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1. Low dietary adherence after a positive food challenge in food allergic adults

Author

Astrid Versluis, Thuy‐My Le, Francine C. van Erp, Mark A. Blankestijn, Geert F. Houben, André C. Knulst, and Harmieke van Os‐ Medendorp

Subjects
erwachsene, diät einhaltung, ernährungsberatung, nahrungsmittelallergien, provokationstestung, Immunologic diseases. Allergy, RC581-607
Abstract

Abstract Background After a positive food challenge (FC), patients receive dietary advice regarding avoidance of the culprit food. We examined the frequency and variables associated with dietary adherence after a positive FC in adults. Methods In this prospective daily practice study, adults with a positive FC were included. After every FC, dietary advice was given consisting of three options: (1) strict avoidance, (2) avoidance but products with precautionary allergen labelling (PAL) allowed and (3) (small) amounts allowed. Questionnaires about dietary adherence and associated variables were completed prior to and 6 months after the FC(s). Results 41 patients (with 58 positive FCs) were included. Overall, patients adhered to the advised diet after 31% of the FCs. After 33 FCs, the advice was strict avoidance, whereof 82% followed a less strict diet. After 16 FCs, the advice was avoidance but products with PAL allowed, whereof 19% followed a less strict and 25% a stricter diet. In 9 FCs with the least strict advice, “(small) amounts allowed’’, 67% followed a stricter diet. Three variables were associated with adherence: misremembering dietary advice, impaired health‐related quality of life (HRQL) on domain “Emotional impact’’ and the need for dietary change after the FC. Conclusion After one third of the positive FCs, patients adhered to the dietary advice. Variables associated with adherence were misremembering dietary advice, impaired HRQL on domain “Emotional impact’’ and the need for dietary change after the FC. It seems important that healthcare professionals should more frequently apply adherence‐enhancing strategies to improve dietary adherence.

Published
2022
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2. Sesame oleosins are minor allergens

Author

Anna M. Ehlers, Madlen Rossnagel, Bettina Brix, Mark A. Blankestijn, Thuy-My Le, Waltraud Suer, Henny G. Otten, and André C. Knulst

Subjects
Diagnostics, Food allergy, IgE hypersensitivity3 oleosins, Sesame, Immunologic diseases. Allergy, RC581-607
Abstract

Abstract Background In daily practice, one-third of sesame allergic patients, confirmed by clinical history or food challenge, do not show any detectable specific IgE using current diagnostics. Currently used sesame extracts are water-based and therefore lacking hydrophobic proteins like oleosins. Oleosins, the stabilizer of lipid droplets in plants, are described as allergens in sesame, peanut and hazelnut. In this study, we examine the role of oleosins in sesame allergy and their potential cross-reactivity between sesame and (pea)nuts. Methods Specific IgE and IgG sensitisation to native and heterologously expressed sesame components and oleosins from other nuts, free of seed storage proteins, was assessed by line blot and sera from 17 sesame allergic patients without detectable specific IgE sensitisation to sesame, and compared to 18 sesame allergic and 13 tolerant patients with specific IgE sensitisation to sesame. Results Sesame allergic patients without sensitisation showed no specific IgE to the tested sesame oleosins or components. Low levels of specific IgE to sesame oleosins were detected in 17% of sesame allergic and 15% of tolerant patients with sIgE sensitisation. Oleosins were recognised by serum IgG from multiple patients confirming immune reactivity and excluding technical issues leading to lack of specific IgE-binding to oleosins. Conclusion Sesame oleosins are minor allergens and appear to have no additonal value in diagnosing sesame allergy in adults based on sIgE and sIgG detection. There is a high need for additional diagnostic tools in those patients to minimize the number of required food challenges.

Published
2019
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3. Sensitization to PR-10 proteins is indicative of distinctive sensitization patterns in adults with a suspected food allergy

Author

Mark A. Blankestijn, André C. Knulst, Edward F. Knol, Thuy-My Le, Heike Rockmann, Henny G. Otten, and Rob J. B. Klemans

Subjects
ImmunoCAP ISAC, Food allergy, PR-10, Specific IgE, Storage proteins, Immunologic diseases. Allergy, RC581-607
Abstract

Abstract Background The extent of co-sensitization within and between food protein families in an adult population is largely unknown. This study aimed to identify the most frequently recognized components in the PR-10 and storage protein family, as well as patterns in (co-)sensitization, in a birch-endemic area. Methods Results of ImmunoCAP ISAC, performed during routine care in Dutch adult outpatients suspected of food allergy, were collected. Results A total of 305 patients were selected, aged 16–79 years (median 32 years). Sensitization to one or more PR-10 proteins was most frequent (74% of all subjects), followed by 35% to storage protein and 15% to nsLTPs. Within the PR-10 family, subjects were most often sensitized to Bet v 1 (73% of 305), Cor a 1.04 (72%) and Mal d 1 (68%). Sensitization to PR-10s from soy, celery and kiwi occurred distinctively less often ( 70%). Subjects sensitized to these ‘less common PR-10 proteins’ were sensitized to more food and inhalant components on the ISAC, compared to subjects sensitized to ‘common PR-10 proteins’ (median 22 vs 13 out of 112, p

Published
2017
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4. Reintroduction failure after negative food challenges in adults is common and mainly due to atypical symptoms

