CSACI position statement: prescribing sublingual immunotherapy tablets for aeroallergens

Quirt, Jaclyn; Gagnon, Rémi; Ellis, Anne K.; Kim, H. L.

doi:10.1186/s13223-017-0225-6

Cited by 26 publications

(22 citation statements)

References 17 publications

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“…The 2 patients with adult-onset PFS had reactions to foods including zucchini, celery, and mango. Further to this, both patients with PFS had positive skin prick testing to fresh forms of the foods which elicited their oral symptoms—a well described phenomenon [ 25 ]—despite this not being a requirement for inclusion in our study.…”

Section: Resultsmentioning

confidence: 87%

“…We conducted a case series of patients assessed for concern of adult-onset IgE-mediated food allergy in both of Manitoba’s two academic allergy clinics from May 2018–July 2020. We defined adult-onset IgE-mediated food allergy as a history in keeping with IgE-mediated allergy—as defined by the immediate onset of symptoms consistent with pollen-food syndrome, isolated (muco)cutaneous symptoms, or anaphylaxis including FDEIA [ 25 ]—following food exposure at the age of 16 or older. No patients were identified as presenting with delayed-onset anaphylaxis, and as such we did not attempt to comment on the adult development of delayed-onset anaphylaxis.…”

Section: Methodsmentioning

confidence: 99%

“…Where SPT was unavailable or confounded, the diagnosis was instead confirmed by elevated food-specific serum IgE levels (ImmunoCAP Phadia) based on elevation above the upper limit of normal on local laboratory testing in the correct clinical context. For patients with symptoms and culprit foods classic for PFS, the positive SPT result was not a requirement for inclusion, as skin testing to these allergens with commercial extracts is of low sensitivity [ 25 ].…”

Section: Methodsmentioning

confidence: 99%

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Adult-onset IgE-mediated food allergy at a Winnipeg allergy clinic: a case series

Walter

Kalicinsky

2020

Allergy Asthma Clin Immunol

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Background It is a putatively understood phenomenon that the overall prevalence of allergic disease has been increasing in recent decades—particularly in industrialized nations. Despite this, there is a relative scarcity of data concerning the development of food-related allergic disease in the adult population. In addition, the paucity of data as it pertains to the Canadian population is particularly marked when compared to other nations. We sought to determine common culprit foods and the reactions they elicited in a series of 14 patients seen in the Winnipeg allergy and immunology clinic. Methods We conducted a retrospective review of patients identified by academic allergists in Winnipeg, Manitoba as fitting criteria for adult-onset IgE-mediated food allergy from May 2018–July 2020. We included patients with IgE-mediated symptoms, including the pollen-food syndrome which developed at the age of 16 or later. We collected data regarding the food which induced the reaction, what the reaction was, and any concomitant atopic disease. Results The most common culprit food identified was shellfish, followed by finfish, pollen-food syndrome, and wheat/flour. The most common reaction experienced was anaphylaxis, followed by food-dependent exercise-induced anaphylaxis and isolated (muco)cutaneous symptoms. With regard to concomitant atopic disease, allergic rhinitis/rhinoconjunctivitis stood out as the most prevalent. Conclusions Adult-onset food allergy—particularly with resultant anaphylaxis—is an important phenomenon to recognize, even when patients have previously tolerated the food in question.

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Section: Resultsmentioning

confidence: 87%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Adult-onset IgE-mediated food allergy at a Winnipeg allergy clinic: a case series

Walter

Kalicinsky

2020

Allergy Asthma Clin Immunol

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“…Food sensitization refers to the presence of allergic antibodies which may not lead to overt allergic reaction. Food sensitization precedes FA in some children, but it does not always develop into FA later in life [ 6 ]. Symptoms of FA range from urticaria to anaphylaxis, in severe cases [ 7 ].…”

Section: Atopic Disorders and Food Allergy In Childhoodmentioning

confidence: 99%

Do Human Milk Oligosaccharides Protect Against Infant Atopic Disorders and Food Allergy?

et al. 2020

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Atopic disorders (AD), often coexistent with food allergy (FA), start developing in early life and have lifelong health consequences. Breastfeeding is thought to be protective against AD and FA, but the data are controversial, and mechanisms are not well understood. Human milk oligosaccharides (HMOs) are complex carbohydrates that are abundant in human milk. These are thought to contribute to the development of the infant immune system by (i) promoting healthy microbiome, (ii) inhibiting pathogen binding to gut mucosa and (iii) modulating the immune system. Differences in microbiome composition between allergic and healthy infants have been observed, regardless of breastfeeding history. To date, limited studies have examined the preventive effects of HMOs on AD and FA in infants and current data relies on observation studies as trials of varying HMO intake through randomising individuals to breastfeeding are unethical. There is evidence for beneficial effects of breastfeeding on lowering the risks of FA, eczema and asthma but there are inconsistencies amongst studies in the duration of breastfeeding, diagnostic criteria for AD and the age at which the outcome was assessed. Furthermore, current analytical methods primarily used today only allow detection of 16–20 major HMOs while more than 100 types have been identified. More large-scale longitudinal studies are required to investigate the role of HMO composition and the impact of changes over the lactation period in preventing AD and FA later in life.

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“…Both subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT) have been shown to be effective in patients with SAR and perennial AR, and are well tolerated with localised side effects, such as pain, itching, and swelling [146]. Because subcutaneous administration of allergens can occasionally cause severe allergic reactions requiring access to adrenaline and other resuscitative measures, SCIT should be administered in a specialist clinic, whereas SLIT can be self-administered [146, 147]. Indirect comparisons indicate that both SLIT and SCIT may be as potent as pharmacotherapy in controlling symptoms of AR [148, 149].…”

Section: Introductionmentioning

confidence: 99%

The complex pathophysiology of allergic rhinitis: scientific rationale for the development of an alternative treatment option

Bjermer

Westman

Holmström

et al. 2019

Allergy Asthma Clin Immunol

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Allergic rhinitis (AR) poses a global health problem and can be challenging to treat. Many of the current symptomatic treatments for AR have been available for decades, yet there has been little improvement in patient quality of life or symptom burden over the years. In this review, we ask why this might be and explore the pathophysiological gaps that exist within the various AR treatment classes. We focus on the benefits and drawbacks of different treatment options and delivery routes for AR treatments and consider how, given what is known about AR pathophysiology and symptomatology, patients may be offered more effective treatment options for rapid, effective, and sustained AR control. In particular, we consider how a new AR preparation, MP-AzeFlu (Dymista ® , Meda, Sweden), comprising a formulation of an intranasal antihistamine (azelastine hydrochloride), an intranasal corticosteroid (fluticasone propionate), and excipients delivered in a single spray, may offer benefits over and above single and multiple AR therapy options. We review the evidence in support of this treatment across the spectrum of AR disease. The concept of AR control is also reviewed within the context of new European Union and Contre les Maladies Chroniques pour un VIeillissement Actif-Allergic Rhinitis and its Impact on Asthma initiatives.

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CSACI position statement: prescribing sublingual immunotherapy tablets for aeroallergens

Cited by 26 publications

References 17 publications

Adult-onset IgE-mediated food allergy at a Winnipeg allergy clinic: a case series

Adult-onset IgE-mediated food allergy at a Winnipeg allergy clinic: a case series

Do Human Milk Oligosaccharides Protect Against Infant Atopic Disorders and Food Allergy?

The complex pathophysiology of allergic rhinitis: scientific rationale for the development of an alternative treatment option

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