journey.
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Affiliation(s)
- Pénélope Bourgoin
- Global Research Organization, Beckman Coulter Life Sciences, Marseille, France
| | - Jean-Marc Busnel
- Global Research Organization, Beckman Coulter Life Sciences, Marseille, France.
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Brasal-Prieto M, Fernández-Prades L, Dakhaoui H, Sobrino F, López-Enríquez S, Palomares F. Update on In Vitro Diagnostic Tools and Treatments for Food Allergies. Nutrients 2023; 15:3744. [PMID: 37686776 PMCID: PMC10489659 DOI: 10.3390/nu15173744] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/15/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023] Open
Abstract
Food allergy (FA) is an adverse immunological reaction to a specific food that can trigger a wide range of symptoms from mild to life-threatening. This adverse reaction is caused by different immunological mechanisms, such as IgE-mediated, non-IgE-mediated and mixed IgE-mediated reactions. Its epidemiology has had a significant increase in the last decade, more so in developed countries. It is estimated that approximately 2 to 10% of the world's population has FA and this number appears to be increasing and also affecting more children. The diagnosis can be complex and requires the combination of different tests to establish an accurate diagnosis. However, the treatment of FA is based on avoiding the intake of the specific allergenic food, thus being very difficult at times and also controlling the symptoms in case of accidental exposure. Currently, there are other immunomodulatory treatments such as specific allergen immunotherapy or more innovative treatments that can induce a tolerance response. It is important to mention that research in this field is ongoing and clinical trials are underway to assess the safety and efficacy of these different immunotherapy approaches, new treatment pathways are being used to target and promote the tolerance response. In this review, we describe the new in vitro diagnostic tools and therapeutic treatments to show the latest advances in FA management. We conclude that although significant advances have been made to improve therapies and diagnostic tools for FA, there is an urgent need to standardize both so that, in their totality, they help to improve the management of FA.
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Alpan O, Wasserman RL, Kim T, Darter A, Shah A, Jones D, McNeil D, Li H, Ispas L, Rathkopf M, Perez E, Siri D, O’Connor M, Plassmeyer M, Romito K, Pettibone C, O’Reilly S, Sønder SU, Marti G. Towards an FDA-cleared basophil activation test. FRONTIERS IN ALLERGY 2023; 3:1009437. [PMID: 36698379 PMCID: PMC9869275 DOI: 10.3389/falgy.2022.1009437] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 11/30/2022] [Indexed: 01/12/2023] Open
Abstract
Food allergy is a global health problem affecting up to 10% of the world population. Accurate diagnosis of food allergies, however, is still a major challenge in medical offices and for patients seeking alternative avenues of diagnosis. A flawless test to confirm or rule out a food allergy does not exist. The lack of optimum testing methods to establish precise clinical correlations remains a major obstacle to effective treatment. Certain IgE measurement methods, including component testing, have received FDA clearance, but they have been used primarily as an analytical tool and not to establish clinical correlations. Most allergy tests are still carried out within the laboratory, and skin tests outside a laboratory setting that are used for food allergy diagnosis rely on non-standardized allergens, according to the FDA definition. Epitope mapping and basophil activation test (BAT) have recently been proposed as a means of establishing better clinical correlations. Yet neither have received FDA clearance for widespread distribution. Of the two methods, the BAT has the advantage of being a functional assay. Over the past few years, several large private practice groups in the United States, have developed BAT as a clinical assay and have started using it in patient care. Given this clinical experience, the vast number of papers published on BAT (more than 1,400 as of 2022) and the trend toward increasing FDA regulation, it is essential to understand the roadmap for regulatory clearance of this assay.
