EpidemAAITO: Features of food allergy in Italian adults attending allergy clinics: a multi‐centre study

Asero, Riccardo; Antonicelli, Leonardo; Arena, A.; Bommarito, Luisa; Caruso, Beatrice; Crivellaro, M; Carli, Marco De; Torre, E. Della; Torre, F. Della; Heffler, Enrico; Rizzini, Fabio Lodi; Longo, Rocco; Manzotti, Giuseppina; Marcotulli, M.; Melchiorre, Antonietta; Minale, Paola; Morandi, Pierre-Alain; Moreni, B.; Moschella, A.; Murzilli, F; Nebiolo, Franco; Poppa, M; Randazzo, Sabrina; Rossi, G.; Senna, Gianenrico

doi:10.1111/j.1365-2222.2008.03167.x

Cited by 122 publications

(138 citation statements)

References 28 publications

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“…Fresh fruit was an important trigger of anaphylaxis, both in adults and in children, peach being the most frequent one, followed by apple. Plant-derived foods, due to lipid transfer protein (LTP) sensitization, are the most important cause of type 1 food allergy in Italy, according to a recent epidemiological survey [22] and in agreement with what is observed in the Mediterranean countries [23]. In our study, food anaphylaxis was more commonly observed in boys than in girls, but this gender preference reverses in adulthood, where it was more commonly observed in female than in male patients.…”

Section: Resultssupporting

confidence: 91%

“…A history of asthma appears to be a major risk factor for life-threatening anaphylactic reactions to food [28][29][30], but it is not particularly specific, as about a third of food allergic patients have asthma. Many of our patients (one-third of adults) had the oral allergic syndrome, mainly due to pollen-food allergy, as it is commonly observed in Northern Italy [22]. In conclusion, food is an important cause of anaphylaxis in the general population, particularly in subjects with respiratory allergic comorbidities (rhinitis and asthma).…”

Section: Resultsmentioning

confidence: 54%

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Incidence of food anaphylaxis in Piemonte region (Italy): data from registry of Center for Severe Allergic Reactions

et al. 2013

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There are wide differences in estimated incidence and prevalence of anaphylaxis because of the absence, until recently, of a universal consensus on the definition of anaphylaxis and the different source of collected data. We aimed to estimate the incidence of food anaphylaxis based on the database of Piemonte Region (Italy) Reference Center for Severe Allergic Reactions. All cases of severe food allergic reactions reported in 2010 were studied. Clinical data associated to the reports were evaluated according to National Institute of Allergy and Infectious Disease and Food Allergy and Anaphylaxis Network diagnostic criteria of anaphylaxis. 75 % of the 778 cases were classified as food anaphylaxis (incidence of 13/100,000 personyears, ranging from 9.9 in adults to 29/100,000 person-years in children). Nuts were the most frequent foods causing anaphylaxis. Milk and eggs were responsible for anaphylaxis more often in children, while peach, vegetables and crustaceans were in adults. Cardiovascular symptoms were more frequent in adults. Gastrointestinal involvement was more frequent in children. A high prevalence of respiratory allergic comorbidities was observed. Food is an important cause of anaphylaxis, particularly in subjects with respiratory allergic comorbidities. Children and adults differ in triggers and clinical presentation of anaphylaxis.Keywords: Anaphylaxis, Food allergy, Epidemiology, Allergy Introduction Population-based studies estimate the incidence of anaphylaxis in western countries to be in the range of 4-50 per 100,000 person-years [1, 2], with a true lifetime prevalence in the range of 0.05-2 % [3]. Foods are reported to be the most important trigger of anaphylaxis, being responsible for 33.2-56 % of all anaphylaxis cases [4]. The other two principal triggers of anaphylaxis are insect stings and drugs [1,5]. The relative contribution of each of these triggers to anaphylaxis may differ according to the study design, study population, or geographic area. The wide differences in the estimated incidences and prevalences of anaphylaxis are the direct result of the absence, until recently, of a universal consensus on the definition of anaphylaxis and the different source of collected data. For this reason in 2005 the National Institute of Allergy and Infectious Disease (NIAID) and the Food Allergy and Anaphylaxis Network (FAAN) developed a very useful preliminary definition, based on diagnostic criteria [6]. The symposium defined anaphylaxis as: "a serious allergic reaction that is rapid in onset and may cause death". Clinically, involvement of at least two organs (skin or mucosal tissue, cardiovascular apparatus, breathing apparatus, gastrointestinal tract) is required, or a sudden reduced blood pressure along with a temporal relationship (generally minutes) to a potential causative agent. A problematic issue with this definition, which may explain the under-reporting or misreporting of anaphylaxis cases, is the failure to agree among health care providers on the severity threshold for classi...

