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Allergy Advisor Digest - March 2017
Editor: Dr. Harris A. Steinman

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This is a monthly digest of interesting information that is being added to Allergy Advisor. While we add a great deal of information every month, here we highlight some of the more interesting articles.
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Snippets NOT posted in the March 2017 Advisor Digest Newsletter

Anaphylactic reaction to intravenous glucocorticoid

Allergic reaction after ingestion of pancakes.

Molecular bases of the cross-reactivity between Act c 12 and the allergens 11S globulin of the seeds: identification in silico of epitopes B of Act c 12

Static and elevated pollen traps do not provide an accurate assessment of personal pollen exposure.

IgE, IgG1 and IgG4 response to specific allergens in sensitized subjects showing different clinical reactivity to Anisakis simplex.

Molecular diagnosis of allergy to Anisakis simplex and Gymnorhynchus gigas fish parasites.

Japanese guidelines for food allergy 2017.

Probability curves for predicting symptom severity during an oral food challenge with wheat.

The emotional, social, and financial burden of food allergies on children and their families.

Fixed food eruption caused by Actinidia arguta (Hardy Kiwi)

Usefulness of house dust mite nasal provocation test in asthma.

Mite allergen extracts and clinical practice.

Cockroach allergen serine proteinases: Isolation, sequencing

The practice and perception of precautionary allergen labelling by the australasian food manufacturing industry.

Hypersensitivity pneumonitis: a complex lung disease.

Sensitization to secretoglobin and lipocalins in a group of young children with risk of developing respiratory allergy.

Approach to the diagnosis of drug hypersensitivity reactions: similarities and differences between Europe and North America.

Advanced DNA- and Protein-based Methods for the Detection and Investigation of Food Allergens.

New trends in food allergens detection: toward biosensing strategies.

Occupational latex allergy: the current state of affairs.

Outstanding animal studies in allergy I. From asthma to food allergy and anaphylaxis.

Tyramine and histamine risk assessment related to consumption of dry fermented sausages by the Spanish population.

Sesame allergy threshold dose distribution.

Role of the lymphocyte transformation test in the evaluation of metal sensitization.

Identifying epithelial endocytotic mechanisms of the peanut allergens Ara h 1 and Ara h 2.

Reactions of buckwheat-hypersensitive patients during oral food challenge are rare, but often anaphylactic.

The role of dietary interventions in the prevention of IgE-mediated food allergy in children.

Gliadin-reactive T cells in Italian children from PreventCD cohort at high risk for celiac disease.

Patients taking amoxicillin-clavulanic can become simultaneously sensitized to both drugs.

Should peanut be banned in schools?

Making the most of in vitro tests to diagnose food allergy.

Managing nut allergy: a remaining clinical challenge.

Primary respiratory and food allergy to mealworm.

Automated identification of an aspirin-exacerbated respiratory disease cohort.

Airborne dust and high temperatures are risk factors for invasive bacterial disease.

IgE sensitization patterns to commonly consumed foods determined by skin prick test in Korean adults.

Snippets posted in the March 2017 Advisor Digest Newsletter

		Histamine intolerance or false food allergies of histamine mechanism
		Low percentage of clinically relevant pistachio nut and mango co-sensitisation in cashew nut sensitised children.
		Hazelnut allergens: molecular characterization, detection, and clinical relevance.
		Christmas from an allergist's perspective.
		Case reports of peanut-fenugreek and cashew-sumac cross-reactivity.
		Prevalence of sensitization and allergy to potato in a large population.
		Allergic reaction from fingerprint kit attributable to unlabeled gluten, probable wheat flour.
		Omalizumab anaphylaxis occurring outside the recommended observation times.
		Peanut oleosins associated with severe peanut allergy - Importance of lipophilic allergens for comprehensive allergy diagnostics.
		Diagnosis of red meat allergy with antigen-specific IgE tests in serum.
		Anaphylaxis to polyethylene glycol (Colyte(R))
		Cross-reactivity between Oak and Birch Pollens in Korean tree pollinosis.

Anaphylactic reaction to intravenous glucocorticoid
Serious anaphylactic reactions to systemic glucocorticoids are rare and have previously mainly been reported in patients with asthma or aspirin allergy. We report a case of severe anaphylactic reaction to an intravenous (IV) glucocorticoid in a patient with chronic obstructive pulmonary disease. A 61-year-old male developed severe bronchospasm within seconds after IV injection of methylprednisolone sodium succinate. The condition was immediately treated with adrenaline and the patient recovered quickly. Clinicians should be aware of the possibility of anaphylactic reactions to glucocorticoids.

Anaphylactic reaction to intravenous glucocorticoid in a patient with chronic obstructive pulmonary disease. [Danish]
Udesen PB, Lindberg MJ.
Ugeskr Laeger 2015 Apr 6;177(15):V12140654

Allergic reaction after ingestion of pancakes.
Buckwheat is increasingly used in food and pillows in Europe and is a potent potential allergen when ingested or inhaled. A 74-year-old Danish woman experienced anaphylaxis after ingesting industrially manufactured pancakes. She was IgE-sensitized and was persistently asymptomatic after allergen elimination.

Allergic reaction after ingestion of pancakes. [Danish]
Willendrup FS, Bodtger U.
Ugeskr Laeger 2015 Jan 26;177(2A):4-5

Molecular bases of the cross-reactivity between Act c 12 and the allergens 11S globulin of the seeds: identification in silico of epitopes B of Act c 12
Kiwi fruit (Actinidia deliciosa, A. chinensis) is an important source of food allergy in children and adults in Western countries. The allergens responsible for this food allergy consist primarily of typical fruit allergens, e.g. the PR10 Bet v 1-like allergen Act d 8, the cysteine protease actinidin Act d 1, the TLP Act d 2, and a chitinase. All of these allergens from A. deliciosa fruits have their counterparts in A. chinensis fruits. Recently, two other allergens belonging to the cupin superfamily (Act c 12) and the 2S albumin family (Act c 13), found in the kernels of A. chinensis fruit, have been identified as hidden fruit allergens responsible for IgE-binding cross-reactivity with peanuts and tree nuts. The sequential IgE-binding epitope regions of Act c 12 were predicted using a combination of in silico predictive approaches. Sequential IgE-binding epitopes of Act c 12 were predicted on a three-dimensional model of the protein from the amino acid sequence comparisons of the IgE-binding regions of cross-reacting cupins of peanuts and tree nuts. Residues of the sequence stretches exposed at the molecular surface were assigned as cross-reacting IgE-binding regions of Act c 12. In addition to their conformational similarities, these putative IgE-binding epitopes share a high degree of sequence similarity with the corresponding IgE-binding regions of peanut and tree-nut cupin allergens. The Act c 12 allergen offers an interesting example of a hidden fruit allergen likely to trigger allergic responses in individuals previously sensitized to peanut and other three-nut cupin allergens.

Molecular bases of the cross-reactivity between Act c 12 and the allergens 11S globulin of the seeds: identification in silico of epitopes B of Act c 12 [French]
A. Barre, A. Delplanque, M. Simplicien, H. Benoist, P. Rougé
Rev Fr Allergol 2017;57(2):58-66

Static and elevated pollen traps do not provide an accurate assessment of personal pollen exposure.
In a geographic area with a high diversity of environmental exposure to pollen, static pollen traps, in contrast to hair washes, do not provide a reliable estimate of this higher diversity

Static and elevated pollen traps do not provide an accurate assessment of personal pollen exposure.
Penel V, Calleja M, Pichot C, Charpin D.
Eur Ann Allergy Clin Immunol 2017 Mar;49(2):59-65

IgE, IgG1 and IgG4 response to specific allergens in sensitized subjects showing different clinical reactivity to Anisakis simplex.
28 Anisakis simplex-hypersensitive adults, 11 with acute symptoms, 9 with chronic urticaria, and 8 sensitized were studied. IgE, IgG1 and IgG4 to rAni s 1, 5, 9 and 10 were sought by ELISA. IgE and IgG4 to nAni s 4 were determined by WB. IgE to Ani s 1, 4, 5, 9, and 10 were found in 8, 3, 2, 5, and 9 sera, respectively. Nine sera did not react to any allergen. IgG1 to Ani s 1, 5, 9, and 10 were detected in 5, 16, 14, and 4 sera, respectively. Four sera did not react to any of the 4 allergens. IgG4 to Ani s 1, 4, 5, 9, and 10 were detected in 10, 0, 2, 6 and 1 sera, respectively. Fifteen subjects did not react to any of the 5 allergens. On ELISA sensitized subjects showed lower IgE and IgG1 levels than patients. IgG4 levels were highest in the sensitized group. The prevalence of IgE, IgG1 or IgG4 reactivity to any of the studied allergens did not differ between the 3 subgroups. The clinical expression of Anisakis simplex sensitization does not seem to depend on IgE reactivity to a specific allergen of the parasite, nor on the presence of IgG antibodies possibly related with blocking activity.

