Low Frequency of IgE-Mediated Food Hypersensitivity in Mastocytosis

Jarkvist, Jesper; Brockow, Knut; Gülen, Theo

doi:10.1016/j.jaip.2020.05.044

Cited by 32 publications

(30 citation statements)

References 41 publications

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“…These observations suggest that food-related symptoms reported by patients with MC disorders mostly result from either a wrong perception of the patients or are due to non-specific causes, whereas the actual prevalence of food allergies may be comparable to that found in the general population [88,89]. Thus, no general elimination diet for mastocytosis patients is recommended without confirmed clinically significant food hypersensitivity [83]. In addition, proper anti-mediator therapy might improve tolerance of certain food products, reducing MCA [1,7].…”

Section: Food Allergensmentioning

confidence: 87%

“…In contrast to the numbers above, a recent study by Jarkvist et al systematically investigated 204 patients with clonal MC disorders and revealed that the prevalence of food hypersensitivity in Swedish mastocytosis patients was only 20.6%; i.e., comparable to the general population [83]. Interestingly, most hypersensitivity symptoms were limited to skin (86%) and/or gastrointestinal tract (45%), as only 2.5% of patients experienced anaphylaxis associated with food products (58).…”

Section: Food Allergensmentioning

confidence: 97%

“…Only a very few data on the clinical impact and prevalence of hypersensitivity reactions to food and related allergies in mastocytosis patients are available [2,12,20,83,84].…”

Section: Food Allergensmentioning

confidence: 99%

“…Interestingly, most hypersensitivity symptoms were limited to skin (86%) and/or gastrointestinal tract (45%), as only 2.5% of patients experienced anaphylaxis associated with food products (58). Furthermore, after thorough allergy workup including skin prick tests and specific IgE tests, only 6% of patients turned out to have an IgE-mediated food allergy [83,87]. These observations suggest that food-related symptoms reported by patients with MC disorders mostly result from either a wrong perception of the patients or are due to non-specific causes, whereas the actual prevalence of food allergies may be comparable to that found in the general population [88,89].…”

Section: Food Allergensmentioning

confidence: 99%

“…There is no data on that topic in food allergy jet [35]. Most of the following recommendations concern general population, however based on available publications [11,12,20,83] and our experience, may be used in MCAS and mastocytosis cases.…”

Section: Food Allergensmentioning

confidence: 99%

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A Challenge for Allergologist: Application of Allergy Diagnostic Methods in Mast Cell Disorders

Romantowski

Górska

Niedoszytko

et al. 2021

IJMS

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Primary and secondary mast cell activation syndromes (MCAS) can occur in patients with mastocytosis. During the past few years our knowledge about the pathogenesis and disease-triggering mechanisms in MCAS and mastocytosis have increased substantially. Whereas mastocytosis is characterized by an accumulation of neoplastic (clonal) mast cells (MC) in various organ systems, MCAS is defined by a massive and systemic activation of these cells. Mast cells are crucial effector cells in allergic diseases, thus their elevated number and activation can cause severe anaphylactic reactions and MCAS in patients with mastocytosis. However, these cells may also degranulate spontaneously or degranulate in response to non-allergic triggers leading to clinical symptoms. In mastocytosis patients, such symptoms may lead to the diagnosis of a primary MCAS. The diagnosis of a concomitant allergy in mastocytosis patients is challenging. In these patients, a mixed form (primary and secondary) of MCAS may be diagnosed. These patients may also suffer from life-threatening anaphylactic reactions when exposed to allergens. In these cases, the possibility of severe side effects of in vivo provocations can sometimes also limit diagnostic evaluations. In the current article, we discuss the diagnosis and management of patients suffering from mastocytosis and concomitant MCAS, with special emphasis on novel diagnostic tests and management, including allergen microarrays, recombinant allergen analysis, basophil activation tests, optimal prophylaxis, and specific therapies.

