“…In terms of study design, the 23 eligible studies were: 12 cohort; 19 , 21 , 27 , 29 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 two case-control; 4 , 20 four cross-sectional; 22 , 23 , 30 , 41 and five case series studies. 24 , 25 , 26 , 28 , 32 …”
Section: Resultsmentioning
confidence: 99%
“…Quality assessment of the 23 included primary studies on symptom-severity assessment suggested that out of 12 cohort studies 10 were judged as strong. 19 , 29 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 68 Out of two case-control studies one was judged as moderate and two as weak. Three cross-sectional studies 22 , 23 , 30 were judged as moderate, and one study 31 was judged as weak.…”
Section: Resultsmentioning
confidence: 99%
“…In 10 out of 23 included primary studies assessing symptom severity, food allergy was confirmed by OFC. 20 , 21 , 22 , 23 , 30 , 31 , 32 , 36 , 37 , 38 Among these 10 studies, 1 31 used a validated questionnaire with a sensitivity of 100% and a specificity of 87% for detecting peanut allergy compared with the gold standard of double-blind placebo-controlled food challenge (DBPCFC). 41 …”
Background and aims
The term “Food Allergy” refers to a complex global health problem with a wide spectrum of severity. However, a uniform definition of severe food allergy is currently missing. This systematic review is the preliminary step towards a state-of-the-art synopsis of the current evidence relating to the severity of IgE-mediated food allergy; it will inform attempts to develop a consensus to define food allergy severity by clinicians and other stakeholders.
Methods
We undertook a mixed-methods systematic review, which involved searching 11 international biomedical databases for published studies from inception to 31 December 2019. Studies were independently screened against pre-defined eligibility criteria and critically appraised by established instruments. The substantial heterogeneity of included studies precluded meta-analyses and, therefore, narrative synthesis of quantitative and qualitative data was performed.
Results
We found 23 studies providing eligible primary data on symptom-specific severity of food allergic reactions, and 31 previously published symptom-severity scoring systems referred to food allergic reactions. There were seven studies which assessed quality-of-life measures in patients (and family members) with different food allergy severity and two studies that investigated the economic burden of food allergy severity. Overall, the quality and the global rating of all included studies were judged as being moderate.
Conclusions
There is heterogeneity among severity scoring systems used and even outcomes considered in the context of severity of food allergy. No score has been validated. Our results will be used to inform the development of an international consensus to define the severity of food allergy.
Systematic review registration
A protocol was prospectively registered with the International Prospective Register of Systematic Reviews (PROSPERO) database with the registration number CRD42020183103 (
https://www.crd.york.ac.uk/prospero/#recordDetails
).
“…In terms of study design, the 23 eligible studies were: 12 cohort; 19 , 21 , 27 , 29 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 two case-control; 4 , 20 four cross-sectional; 22 , 23 , 30 , 41 and five case series studies. 24 , 25 , 26 , 28 , 32 …”
Section: Resultsmentioning
confidence: 99%
“…Quality assessment of the 23 included primary studies on symptom-severity assessment suggested that out of 12 cohort studies 10 were judged as strong. 19 , 29 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 68 Out of two case-control studies one was judged as moderate and two as weak. Three cross-sectional studies 22 , 23 , 30 were judged as moderate, and one study 31 was judged as weak.…”
Section: Resultsmentioning
confidence: 99%
“…In 10 out of 23 included primary studies assessing symptom severity, food allergy was confirmed by OFC. 20 , 21 , 22 , 23 , 30 , 31 , 32 , 36 , 37 , 38 Among these 10 studies, 1 31 used a validated questionnaire with a sensitivity of 100% and a specificity of 87% for detecting peanut allergy compared with the gold standard of double-blind placebo-controlled food challenge (DBPCFC). 41 …”
Background and aims
The term “Food Allergy” refers to a complex global health problem with a wide spectrum of severity. However, a uniform definition of severe food allergy is currently missing. This systematic review is the preliminary step towards a state-of-the-art synopsis of the current evidence relating to the severity of IgE-mediated food allergy; it will inform attempts to develop a consensus to define food allergy severity by clinicians and other stakeholders.
Methods
We undertook a mixed-methods systematic review, which involved searching 11 international biomedical databases for published studies from inception to 31 December 2019. Studies were independently screened against pre-defined eligibility criteria and critically appraised by established instruments. The substantial heterogeneity of included studies precluded meta-analyses and, therefore, narrative synthesis of quantitative and qualitative data was performed.
Results
We found 23 studies providing eligible primary data on symptom-specific severity of food allergic reactions, and 31 previously published symptom-severity scoring systems referred to food allergic reactions. There were seven studies which assessed quality-of-life measures in patients (and family members) with different food allergy severity and two studies that investigated the economic burden of food allergy severity. Overall, the quality and the global rating of all included studies were judged as being moderate.
Conclusions
There is heterogeneity among severity scoring systems used and even outcomes considered in the context of severity of food allergy. No score has been validated. Our results will be used to inform the development of an international consensus to define the severity of food allergy.
Systematic review registration
A protocol was prospectively registered with the International Prospective Register of Systematic Reviews (PROSPERO) database with the registration number CRD42020183103 (
https://www.crd.york.ac.uk/prospero/#recordDetails
).
“…In recent years, the importance of almond allergies has been stressed. 97,98 Some almond proteins have been characterized as food allergens, alrhough some IgE-reacting proteins have been misidentified as a result of data limitation. Apparently based solely on sequence homology, two proteins have been called almond allergens and given names similar to official allergen names designated by the WHO/IUIS Allergen Nomenclature Sub-Committee.…”
Almond (Prunus dulcis) is not only widely used as a human food as a result of its flavor, nutrients, and health benefits, but it is also one of the most likely tree nuts to trigger allergies. Almond allergens, however, have not been studied as extensively as those of peanuts and other selected tree nuts. This review provides an update of the molecular properties of almond allergens to clarify some confusion about the identities of almond allergens and our perspective on characterizing putative almond allergens. At present, the following almond allergens have been designated by the World Health Organization/International Union of Immunological Societies Allergen Nomenclature Sub‐Committee: Pru du 3 (a non‐specific lipid transfer protein 1, nsLTP1), Pru du 4 (a profilin), Pru du 5 (60S acidic ribosomal protein 2), Pru du 6 (an 11S legumin known as prunin) and Pru du 8 (an antimicrobial protein with cC3C repeats). Besides, almond vicilin and almond γ‐conglutin have been identified as food allergens, although further characterization of these allergens is still of interest. In addition, almond 2S albumin was reported as a food allergen as a result of the misidentification of Pru du 8. Two more almond proteins have been called allergens based on their sequence homology with known food allergens and their ‘membership’ in relevant protein families that contain allergens in many species. These include the pathogenesis related‐10 protein (referred to as Pru du 1) and the thaumatin‐like protein (referred to as Pru du 2). Almonds thus have five known food allergens and five more likely ones that need to be investigated further. Published 2020. This article is a U.S. Government work and is in the public domain in the USA.
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