Author

André C. Knulst, Harmieke van Os-Medendorp, Astrid Versluis, Yolanda Meijer, Francine C. van Erp, Mark A. Blankestijn, and Thuy-My Le

Subjects
0301 basic medicine, Adult, Male, medicine.medical_specialty, Adolescent, Immunology, Aftercare, Anxiety, Culprit, food challenge, 03 medical and health sciences, 0302 clinical medicine, Quality of life, Food allergy, Internal medicine, Surveys and Questionnaires, medicine, Immunology and Allergy, Humans, Clinical significance, Prospective Studies, Prospective cohort study, Clinical Allergy, reintroduction, Aged, Univariate analysis, food allergy, business.industry, Feeding Behavior, Middle Aged, medicine.disease, 030104 developmental biology, 030228 respiratory system, Telephone interview, Food, Quality of Life, Original Article, Female, medicine.symptom, ORIGINAL ARTICLES, business, Food Hypersensitivity
Abstract

BACKGROUND: Reintroduction of a food after negative food challenge (FC) faces many obstacles. There are no studies available about this subject in adults. OBJECTIVE: To investigate the frequency, reasons and risk factors of reintroduction failure in adults. METHODS: In this prospective study, adult patients received standardized follow-up care after negative FCs including a reintroduction scheme and supportive telephone consultations. Data were collected by telephone interview (2 weeks after FC) and questionnaires (at baseline and 6 months after FC(s)): food habits questionnaire, State-Trait Anxiety Inventory, Food Allergy Quality of Life Questionnaire-Adult Form and Food Allergy Independent Measure. Frequency and reasons of reintroduction failure were analysed using descriptive statistics and risk factors with univariate analyses. RESULTS: Eighty patients were included with, in total, 113 negative FCs. Reintroduction failed on short-term (2 weeks after FC) in 20% (95% CI: 13%-28%). Common reasons were symptoms upon ingestion during the reintroduction scheme (50%) and no need to eat the food (23%). On the long-term (5-12 months after FC(s)), reintroduction failure increased to 40% (95% CI: 28%-53%). Common reasons were atypical symptoms after eating the food (59%) and fear for an allergic reaction (24%). Five risk factors for long-term reintroduction failure were found: if culprit food was not one of the 13 EU regulated allergens, reintroduction failure at short-term, atypical symptoms during FC, a lower quality of life and a higher state anxiety. CONCLUSIONS AND CLINICAL RELEVANCE: Reintroduction failure after negative FCs in adults is common, increases over time, and is primarily due to atypical symptoms. This stresses the need for more patient-tailored care before and after negative food challenges.

Published
2020

5. Can alternative epitope mapping approaches increase the impact of B‐cell epitopes in food allergy diagnostics?

Author

Mark A. Blankestijn, Anna M. Ehlers, André C. Knulst, Marco Klinge, and Henny G. Otten

Subjects
0301 basic medicine, B‐cell epitopes, Allergy, medicine.drug_class, Immunology, Reviews, Review, Immunoglobulin E, Monoclonal antibody, Epitope, 03 medical and health sciences, 0302 clinical medicine, Food allergy, medicine, Animals, Humans, Immunology and Allergy, B-Lymphocytes, food allergy, biology, business.industry, Allergens, medicine.disease, epitope mapping, 030104 developmental biology, Epitope mapping, 030228 respiratory system, Polyclonal antibodies, B-cell epitopes, biology.protein, Epitopes, B-Lymphocyte, monoclonal antibodies, Antibody, business, Food Hypersensitivity
Abstract

Summary In vitro allergy diagnostics are currently based on the detection of specific IgE binding on intact allergens or a mixture thereof. This approach has drawbacks as it may yield false‐negative and/or false‐positive results. Thus, we reviewed the impact of known B‐cell epitopes of food allergens to predict transience or persistence, tolerance or allergy and the severity of an allergic reaction and to examine new epitope mapping strategies meant to improve serum‐based allergy diagnostics. Recent epitope mapping approaches have been worthwhile in epitope identification and may increase the specificity of allergy diagnostics by using epitopes predominately recognized by allergic patients in some cases. However, these approaches did not lead to discrimination between clinically relevant and irrelevant epitopes so far, since the polyclonal serum IgE‐binding epitope spectrum seems to be too individual, independent of the disease status of the patients. New epitope mapping strategies are necessary to overcome these obstacles. The use of patient‐derived monoclonal antibodies instead of patient sera for functional characterization of clinically relevant and irrelevant epitope combinations, distinguished by their ability to induce degranulation, might be a promising approach to gain more insight into the allergic reaction and to improve serum‐based allergy diagnostics.