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Section: Food Allergensmentioning

confidence: 87%

Section: Food Allergensmentioning

confidence: 97%

“…Only a very few data on the clinical impact and prevalence of hypersensitivity reactions to food and related allergies in mastocytosis patients are available [2,12,20,83,84].…”

Section: Food Allergensmentioning

confidence: 99%

Section: Food Allergensmentioning

confidence: 99%

Section: Food Allergensmentioning

confidence: 99%

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A Challenge for Allergologist: Application of Allergy Diagnostic Methods in Mast Cell Disorders

Romantowski

Górska

Niedoszytko

et al. 2021

IJMS

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The influence of nutritional habits, body mass index and intestinal microbiota in mastocytosis on clinical symptoms using conventional culture and next generation sequencing

Harcęko‐Zielińska,

Niedoszytko,

Górska

et al. 2024

Clinical & Translational All

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BackgroundMastocytosis is a rare neoplastic disease of the bone marrow associated with the proliferation and accumulation of mast cells in various internal organs, including the gastrointestinal tract. There are few studies describing the gut microbiome of patients with mastocytosis using next generation sequencing supported using traditional culture methods. The aims of the study were, firstly, the determination of nutrition habits, composition of the intestinal microflora and BMI in mastocytosis, and secondly, analysis of mastocytosis severity and symptoms depending on the composition of the intestinal microflora.MethodsThe study included 47 patients with indolent systemic mastocytosis and 18 healthy controls. All participants gave their informed consent to participate in the study. The study consisted of 3 parts: I‐clinical assessment, II ‐ examination of the intestinal microflora using the biochemical method, III ‐ 16S rRNA sequencing.ResultsThe nutrition habits and BMI of mastocytosis patients were similar to controls; however, most patients with mastocytosis had a low dietary vitamin and mineral content. As many as 94.5% of patients had too little fiber intake and mineral content. The most common cause of the abnormal stool test result with traditional culture was a titer of E. coli <106. The low richness of microbiota species indicated by the Simpson index was observed in mastocytosis, p = 0.04. There were no significant differences in the composition of the intestinal microflora depending on the type of mastocytosis; however, the tryptase level correlated with the amount of Suterella, Barnesiellaceae, Eubacterium, Odoribacter, and Anaerostipes.ConclusionsThe nutritional habits and BMI of mastocytosis patients are similar to the general population, except for too little fiber intake and mineral content. The gastrointestinal symptoms of mastocytosis patients may be related to the low richness of microbiota species and the amount of Suterella, Barnesiellaceae, Eubacterium, Odoribacter, Anaerostipes, which correlated with tryptase levels.

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Idiopathic Anaphylaxis: a Perplexing Diagnostic Challenge for Allergists

Gülen

Akin

2021

Curr Allergy Asthma Rep

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Purpose of Review The aim of this systematic review is to present the proposed theories of pathogenesis for idiopathic anaphylaxis (IA), to discuss its classification, its diagnostic approach, and management. Recent Findings IA represents a major diagnostic challenge and is diagnosed when excluding the possible identifiable triggers of anaphylaxis. The current research, however, revealed that certain conditions including mastocytosis, mast cell activation syndromes, and hereditary alpha tryptasemia can masquerade and overlap with its symptomatology. Also, newly identified galactose-alpha-1,3-galactose mammalian red meat allergy has recently been recognized as underlying cause of anaphylaxis in some cases that were previously considered as IA. Summary IA comprises a heterogenous group of conditions where, in some cases, inherently dysfunctional mast cells play a role in pathogenesis. The standard trigger avoidance strategies are ineffective, and episodes are unpredictable. Therefore, prompt recognition and treatment as well as prophylaxis are critical. The patients should always carry an epinephrine autoinjector.

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Low Frequency of IgE-Mediated Food Hypersensitivity in Mastocytosis

Cited by 32 publications

References 41 publications

A Challenge for Allergologist: Application of Allergy Diagnostic Methods in Mast Cell Disorders

A Challenge for Allergologist: Application of Allergy Diagnostic Methods in Mast Cell Disorders

The influence of nutritional habits, body mass index and intestinal microbiota in mastocytosis on clinical symptoms using conventional culture and next generation sequencing

Idiopathic Anaphylaxis: a Perplexing Diagnostic Challenge for Allergists

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