IgE, IgG1 and IgG4 response to specific allergens in sensitized subjects showing different clinical reactivity to Anisakis simplex.
Ventura MT, Rodriguez-Perez R, Caballero ML, Garcia-Alonso M, Antonicelli L, Asero R.
Eur Ann Allergy Clin Immunol 2017 Mar;49(2):52-58

Molecular diagnosis of allergy to Anisakis simplex and Gymnorhynchus gigas fish parasites.
The objective of this study was to assess IgE hypersensitivity caused by fish parasite allergens in patients with gastro-allergic symptoms after consumption of fish, shellfish or cephalopods, compared with healthy subjects, pollen allergic individuals and children with digestive symptoms after eating marine food. Skin prick and specific IgE determination, Western blot, and component resolved diagnostics (CRD) using microarray analysis were conducted in all patients. CRD better detected sensitisation to allergens from marine parasites than skin prick tests and determination of specific IgE by CAP. Sensitisation to Gymnorhynchus gigas was detected in 26% of patients measured by skin prick tests and 36% measured by IgE.

Molecular diagnosis of allergy to Anisakis simplex and Gymnorhynchus gigas fish parasites.
Armentia A, Santos J, Serrano Z, Martin B, Martin S, Barrio J, Fernandez S, Gonzalez-Sagrado M, Pineda F, Palacios R.
Allergol Immunopathol (Madr ) 2017 Mar 21;

Japanese guidelines for food allergy 2017.
Five years have passed since the Japanese Pediatric Guideline for Food Allergy (JPGFA) was first revised in 2011 from its original version. As many scientific papers related to food allergy have been published during the last 5 years, the second major revision of the JPGFA was carried out in 2016. In this guideline, food allergies are generally classified into four clinical types: (1) neonatal and infantile gastrointestinal allergy, (2) infantile atopic dermatitis associated with food allergy, (3) immediate-type of food allergy (urticaria, anaphylaxis, etc.), and (4) special forms of immediate-type of food allergy such as food-dependent exercise-induced anaphylaxis and oral allergy syndrome (OAS). Much of this guideline covers the immediate-type of food allergy that is seen during childhood to adolescence.

Japanese guidelines for food allergy 2017.
Ebisawa M, Ito K, Fujisawa T.
Allergol Int 2017 Mar 9;

Probability curves for predicting symptom severity during an oral food challenge with wheat.
Wheat allergy is the third most common food allergy among young children in Japan. The most reliable examination for the definitive diagnosis of a food allergy is an oral food challenge (OFC); however, consuming wheat appears to be an independent risk factor for anaphylaxis during OFC. As predictive factors for severe wheat OFC outcomes have not yet been identified, simple and easy indicators to predict induced symptom severity during wheat OFCs are needed. Omega-5 gliadin is a major allergen in young children with an immediate allergic reaction to wheat, and the serum ?-5 gliadin-specific IgE level was reported to be a useful parameter for predicting positive OFC outcomes.

Probability curves for predicting symptom severity during an oral food challenge with wheat.
Kamioka N, Nomura T, Kato T, Yoneyama M, Sobajima T, Tanida H, Morishita T, Sugiura S, Suda Y, Hirabayashi Y, Misawa C, Tanaka H, Mizuno M, Terada A, Kanda Y, Saitoh S.
Allergol Int 2017 Mar 8;

The emotional, social, and financial burden of food allergies on children and their families.
Food allergy can significantly impact pediatric patients and their families in all areas of their lives. Clinicians should be aware of these issues when working with these families. Implementing a multidisciplinary approach can help families cope with emotional, social, and financial burdens

The emotional, social, and financial burden of food allergies on children and their families.
Patel N, Herbert L, Green TD.
Allergy Asthma Proc 2017 Mar 1;38(2):88-91

Fixed food eruption caused by Actinidia arguta (Hardy Kiwi)
Fixed drug eruption (FDE) is a common hypersensitivity reaction characterized by recurrent, well-circumscribed, erythematous patches that arise at the same site as a result of systemic drug exposure. However, fixed food eruption (FFE), a lesion triggered by food ingestion, is a rare allergy that was first defined in 1996. Based on their anti-inflammatory and anti-oxidant properties, the fruit and leaves of Actinidia arguta, the hardy kiwi, are widely consumed across Korea, Japan, and China. This report describes the first case of FFE caused by hardy kiwi leaves, known as Daraesun in Korean, confirmed by oral provocation tests and skin biopsy

Fixed food eruption caused by Actinidia arguta (Hardy Kiwi): A case report and literature review.
Sohn KH, Kim BK, Kim JY, Song WJ, Kang HR, Park HW, Cho SH, Min KU.
Allergy Asthma Immunol Res 2017 Mar;9(2):182-184

Usefulness of house dust mite nasal provocation test in asthma.
The skin prick test is more sensitive, whereas the nasal test is more specific and accurate, for predicting an early airway reaction to house dust mite in patients with asthma

Usefulness of house dust mite nasal provocation test in asthma.
Choi IS, Kim SJ, Won JM, Park MS.
Allergy Asthma Immunol Res 2017 Mar;9(2):152-157

Mite allergen extracts and clinical practice.
This paper is to provide physicians, researchers, and other interested health care professionals with information about how mite source materials and allergen extracts are manufactured, including the critical process parameters that can affect the final composition of allergenic extracts available for clinical use.

Dermatophagoides farinae and Dermatophagoides pteronyssinus are the primary species responsible for allergen sensitizations and allergy symptoms in genetically predisposed individuals. Storage mites belonging to the families Glycyphagidae, Echimyopodidae, and Acaridae can also be relevant sources of indoor mite allergens. The cultivation and purification processes used to produce mite raw materials play a critical role in the final composition of mite allergen extracts. Mite extract standardization in the United States is based on total allergenic activity with respect to a single national standard, whereas in Europe consistency is ensured by in-house standards and international references. Because of the limitation of allergen avoidance and pharmacotherapy for patients with severe allergic rhinitis and asthma, house dust mite subcutaneous immunotherapy or sublingual immunotherapy can be an invaluable treatment option for them.

Differences in manufacturing processes and extract standardization approaches may lead to differences in extract quality and potency. Physicians should be aware of these potential sources of mite extract variability. Use of well-standardized house dust mite extracts would be critical for success in the diagnosis and treatment of house dust mite allergy.

Mite allergen extracts and clinical practice.
Carnes J, Iraola V, Cho SH, Esch RE.
Ann Allergy Asthma Immunol 2017 Mar;118(3):249-256

Cockroach allergen serine proteinases: Isolation, sequencing
This study aimed to identify, isolate and characterize the trypsin-like proteinases in German cockroach allergen extracts used for clinical skin tests. Three distinct enzymes were detected. Each of the three serine proteinase-activity-based probe-labelled enzymes isolated were biochemically distinct, with different enzyme kinetic profiles and primary amino acid sequences. The three enzymes showed a 57 to 71% sequence identity with a proteinase previously cloned from the American cockroach (Per a 10). Each enzyme was found to activate both Ca++ and MAPK signaling via PAR2.

Cockroach allergen serine proteinases: Isolation, sequencing and signalling via proteinase-activated receptor-2 (PAR2).
Polley DJ, Mihara K, Ramachandran R, Vliagoftis H, Renaux B, Saifeddine M, Daines MO, Boitano S, Hollenberg MD.
Clin Exp Allergy 2017 Mar 20;

The practice and perception of precautionary allergen labelling by the australasian food manufacturing industry.
The precautionary allergen labelling (PAL) and Voluntary Incidental Trace Allergen Labelling (VITAL(R) ) tools were designed by industry to assist consumers with selecting safe foods for consumption. However, a sizeable proportion of food products bear no label and it is unclear whether these products are free from allergens and therefore safe to consume or have simply not undergone a risk assessment and therefore remain unlabelled for that reason. This study assessed the prevalence of unlabelled products that have undergone a risk assessment process and to examine the factors influencing industry's uptake of the VITAL(R) process.