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Section: Resultssupporting

confidence: 91%

Section: Resultsmentioning

confidence: 54%

Incidence of food anaphylaxis in Piemonte region (Italy): data from registry of Center for Severe Allergic Reactions

et al. 2013

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“…Non-specific lipid transfer proteins (nsLTPs), particularly peach Pru p 3, are the most important plant food allergens in the Mediterranean area (Asero et al, 2009;Fernandez-Rivas et al, 2003;Salcedo et al, 2007;van Ree, 2002). They constitute a panallergen family of 9 kDa (90-95 amino acids) basic peptides, with a rigid 3D-structure due to the presence of four conserved disulphide bridges .…”

Section: Introductionmentioning

confidence: 99%

Molecular basis of allergen cross-reactivity: Non-specific lipid transfer proteins from wheat flour and peach fruit as models

Tordesillas¹,

Pacios²,

Palacín³

et al. 2009

Molecular Immunology

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“…Despite a low prevalence of buckwheat allergy, it is one of the major foods causing severe life‐threatening reactions 3, 4, 5, 6, 7, 9. As neither skin testing nor the presence of buckwheat‐sIgE proved to be useful for precisely predicting clinical allergy, the diagnosis is still based on a positive food challenge and/or a clear‐cut history of severe reactions.…”

Section: Discussionmentioning

confidence: 99%

“…Two Italian studies reported a sensitization prevalence of 3.6% and a prevalence of buckwheat anaphylaxis of 1%, respectively. In France, the prevalence was 4.5% of cases of food anaphylaxis 8, 9, 10…”

Section: Introductionmentioning

confidence: 99%

Concomitant sensitization to legumin, Fag e 2 and Fag e 5 predicts buckwheat allergy

Geiselhart

Nagl

Dubiela

et al. 2017

Clin Experimental Allergy

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SummaryBackgroundBuckwheat (Fagopyrum esculentum) has become increasingly popular as a healthy food in Europe. However, for sensitized individuals, consumption can cause anaphylactic reactions. The aim of this study was to identify individual well‐characterized buckwheat allergens for component‐resolved diagnosis.MethodsPatients were selected by positive skin prick test to buckwheat and divided into two groups: (1) sensitized to buckwheat without clinical symptoms and (2) buckwheat allergy. Buckwheat proteins were extracted from raw buckwheat seeds, purified applying a combination of protein precipitation and chromatographic methods, and analyzed by IgE immunoblotting and ELISA.ResultsBuckwheat‐allergic patients had a significantly larger median skin prick test weal diameter for buckwheat than the sensitized group and the positive control. Also, IgE immunoblotting clearly showed a distinct pattern in sera from allergic patients when compared to sensitized individuals. Several IgE‐reactive proteins were purified from crude buckwheat extract, namely legumin (Fag e 1 plus its large subunit), Fag e 2 (2S albumin), and newly identified Fag e 5 (vicilin‐like) as well as hevein‐like antimicrobial peptides, designated Fag e 4. All four allergens showed superior diagnostic precision compared to extract‐based ImmunoCAP with high sensitivity as well as high specificity.ConclusionsPatients with clinical symptoms clearly show a distinct allergen recognition pattern. We characterized a buckwheat vicilin‐like protein as a new relevant marker allergen, designated Fag e 5. Additionally, another new allergen, Fag e 4, potentially important for cross‐reactivity to latex was added to the allergen panel of buckwheat. Further, our data show that the full‐length legumin comprising both, large and small subunit should be applied for component‐resolved diagnosis. Our data indicate that concomitant sensitization to legumin, Fag e 2 and Fag e 5, predicts buckwheat allergy.

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EpidemAAITO: Features of food allergy in Italian adults attending allergy clinics: a multi‐centre study

Cited by 122 publications

References 28 publications

Incidence of food anaphylaxis in Piemonte region (Italy): data from registry of Center for Severe Allergic Reactions

Incidence of food anaphylaxis in Piemonte region (Italy): data from registry of Center for Severe Allergic Reactions

Molecular basis of allergen cross-reactivity: Non-specific lipid transfer proteins from wheat flour and peach fruit as models

Concomitant sensitization to legumin, Fag e 2 and Fag e 5 predicts buckwheat allergy

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