From Allergen Molecules to Molecular Immunotherapy of Nut Allergy: A Hard Nut to Crack

Peanuts and tree nuts are two of the most common elicitors of immunoglobulin E (IgE)-mediated food allergy. Nut allergy is frequently associated with systemic reactions and can lead to potentially life-threatening respiratory and circulatory symptoms. Furthermore, nut allergy usually persists throughout life. Whether sensitized patients exhibit severe and life-threatening reactions (e.g., anaphylaxis), mild and/or local reactions (e.g., pollen-food allergy syndrome) or no relevant symptoms depends much on IgE recognition of digestion-resistant class I food allergens, IgE cross-reactivity of class II food allergens with respiratory allergens and clinically not relevant plant-derived carbohydrate epitopes, respectively. Accordingly, molecular allergy diagnosis based on the measurement of allergen-specific IgE levels to allergen molecules provides important information in addition to provocation testing in the diagnosis of food allergy. Molecular allergy diagnosis helps identifying the genuinely sensitizing nuts, it determines IgE sensitization to class I and II food allergen molecules and hence provides a basis for personalized forms of treatment such as precise prescription of diet and allergen-specific immunotherapy (AIT). Currently available forms of nut-specific AIT are based only on allergen extracts, have been mainly developed for peanut but not for other nuts and, unlike AIT for respiratory allergies which utilize often subcutaneous administration, are given preferential...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research

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Food allergy is an immune-mediated disease and must be differentiated from other adverse effects related to food that are non –immune mediated. Symptoms of immunoglobulin (Ig) E–mediated allergy can range from mild to severe, and life-threatening anaphylaxis may occur. Current recommended strategies for diagnosis include the use of skin prick tests, allergen-specific serum IgE, and/or oral food challenges. Management e ntails allergen avoidance and appropriate treatment of allergic reactions should accidental ingestions occur. Treatment approaches under investigation include immunotherapy as well as biologics a...
Source: Immunology and Allergy Clinics of North America - Category: Allergy & Immunology Authors: Source Type: research
In conclusion, even though many protocols, reviews and meta-analysis have been published on this topic, pediatric OIT remains a controversial therapy and no definitive generalized conclusion may be drawn so far. It should be an option provided by specialized teams, when both patients and their families are prone to adhere to the proposed protocol. Efficacy, long-term effectiveness, possible role of adjuvant therapies, risk of severe reactions including anaphylaxis or eosinophilic esophagitis, and impact on the quality of life of both children and caregivers are all aspects that should be discussed before starting OIT. Futu...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
AbstractImmunoglobulin E (IgE)-mediated food allergy is a real public health problem worldwide. The prevalence of food allergy is particularly high in children. Patients with food allergy experience high morbidity with a change in quality of life due to the risk of severe anaphylaxis. Current treatment options are poor. Allergen avoidance is widely recommended but exposes patients to accidental ingestion. Oral immunotherapy is also used in patients with food allergies to the most common allergens. Oral immunotherapy consists of a daily administration of small, gradually increasing amounts of allergens to induce desensitisa...
Source: Clinical Reviews in Allergy and Immunology - Category: Allergy & Immunology Source Type: research
Allergy is an IgE-dependent type-I hypersensitivity reaction that can lead to life-threatening systemic symptoms such as anaphylaxis. In the pathogenesis of the allergic response, the common upstream event is the binding of allergens to specific IgE, inducing cross-linking of the high-affinity FcεRI on mast cells, triggering cellular degranulation and the release of histamine, proteases, lipids mediators, cytokines and chemokines with inflammatory activity. A number of novel therapeutic options to curb mast cell activation are in the pipeline for the treatment of severe allergies. In addition to anti-IgE therapy an...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
To better explore the pathophysiology of FA and its therapy, we aimed to establish a simple and practicable FA model with Freund ’s adjuvant and introduce an easy and reliable laboratory evaluation method for assessment of inflammation in intestinal segments at different anatomical locations. BALB/c mice were sensitized with ovalbumin combined with Freund’s adjuvant. Complete Freund’s adjuvant was chosen for the first s ensitization and two weeks later incomplete Freund’s adjuvant was used for a second sensitization. Two weeks later, the sensitized mice were challenged with 50 mg ovalbumin every oth...
Source: Bulletin of Experimental Biology and Medicine - Category: Biology Source Type: research
An Pediatr (Barc). 2021 Jun 9:S1695-4033(21)00184-3. doi: 10.1016/j.anpedi.2021.04.014. Online ahead of print.ABSTRACTIn the last decades, allergic diseases have increased exponentially and although pediatric asthma prevalence is stabilizing, in Spain is estimated around 10%. Not the same with food allergy and anaphylaxis which are clearly increasing, becoming a public health problem of the first magnitude. Considering epidemiological trends, the European Academy of Allergy and Clinical Immunology (EAACI) estimates that in less than 15 years more than half of European population will suffer from some type of allergy. The a...
Source: Anales de Pediatria - Category: Pediatrics Authors: Source Type: research
Opinion statementPurpose of reviewThe recent approval of the first commercial peanut oral immunotherapy formulation ushered a new era of clinical food allergy treatment. With different options for peanut immunotherapy available, it is important review the evidence of efficacy, risks, and unique considerations for the individual modalities.Recent findingsOral immunotherapy (OIT), epicutaneous immunotherapy (EPIT), and sublingual immunotherapy (SLIT) for peanut allergy have risen as possible treatments for peanut allergy. Numerous studies indicate that OIT effectively desensitizes by increasing the amount of peanut protein t...
Source: Current Treatment Options in Allergy - Category: Allergy & Immunology Source Type: research
Grass pollen allergy, typically associated with non-life-threatening symptoms such as rhinoconjunctivitis is one of the most common allergies worldwide.1 Rarely, anaphylaxis occurs after grass pollen exposure in children.2 Oral immunotherapy (OIT) for the treatment of food allergy has been gaining popularity over the last decade as evidence on methodology, effectiveness and safety has progressed.3 4 Studies have shown that peanut-allergic patients on OIT with seasonal allergic rhinitis experience dose-related adverse events more frequently with seasonal patterns.
Source: Annals of Allergy, Asthma and Immunology - Category: Allergy & Immunology Authors: Source Type: research
Grass pollen allergy, typically associated with non –life-threatening symptoms, such as rhinoconjunctivitis, is one of the most common allergies worldwide.1 Rarely, anaphylaxis occurs after grass pollen exposure in children.2 Oral immunotherapy (OIT) for the treatment of food allergy has been gaining popularity in the last decade as evidence on met hodology, effectiveness, and safety has progressed.3,4 Studies have revealed that patients with peanut allergy on OIT with seasonal allergic rhinitis experience dose-related adverse events more frequently with seasonal patterns.
Source: Annals of Allergy, Asthma and Immunology - Category: Allergy & Immunology Authors: Tags: Letters Source Type: research
Eur Ann Allergy Clin Immunol. 2021 May 5. doi: 10.23822/EurAnnACI.1764-1489.211. Online ahead of print.ABSTRACTAlthough allergic diseases have become increasingly prevalent in the elderly, there are few data on this population. Through a retrospective analysis of the electronic medical records of patients aged 65 years and above followed in our Immunoallergology Unit, we aimed to characterize the immunoallergic diseases of the elderly. The most common disorders were respiratory diseases (n = 185; 50%), mucocutaneous diseases (n = 113; 31%), drug allergy (n = 31; 8%), food allergy (n = 9; 2%), and anaphylaxis (n = 9; 2%). U...
Source: European Annals of Allergy and Clinical Immunology - Category: Allergy & Immunology Authors: Source Type: research
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