The authors conclude that they estimate that at least 30% of products may have been through a risk assessment process and yet bear no PAL statement on the label. Permissive labelling could be incorporated onto these products if they have been assessed to be safe for consumption.

The practice and perception of precautionary allergen labelling by the australasian food manufacturing industry.
Zurzolo GA, Peters RL, Koplin JJ, de Court, Mathai ML, Tye-Din JA, Tang ML, Campbell DE, Ponsonby AL, Prescott SL, Gurrin L, Dharmage S, Allen KJ.
Clin Exp Allergy 2017 Mar 14;

Hypersensitivity pneumonitis: a complex lung disease.
ypersensitivity pneumonitis (HP), also called extrinsic allergic alveolitis, is a respiratory syndrome involving the lung parenchyma and specifically the alveoli, terminal bronchioli, and alveolar interstitium, due to a delayed allergic reaction. Such reaction is secondary to a repeated and prolonged inhalation of different types of organic dusts or other substances to which the patient is sensitized and hyper responsive, primarily consisting of organic dusts of animal or vegetable origin, more rarely from chemicals. The prevalence of HP is difficult to evaluate because of uncertainties in detection and misdiagnosis and lacking of widely accepted diagnostic criteria, and varies considerably depending on disease definition, diagnostic methods, exposure modalities, geographical conditions, agricultural and industrial practices, and host risk factors. HP can be caused by multiple agents that are present in work places and in the home, such as microbes, animal and plant proteins, organic and inorganic chemicals. The number of environment, settings and causative agents is increasing over time. From the clinical point of view HP can be divided in acute/subacute and chronic, depending on the intensity and frequency of exposure to causative antigens. The mainstay in managing HP is the avoidance of the causative antigen, though the complete removal is not always possible due to the difficulties to identify the agent or because its avoidance may lead to major changes in life style or occupational settings. HP is a complex syndrome that needs urgently for more stringent and selective diagnostic criteria and validation, including wider panels of IgG, and a closer collaboration with occupational physicians, as part of a multidisciplinary expertise.

Hypersensitivity pneumonitis: a complex lung disease.
Riario Sforza GG, Marinou A.
Clin Mol Allergy 2017;156

Sensitization to secretoglobin and lipocalins in a group of young children with risk of developing respiratory allergy.
This study evaluates the emergence and evolution of IgE to aeroallergens among a cohort of children with physician-diagnosed atopic dermatitis and/or showing food allergy symptoms and to examine the relation to asthma development. Three-hundred and four children (median age 13.4 months at entry) with food allergy symptoms and/or atopic dermatitis without asthma at inclusion were analysed for IgE antibodies against food-, indoor- and outdoor-allergens and pet allergen components and correlated to the individuals' outcome on asthma inception. At 2 years of follow-up, physician-diagnosed asthma was 19.7% (n = 49) and asthma diagnosed any time was 24% (n = 67). History of persistent cough and asthma of father, combination of milk- and wheat-allergy symptoms and dual sensitization to house dust mite and Japanese cedar were independent risk factors for asthma. Sensitization to dog was the most prevalent inhalant allergen at entry. Asthma children had a higher proportion of sensitization to dog, cat and horse allergens at entry compared with non-asthma children. Being sensitized to both food, house dust mite and pet allergens was strongly associated with asthma (p = 0.0006). Component resolved diagnosis for dog and cat allergens showed that IgE antibodies to Can f 1 and Fel d 1 was common even at very young age.

Early sensitization to inhalant allergens increases the risk of developing asthma as well as having milk and wheat allergy symptoms. Sensitization to dog, was common at an early age despite dog ownership. Sensitization to secretoglobin and lipocalins and less to serum albumins explained the pet sensitization

Sensitization to secretoglobin and lipocalins in a group of young children with risk of developing respiratory allergy.
Nagao M, Borres MP, Sugimoto M, Petersson CJ, Nakayama S, Kuwabara Y, Masuda S, Dykiel P, Fujisawa T.
Clin Mol Allergy 2017;154

Approach to the diagnosis of drug hypersensitivity reactions: similarities and differences between Europe and North America.
Drug hypersensitivity reactions (DHRs) affect an unknown proportion of the general population, and are an important public health problem due to their potential to cause life-threatening anaphylaxis and rare severe cutaneous allergic reactions. DHR evaluations are frequently needed in both ambulatory and hospital settings and have a complex diagnosis that requires a detailed clinical history and other tests that may include in vitro tests and in vivo procedures such as skin tests and drug provocation tests. Although over the years both European and U.S. experts have published statements on general procedures for evaluating DHRs, a substantial discordance in their daily management exists. In this review, we highlight both the differences and the similarities between the European and U.S. PERSPECTIVES: While a general consensus exists on the importance of skin tests for evaluating DHRs, concordance between Americans and Europeans exists solely regarding their use in immediate reactions and the fact that a confirmation of a presumptive diagnosis by drug provocation tests is often the only reliable way to establish a diagnosis. Finally, great heterogeneity exists in the application of in vitro tests, which require further study to be well validated

Approach to the diagnosis of drug hypersensitivity reactions: similarities and differences between Europe and North America.
Torres MJ, Romano A, Celik G, Demoly P, Khan DA, Macy E, Park M, Blumenthal K, Aberer W, Castells M, Barbaud A, Mayorga C, Bonadonna P.
Clin Transl Allergy 2017;77

Advanced DNA- and Protein-based Methods for the Detection and Investigation of Food Allergens.
Currently, food allergies are an important health concern worldwide. The presence of undeclared allergenic ingredients or the presence of traces of allergens due to contamination during food processing poses a great health risk to sensitized individuals. Therefore, reliable analytical methods are required to detect and identify allergenic ingredients in food products. The present review addresses the recent developments regarding the application of DNA- and protein-based methods for the detection of allergenic ingredients in foods. The fitness-for-purpose of reviewed methodology will be discussed, and future trends will be highlighted. Special attention will be given to the evaluation of the potential of newly developed and promising technologies that can improve the detection and identification of allergenic ingredients in foods, such as the use of biosensors and/or nanomaterials to improve detection limits, specificity, ease of use, or to reduce the time of analysis. Such rapid food allergen test methods are required to facilitate the reliable detection of allergenic ingredients by control laboratories, to give the food industry the means to easily determine whether its product has been subjected to cross-contamination and, simultaneously, to identify how and when this cross-contamination occurred

Advanced DNA- and Protein-based Methods for the Detection and Investigation of Food Allergens.
Prado M, Ortea I, Vial S, Rivas J, Calo-Mata P, Barros-Velazquez J.
Crit Rev Food Sci Nutr 2016 Nov 17;56(15):2511-2542

New trends in food allergens detection: toward biosensing strategies.
Food allergens are a real threat to sensitized individuals. Although food labeling is crucial to provide information to consumers with food allergies, accidental exposure to allergenic proteins may result from undeclared allergenic substances by means of food adulteration, fraud or uncontrolled cross-contamination. Allergens detection in foodstuffs can be a very hard task, due to their presence usually in trace amounts, together with the natural interference of the matrix. Methods for allergens analysis can be mainly divided in two large groups: the immunological assays and the DNA-based ones. Mass spectrometry has also been used as a confirmatory tool. Recently, biosensors appeared as innovative, sensitive, selective, environmentally friendly, cheaper and fast techniques (especially when automated and/or miniaturized), able to effectively replace the classical methodologies. In this review, we present the advances in the field of food allergens detection toward the biosensing strategies and discuss the challenges and future perspectives of this technology.

New trends in food allergens detection: toward biosensing strategies.
Alves RC,, Barroso MF, González-García MB, Oliveira MB, Delerue-Matos C.
Crit Rev Food Sci Nutr 2016 Oct 25;56(14):2304-2319

Occupational latex allergy: the current state of affairs.
The aim of this review was to provide a comprehensive compilation of the current status of occupational NRL allergy. Recent advances led to the characterization of 15 NRL allergens and the development of assays for measuring the allergen content of NRL materials and specific IgE antibodies against NRL allergen components. Preventive measures aimed at reducing workplace exposure to NRL allergens were associated with decreasing incidence rates of NRL allergy. However, a pooled analysis of epidemiological surveys published during the last 10 years provided prevalence estimates of NRL sensitization and allergy similar to those derived from studies conducted before 2003. Substantial progress has been made in the understanding and prevention of NRL allergy, although the disease may still remain a worldwide cause of concern

Occupational latex allergy: the current state of affairs.
Vandenplas O, Raulf M.
Curr Allergy Asthma Rep 2017 Mar;17(3):14

Outstanding animal studies in allergy I. From asthma to food allergy and anaphylaxis.
Purpose of Review: Animal models published within the past 18 months on asthma, food allergy and anaphylaxis, all conditions of rising public health concern, were reviewed.