Published
2018

6. Specific IgE to peanut 2S albumin Ara h 7 has a discriminative ability comparable to Ara h 2 and 6

Author

Edward F. Knol, Alf Weimann, Henny G. Otten, Waltraud Suer, André C. Knulst, and Mark A. Blankestijn

Subjects
Male, 0301 basic medicine, Peanut allergy, Immunoglobulin E, Epitope, law.invention, Epitopes, 0302 clinical medicine, law, Immunology and Allergy, heterocyclic compounds, Sensitization, chemistry.chemical_classification, biology, Chemistry, peanut allergy, food and beverages, Middle Aged, Blot, medicine.anatomical_structure, storage proteins, Recombinant DNA, Female, lipids (amino acids, peptides, and proteins), 2S Albumins, Plant, Adult, Adolescent, Immunology, Cross Reactions, Ara h 7, 03 medical and health sciences, 2S albumin, Ara h 6, Food allergy, Ara h 2, Journal Article, medicine, Humans, Storage protein, Peanut Hypersensitivity, Aged, food allergy, Antigens, Plant, biochemical phenomena, metabolism, and nutrition, medicine.disease, Molecular biology, carbohydrates (lipids), 030104 developmental biology, 030228 respiratory system, biology.protein
Abstract

Background Little is known on the clinical relevance of peanut 2S albumin Ara h 7. Objective To investigate the discriminative ability of Ara h 7 in peanut allergy and assess the role of cross-reactivity between Ara h 2, 6 and Ara h 7 isoforms. Methods Sensitization to recombinant peanut storage proteins Ara h 1, 2, 3, 6 and 7 was assessed using a line blot in sera from 40 peanut tolerant and 40 peanut allergic patients, based on food challenge outcome. A dose-dependent ELISA inhibition experiment was performed with recombinant Ara h 2, 6 and Ara h 7 isoforms. Results For Ara h 7.0201 an area under the ROC curve was found of 0.83, comparable to Ara h 2 (AUC 0.81) and Ara h 6 (AUC 0.85). Ara h 7 intensity values strongly correlated with those from Ara h 2 and 6 (rs=0.81). Of all patients sensitized to 2S albumins Ara h 2, 6 or 7, the majority was co-sensitized to all three (n=24, 68%), although mono-sensitization to either 2S albumin was also observed in selected patients (Ara h 2: n=6, 17%; Ara h 6: n=2, 6%; Ara h 7: n=2, 6%). Binding to Ara h 7.0101 could be strongly inhibited by Ara h 7.0201, but not the other way around. Conclusions & Clinical Relevance Specific IgE against Ara h 7.0201 has a predictive ability for peanut allergy similar to Ara h 2 and 6, and possesses unique IgE epitopes as well as epitopes shared between the other Ara h 7 isoform and Ara h 2 and 6. While co-sensitization to all three 2S albumins is most common, mono-sensitization to either Ara h 2, 6 or 7 occurs in selected patients, leading to a risk of misdiagnosis when testing for a single 2S albumin. This article is protected by copyright. All rights reserved.

Published
2017

7. Threshold Dose Distribution in Walnut Allergy

Author

W. Marty Blom, Rob J.B. Klemans, Steve L. Taylor, André C. Knulst, Joseph L. Baumert, Mark A. Blankestijn, Geert F. Houben, and Benjamin C. Remington

Subjects
Adult, Male, Risk, Allergy, medicine.medical_specialty, Walnut, No-observed-adverse-effect level, Food industry, Population, Administration, Oral, Juglans, Toxicology, 03 medical and health sciences, 0404 agricultural biotechnology, 0302 clinical medicine, Food Labeling, Food allergy, Journal Article, medicine, Humans, Immunology and Allergy, Prospective Studies, Adverse effect, education, education.field_of_study, business.industry, 04 agricultural and veterinary sciences, Allergens, Eliciting doses, medicine.disease, 040401 food science, Surgery, Allergen thresholds, Lowest-observed-adverse-effect level, Threshold dose, 030228 respiratory system, Threshold dose distributions, Female, Immunization, Nut Hypersensitivity, business
Abstract

Background In food allergy, eliciting doses (EDs) of foods on a population level can improve risk management and labeling strategies for the food industry and regulatory authorities. Previously, data available for walnut were unsuitable to determine EDs. Objective The objective of this study was to determine EDs for walnut allergic adults and to compare with previously established threshold data for peanut and tree nuts. Methods Prospectively, adult subjects with a suspected walnut allergy underwent a low-dose double-blind, placebo-controlled food challenge. Individual no observed and lowest observed adverse effect levels were determined and log-normal, log-logistic, and Weibull models were fit to the data. Estimated ED values were calculated for the ED5, ED10, and ED50, the dose respectively predicted to provoke an allergic reaction in 5%, 10%, and 50% of the walnut allergic population. Results Fifty-seven subjects were challenged and 33 subjects were confirmed to be walnut allergic. Objective symptoms occurred in 20 of the positive challenges (61%). The cumulative EDs in the distribution models ranged from 3.1 to 4.1 mg for the ED05, from 10.6 to 14.6 mg walnut protein for the ED10, and from 590 to 625 mg of walnut protein for the ED50. Conclusions Our data indicate that population EDs for walnut are slightly higher compared with those for peanut and hazelnut allergy. Currently available data indicate that the ED values for hazelnut could be used as a conservative temporary placeholder when implementing risk management strategies for other tree nuts where little or no food challenge data are available.

