Diagnostic value of hazelnut allergy tests including <scp>rCor</scp> a 1 spiking in double‐blind challenged children

Masthoff, L. J.; Pasmans, Suzanne G.M.A.; Hoffen, Els van; Knol, Mirjam J.; Bruijnzeel-Koomen, Carla A.F.M.; Flinterman, Annebeth E.; Kentie, Petra A.; Knulst, André C.; Meijer, Y.

doi:10.1111/j.1398-9995.2011.02766.x

Cited by 34 publications

(33 citation statements)

References 26 publications

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“…Our patients had relatively high values of skin prick test (7.2 ± 2.98 mm) and s-IgE to hazelnut (25.4 ± 32.4 kU/L) and underwent H-LDOFC with a good success rate (66% of patients completed it) and with mild and local adverse reactions (oral allergy syndrome, abdominal pain, rash). Children with atopic dermatitis in their history had significantly higher levels of s-IgE for hazelnut compared to children without atopic dermatitis, as has been already reported [9]. In our study, the presence of atopic dermatitis in the history was statistically significantly different in patients with symptoms during H-LDOFC compared to asymptomatic patients.…”

Section: Discussionsupporting

confidence: 77%

“…In our study, the presence of atopic dermatitis in the history was statistically significantly different in patients with symptoms during H-LDOFC compared to asymptomatic patients. Atopic dermatitis is a well-known risk factor to the development of FA; in fact the presence of epidermal barrier dysfunction allows increased exposure to food allergen through the skin, leading to sensitization [9] and, therefore, to clinical FA [10]. Cor a 14 was found to be a marker of HA [8].…”

Section: Discussionmentioning

confidence: 99%

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Low-Dose Oral Food Challenge with Hazelnut: Efficacy and Tolerability in Children

Barni

Mori

Piccorossi

et al. 2018

Int Arch Allergy Immunol

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Background: Hazelnut allergy (HA) is one of the more common food allergies (FAs) in Europe with a prevalence of 0.2%. The gold standard for diagnosing FA is oral food challenge (OFC) with the culprit food. Another purpose of OFC is to identify the “threshold level” of food as the dose that elicits symptoms. In this way it is possible to avoid a strict elimination diet and to determine the minimal quantity of the culprit food tolerated by the patient. Objective: The aim of our study was to assess the efficacy and tolerability of hazelnut low-dose OFC (H-LDOFC) in children with HA. Methods: From January 2015 to December 2016, we retrospectively analyzed the charts of patients referred to Allergy Unit of Meyer Children’s Hospital, Florence, Italy for a history of HA. Prick by prick (PbP) and specific serum IgE (s-IgE) to hazelnut were performed. We proposed conducting an H-LDOFC to parents of children with HA. The H-LDOFC was considered completed when a cumulative dose of 2.5 g of hazelnut was reached. We divided the patients who underwent the H-LDOFC into an asymptomatic and a symptomatic group. For statistics we used SPSS for Windows version 16.0 and conducted a t test for comparing the averages, considering a p value of < 0.05 significant. Results: Forty-three out of 70 patients (61.4%) with HA underwent an H-LDOFC. The PbP to hazelnut (mean ± SD) was 7.2 ± 2.9 mm and the s-IgE to hazelnut 25.3 ± 32.5 kU/L. Twenty-eight out of the 43 patients (65.1%) who underwent H-LDOFC reached the cumulative dose of 2.5 g of hazelnut. During the H-LDOFC, 20/43 patients (46.5%) had no reactions and 23/43 patients had a total of 55 reactions: 34 (61.8%) oral allergy syndrome, 8 (14.5%) rash, 6 (10.9%) abdominal pain, 2 (3.6%) urticaria, 2 (3.6%) angioedema, and 3 (5.4%) dyspnea. Atopic dermatitis was found to present the only statistically significant difference (p = 0.002) in patients with symptoms compared to asymptomatic patients during H-LDOFC. Conclusions: To our knowledge, this was the first study to assess the efficacy and tolerability of H-LDOFC in a pediatric population. Our study suggests that in children with HA, H-LDOFC is well accepted and safe because adverse reactions are mild and the majority are represented by localized symptoms (oral allergy syndrome) and efficient, especially in terms of improvement of quality of life. For these reasons it could be more extensively used in the treatment of HA.

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Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Low-Dose Oral Food Challenge with Hazelnut: Efficacy and Tolerability in Children

Barni

Mori

Piccorossi

et al. 2018

Int Arch Allergy Immunol

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“…Patients with objective symptoms had significantly higher Cor a 9 and Cor a 14 compared to those who are not clinically reactive (median sIgE to Cor a 9:5.31 vs. 0.18 kU A /L; median sIgE to Cor a 14:2.18 vs. <0.10 kU A /L). Cor a 14 is age dependent and detected more frequently in preschoolers [60,61]. There was no difference between the sIgE to Cor a 1 (median 2.26 vs. 3.91 kU A /L), SPT, and sIgE to hazelnut extract between those with and without clinical reactivity.…”

Section: Hazelnutmentioning

confidence: 44%

Utility of Component-Resolved Diagnostics in Food Allergy

Tuano

Davis

2015

Curr Allergy Asthma Rep

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Allergen component-resolved diagnostic testing (CRD) is a new methodology in clinical food allergy diagnosis, improving the ability to identify specific clinical phenotypes. Instead of relying on the crude allergen extracts used in standard allergy diagnostics, CRD utilizes purified or recombinant allergens for identification of specific molecules causing sensitization or allergy. This method is able to determine risk of the severity of allergic reactions in specific cases, like soy, peanut, and hazelnut allergy. The severity of allergic reaction can be predicted in peanut allergy with Ara h 2, and clinically relevant disease in pollen-allergic patients can be identified. However, age and geographic differences affect CRD results and it should always be utilized in the context of a clinical history. In the future, clinical phenotypes may be differentiated with larger prospective studies utilizing food challenges.