Recent Findings: While domestic animals spontaneously develop asthma, food allergy and anaphylaxis, in animal models, divergent sensitization and challenge routes, dosages, intervals and antigens are used to induce asthmatic, food allergic or anaphylactic phenotypes. This must be considered in the interpretation of results. Instead of model antigens, gradually relevant allergens such as house dust mite in asthma, and food allergens like peanut, apple and peach in food allergy research were used. Novel engineered mouse models such as a mouse with a T-cell receptor for house dust mite allergen Der p 1, or with transgenic human hFcgammaR genes, facilitated the investigation of single molecules of interest. Whole-body plethysmography has become a state-of-the-art in-vivo readout in asthma research. In food allergy and anaphylaxis research, novel techniques were developed allowing real-time monitoring of in-vivo effects following allergen challenge. Networks to share tissues were established as an effort to reduce animal experiments in allergy which cannot be replaced by in-vitro measures.

Summary: Natural and artificial animal models were used to explore the pathophysiology of asthma, food allergy and anaphylaxis and to improve prophylactic and therapeutic measures. Especially the novel mouse models mimicking molecular aspects of the complex immune network in asthma, food allergy and anaphylaxis will facilitate proof-of-concept studies under controlled conditions

Outstanding animal studies in allergy I. From asthma to food allergy and anaphylaxis.
Jensen-Jarolim E, Pali-Scholl I, Roth-Walter F.
Curr Opin Allergy Clin Immunol 2017 Mar 24;

Tyramine and histamine risk assessment related to consumption of dry fermented sausages by the Spanish population.
Tyramine and histamine are the main dietary bioactive amines related to acute adverse health effects. Dry fermented sausages can easily accumulate high levels of these hazards and are frequently consumed in Spain. The present work aims to assess the exposure to tyramine and histamine from the consumption of dry fermented sausages by the Spanish population and to assess the risk to suffer acute health effects from this exposure. The mean dietary exposure to tyramine and histamine was 6.2 and 1.39 mg/meal, respectively. The risk of suffering hypertensive crisis or histamine intoxication by healthy population due to tyramine or histamine intake, respectively, exclusively from dry fermented sausages, can be considered negligible. For individuals under treatment with MAOI drugs, the probability to surpass the safe threshold dose (6 mg/meal) was estimated as 34%. For patients with histamine intolerance, even the presence of this amine in food is not tolerable and it could be estimated that 7000 individuals per million could be at risk to suffer the related symptoms after consuming dry fermented sausages.

Tyramine and histamine risk assessment related to consumption of dry fermented sausages by the Spanish population.
Latorre-Moratalla ML, Comas-Baste O, Bover-Cid S, Vidal-Carou MC.
Food Chem Toxicol 2017 Jan;9978-85

Sesame allergy threshold dose distribution.
Fourteen patients (10 M/4 F, 22 ± 14.85 years old) with objective symptoms were added to previously published data making a total of 35 sesame allergic patients. The most sensitive patient reacted to the first dose at challenge of 1.02 mg sesame protein. The ED05 ranges between 1.2 and 4.0 mg of sesame protein (Log-Normal, Log-Logistic, and Weibull models) and the ED10 between 4.2 and 6.2 mg. The optimal food challenge dosing scheme for sesame follows semi-log dose increases from 0.3 to 3000 mg protein.

Sesame allergy threshold dose distribution.
Dano D, Remington BC, Astier C, Baumert JL, Kruizinga AG, Bihain BE, Taylor SL, Kanny G.
Food Chem Toxicol 2015 Sep;8348-53

Role of the lymphocyte transformation test in the evaluation of metal sensitization.
This article concludes that to detect metal sensitization, the lymphocyte transformation test can be useful especially in situations in which exposure did not occur via the skin, but from inside the body (e. g. by metal implants)

Role of the lymphocyte transformation test in the evaluation of metal sensitization. [German]
Summer B, Stander S, Kapp F, Thomas P.
Hautarzt 2016 May;67(5):380-384

Identifying epithelial endocytotic mechanisms of the peanut allergens Ara h 1 and Ara h 2.
These findings demonstrate that the peanut allergens Ara h 1 and Ara h 2 are transported through intestinal epithelia initially via early endosomes using multiple endocytotic mechanisms. From there, they are then transported to late endosomes and ultimately to lysosomes.

Identifying epithelial endocytotic mechanisms of the peanut allergens Ara h 1 and Ara h 2.
Price D, Ackland ML, Suphioglu C.
Int Arch Allergy Immunol 2017 Mar 8;172(2):106-115

Reactions of buckwheat-hypersensitive patients during oral food challenge are rare, but often anaphylactic.
Buckwheat (BW) is a common cause of life-threatening allergy in Asia. Few have examined oral food challenges (OFCs) using BW. This study describes the OFC outcomes for the diagnosis or confirmation of tolerance acquisition and clarify risk factors for positive OFCs.

Data from children who underwent OFCs using 3,072 mg of BW protein were retrospectively reviewed. Of 476 patients, 419 aged 1-17 years were analyzed. Forty-four (10.5%) reacted to the BW OFC and 24 (54.5%) experienced anaphylaxis. Among patients with suspected BW allergies (n = 369), 30 (8.1%) reacted to OFC. BW allergies are rare among children suspected of having BW allergies due to positivity for BW-specific IgE. Most children with definitive BW allergies can tolerate BW, even after anaphylactic reactions. Nevertheless, careful observation is needed when performing BW OFCs, considering the high incidence of anaphylactic reactions

Reactions of buckwheat-hypersensitive patients during oral food challenge are rare, but often anaphylactic.
Yanagida N, Sato S, Takahashi K, Nagakura KI, Ogura K, Asaumi T, Ebisawa M.
Int Arch Allergy Immunol 2017 Mar 8;172(2):116-122

The role of dietary interventions in the prevention of IgE-mediated food allergy in children.
Over the last 30 years, the prevalence of food allergy has been on the rise and remains a disease that can have a significant impact on the quality of life of children and their families. There are several hypotheses that have been suggested to account for the increasing prevalence but this review will focus on the impact dietary factors have on food allergy development. In the past food allergy prevalence has largely focused on allergen avoidance; however there is increasing evidence from interventional studies that have shown that early introduction to potential food allergens may have a beneficial role in allergy prevention. This review aims to look at the evidence in support of early introduction of allergens into infant diets to prevent against the development of food allergy.

The role of dietary interventions in the prevention of IgE-mediated food allergy in children.
du Toit G, Foong RX, Lack G.
Pediatr Allergy Immunol 2017 Mar 4;

Gliadin-reactive T cells in Italian children from PreventCD cohort at high risk for celiac disease.
Newborns at high risk for celiac disease (CD) were recruited in Italy in the context of the PreventCD Study and closely monitored for CD, from 4 months up to a mean age of 8 years at follow-up. The aim of our study was to investigate intestinal T cell reactivity to gliadin at the first clinical and/or serological signs of CD. Gliadin-reactive T cell lines were generated from intestinal biopsies of 19 HLA-DQ2 or HLA-DQ8 positive children. Most of the children with CD (either acute or potential) had an inflammatory response to gliadin. Notably, signs of T cell reactivity to gliadin were also found in some non-celiac subjects, in which IFN-gamma responses occurred mainly when regulatory IL-10 and TGF-beta cytokines were blocked. Interestingly, PreventCD children reacted to gliadin peptides found active in adult CD patients, and tTG-deamidation markedly enhanced gliadin recognition. T cells reactive to gliadin can be detected in the intestine of children at high risk of developing CD, in some cases also in the presence of a normal mucosa and negative CD-associated antibodies. Furthermore, children at a very early stage of CD recognize the same gliadin epitopes that are active in adult CD patients. Tissue transglutaminase strongly enhances gluten T cell immunogenicity in early CD.