Published
2017

8. Efficacy of Treatment of Non-hereditary Angioedema

Author

Henderikus G. Otten, Mignon T. van den Elzen, André C. Knulst, M. F. C. L. Go, H. van Os-Medendorp, and Mark A. Blankestijn

Subjects
medicine.medical_specialty, Angiotensin-Converting Enzyme Inhibitors, Omalizumab, Pharmacology, Bradykinin, Article, 03 medical and health sciences, Ecallantide, chemistry.chemical_compound, 0302 clinical medicine, Refractory, Icatibant, medicine, Humans, Immunology and Allergy, 030212 general & internal medicine, Angioedema, business.industry, Wheals, General Medicine, Idiopathic, medicine.disease, Dermatology, Treatment, Treatment Outcome, Tranexamic Acid, 030228 respiratory system, chemistry, Angiotensin-converting enzyme inhibitor, Hereditary angioedema, Fresh frozen plasma, Progestins, medicine.symptom, business, Tranexamic acid, medicine.drug
Abstract

Non-hereditary angioedema (AE) with normal C1 esterase inhibitor (C1INH) can be presumably bradykinin- or mast cell-mediated, or of unknown cause. In this systematic review, we searched PubMed, EMBASE, and Scopus to provide an overview of the efficacy of different treatment options for the abovementioned subtypes of refractory non-hereditary AE with or without wheals and with normal C1INH. After study selection and risk of bias assessment, 61 articles were included for data extraction and analysis. Therapies were described for angiotensin-converting enzyme inhibitor-induced AE (ACEi-AE), for idiopathic AE, and for AE with wheals. Described treatments consisted of ecallantide, icatibant, C1INH, fresh frozen plasma (FFP), tranexamic acid (TA), and omalizumab. Additionally, individual studies for anti-vitamin K, progestin, and methotrexate were found. Safety information was available in 26 articles. Most therapies were used off-label and in few patients. There is a need for additional studies with a high level of evidence. In conclusion, in acute attacks of ACEi-AE and idiopathic AE, treatment with icatibant, C1INH, TA, and FFP often leads to symptom relief within 2 h, with limited side effects. For prophylactic treatment of idiopathic AE and AE with wheals, omalizumab, TA, and C1INH were effective and safe in the majority of patients.

Published
2018

9. A subset of walnut allergic adults is sensitized to walnut 11S globulin Jug r 4

Author

Kitty C.M. Verhoeckx, André C. Knulst, Marco Gaspari, W.M. Blom, Henderikus G. Otten, C. F. den Hartog Jager, Mark A. Blankestijn, G. A.H. de Jong, and Geert F. Houben

Subjects
0301 basic medicine, Male, Allergy, medicine.disease_cause, Immunoglobulin E, Mass Spectrometry, 11s globulin, 0302 clinical medicine, Allergen, immunoblot, Immunology and Allergy, Walnut allergy, Sensitization, Plant Proteins, Immunoassay, education.field_of_study, biology, Predictive value, medicine.anatomical_structure, Female, Nut Hypersensitivity, walnut allergy, Juglans, Adult, Population, Immunology, double blind placebo controlled food challenge, Cross Reactions, Immunoblot, Sensitivity and Specificity, 03 medical and health sciences, Young Adult, medicine, Double blind placebo controlled food challenge, Humans, Jug r 4, education, Skin Tests, Nutrition, business.industry, Plant Extracts, Antigens, Plant, medicine.disease, biology.organism_classification, 030104 developmental biology, 030228 respiratory system, biology.protein, business, Chromatography, Liquid
Abstract

Background: The role of sensitization to commercially available allergens of English walnut (Juglans regia) Jug r 1, 2 and 3 in walnut allergy has been previously investigated in walnut allergic adults and was unable to explain all cases of walnut allergy. Objectives: Identify recognized walnut allergens, other than the ones previously investigated (Jug r 1-3), in walnut allergic adults and determine the sensitization frequency and diagnostic value. Methods: Three different in-house walnut extracts were prepared and analysed on SDS-PAGE blots to identify allergenic walnut proteins. Immunoblots and immunoprecipitation, followed by LC-MS analysis, were performed to screen for, and confirm, IgE binding to walnut allergens in selected walnut allergic adults. In a cohort of 55 walnut challenged adults, including 33 allergic and 22 tolerant, sensitization to native and recombinant walnut allergen Jug r 4 was assessed using immunoblotting and immuno-line blot (EUROLINE), respectively. Results: Screening of sera of 8 walnut allergic adults identified Jug r 4 as an allergen in our population. In the total cohort of 55 subjects, 5 were positive for Jug r 4 on immunoblot and 10 on EUROLINE. All but one EUROLINE positive subject had a positive food challenge (sensitivity 27%, specificity 95%, PPV 90%, NPV 47%). All 5 subjects positive on immunoblot were also positive on EUROLINE. LC-MS analysis showed a lack of Jug r 4 in the ImmunoCAP extract. Co-sensitization to other 11S albumins (eg hazelnut Cor a 9) was common in Jug r 4 sensitized subjects, potentially due to cross-reactivity. Conclusions: Walnut 11S globulin Jug r 4 is a relevant minor allergen, recognized by 27% of walnut allergic adults. It has a high positive predictive value of 90% for walnut allergy. Specific IgE against Jug r 4 occurred mostly with concomitant sensitization to other walnut components, mainly Jug r 1. © 2018 The Authors. Clinical & Experimental Allergy Published by John Wiley & Sons Ltd

Published
2018

10. Sensitization to PR-10 proteins is indicative of distinctive sensitization patterns in adults with a suspected food allergy

Author

André C. Knulst, Mark A. Blankestijn, Henny G. Otten, Thuy My Le, Rob J.B. Klemans, Edward F. Knol, and Heike Röckmann

