Predictors of health-related quality of life of European food-allergic patients

Saleh-Langenberg, J.; Goossens, Nicole; Blok, B. M. J. Flokstra‐de; Kollen, B. J.; Meulen, Gerbrich N van der; Le, Thuy‐My; Knulst, André C.; Jędrzejczak-Czechowicz, Monika; Kowalski, Marek L.; Rokicka, Ewa; Starosta, Paweł; Caballer, Belén de la Hoz; Vázquez-Cortés, Sonia; Cerecedo, Inmaculada; Barreales, Laura; Asero, Riccardo; Clausen, Michael; DunnGalvin, Audrey; Hourihane, Jonathan; Purohit, Ashok; Papadopoulos, Nikolaos G.; Fernández-Rivas, M.; Frewer, Lynn J.; Burney, Peter; Duiverman, Eric J.; Dubois, Anthony

doi:10.1111/all.12582

Cited by 68 publications

(63 citation statements)

References 30 publications

(50 reference statements)

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“…We also observed that the level of avoidance, as well as comorbidities (AD AE asthma), was linked to anxiety and consequently to the quality of life. In contrast, a history of severe reaction was surprisingly not linked to anxiety, as has previously been discussed in the literature [34,35]. Overall, this raises the question of the criteria associated with dietary advice about PAL, which deserve to be clarified.…”

Section: Dietary Advice By the Allergists Patient Anxietymentioning

confidence: 79%

Peanut‐allergic patients in the MIRABEL survey: characteristics, allergists’ dietary advice and lessons from real life

Deschildre

Elegbede

Just

et al. 2016

Clin Experimental Allergy

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Section: Dietary Advice By the Allergists Patient Anxietymentioning

confidence: 79%

Peanut‐allergic patients in the MIRABEL survey: characteristics, allergists’ dietary advice and lessons from real life

Deschildre

Elegbede

Just

et al. 2016

Clin Experimental Allergy

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“…Forty to sixty percent of children with milk or egg allergy will outgrow their food allergy until the age of 6 years (100, 101), whereas this occurs at a lower rate in children with allergy to peanut or tree nuts. These individuals may be considered prototypic for tolerance acquisition after established potentially life-threatening food allergy (100,(102)(103)(104)(105). The sequence of events and biomarkers that define individuals with persistent food allergy and those who outgrow their food allergy remain unclear.…”

Section: Oral and Sublingual Immunotherapy In Food Allergymentioning

confidence: 99%

Markers of tolerance development to food allergens

Ponce

Diesner

Szépfalusi

et al. 2016

Allergy

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IgE-mediated reactions to food allergens are the most common cause of anaphylaxis in childhood. Although allergies to cow's milk, egg, or soy proteins, in contrast to peanut and tree nut allergens, resolve within the first 6 years of life in up to 60% due to natural tolerance development, this process is not well understood. At present, there is no cure or treatment for food allergy that would result in an induction of tolerance to the symptom-eliciting food. Avoidance, providing an emergency plan and education, is the standard of treatment. Oral immunotherapeutic approaches have been proven reasonable efficacy; however, they are associated with high rates of side-effects and low numbers of patients achieving tolerance. Nevertheless, mechanisms that take place during oral immunotherapy may help to understand tolerance development. On the basis of these therapeutic interventions, events like loss of basophil activation and induction of regulatory lymphocyte subsets and of blocking antibodies have been described. Their functional importance at a clinical level, however, remains to be investigated in detail. Consequently, there is eminent need to understand the process of tolerance development to food allergens and define biomarkers to develop and monitor new treatment strategies for food allergy.IgE-mediated food allergy represents the most important cause of anaphylaxis in childhood. While milk and egg allergy are associated with a high rate of natural tolerance development within the first 6 years of life, this is less clear for other food allergies. Consequently, once it is communicated the diagnosis persists often lifelong severely impacting the quality of life of the patient and the environment despite the recommendation to reconsider clinical tolerance development from time to time.Currently, avoidance, providing an emergency plan and teaching, is the standard of treatment; however, there is no cure or treatment that has reached the level of recommendation to re-induce tolerance to the symptom-eliciting food. Tolerance assessment occurs either via oral food challenges or due to unintended exposure. Given the cost and time intensiveness of oral food challenges and its potential harmfulness, there is eminent need to understand the process of tolerance development and define markers thereof to develop and monitor new treatment strategies for food allergy. This review aimed to provide an overview on recent advances regarding markers and mechanisms of tolerance development to food allergens.Oral tolerance in the context of food allergy is considered to occur if the antigen/food can be ingested without problems despite prolonged periods of avoidance, while the status of desensitization is strictly dependent on regular ingestion of the respective food in order to confer protection from allergic reactions. Currently, there is no general consensus on the exact time frame of avoidance and re-exposure that would allow the usage of the terminus tolerance that is considered equivalent to cure in the context of or...