Gliadin-reactive T cells in Italian children from PreventCD cohort at high risk for celiac disease.
Camarca A, Auricchio R, Picascia S, Fierro O, Maglio M, Miele E, Malamisura B, Greco L, Troncone R, Gianfrani C.
Pediatr Allergy Immunol 2017 Mar 24;

Patients taking amoxicillin-clavulanic can become simultaneously sensitized to both drugs.
This study provides evidence that patients taking amoxicillin-clavulanic can become simultaneously sensitized to both drugs.

Patients taking amoxicillin-clavulanic can become simultaneously sensitized to both drugs.
Salas M, Laguna JJ, Dona I, Barrionuevo E, Fernandez-Santamaria R, Ariza A, Perez-Inestrosa E, Mayorga C, Fernandez TD, Torres MJ.
J Allergy Clin Immunol Pract 2017 Mar 22;

Should peanut be banned in schools?
SUMMARY AND CONCLUSIONS

It is imperative to ensure safe learning environments for foodallergic children. Early recognition of food-allergic reactions and timely administration of epinephrine are essential for optimal outcomes, but far too much variation in how this is handled exists. Although there are no large-scale studies providing definitive evidence supporting or refuting the efficacy of peanut bans in schools, management of food allergies requires consideration of the individual child as well as available school staff and resources. Allergen restriction may be more beneficial and appropriate in specific situations, such as for very young students, but may not present the most efficient use of resources when considering older students. There should be a concerted focus on making recognition and management of an allergic reaction a basic health tenet that we teach children, parents, and school staff as opposed to focus on unlikely scenarios and rare circumstances of how and where a student may have a reaction (eg, inhalation and casual contact). Schools, health care providers, and families should work together to ensure evidence-based practices regarding avoidance and environmental abatement. Energy can also be directed toward educational campaigns that have longlasting returns on investment in terms of preparing foodallergic and nonefood-allergic students and school staff to have awareness, empathy, and a common-sense management plan in the event that a reaction does occur. These and other necessary approaches to ensure the safety of children with food allergies will require a multipronged, collaborative approach, with efforts from national and international pediatric and allergy professional societies, advocacy groups, and departments of education, and importantly from respective local and national governing agencies to provide the legal impetus to enforce such programs.

Should peanut be banned in schools?
Wang J, Fleischer DM.
J Allergy Clin Immunol Pract 2017 Mar;5(2):290-294

Making the most of in vitro tests to diagnose food allergy.
Various in vitro tests assess different aspects of the underlying immune mechanism of IgE-mediated food allergy. Some can be used for diagnostic purposes; specific IgE to allergen extracts is widely available; specific IgE to allergen components is used in most specialist centers, and the basophil activation test is becoming increasingly used clinically. IgE to allergen peptides, T-cell assays, allergen-specific/total IgE ratios, and allergen-specific IgG4/IgE ratios are currently reserved for research. Different factors can modulate the likelihood of IgE-mediated food allergy of a given allergy test result, namely, the patients' age, ethnicity, previous allergic reaction to the identified food, concomitant atopic conditions, and geographical location, and need to be taken into account when interpreting the allergy test results in the clinic. The importance of the specific food, the clinical resources available, and patient preferences are additional aspects that need to be considered when deciding whether an oral food challenge is required to reach an accurate diagnosis of IgE-mediated food allergy

Making the most of in vitro tests to diagnose food allergy.
Santos AF, Brough HA.
J Allergy Clin Immunol Pract 2017 Mar;5(2):237-248

Managing nut allergy: a remaining clinical challenge.
Peanut and tree nut allergies have become a public health problem over the last 2 decades. The diagnostic procedure relies on a suggestive history, as well as on evidence of sensitization (skin prick testing and/or specific IgE blood testing), followed in selected cases by a food challenge. Standard IgE tests may be positive to more than 1 nut, due to cross-reactivity (allergens common to several nuts) or cosensitivity (frequently associated positive test results without cross-reactivity). Thus, many patients with a peanut or a tree nut allergy avoid all nuts, relying on positive test results without clinical evidence of reactivity. In addition, coexisting pollen sensitivity may add to diagnostic uncertainty due to potential cross-reactivity between pollens and nuts. In this article, we discuss challenges in diagnosis and clinical management of peanut and tree nut allergy related to cross-reactivity and cosensitization, as well as the avoidance of nuts tested positive to reduce the risk of reactions by cross-contamination. Studies to provide more accurate characterization of genuine clinically relevant cross-reactivity or cosensitivity to multiple nuts are needed.

Managing nut allergy: a remaining clinical challenge.
Eigenmann PA, Lack G, Mazon A, Nieto A, Haddad D, Brough HA, Caubet JC.
J Allergy Clin Immunol Pract 2017 Mar;5(2):296-300

Primary respiratory and food allergy to mealworm.
There is risk of mealworm allergy in the majority of shrimp allergic patients. This study addresses the risk of mealworm sensitization and allergy in subjects without shrimp allergy. The study concludes that exposure to mealworm can lead to primary sensitization in a mouse model and in humans and can result in both food and inhalant allergy. mealworm larval cuticle proteins might be major allergens in mealworm allergy.

Primary respiratory and food allergy to mealworm.
Broekman H, Knulst AC, den Hartog Jager CF, van Bilsen JH, Raymakers FM, Kruizinga AG, Gaspari M, Gabriele C, Bruijnzeel-Koomen CA, Houben GF, Verhoeckx KC.
J Allergy Clin Immunol 2017 Mar 5;

Automated identification of an aspirin-exacerbated respiratory disease cohort.
An informatics algorithm can successfully identify both known and previously undiagnosed cases of aspirin-exacerbated respiratory disease (AERD) with a high positive predictive value. Involvement of an allergist/immunologist significantly increases the likelihood of an AERD diagnosis.

Automated identification of an aspirin-exacerbated respiratory disease cohort.
Cahill KN, Johns CB, Cui J, Wickner P, Bates DW, Laidlaw TM, Beeler PE.
J Allergy Clin Immunol 2017 Mar;139(3):819-825

Airborne dust and high temperatures are risk factors for invasive bacterial disease.
"Our findings show that climatic factors can have a substantial influence on infectious disease patterns, altering density of pneumococcal nasopharyngeal carriage, reducing phagocytic killing, and resulting in increased inflammation and tissue damage and consequent invasiveness. Climatic surveillance should be used to forecast invasive bacterial disease epidemics, and simple control measures to reduce particulate inhalation might reduce the incidence of invasive bacterial disease in regions of the world exposed to high temperatures and increased airborne dust."

Airborne dust and high temperatures are risk factors for invasive bacterial disease.
Jusot JF, Neill DR, Waters EM, Bangert M, Collins M, Bricio ML, Lawan KG, Moussa MM, Dearing E, Everett DB, Collard JM, Kadioglu A.
J Allergy Clin Immunol 2017 Mar;139(3):977-986

IgE sensitization patterns to commonly consumed foods determined by skin prick test in Korean adults.
In this study, we analysed sensitization rates to commonly consumed foods in Korean adults suspected of having food allergy. One hundred and thirty four subjects underwent a skin prick test (SPT) with 55 food allergens. Of the 134 patients, 73 (54.5%) were sensitized to one or more food allergens. Sensitization to chrysalis was detected most frequently, at a rate of 25.4%. Sensitization rates to other food allergens were as follows: maize grain (13.4%), shrimp (11.9%), almond (11.1%), wheat flour (8.2%), lobster (8.2%), buckwheat (8.2%), mackerel (5.2%), pollack (5.2%), halibut (4.5%), peanut (4.5%), anchovy (4.4%), squid (3.7%), saury (3.0%), common eel (3.0%), yellow corvina (3.0%), hairtail (2.2%), octopus (2.2%), and others. In addition to well-known food allergens, sensitivity to mackerel, silkworm chrysalis, pollack, and halibut, which are popular foods in Korea, was observed at high rates in Korean adults.