Subjects
0301 basic medicine, Pulmonary and Respiratory Medicine, Intoxicative inhalant, Allergy, Immunology, Adult population, Storage proteins, 03 medical and health sciences, 0302 clinical medicine, Food allergy, medicine, Storage protein, Immunology and Allergy, PR-10, Sensitization, chemistry.chemical_classification, Food protein, business.industry, Research, RC581-607, medicine.disease, 030104 developmental biology, medicine.anatomical_structure, Specific IgE, 030228 respiratory system, chemistry, Concomitant, Immunologic diseases. Allergy, ImmunoCAP ISAC, business
Abstract

Background The extent of co-sensitization within and between food protein families in an adult population is largely unknown. This study aimed to identify the most frequently recognized components in the PR-10 and storage protein family, as well as patterns in (co-)sensitization, in a birch-endemic area. Methods Results of ImmunoCAP ISAC, performed during routine care in Dutch adult outpatients suspected of food allergy, were collected. Results A total of 305 patients were selected, aged 16–79 years (median 32 years). Sensitization to one or more PR-10 proteins was most frequent (74% of all subjects), followed by 35% to storage protein and 15% to nsLTPs. Within the PR-10 family, subjects were most often sensitized to Bet v 1 (73% of 305), Cor a 1.04 (72%) and Mal d 1 (68%). Sensitization to PR-10s from soy, celery and kiwi occurred distinctively less often ( 70%). Subjects sensitized to these ‘less common PR-10 proteins’ were sensitized to more food and inhalant components on the ISAC, compared to subjects sensitized to ‘common PR-10 proteins’ (median 22 vs 13 out of 112, p

Published
2017

11. Could daratumumab be used to treat severe allergy?

Author

Henny G. Otten, André C. Knulst, Niels W.C.J. van de Donk, Mark A. Blankestijn, Kate Sasser, Hematology, and AII - Inflammatory diseases

Subjects
0301 basic medicine, Allergy, Immunology, Plasma Cells, Omalizumab, 030204 cardiovascular system & hematology, Immunoglobulin E, 03 medical and health sciences, 0302 clinical medicine, Severe allergy, medicine, Hypersensitivity, Immunology and Allergy, Animals, Humans, Antigens, Dermatophagoides, Drug Approval, Multiple myeloma, Betula, Netherlands, biology, business.industry, Pyroglyphidae, Daratumumab, Antibodies, Monoclonal, medicine.disease, ADP-ribosyl Cyclase 1, 030104 developmental biology, B cell depletion, biology.protein, Pollen, Immunotherapy, business, Multiple Myeloma, medicine.drug
Abstract

In the management of allergic diseases, targeting IgE using biologicals is a current research focus. This proof of concept shows that plasma cell depletion using daratumumab results in decreased total and allergen-specific IgE levels.

