New arrivals in anaphylaxis to foods

Abstract

Purpose of review More people are excluding wheat from their diet, or turning to a more sustainable diet in which includes meat substitutes or is mainly or wholly plant-based. This increases the availability of new foods and with it the increasing likelihood of novel allergens. Recent findings There is a growing body of evidence which suggests that allergies to seeds and legumes are increasing potentially due to their use in concentrated form in vegan or health foods. Insects can be a sustainable source of protein, but mealworm could provoke symptoms in individuals sensitized or allergic to shellfish or house dust mite. Novel plant food allergens such as gibberellin-regulated proteins and thaumatin-like proteins are increasingly being reported as significant causes of severe reactions to fruits. Summary these findings make it even more imperative to take a full dietary history to ensure apparent idiopathic anaphylaxis is not in reality due to a novel food, especially in cases where other forms of the food are tolerated. Given the lack of diagnostic tests for these novel foods, a prick-to-prick skin prick test should be performed with the suspected food. There is currently more work needed to define and sequence many of the allergens involved.

Emerging and Novel Elicitors of Anaphylaxis: Collegium Internationale Allergologicum Update 2024

“…For allergologists, it is important in dietary history to take into consideration novel foods as potential triggers for food allergy [14].…”

“…The menu is supplemented with pulses (e.g., soy, lentils, peas), nuts (e.g., cashew, macadamia, almond, pecan, para, walnut), and seeds (e.g., chia, flaxseed) or pseudograins (quinoa, buckwheat). Indeed, the product range is expanding to include vegan foods such as milk alternatives (e.g., oat, almond, soy drinks) and cheese or meat substitutes (e.g., soy-based) [12,14].…”

“…Most allergens act through an IgE-mediated pathway, but some non-allergen triggers can act independent of IgE (e.g., via direct activation of mast cells). Novel plant food allergens such as gibberellinregulated proteins, e.g., Pru p 7 from peach, and thaumatin-like proteins, e.g., Pru p 2 from peach, are increasingly being reported as significant causes of severe reactions to fruits [14]. Here, selected food allergens with recent growing importance shall be presented in detail.…”