IgE sensitization patterns to commonly consumed foods determined by skin prick test in Korean adults.
Kim SR, Park HJ, Park KH, Lee JH, Park JW.
J Korean Med Sci 2016 Aug;31(8):1197-1201

Allergen-, Food allergy-, Intolerance-related articles

Evaluation of the sensitizing potential of food proteins using two mouse models.
Smit J, Zeeuw-Brouwer ML, van RM, de JG, van BJ. Toxicol Lett 2016 Nov 16;26262-69

Determination of albumin adducts of 4,4'-methylenediphenyl diisocyanate after specific inhalative challenge tests in workers.
Sabbioni G, Dongari N, Kumar A, Baur X. Toxicol Lett 2016 Oct 17;26046-51

Anaphylactic reaction to intravenous glucocorticoid in a patient with chronic obstructive pulmonary disease. [Danish]
Udesen PB, Lindberg MJ. Ugeskr Laeger 2015 Apr 6;177(15):V12140654

Anaphylactic shock after intradermal injection of corticosteroid. [Danish]
Meyer MW, Zachariae C, Garvey LH. Ugeskr Laeger 2015 Jan 19;177(4):V10140532

Allergic reaction after ingestion of pancakes. [Danish]
Willendrup FS, Bodtger U. Ugeskr Laeger 2015 Jan 26;177(2A):4-5

Climate change, allergy and asthma, and the role of tropical forests.
D'Amato G, Vitale C, Rosario N, Neto HJ, Chong-Silva DC, Mendonca F, Perini J, Landgraf L, Sole D, Sanchez-Borges M, Ansotegui I, D'Amato M. World Allergy Organ J 2017;10(1):11

Allergy to cows' milk proteins: natural history and persistence factors [French]
K. Aissa, S. Ben Ameur, F. Kamoun, S. Feki, S. Kmiha, H. Aloulou, H. Masmoudi, I. Chabchoub, M. Hachicha Rev Fr Allergol 2017;57(1):18-23

Histamine intolerance or false food allergies of histamine mechanism [French]
S. Lefèvre, C. Astier, G. Kanny Rev Fr Allergol 2017;57(1):24-34

Allergic Hazards of Proton Pump Inhibitors: Mild Reactions to Anaphylaxis! [French]
G. Dutau, F. Lavaud Rev Fr Allergol 2017;57(2):55-57

Molecular bases of the cross-reactivity between Act c 12 and the allergens 11S globulin of the seeds: identification in silico of epitopes B of Act c 12 [French]
A. Barre, A. Delplanque, M. Simplicien, H. Benoist, P. Rougé Rev Fr Allergol 2017;57(2):58-66

Food allergy (AA) and catering: how to improve the reception of students? Review of the experience in Franche-Comté [French]
J.-M. Rame, A. Doc, J. Raibaut, E. Lalaurie Rev Fr Allergol 2017;57(2):67-76

Allergy to dust mites. Diagnosis, management and modalities of ITA in poly-allergic patients [French]
P. Demoly Rev Fr Allergol 2017;57(2):83-90

Immediate hypersensitivity allergic to omeprazole and cross-sensitization
E. Degache, P. Pralong, J.-P. Jacquier, S. Logerot, M. Pernollet, C. Chatain, M.-T. Leccia Rev Fr Allergol 2017;57(2):103-107

Combined use of ECMO and hemodialysis in the case of contrast-induced biphasic anaphylactic shock.
Sugiura A, Nakayama T, Takahara M, Sugimoto K, Hattori N, Abe R, Fujimoto Y, Oda S, Kobayashi Y. Am J Emerg Med 2016 Sep;34(9):1919-2

Upper extremity edema caused by sotalol.
Abboud ME, Frasure SE. Am J Emerg Med 2016 Sep;34(9):1920-1926

Hypersensitivity reaction after administration of rivaroxaban (Xarelto).
Vernon HM, Nielsen AK, O'Bryan EC. Am J Emerg Med 2016 Jul;34(7):1325-2

Gadolinium-based contrast agent anaphylaxis, a unique presentation of acute abdominal pain.
Pourmand A, Guida K, Abdallah A, Taheri MR, Shokoohi H. Am J Emerg Med 2016 Aug;34(8):1737-2

Purpuric skin eruption in an illicit drug user: Levamisole-induced vasculitis.
Graff N, Whitworth K, Trigger C. Am J Emerg Med 2016 Jul;34(7):1321-1326

Selective hypersensitivity to cefazolin and contribution of the basophil activation test.
Almeida JP, Lopes A, Campos MA, Pereira Santos MC, Pereira BM. Eur Ann Allergy Clin Immunol 2017 Mar;49(2):84-87

Static and elevated pollen traps do not provide an accurate assessment of personal pollen exposure.
Penel V, Calleja M, Pichot C, Charpin D. Eur Ann Allergy Clin Immunol 2017 Mar;49(2):59-65

IgE, IgG1 and IgG4 response to specific allergens in sensitized subjects showing different clinical reactivity to Anisakis simplex.
Ventura MT, Rodriguez-Perez R, Caballero ML, Garcia-Alonso M, Antonicelli L, Asero R. Eur Ann Allergy Clin Immunol 2017 Mar;49(2):52-58

Molecular diagnosis of allergy to Anisakis simplex and Gymnorhynchus gigas fish parasites.
Armentia A, Santos J, Serrano Z, Martin B, Martin S, Barrio J, Fernandez S, Gonzalez-Sagrado M, Pineda F, Palacios R. Allergol Immunopathol (Madr ) 2017 Mar 21;

Prevalence of oral allergy syndrome in children with allergic diseases.
Bedolla-Barajas M, Kestler-Gramajo A, cala-Padilla G, Morales-Romero J. Allergol Immunopathol (Madr ) 2017 Mar;45(2):127-133

Epidemiology of drug-induced anaphylaxis in a tertiary hospital in Korea.
Park HK, Kang MG, Yang MS, Jung JW, Cho SH, Kang HR. Allergol Int 2017 Mar 10;

Japanese guidelines for food allergy 2017.
Ebisawa M, Ito K, Fujisawa T. Allergol Int 2017 Mar 9;

Probability curves for predicting symptom severity during an oral food challenge with wheat.
Kamioka N, Nomura T, Kato T, Yoneyama M, Sobajima T, Tanida H, Morishita T, Sugiura S, Suda Y, Hirabayashi Y, Misawa C, Tanaka H, Mizuno M, Terada A, Kanda Y, Saitoh S. Allergol Int 2017 Mar 8;

Eosinophilic gastroenteritis caused by eating hens' eggs: A case report.
Yanagimoto Y, Taniuchi S, Ishizaki Y, Nakano K, Hosaka N, Kaneko K. Allergol Int 2017 Mar 6;

Relation of indoor and outdoor airborne fungal spore levels in the Kansas City metropolitan area.
Jara D, Portnoy J, Dhar M, Barnes C. Allergy Asthma Proc 2017 Mar 1;38(2):130-135

The emotional, social, and financial burden of food allergies on children and their families.
Patel N, Herbert L, Green TD. Allergy Asthma Proc 2017 Mar 1;38(2):88-91

Can the burden of disease due to food allergy be prevented?
Bellanti JA, Settipane RA. Allergy Asthma Proc 2017 Mar 1;38(2):85-87

Fixed food eruption caused by Actinidia arguta (Hardy Kiwi): A case report and literature review.
Sohn KH, Kim BK, Kim JY, Song WJ, Kang HR, Park HW, Cho SH, Min KU. Allergy Asthma Immunol Res 2017 Mar;9(2):182-184

Sputum Inflammatory Mediators Are Increased in Aspergillus fumigatus Culture-Positive Asthmatics.
Ghebre MA, Desai D, Singapuri A, Woods J, Rapley L, Cohen S, Herath A, Wardlaw AJ, Pashley CH, May R, Brightling CE. Allergy Asthma Immunol Res 2017 Mar;9(2):177-181

Usefulness of house dust mite nasal provocation test in asthma.
Choi IS, Kim SJ, Won JM, Park MS. Allergy Asthma Immunol Res 2017 Mar;9(2):152-157

AAAAI/ACAAI Joint Venom Extract Shortage Task Force Report.
Golden DB, Bernstein DI, Freeman TM, Tracy JM, Lang DM, Nicklas RA. Ann Allergy Asthma Immunol 2017 Mar;118(3):283-285

Mite allergen extracts and clinical practice.
Carnes J, Iraola V, Cho SH, Esch RE. Ann Allergy Asthma Immunol 2017 Mar;118(3):249-256

Mechanisms of anaphylaxis beyond classically mediated antigen- and IgE-induced events.
Lieberman P. Ann Allergy Asthma Immunol 2017 Mar;118(3):246-248

Performance of a polymer coated silicon microarray for simultaneous detection of food allergen specific IgE and IgG4.
Sievers S, Cretich M, Gagni P, Ahrens B, Grishina G, Sampson H, Niggemann B, Chiari M, Beyer K. Clin Exp Allergy 2017 Mar 27;