Published
2017

12. Abstracts from the Food Allergy and Anaphylaxis Meeting 2016

Author

Georgios Rentzos, Esben Eller, Annick Mercenier, Magna Correia, Pedro Moreira, Linda Verrill, Mário Morais-Almeida, Frauke Schocker, Carsten Bindslev-Jensen, Ulrike Lehnigk, Andreas Frey, Lars Verschuren, Anna-Lena Bramstång Björk, Lene Heise Garvey, Elena Molina, Katrine L. Bøgh, J. L. van der Velde, Montserrat Alvaro, Phil Padfield, Niamh Brosnan, Nelly Gourdon-Dubois, Christian Harwanegg, Manuel Branco Ferreira, Songül Yürek, Amyra Ali Azamar Jácome, Rashid Amin, José Ramón Fernández Lorenzo, Kirsten Beyer, Florin-Adrian Secureanu, Charlotte Bernhard Madsen, Julie Galand, Claudia Pföhler, Rabea Reinert, Heinz Fehrenbach, Anton Hartmann, Maria Salas, Arne Homann, Rand Arnaout, Sarah Lindsley, Nerea Sarmiento Carrera, Patrícia Padrão, Berber Vlieg-Boerstra, Alkerta Ibranji, Benoît Sterling, Maria Auxiliadora Guerrero, Maria L. Baeza, Maurizio Tamburrini, Eva Untersmayr, Tanja Cirkovic Velickovic, Farrukh Sheikh, Sarah Kuntz, Sara Martínez, Kriti Gupta, Maria de Lurdes Torre, Yvonne Vergouwe, Ross Yarham, Faisal R. Bakhsh, Marta Vazquez-Ortiz, João Marcelino, Tullio Frediani, Ricardo Prata, Anna Kaarina Kukkonen, Gustavo Soldateli, Ines Mrakovčić-Šutić, Elodie Drumez, Cristina Ornelas, Maria Vazquez de La Torre, Renata Barros, Agata Szymkiewicz, Aneta Tomaszewska, Stefanie Rohwer, Charlotte Eisenmann, Adriana Muntean, Matteo Moretti, Johanna P. M. van der Valk, Birgit Quinting, Stefan Kabasser, David Gillick, Michał Przybyszewski, Grzegorz Sergiejko, Antonio Jorge Cabral, Alba Pablos-Tanarro, Robert Elfont, Marit Reitsma, Roxana Silvia Bumbăcea, Nelson Rosario, Maria Livia Bernardi, Cristiane N. Santos, Christian Radauer, Sandra Denery-Papini, Geert F. Houben, Nicolette W. de Jong, Marta Anda, Alexander Rohrbach, Teodorikez Wilfox Jimenez-Rodriguez, María Teresa Villalba, Karine Patient, Harmieke van Os-Medendorp, Kathrin Scherer, Marta Goñi Esarte, Svetlan Dermendzhiev, Jossie Garthoff, Michelle M. Epstein, Catherine Bertholet, Bruna Pultrini Aquilante, Didier G. Ebo, Roberta Aina, Jorge Kalil, Petri Kulmala, Lars K. Poulsen, Barbara Ballmer, H. Mary-Lene de Zeeuw-Brouwer, Karin Hoffman-Sommergruber, Winfried Leeman, Anne Miles, Nehad Gomaa, Maria Teresa Costantino, Evelyne Mangodt, Maria Konstantakopoulou, Rosa Jimenez, Attilio Francesco Speciani, Helga Magnusdottir, Inmaculada Sánchez-Machín, H. Kaddouri, Raquel Perez, Astrid Versluis, Anthony E. J. Dubois, Anja Koren Jeverica, Zdenka Barićev-Novaković, Joost Westerhout, A.M. Plaza, Júlio Oliveira, Pierre Lukas, Oksana Matsyura, Giuseppe Pingitore, Mira Silar, Huub F. J. Savelkoul, Urszula Samolinska-Zawisza, Chantal Brossard, Ana Reis Ferreira, Reiko Teshima, Serena Perna, Mariola Dietrich, Dirk Verhoeven, Fiona Kenna, Paloma Poza-Guedes, Cristobalina Mayorga, Pilar Hernandez, Roberto Bernardini, Roberto Berni Canani, Maria Francesca Patria, Mariana Vieru, Julie Locklear, Esther van Twuijver, Marina A. Kiseleva, H. Kim A. Brand, Gabriele Schulz, Ileana-Maria Ghiordanescu, Nikolaos G. Papadopoulos, Danijela Apostolovic, Maria del Mar Folqué, Eva Lasa, Mohammad Al Bahkali, Arianna Dondi, Sofia Kostoudi, Simon Rosenberg, Véronique Nève, Rumyana Yankova, Barbara Ballmer-Weber, Maria Jose Goikoetxea, María José Barasona Villarejo, Teija Dunder, Tina Vesel, Elisa Gritti, Marianne van Hage, Laure Castan, Etienne Beaudouin, Margherita Di Costanzo, Natalia Ukleja-Sokołowska, Matthew Sperrin, Paul Turner, Saskia Albroscheit, Rebeca Lopez, Sonja Posega Devetak, Francisca Palomares, Laetitia Sellam, Jennifer Hammond, Astrid G. Kruizinga, Konrad Furmanczyk, Patricia Macchiaverni, Olga Pakholchuk, I V Vorozhko, Ania Carsin, Aleksandar Bulog, Joris Mens, Bianca Balbino, James P. Hindley, Jaap H. Akkerdaas, Jonathan Hourihane, Hilde Cnossen, Tatyana A Popova, Rupert Schlags, Natalia Nenasheva, A. Ehrenberg, Sigurveig T. Sigurdardottir, Anna Iliopoulou, Clara Ippolito, Piotr Samel-Kowalik, Paloma Campo, Gador Bogas, Constantinos Pitsios, Sarah Grosche, Karla Leversia Borjas Aguilar, Amena Warner, Birgit Kalb, Lénaïck Dupuis, Harry J. Wichers, Diana Silva, Gabriele Piuri, Linus Grabenhenrich, Emanuel