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Affiliation(s)
- Oral Alpan
- Amerimmune, Fairfax, VA, United States,Correspondence: Oral Alpan
| | | | - Theodore Kim
- Allergy Partners of Northern Virginia, Chantilly, VA, United States
| | - Amy Darter
- Oklahoma Institute of Allergy, Asthma and Immunology, Oklahoma City, OK, United States
| | - Atul Shah
- New York Food Allergy and Wellness Center, Centereach, NY, United States
| | | | | | - Henry Li
- Institute for Asthma and Allergy, Wheaton, MD, United States
| | - Laura Ispas
- Allergy, Asthma and Immunology Institute, Leesburg, VA, United States
| | - Melinda Rathkopf
- Allergy Asthma and Immunology Center of Alaska, Anchorage, AK, United States
| | - Elena Perez
- Allergy Associates of the Palm Beaches, Palm Beach, FL, United States
| | - Dareen Siri
- Midwest Allergy Sinus Asthma, Normal, IL, United States
| | - Maeve O’Connor
- Allergy, Asthma and Immunology Relief of Charlotte, Charlotte, NC, United States
| | | | | | | | - Sean O’Reilly
- New Columbia Capital, LLC, Arlington, VA, United States
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Lisik D, Ioannidou A, Spolidoro G, Ali M, Nyassi S, Amera Y, Rovner G, Khaleva E, Venter C, van Ree R, Worm M, Vlieg‐Boerstra B, Sheikh A, Muraro A, Roberts G, Nwaru BI. Prevalence of sensitization to molecular food allergens in Europe: A systematic review. Clin Transl Allergy 2022; 12:e12175. [PMID: 35821705 PMCID: PMC9260209 DOI: 10.1002/clt2.12175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 06/21/2022] [Indexed: 11/07/2022] Open
Abstract
Background Recent reports indicate that the prevalence of food allergy is increasing, but accurate estimates remain a challenge due to cross-reactivity and limited use of precise diagnostic methods. Molecular allergy diagnostics, in which sensitization to individual molecular allergens is measured, is emerging as a promising tool for evaluation of sensitization profiles. In this systematic review, we summarized estimates of prevalence of sensitization to molecular food allergens in the general population in Europe. Methods Following a protocol prospectively registered with the International Prospective Register of Systematic Reviews (PROSPERO; reference CRD42021266657), we searched seven databases with no restrictions on publication date or language. Two reviewers independently screened the literature, extracted data, and appraised the risk of bias in the included studies. The findings were synthesized narratively. Results From 4776 de-duplicated records, five studies, with low to moderate overall risk of bias, were included. Forty-six molecular allergens from 18 foods were investigated. Overall, the prevalence of sensitization was low, particularly for major allergens, and non-existent for 10 molecular allergens (0% [95% CI 0-0.8]). The highest prevalence was seen for PR-10 proteins, such as Cor a 1.04 (13.6% [95% CI 10.9-16.9]). Conclusions Available data, primarily from North-western Europe, indicate that sensitization to molecular food allergens is overall low. The highest estimates were found for cross-reactive PR-10 proteins. There were not enough studies to discern regional differences or perform meta-analysis, highlighting the need for more population-representative studies in order to elucidate patterns of sensitization to molecular food allergens in Europe.