CXCL4 is a novel nickel-binding protein and augments nickel allergy.
Kuroishi T, Bando K, Tanaka Y, Shishido K, Kinbara M, Ogawa T, Muramoto K, Endo Y, Sugawara S. Clin Exp Allergy 2017 Mar 20;

Cockroach allergen serine proteinases: Isolation, sequencing and signalling via proteinase-activated receptor-2 (PAR2).
Polley DJ, Mihara K, Ramachandran R, Vliagoftis H, Renaux B, Saifeddine M, Daines MO, Boitano S, Hollenberg MD. Clin Exp Allergy 2017 Mar 20;

The practice and perception of precautionary allergen labelling by the australasian food manufacturing industry.
Zurzolo GA, Peters RL, Koplin JJ, de Court, Mathai ML, Tye-Din JA, Tang ML, Campbell DE, Ponsonby AL, Prescott SL, Gurrin L, Dharmage S, Allen KJ. Clin Exp Allergy 2017 Mar 14;

Hypersensitivity pneumonitis: a complex lung disease.
Riario Sforza GG, Marinou A. Clin Mol Allergy 2017;156

Sensitization to secretoglobin and lipocalins in a group of young children with risk of developing respiratory allergy.
Nagao M, Borres MP, Sugimoto M, Petersson CJ, Nakayama S, Kuwabara Y, Masuda S, Dykiel P, Fujisawa T. Clin Mol Allergy 2017;154

Low percentage of clinically relevant pistachio nut and mango co-sensitisation in cashew nut sensitised children.
van der Valk JP, Bouche RE, Gerth van Wijk R, de Groot H, Wichers HJ, Dubois AE, de Jong NW. Clin Transl Allergy 2017;78

Approach to the diagnosis of drug hypersensitivity reactions: similarities and differences between Europe and North America.
Torres MJ, Romano A, Celik G, Demoly P, Khan DA, Macy E, Park M, Blumenthal K, Aberer W, Castells M, Barbaud A, Mayorga C, Bonadonna P. Clin Transl Allergy 2017;77

Mold and Human Health: a Reality Check.
Borchers AT, Chang C, Eric GM. Clin Rev Allergy Immunol 2017 Mar 16;

Advanced DNA- and Protein-based Methods for the Detection and Investigation of Food Allergens.
Prado M, Ortea I, Vial S, Rivas J, Calo-Mata P, Barros-Velazquez J. Crit Rev Food Sci Nutr 2016 Nov 17;56(15):2511-2542

New trends in food allergens detection: toward biosensing strategies.
Alves RC,, Barroso MF, González-García MB, Oliveira MB, Delerue-Matos C. Crit Rev Food Sci Nutr 2016 Oct 25;56(14):2304-2319

Hazelnut allergens: molecular characterization, detection, and clinical relevance.
Costa J, Mafra I, Carrapatoso I, Oliveira MB. Crit Rev Food Sci Nutr 2016 Nov 17;56(15):2579-2605

Occupational latex allergy: the current state of affairs.
Vandenplas O, Raulf M. Curr Allergy Asthma Rep 2017 Mar;17(3):14

Outstanding animal studies in allergy I. From asthma to food allergy and anaphylaxis.
Jensen-Jarolim E, Pali-Scholl I, Roth-Walter F. Curr Opin Allergy Clin Immunol 2017 Mar 24;

Impact of elimination diets on nutrition and growth in children with multiple food allergies.
Venter C, Mazzocchi A, Maslin K, Agostoni C. Curr Opin Allergy Clin Immunol 2017 Mar 18;

Christmas from an allergist's perspective. [German]
Wedi B. Dtsch Med Wochenschr 2016 Dec;141(25):1828-1834

Tyramine and histamine risk assessment related to consumption of dry fermented sausages by the Spanish population.
Latorre-Moratalla ML, Comas-Baste O, Bover-Cid S, Vidal-Carou MC. Food Chem Toxicol 2017 Jan;9978-85

Characterization of the potential allergenicity of irradiated bovine alpha-lactalbumin in a BALB/c mouse model.
Meng X, Li X, Gao J, Chen H. Food Chem Toxicol 2016 Nov;97402-410

Evaluation of Bar, Barnase, and Barstar recombinant proteins expressed in genetically engineered Brassica juncea (Indian mustard) for potential risks of food allergy using bioinformatics and literature searches.
Siruguri V, Bharatraj DK, Vankudavath RN, Mendu VV, Gupta V, Goodman RE. Food Chem Toxicol 2015 Sep;8393-102

Sesame allergy threshold dose distribution.
Dano D, Remington BC, Astier C, Baumert JL, Kruizinga AG, Bihain BE, Taylor SL, Kanny G. Food Chem Toxicol 2015 Sep;8348-53

Food safety assessment of an antifungal protein from Moringa oleifera seeds in an agricultural biotechnology perspective.
Pinto CE, Farias DF, Carvalho AF, Oliveira JT, Pereira ML, Grangeiro TB, Freire JE, Viana DA, Vasconcelos IM. Food Chem Toxicol 2015 Sep;831-9

Adverse reactions to metal orthopedic implants after knee arthroplasty. [German]
Thomsen M, Krenn V, Thomas P. Hautarzt 2016 May;67(5):347-351

Role of the lymphocyte transformation test in the evaluation of metal sensitization. [German]
Summer B, Stander S, Kapp F, Thomas P. Hautarzt 2016 May;67(5):380-384

Identifying epithelial endocytotic mechanisms of the peanut allergens Ara h 1 and Ara h 2.
Price D, Ackland ML, Suphioglu C. Int Arch Allergy Immunol 2017 Mar 8;172(2):106-115

Reactions of buckwheat-hypersensitive patients during oral food challenge are rare, but often anaphylactic.
Yanagida N, Sato S, Takahashi K, Nagakura KI, Ogura K, Asaumi T, Ebisawa M. Int Arch Allergy Immunol 2017 Mar 8;172(2):116-122

Multiple Drug Hypersensitivity.
Pichler WJ, Srinoulprasert Y, Yun J, Hausmann O. Int Arch Allergy Immunol 2017 Mar 18;172(3):129-138

Reducing exposure to mouse allergen among children and adolescents with asthma is achievable, but is it enough?
Bacharier LB. JAMA 2017 Mar 14;317(10):1023-1025

Implementing primary prevention for peanut allergy at a population level.
Turner PJ, Campbell DE. JAMA 2017 Mar 21;317(11):1111-1112

The role of dietary interventions in the prevention of IgE-mediated food allergy in children.
du Toit G, Foong RX, Lack G. Pediatr Allergy Immunol 2017 Mar 4;

Perioperative midazolam hypersensitivity in a seven-year old boy.
Bernardini R, Bonadonna P, Catania P, Passalacqua G. Pediatr Allergy Immunol 2017 Mar 24;

Partially hydrolyzed whey formula intolerance in cow's milk allergic patients.
Egan M, Lee T, Andrade J, Grishina G, Mishoe M, Gimenez G, Sampson HA, Bunyavanich S. Pediatr Allergy Immunol 2017 Mar 24;

Gliadin-reactive T cells in Italian children from PreventCD cohort at high risk for celiac disease.
Camarca A, Auricchio R, Picascia S, Fierro O, Maglio M, Miele E, Malamisura B, Greco L, Troncone R, Gianfrani C. Pediatr Allergy Immunol 2017 Mar 24;

Nutritional therapy - Facing the gap between coeliac disease and gluten-free food.
Foschia M, Horstmann S, Arendt EK, Zannini E. Int J Food Microbiol 2016 Dec 19;239113-124

Patients taking amoxicillin-clavulanic can become simultaneously sensitized to both drugs.
Salas M, Laguna JJ, Dona I, Barrionuevo E, Fernandez-Santamaria R, Ariza A, Perez-Inestrosa E, Mayorga C, Fernandez TD, Torres MJ. J Allergy Clin Immunol Pract 2017 Mar 22;

Amoxicillin challenge without penicillin skin testing in evaluation of penicillin allergy in a cohort of Marine recruits.
Tucker MH, Lomas CM, Ramchandar N, Waldram JD. J Allergy Clin Immunol Pract 2017 Mar 21;

Evaluation of basophil activation test in the management of immediate hypersensitivity reactions to gadolinium-based contrast agents: a five-year experience.
Kolenda C, Dubost R, Hacard F, Mullet C, Le QD, Garnier L, Bienvenu J, Piriou V, Berard F, Bienvenu F, Viel S. J Allergy Clin Immunol Pract 2017 Mar 21;