Sarinho, M. Eleonore Pettersson, Rodrigo Barderas, Gary Stiefel, E. N. Clare Mills, Lali Saginadze, Ruta Dubakiene, Francesca Cipriani, Mindy Tsai, Marina Themisb, Michela Ciancamerla, Rebecca Knibb, Ruperto González-Pérez, Marina Peredelskaya, André C. Knulst, Irene Berends, S N Denisova, Montserrat Fernandez-Rivas, Paolo Maria Matricardi, Daniel Sampaio, Giorgio Bedogni, Sira Miquel, Koen Smit, Stefania Arasi, Sylvia Osscini, Justine Courtois, Cristina Deaconu, Srdan Banac, Kirsten Hansen, Jennette Higgs, Charlotte Hands Plovdiv, Carlotta Povesi Dascola, Noe Ontiveros, Rik Schrijvers, Carla Mastrorilli, Maria Passioti, Sebastian Tschirner, Bjorn R. Ludviksson, Joana Caiado, Daniel Corbacho, Sophie Nutten, Agustin Madroñero, Marina Suárez Vergara, Boudewjin J. Kollen, Catherine J Nock, Johanna Rost, Agnieszka Lipiec, Skadi Kull, Geert Houben, Carlo Caffarelli, Jordi Roca-Ferrer, Bolesław Samoliński, Isabelle Cleach, Colette Larré, Aideen Byrne, Corinne Herouet-Guicheney, Jonas Lidholm, Vera Assmann, W. Marty Blom, Adriano Mari, Adam T. Fox, Giuseppe Crisafulli, Afke M. M. Schins, Anastasia Papadopoulou, Flávio Sano, Richard Cooke, Franziska Ruëff, L Jorjoliani, Rebekah Sayers, Anne-Marie Kochuyt, Borja Bartalomé, Anne Moneret-Vautrin, Juan Carlos Julia, Jelena Mihailovic, Katarzyna Pyrz, Kollen Boudewijn, Margherita Varini, Paolo Giordani, Claudia Alessandri, Johanna van der Valk, Antoine Deschildre, Mariam Tskhakaia, Rosina López-Fandiño, Omar Kheroua, Nicolette J. T. Arends, Alina Zbróg, Chung-Hsiung Huang, Andrea Wangorsch, Ulf Bengtsson, Jim Langridge, Dasha Roa-Medellín, Jose Ignacio Larco, Bert Popping, Ana Prieto del Prado, José Antonio Bácter Martos, Rita Nocerino, Sophia Watts, Elisa Haroun, Danilo Villalta, Lee A. Gethings, María Ángeles Algaba Mármol, Ewa Gawrońska-Ukleja, Cornelia Jansen, André Moreira, V A Revyakina, Robert Zacniewski, Xavier Domingo Miró, Francesco Macrì, Mayra de Barros Dorna, Akanksha Sharma, Stephen J. Till, Ali Almontasheri, Chrystyna Kalicinsky, Robbert Sutorius, Akila Rekima, Mark A. Blankestijn, Nicolette Arends, Chiara Pistoletti, Merima Bublin, Manuel Pereira-Barbosa, Reyna Simon, Martin Karjalainen, Sam Mehr, Tushar Banerjee, Carmen Riggioni, Bertrand Evrard, Antonio Carlos Pastorino, Lidia Ilènko, Nikolaos Douladiris, Miguel Vieira, Erik Wambre, Francisco Cabrera-Chavez, Nikos G. Papadopoulos, Piotr Humeniuk, Gert van Duijn, Francesco Zinno, Young-Ae Lee, Lisa Tuppo, Hans de Groot, Léon M.J. Knippels, Pawel Dubiela, Henrik Fomsgaard Kjaer, Andrea Vereda, Djamel Saidi, Kok Loong Ue, Henk Van Loveren, Maria Jose Rodriguez, Marta Lomikovska, Elodie Michaud, Josefina Cernadas, Carmen Ponce, Marysia Recto, Frances Smith, Hassan Al-Dhekri, Shinobu Sakai, Thomas Eiwegger, Ana Rodolfo, Diego Peroni, Nikki Edelbroek, Waltraud Suer, Jenny van Odijk, Irena Nedelea, Borja Bartolomé, Lauren Lissner, Marjeta Sedmak, Annette Jamin, Italo De Vitis, Bo Pontoppidan, Annabelle Capt, Diego G. Peroni, Susana Rodrigues, Juan Carlos López-Rodríguez, David Endesfelder, Lesya Besh, Danila Zennaro, Charlotte G. Mortz, Kati Palosuo, María José Torres, Esozia Arroabarren, Lynne Regent, Laura Valdesoiro Navarrete, Ana Molina, Agha Rehan Khaliq, Phil Couch, Ana Miranda, Thomas Marichal, Riccardo Asero, Denise Borges, Dikla Pivko Levy, Miriam Palacios, Mireille Eb, Stephen J. Galli, Karin Hoffmann-Sommergruber, Anna Gudrun Vidarsdottir, Ifigenia Sfika, André Wolterbeek, Mauro Calvani, Edward F. Knol, Joyce A. M. Emons, Anne-Marie Oomkes-Pilon, Montserrat Bosque García, Daniel Lozano-Ojalvo, Filip Raciborski, Deirdre Galloway, Nanna Juel-Berg, Margareta Brandt Gertmo, Cornelia Bergmayr, Rob Klemans, Juliane Gregersen, Yolanda Meijer, Bettina Brix, Susanne Lau, Karine Adel-Patient, Hanneke van der Kleij, Mareike Price, Jean-Louis Mege, Lizalet Oosthuizen, Agurtzane Bilbao, Indre Butiene, Antonino Romano, Colin Barber, Rosana Camara Agondi, Nour Baïz, Soraya Ainad Tabet, Peter Korošec, Laurian Jongejan, Francine C. van Erp, José Pedro Moreira Silva, Nandinee Patel, Jaime Lozano, Prescilla V. Jeurink, Artur Walkiewicz, Bryan M. Harvey, Tiina J. Kauppila, Aida Semic-Jusufagic, Marianna Murdjeva, Miren