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“…Validated health‐related quality of life (HRQL) instruments are available for children, adolescents, and adults with food allergies and for their parents or caregivers . Interestingly, one study on HRQL showed that experience of anaphylaxis had limited impact on HRQL; it also found that allergies to fish and milk in adults and peanuts and soy in children caused greater HRQL impairment as compared to other foods . A prospective cohort study examining food allergy‐associated quality of life found that performing a food challenge improved the quality of life irrespective of the outcome of the challenge .…”

Section: Quality Of Lifementioning

confidence: 99%

Update on food allergy

Carrard

Rizzuti

Sokollik

2015

Allergy

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Food allergies are a global health issue with increasing prevalence. Allergic reactions can range from mild local symptoms to severe anaphylactic reactions. Significant progress has been made in diagnostic tools such as componentresolved diagnostics and its impact on risk stratification as well as in therapeutic approaches including biologicals. However, a cure for food allergy has not yet been achieved and patients and their families are forced to alter eating habits and social engagements, impacting their quality of life. New technologies and improved in vitro and in vivo models will advance our knowledge of the pathogenesis of food allergies and multicenter-multinational cohort studies will elucidate interactions between genetic background, lifestyle, and environmental factors. This review focuses on new insights and developments in the field of food allergy and summarizes recently published articles.Food allergy is an adverse, reproducible immune-mediated reaction to a given food. The most common allergens affecting infants are milk and egg. Peanuts, tree nuts, seafood, eggs, and milk commonly trigger allergic reactions in older children. In adults, pollen allergy often leads to cross-reactive food allergies. Allergic reactions can range from mild local symptoms, for example, in oral allergy syndrome (OAS), to severe life-threatening anaphylaxis. These reactions are absent during avoidance of the specific trigger. The underlying immune responses can be classified as IgE-mediated, non-IgE-mediated, or a mixture of both (Fig. 1). However, the pathogenesis of food allergy is still not completely understood. Importantly, the prevalence of food allergies is rising in both developed and developing countries, especially over the last 10-15 years (1), which increases the personal as well as global health burden. New diagnostic tools allow for better risk stratification of allergic reactions, but therapeutic options are still limited.In this review, we will examine recent publications and their impact on our knowledge of the epidemiology, pathogenesis, diagnosis, and management of food allergy. The primary aim is to summarize novelties and put them into perspective rather than providing a comprehensive review. EpidemiologyThe prevalence of food allergy is not well established; it varies widely according to the methodology used to diagnose a food allergy. In a systematic review and meta-analysis of European studies, the self-reported lifetime prevalence of allergy to cow's milk was 6.0% but only 0.6% for positive food challenge (2). The EuroPrevall project has set up three complementary studies: a birth cohort study (3), a Abbreviations AAI, adrenaline auto-injector; AIT, allergen-specific immunotherapy; BAT, basophil activation test; CMPA, cow's milk protein allergy; CRD, component-resolved diagnostics; EoE, eosinophilic esophagitis; FPE, food protein enteropathy; FPIAP, food proteininduced allergic proctocolitis; FPIES, food protein-induced enterocolitis syndrome; HRQL, health-related quality of life; HWP, h...

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Predictors of health-related quality of life of European food-allergic patients

Cited by 68 publications

References 30 publications

Peanut‐allergic patients in the MIRABEL survey: characteristics, allergists’ dietary advice and lessons from real life

Peanut‐allergic patients in the MIRABEL survey: characteristics, allergists’ dietary advice and lessons from real life

Markers of tolerance development to food allergens

Update on food allergy

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