Trends in Provider Management of Patients with Food Protein-Induced Enterocolitis Syndrome.
Greenhawt M, Bird JA, Nowak-Wegrzyn AH. J Allergy Clin Immunol Pract 2017 Mar 8;

First case of allergy to nivolumab.
Saenz de Santa Maria Garcia, Noguerado-Mellado B, Rojas-Perez-Ezquerra P, Prieto-Garcia A, Bartolome-Zavala B, Tornero P. J Allergy Clin Immunol Pract 2017 Mar 8;

Nutritional Deficiencies and Food Allergy.
Robbins KA, Uygungil B. J Allergy Clin Immunol Pract 2017 Mar;5(2):528-529

Food protein-induced enterocolitis syndrome to fish and egg usually resolves by age 5 years in Spanish children.
Vazquez-Ortiz M, Machinena A, Dominguez O, Alvaro M, Calvo-Campoverde K, Giner MT, Jimenez-Feijoo R, Lozano J, Piquer M, Dias M, Folque MD, Plaza AM. J Allergy Clin Immunol Pract 2017 Mar;5(2):512-515

Case reports of peanut-fenugreek and cashew-sumac cross-reactivity.
Che CT, Douglas L, Liem J. J Allergy Clin Immunol Pract 2017 Mar;5(2):510-511

Prevalence of sensitization and allergy to potato in a large population.
Chiriac AM, Bourrain JL, Lepicard E, Molinari N, Demoly P. J Allergy Clin Immunol Pract 2017 Mar;5(2):507-509

Food allergy prevalence, knowledge, and behavioral trends among college students - A 6-year comparison.
Karam M, Scherzer R, Ogbogu PU, Green TD, Greenhawt M. J Allergy Clin Immunol Pract 2017 Mar;5(2):504-506

To Eat or Not to Eat? Introduction of food after negative oral food challenge.
Beigelman A. J Allergy Clin Immunol Pract 2017 Mar;5(2):477-478

Food Challenge and Community-Reported Reaction Profiles in Food-Allergic Children Aged 1 and 4 Years: A Population-Based Study.
Chan JC, Peters RL, Koplin JJ, Dharmage SC, Gurrin LC, Wake M, Tang ML, Prescott S, Allen KJ. J Allergy Clin Immunol Pract 2017 Mar;5(2):398-409

Penicillin Allergy testing should be performed routinely in patients with self-reported penicillin allergy.
J Allergy Clin Immunol Pract 2017 Mar;5(2):333-334

Food Allergy: Unmet Needs and New Perspectives.
Wang J, Lack G. J Allergy Clin Immunol Pract 2017 Mar;5(2):295

Should peanut be banned in schools?
Wang J, Fleischer DM. J Allergy Clin Immunol Pract 2017 Mar;5(2):290-294

Food-Dependent, Exercise-Induced Anaphylaxis: Diagnosis and Management in the Outpatient Setting.
Feldweg AM. J Allergy Clin Immunol Pract 2017 Mar;5(2):283-288

Statistical Considerations of Food Allergy Prevention Studies.
Bahnson HT, du Toit G, Lack G. J Allergy Clin Immunol Pract 2017 Mar;5(2):274-282

Making the most of in vitro tests to diagnose food allergy.
Santos AF, Brough HA. J Allergy Clin Immunol Pract 2017 Mar;5(2):237-248

Managing nut allergy: a remaining clinical challenge.
Eigenmann PA, Lack G, Mazon A, Nieto A, Haddad D, Brough HA, Caubet JC. J Allergy Clin Immunol Pract 2017 Mar;5(2):296-300

Allergic reaction from fingerprint kit attributable to unlabeled gluten, probable wheat flour.
Taylor SL, Baumert JL, Boudreau-Romano SM. J Allergy Clin Immunol Pract 2017 Mar;5(2):479-481

Internet and food allergy: What patients are seeking and what they do with the information.
Ross J, Fishman J, Wang J. J Allergy Clin Immunol Pract 2017 Mar;5(2):494-495

Omalizumab anaphylaxis occurring outside the recommended observation times.
Kelso JM. J Allergy Clin Immunol 2017 Mar 3;

alphaS1-casein Elucidate Major T Cell Responses in Cow's Milk Allergy.
Archila LD, Khan FS, Bhatnagar N, Robinson D, Farrington ML, Kwok WW. J Allergy Clin Immunol 2017 Mar 23;

Thunderstorm Related Asthma Attacks.
D'Amato G, Annesi M, Antonio M, Vitale C, D'Amato M. J Allergy Clin Immunol 2017 Mar 22;

Peanut oleosins associated with severe peanut allergy - Importance of lipophilic allergens for comprehensive allergy diagnostics.
Schwager C, Kull S, Behrends J, Rockendorf N, Schocker F, Frey A, Homann A, Becker WM, Jappe U. J Allergy Clin Immunol 2017 Mar 22;

Fatal anaphylaxis in France: analysis of national anaphylaxis data, 1979-2011.
Pouessel G, Claverie C, Labreuche J, Dorkenoo A, Renaudin JM, Eb M, Lejeune S, Deschildre A, Leteurtre S. J Allergy Clin Immunol 2017 Mar 7;

Circulating Gluten-Specific FOXP3+CD39+ Regulatory T Cells Have Impaired Suppressive Function in Celiac Disease.
Cook L, Munier CM, Seddiki N, van BD, Ontiveros N, Hardy MY, Gillies JK, Levings MK, Reid H, Peterson J, Rossjohn J, Anderson RP, Zaunders J, Tye-Din JA, Kelleher AD. J Allergy Clin Immunol 2017 Mar 7;

Diagnosis of red meat allergy with antigen-specific IgE tests in serum.
Brestoff JR, Zaydman MA, Scott MG, Gronowski AM. J Allergy Clin Immunol 2017 Mar 6;

Primary respiratory and food allergy to mealworm.
Broekman H, Knulst AC, den Hartog Jager CF, van Bilsen JH, Raymakers FM, Kruizinga AG, Gaspari M, Gabriele C, Bruijnzeel-Koomen CA, Houben GF, Verhoeckx KC. J Allergy Clin Immunol 2017 Mar 5;

Automated identification of an aspirin-exacerbated respiratory disease cohort.
Cahill KN, Johns CB, Cui J, Wickner P, Bates DW, Laidlaw TM, Beeler PE. J Allergy Clin Immunol 2017 Mar;139(3):819-825

Airborne dust and high temperatures are risk factors for invasive bacterial disease.
Jusot JF, Neill DR, Waters EM, Bangert M, Collins M, Bricio ML, Lawan KG, Moussa MM, Dearing E, Everett DB, Collard JM, Kadioglu A. J Allergy Clin Immunol 2017 Mar;139(3):977-986

Relationships among aeroallergen sensitization, peripheral blood eosinophils, and periostin in pediatric asthma development.
Anderson HM, Lemanske RF, Arron JR, Holweg CT, Rajamanickam V, Gangnon RE, Gern JE, Jackson DJ. J Allergy Clin Immunol 2017 Mar;139(3):790-796

Fragrances and work-related asthma-California surveillance data, 1993-2012.
Weinberg JL, Flattery J, Harrison R. J Asthma 2017 Mar 23;1-10

Allergic Diseases, Smoking and Environmental Exposure Among University Students in Lebanon.
Hallit S, Bou AT, Hallit R, Salameh P. J Asthma 2017 Mar 15;0

Anaphylaxis to polyethylene glycol (Colyte(R)) in a patient with diverticulitis.
Lee SH, Hwang SH, Park JS, Park HS, Shin YS. J Korean Med Sci 2016 Oct;31(10):1662-1663

Cross-reactivity between Oak and Birch Pollens in Korean tree pollinosis.
Jeong KY, Son M, Park JH, Park KH, Park HJ, Lee JH, Hong CS, Park JW. J Korean Med Sci 2016 Aug;31(8):1202-1207

IgE sensitization patterns to commonly consumed foods determined by skin prick test in Korean adults.
Kim SR, Park HJ, Park KH, Lee JH, Park JW. J Korean Med Sci 2016 Aug;31(8):1197-1201

Managing simple food allergy in community settings: A pilot study investigating a new model of care.
Danchin M, De BN, Allen K, Tang M, Hiscock H. J Paediatr Child Health 2016 Mar;52(3):315-320

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