![]() Pollen-associated tree nut allergy is often confined to local symptoms in the oral cavity, and it rarely leads to severe clinical reactions ( 15, 16). In Northern Europe, a birch pollen allergy-endemic area, cross-sensitivity between allergens in birch pollen (Bet v 1) and hazelnut (Cor a 1) is common ( 12– 14). Cross-sensitization occurs because of structural similarities between the immunoglobulin E (IgE)-binding epitopes in different allergens ( 10, 11). Eating habits and pollen exposure vary by geographical region, and therefore, regional differences in the allergic phenotype can be expected ( 5– 9). The worldwide prevalence of confirmed tree nut allergy ranges from 0 to 1.6% ( 4). Tree nuts are some of the most frequent triggers of allergy to plant foods ( 1– 3). These findings are consistent with a strong sIgE correlation between hazelnut and walnut and a close to total sIgE correlation between cashew and pistachio. There were two distinct and independent allergic phenotypes the majority of hazelnut allergic subjects were also allergic to walnut, and all but one subject with cashew allergy were dual allergic to pistachio. Clinical reactivity and the allergy patterns were to some extent reflected by sIgE levels and by correlations in sIgE between the nuts.Ĭonclusions: In this Northern European cohort, subjects with clinically relevant tree nut allergy were generally allergic to two or more tree nuts and close to half of them also to peanuts. OFC threshold levels were within the same range, but cashew was distinguished from other nuts by causing allergic symptoms at the lowest dose. Oral symptoms followed by a skin reaction were the most common symptomatology that lead to OFC cessation and subjects often presented with symptoms from two or more organ systems. Half of all assessed subjects were allergic to peanuts. Allergy to cashew was coincided in all but one of the assessed subjects with pistachio allergy. Hazelnut-walnut dual allergy was common but not exclusively observed as concomitant allergies. ![]() Results: Allergy to two or more tree nuts was observed in most cases. Clinical presentation and allergen-specific immunoglobulin E (sIgE) levels together with eliciting dose and rescue medication in OFCs were furthermore assessed. Methods: Forty tree nut allergic subjects were assessed for clinical reactivity to six nuts, i.e., hazelnut, walnut, pistachio, cashew, almond, and peanut, by OFCs or convincing medical history of an immediate allergic reaction or tolerance. ![]() Objective: This study aimed to investigate patterns of sensitization and clinical reactivity to tree nuts and peanuts and threshold levels for oral food challenges (OFCs) in a Danish cohort of tree nut allergic children, adolescents, and young adults. Denmark is located in a birch pollen endemic area, which could influence the allergy patterns due to pollen cross-sensitization. There are regional differences in sensitization profiles that result in differences in clinical presentation. 2Department of Pediatrics, Copenhagen University Hospital, Herlev, Denmarkīackground: Tree nut allergy is associated with severe reactions and poly-sensitization to other nuts and peanuts often occurs.1Allergy Clinic, Department of Dermatology and Allergy, Copenhagen University Hospital, Gentofte, Denmark.doi:10.1111/cea.Nanna Juel-Berg 1,2, Lau Fabricius Larsen 1, Niels Küchen 1,2, Ida Norgil 1,2, Kirsten Skamstrup Hansen 1,2 and Lars K. Tree nut allergies: allergen homology, cross-reactivity, and implications for therapy. Food-induced anaphylaxis: role of hidden allergens and cofactors. Herbs and spices- biomarkers of intake based on human intervention studies - a systematic review. Vázquez-Fresno R, Rosana ARR, Sajed T, Onookome-Okome T, Wishart NA, Wishart DS. Can spices cause allergic reactions?.Ĭhen JL, Bahna SL. ![]() doi:10.1021/acs.jafc.5b05497Īmerican Academy of Allergy Asthma and Immunology. Presence of undeclared food allergens in cumin: the need for multiplex methods. Everything you need to know about tree nut allergy.įischer D, Vander Leek TK, Ellis AK, Kim H. Nut and peanut allergy (for parents).Īmerican Academy of Allergy Asthma and Immunology. Prevalence and natural history of tree nut allergy. McWilliam VL, Perrett KP, Dang T, Peters RL.
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