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“…Tüm allerjen reajanlarında bilindiği gibi bu mümkün değildir ve bundan dolayı rekombinan allerjenlerle zenginleştirme yapılır buna 'spiking' de denilmektedir. Lâteks, nut (kuruyemiş) karışımı, fındık ve wasp (eşek arısı) reajanlarında yapılan bu zenginleştirme ile özellikle negatif perediktif değer artırılmıştır (11). Yine günümüzde modern biochip teknolojisiyle 30μl kadar serum kullanılarak 100'den fazla (ImmunoCAP™ ISAC sIgE 112, Phadia/Thermo Fisher Scientific) allerjene karşı aynı anda topluca sIgE ile bakılabilmektedir (12).…”

Section: Klasik Teşhis Yöntemleri Ve Yeniliklerunclassified

“…Enfeksiyöz rinitlerde nötrofil sayısında artış izlenmektedir. Nazal smear ile eozinofili tespitinde standart bir tekniğin olmaması kısıtlayıcı bir durumdur (9,11).…”

Section: Belirlenmiş (Moleküler) Komponentin Teşhisiunclassified

New Developments in the Diagnosis and Therapy of Allergic Rhinitis

Özdemir¹,

Elmas²

2017

Asthma Allergy Immunol

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ÖZAllerjik rinit (AR) tüm yaş gruplarında görülen en sık ve kronik hastalıklardan biridir. Allerjik rinit IgE-aracılı nazal havayolunun allerjik enflamasyounu olup hapşırık, gözde kaşıntı-sulanma, burun mukozasının şişlik ve enflamasyonu ile kendini gösterir. Küresel sağlık problemi ve çocukluktan erişkinliğe kadar birçok kişiyi etkileyen ağır bir hastalıktır. Dünyada çocukluk çağı AR prevalansı %0.8 -45 arasında değişmektedir. Türkiye' de değişik bölgelerde sıklığı %2.9-44 olarak bildirilmektedir. Derlememizin amacı AR teşhis ve tedavisinde güncel tedavi ve teşhis yöntemlerini anlatmaktır. Hastalığın astım üzerine ve hastanın hayatına etkisinden dolayı AR en güvenilir ve etkin tedavi yöntemleriyle tedavi edilmelidir. İkinci kuşak antihistaminikler ve intranazal steroidler tedavinin temel taşlardır. Fakat mevcut ilaçların yeni formülasyonları (rupatadin oral solusyonu, hızlı çözünen ebastin tablet ve intranazal flutikazon propionat ve azelastin hidroklorit kombinasyonu vb.), yeni keşfedilmiş moleküller (siklesonid, bilastin, roflumilast vb.), immünolojik hedefi olan tedaviler (omalizumab gibi) ve klasik olmayan tedaviler (homeopatik yöntemler gibi) AR tedavisinde yeni ufukları temsil etmektedir. Allerjik rinitin doğru teşhis edilmesi tedavi başarısında esastır. Teşhiste ümit verici gelişmeler özgün risk molekülünü tanıyan rekombinant allerjenleri kullanan teşhis yöntemlerinden beklenmektedir. Hastaların duyarlı olduğu kişisel molekülleri tanımlayan pür doğal ve rekombinan allerjenler moleküler ya da belirlenmiş komponentin teşhis yöntemiyle saptanabilir. Böylece, belirlenmiş komponente dayalı teşhis yöntemi provokasyon testine olan ihtiyacı azaltabilir ve allerjen immünoterapisinin özgünlüğünü artırabilir. Yine teşhiste, nazal nitrik oksit (nNO) düzeyini ölçmekte günümüzde değişik yöntemler vardır. Azalmış nNO, kistik fibroz için tipik olmakla beraber, primer silyer diskinezide olduğu kadar düşük değildir. nNO'nun AR gibi üst solunum yolu hastalıklarında klinikte kullanımı yaygınlaşmamıştır. ABSTRACTAllergic rhinitis (AR) is one of the most common chronic diseases in all age groups. It is an IgE-mediated allergic inflammation of the nasal airways and is characterized by sneezing, swelling and inflammation of the nasal mucosa as well as itchy and watery eyes. It is a global health problem and a burdensome disorder affecting many people from childhood to adulthood. The prevalence of childhood AR shows wide variation throughout the world, ranging from 0.8 to 45%. The prevalence rates for different regions of Turkey ranges from 2.9 to 44%. The aim of the present review is to provide an update on AR treatment and diagnosis. Because of its burden on patient's lives and its impact on asthma, AR should be taken care of properly with effective and safe treatments. Second-generation antihistamines and intranasal steroids represent the milestone of AR therapy. New formulations of available drugs (rupatadine oral solution, ebastine fast-dissolving tablets, combination of intranasal fluticasone propionate and azelastine hydr...

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Diagnostic value of hazelnut allergy tests including rCor a 1 spiking in double‐blind challenged children

Abstract: This study showed a good NPV of diagnostic tests for hazelnut allergy in children which further improved by rCor a 1 spiking. However, the PPVs are moderate and decreased by spiking.

Cited by 34 publications

References 26 publications

Low-Dose Oral Food Challenge with Hazelnut: Efficacy and Tolerability in Children

Low-Dose Oral Food Challenge with Hazelnut: Efficacy and Tolerability in Children

Utility of Component-Resolved Diagnostics in Food Allergy

New Developments in the Diagnosis and Therapy of Allergic Rhinitis

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