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Affiliation(s)
- Daniil Lisik
- Krefting Research CentreUniversity of GothenburgGothenburgSweden
| | - Athina Ioannidou
- Krefting Research CentreUniversity of GothenburgGothenburgSweden
| | - Giulia Spolidoro
- Department of Clinical Science and Community HealthUniversity of MilanMilanItaly
| | - Mohamed Ali
- Krefting Research CentreUniversity of GothenburgGothenburgSweden
| | - Sungkutu Nyassi
- Krefting Research CentreUniversity of GothenburgGothenburgSweden
| | - Yohanes Amera
- Krefting Research CentreUniversity of GothenburgGothenburgSweden
| | - Graciela Rovner
- Division of PhysiotherapyDepartment of Neurobiology, Care Sciences and SocietyKarolinska InstitutetStockholmSweden
- ACT Institutet SwedenGothenburgSweden
| | | | - Carina Venter
- Section of Allergy & ImmunologyUniversity of ColoradoDenver School of Medicine and Children's HospitalDenverColoradoUSA
| | - Ronald van Ree
- Department of Experimental Immunology and Department of OtorhinolaryngologyAcademic Medical CenterAmsterdamThe Netherlands
| | - Margitta Worm
- Division of Allergy and ImmunologyDepartment of Dermatology, Allergy and VenerologyCharité Universitätsmedizin BerlinBerlinGermany
| | | | - Aziz Sheikh
- Usher InstituteUniversity of EdinburghEdinburghUK
| | - Antonella Muraro
- Department of Mother and Child HealthUniversity of PaduaPaduaItaly
| | - Graham Roberts
- Faculty of MedicineUniversity of SouthamptonSouthamptonUK
- David Hide Asthma and Allergy Research CentreSt Mary's HospitalNewportUK
| | - Bright I. Nwaru
- Krefting Research CentreUniversity of GothenburgGothenburgSweden
- Wallenberg Centre for Molecular and Translational MedicineUniversity of GothenburgGothenburgSweden
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Luengo O, Galvan-Blasco P, Cardona V. Molecular diagnosis contribution for personalized medicine. Curr Opin Allergy Clin Immunol 2022; 22:175-180. [PMID: 35174793 DOI: 10.1097/aci.0000000000000822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
PURPOSE OF REVIEW The purpose of the current review is to highlight the most recent findings in molecular allergy and its applicability in precision medicine for allergic patients. RECENT FINDINGS Molecular allergy provides useful information in areas of respiratory allergy (house dust mites, pet dander and pollen allergy), food allergy (tree nuts, peanuts, fruits and vegetables), hymenoptera venom allergy and others, in order to improve management of patients. Regional differences in sensitization profiles, assay characteristics and interpretation of molecular sensitization in relation to whole extracts and total immunoglobulin E need to be taken into account. Studies of the impact of such strategies are needed. SUMMARY Molecular allergy diagnosis represents a major contribution for personalized medicine. It aids in the assesment of risk prediction, disease severity, genuine/cross-reactive sensitization, and finally to apply precise management strategies.
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Affiliation(s)
- Olga Luengo
- Allergy Section, Internal Medicine Department, Hospital Universitari Vall d'Hebron
- Vall d'Hebron Institut de Recerca (VHIR), Immunomediated Diseases and Innovative Therapies, Barcelona
- ARADyAL Research Network, Instituto de Salud Carlos III (ISCIII), Madrid
- Universitat Autonomade Barcelona (UAB), Medicine Department, Barcelona, Spain
| | - Paula Galvan-Blasco
- Allergy Section, Internal Medicine Department, Hospital Universitari Vall d'Hebron
- Vall d'Hebron Institut de Recerca (VHIR), Immunomediated Diseases and Innovative Therapies, Barcelona
- ARADyAL Research Network, Instituto de Salud Carlos III (ISCIII), Madrid
- Universitat Autonomade Barcelona (UAB), Medicine Department, Barcelona, Spain
| | - Victoria Cardona
- Allergy Section, Internal Medicine Department, Hospital Universitari Vall d'Hebron
- Vall d'Hebron Institut de Recerca (VHIR), Immunomediated Diseases and Innovative Therapies, Barcelona
- ARADyAL Research Network, Instituto de Salud Carlos III (ISCIII), Madrid
- Universitat Autonomade Barcelona (UAB), Medicine Department, Barcelona, Spain
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Shamji MH, Boyle RJ. Real word evidence studies: Is it the way forward? Clin Exp Allergy 2021; 51:748-750. [PMID: 34033691 DOI: 10.1111/cea.13893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Mohamed H Shamji
- Immunomodulation and Tolerance Group, Allergy and Clinical Immunology, Department of National Heart and Lung Institute, Imperial College London, London, UK.,Asthma UK Centre in Allergic Mechanisms of Asthma, London, Imperial College London, London, UK
| | - Robert J Boyle
- National Heart and Lung Institute, Wright Fleming Institute, Imperial College London, London, UK
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