Cor a 14, Hazelnut-Specific IgE, and SPT as a Reliable Tool in Hazelnut Allergy Diagnosis in Eastern Mediterranean Children

Büyüktiryaki, Betül; Cavkaytar, Özlem; Şahiner, Ümit Murat; Yılmaz, Ebru; Yavuz, Süleyman Tolga; Soyer, Özge; Şekerel, Bülent Enis; Tuncer, Ayfer; Saçkesen, Cansın

doi:10.1016/j.jaip.2015.12.012

Cited by 42 publications

(50 citation statements)

References 27 publications

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“…The systematic literature search identified 2225 unique citations; 2025 citations were excluded based on the title and abstract, leaving 200 full‐text publications for a second review. Finally, eight studies on the accuracy of hazelnut component sIgE antibody for the diagnosis of hazelnut allergy were relevant for inclusion in the meta‐analysis (Figure A) . Of these, seven were cross‐sectional and one had a case‐control design (Table ), and presented data from Europe (n = 7) and the United States (n = 1).…”

Section: Resultsmentioning

confidence: 99%

“…Six of the included studies recruited pediatric patients only, two included both children and adults, one of which presented these data separately . At the 0.35 kU A /L threshold, seven studies reported data for Cor a 14‐sIgE, five Cor a 9 sIgE, while four studies reported the diagnostic accuracy of Cor a 1‐sIgE (Table ) . Data on sIgE to Cor a 8 at 0.35 kU A /L were only reported in two studies (both enrolling children and adults, Table ) .…”

Section: Resultsmentioning

confidence: 99%

“…A, Sensitivity and specificity of sIgE to hazelnut components per included study and pooled values, where applicable (primary analysis: 0.35 kU A /L cutoff) (a), adults; (ch), children; FN, false negatives; FP, false positives; TN true negatives; TP, true positives. B, Pooled estimates of sensitivity and specificity for hazelnut component sIgE and sIgE to hazelnut extract at 0.35 kUA/L threshold in children (subanalysis) Based on data from…”

Section: Resultsmentioning

confidence: 99%

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Allergen components in diagnosing childhood hazelnut allergy: Systematic literature review and meta‐analysis

Nilsson

Berthold

Mascialino

et al. 2020

Pediatric Allergy Immunology

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Background Hazelnut‐specific IgE antibodies (sIgEs) in serum support the diagnosis of hazelnut allergy, but extract‐based tests have low diagnostic specificity, commonly leading to over‐diagnosis. Measuring sensitization to individual allergen components may enhance the diagnosis of hazelnut allergy. We systematically examined data on diagnostic accuracy of sIgE to commercially available hazelnut components to compare their individual contributions in diagnosing hazelnut allergy. Methods Seven databases were searched for diagnostic studies on patients suspected of having hazelnut allergy. Studies employing component‐specific IgE testing on patients whose final diagnosis was determined by oral food challenges were included in the meta‐analysis. Study quality was assessed as recommended by Cochrane. Results Seven cross‐sectional studies and one case‐control study were identified, seven presenting data on children (N = 635), and one on a mixed age population. Overall, the diagnostic accuracies of sIgE to both Cor a 9 and Cor a 14 were significantly higher than for Cor a 1‐sIgE (P < .05). In children, the specificity of Cor a 14‐sIgE at 0.35 kUA/L cutoff was 81.7% (95% CI 77.1, 85.6), and 67.3% (60.3, 73.6) for Cor a 9‐sIgE. The specificities for Cor a 1‐sIgE and hazelnut‐sIgE were 22.5% (7.4, 51.2) and 10.8% (3.4, 29.8), respectively. The sensitivity of Cor a 1‐sIgE (60.2% [46.9, 72.2]) was lower than for hazelnut extract‐sIgE (95.7% [88.7, 98.5]), while their specificities did not differ significantly. Conclusion sIgE to Cor a 14 and Cor a 9 hazelnut storage proteins increases diagnostic specificity in assessing hazelnut allergy in children. The combined use of hazelnut extract and hazelnut storage proteins may improve diagnostic value.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Allergen components in diagnosing childhood hazelnut allergy: Systematic literature review and meta‐analysis

Nilsson

Berthold

Mascialino

et al. 2020

Pediatric Allergy Immunology

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“…Jug r 1 is a clinically important major walnut component associated with systemic allergic reactions to walnut [104]. The roles of slgE to walnut and Brazil nut components are not yet established [98,105,106]. allergy, and a LR ≤ 0.1 is strongly suggestive of no allergy.…”

Section: Allergy Testsmentioning

confidence: 99%

BSACI guideline for the diagnosis and management of peanut and tree nut allergy

Stiefel

Anagnostou

Boyle

et al. 2017

Clin Experimental Allergy

119

134

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SummaryPeanut nut and tree nut allergy are characterised by IgE mediated reactions to nut proteins. Nut allergy is a global disease. Limited epidemiological data suggest varying prevalence in different geographical areas. Primary nut allergy affects over 2% of children and 0.5% of adults in the UK. Infants with severe eczema and/or egg allergy have a higher risk of peanut allergy. Primary nut allergy presents most commonly in the first five years of life, often after the first known ingestion with typical rapid onset IgE-mediated symptoms. The clinical diagnosis of primary nut allergy can be made by the combination of a typical clinical presentation and evidence of nut specifc IgE shown by a positive skin prick test (SPT) or specific IgE (sIgE) test. Pollen food syndrome is a distinct disorder, usually mild, with oral/pharyngeal symptoms, in the context of hay fever or pollen sensitisation, which can be triggered by nuts. It can usually be distinguish clinically from primary nut allergy. The magnitude of a SPT or sIgE relates to the probability of clinical allergy, but does not relate to clinical severity. SPT of ≥ 8 mm or sIgE ≥ 15 KU/L to peanut is highly predictive of clinical allergy. Cut off values are not available for tree nuts. Test results must be interpreted in the context of the clinical history. Diagnostic food challenges are usually not necessary but may be used to confirm or refute a conflicting history and test result. As nut allergy is likely to be a long-lived disease, nut avoidance advice is the cornerstone of management. Patients should be provided with a comprehensive management plan including avoidance advice, patient specific emergency medication and an emergency treatment plan and training in administration of emergency medication. Regular re-training is required.

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“…2,3,4 Contrary to the common birch pollen sensitization in central and northern Europe, grass allergy is the most common cause of pollinosis and tree allergy is relatively rare compared with grass and weed sensitization in Turkey, a Mediterranean area country. 5 There is limited data regarding PFAS from southeastern Europe and Turkey. Additionally, grass pollen and food cross reactivity is not as well described as tree pollen or weed pollen related PFAS.…”

Section: Introductionmentioning

confidence: 99%

Pollen food allergy syndrome in Turkey: Clinical characteristics and evaluation of its association with skin test reactivity to pollens

Özdemir

Özgüςlü

2017

Asian Pac J Allergy Immunol

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Cor a 14, Hazelnut-Specific IgE, and SPT as a Reliable Tool in Hazelnut Allergy Diagnosis in Eastern Mediterranean Children

Cited by 42 publications

References 27 publications

Allergen components in diagnosing childhood hazelnut allergy: Systematic literature review and meta‐analysis

Allergen components in diagnosing childhood hazelnut allergy: Systematic literature review and meta‐analysis

BSACI guideline for the diagnosis and management of peanut and tree nut allergy

Pollen food allergy syndrome in Turkey: Clinical characteristics and evaluation of its association with skin test reactivity to pollens

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