Arteaga, Y. Bouferkas, Geunwoong Noh, Henny G. Otten, Sabine Dölle, Christopher Munro, O Dominguez, Gerard H. Koppelman, Leonieke N. van Veen, Vasti Iancu, Georg Mitterer, Patrizia Polverino de Laureto, Juliane Schulz, Ewa Ternesten Hasseus, Caroline Zimmermann, Ivona Barcievic-Jones, Shira Benor, Susanne Schwarz, Eun Ha Jang, Josefina Rodrigues Cernadas, Tadej Avcin, Joseph L. Baumert, Pernille Winther, Stéphane Leteurtre, Gabriela Canto, Louise J Michaelis, Jorge Alvarez, Gabriel Gastaminza, Michela Carola Speciani, Rute Gonçalves, Leire Dopazo, Evgen Benedik, Susanne C. Diesner, Luc S. De Clerck, A. Wesley Burks, Maurits S. van Maaren, Salvatore Tripodi, Philippe Aubert, Kamel Eddine El Mecherfi, Aline B. Sprikkelman, Ana Prieto, Margitta Worm, Edyta Krzych, Maja Krstic, Iride Dello Iacono, Melanie Cap, Alf Weimann, Maria Nassiri, Niels Röckendorf, Vladyslava Barzylovych, Marcia C. Mallozi, Pierre Bruhns, Jeanette Fisker Trandbohus, Ekaterini Papadopoulou, Vicente Albendiz, Timothy Watts, Uta Jappe, Javier Moreno, Maria Carmen Verga, Beatriz Secades Barbado, Carmen Di Scala, Roy Gerth van Wijk, Vladimir Mićović, Esther Barrionuevo, Giampaolo Ricci, Luisa Galindo, Ana Paula Beltran Moschione Castro, Oona Mustonen, Jia Yin, Lucia Caminiti, Jorge Esparza-Gordillo, N Adamia, Anna-Maija Hanni, Romy Gadisseur, Stefano Luccioli, Regina Treudler, Rosetta Ferrara, M. Guendouz, Jaakko Yrjänä, Philipp Starkl, Premendra D. Dwivedi, Javier Cuesta-Herranz, Johan Garssen, Ekaterini Goudouris, Sridevi Muralidharan, Kate Grimshaw, Carolina Sanchez Aranda, Ioana Maris, Manzoor Ahmed, Hajime Karasuyama, Stephanie Claus, Chantal Agabriel, Karen English, Dorien Van Ginkle, Eleonora Savi, Loredana Chini, Ine I. Decuyper, Sabine Schnadt, Valérie Trendelenburg, Jean-Luc Fauquert, Maurizio Mennini, Nikolaos Mikos, Ana Célia Costa, Steve L. Taylor, A. A. Schoemaker, Sara Abián, Margo M. Hagendorens, Andrea Di Rienzo Businco, Melina Makatsori, Eugénia Matos, Lucy Walker, Nikolaos A. Kitsioulis, David Alejandro Mendoza Hernández, Maria Starkhammar, Djordje Filipovic, Aine Adams, Mukul Das, Sonsoles Intente-Herrero, Natalia Blanca López, Marek L. Kowalski, Diana Deleanu, Bernard P. Mahon, Jean-Michel Wal, Lucia Decastelli, Mihaela Popescu, Aimee Lou Nano, Eva Batanero, Tong-Rong Jan, Yolanda Puente, Jacek Borowicz, Aimée Dorkenoo, J. Östling, Mashary Altamimi, Michel Neunlist, Zerrin Yalvaç, Sonia Ricò, Wentong Xue, Linda Cosenza, David C. A. Candy, Robert D. Voyksner, Montserrat De Prada, Abdulhadi Al-Qahtani, Sébastien Holvoet, Wolf-Meinhard Becker, Meropi D. Kontogianni, Bruno Pereira, F. Pineau, Eva Corbet, Kirsten Mehlig, Rosella De Poi, Jolanda H. M. van Bilsen, José Luís Plácido, Hans-Jørgen Malling, Chia-Chi Wang, Philip Couch, Kerrie Kirk, Agata Michalska, Sylke Rietz, Mariya Ivanovska, Victor Matheu-Delgado, Carl Hamsten, Francisca Gómez, Neusa Falbo Wandalsen, Mika J. Mäkelä, Tatyana Sentsova, Kristian Bravin, Philippe Delahaut, Hervé Bernard, Leonor Carneiro-Leão, Michele Miraglia del Giudice, Elena D. Kuvshinova, Jochen Behrends, Caroline Klingebiel, Meta Accetto, Claire Mills, Mariona Pascal, Miguel García Domínguez, Huan Rao, Carmen Saviana Ganea, Umberto Pelosi, Stefano Pattini, Bodo Niggemann, Annamaria Bianchi, Laura Martín-Pedraza, Anna Selby, Cristina Bueno, Stefan Vieths, Luis Felipe Ensina, Florin-Dan Popescu, Antonio Fernandez, Soren Wille, Erna Van Hoeyveld, Carina Kelleher, Athina L. Van Gasse, Anders Blom Jensen, Zorica Zivkovic, Moshe Ben-Shoshan, Sara Pereiro Fernández, Ronald van Ree, Antima Banerjee, Pablo Merida, Mandy Ziegert, Barbara Wróblewska, Morten Christensen, Gador Gomez, Pablo San Segundo-Acosta, Khaled Messaoudi, Anne-Sofie Ravn Ballegaard, Mikael Kuitunen, David Luyt, Vito Sabato, Nesrine Zaabat, Svitlana Zubchenko, Julien Labreuche, Elin Lustig, Katharina Blumchen, Guillaume Pouessel, Ana Fiandor, Stéphanie Lejeune, Paola Dignetti, Helen Brown, Anastasia Cirisano, Evangelia Kompoti, Anna Sokolova, Mercedes Escarrer Jaume, Shan Deng, Dirceu Solé, Chiara Fiamingo, Alessandro Travaglini, Nicolas Gaudenzio, Zbigniew Bartuzi, Antonia Rojas, Roberta Olcese, Nanju Alice Lee, Sandra Brandhoff, Lucien F. Harthoorn, Anna Maria Szyc, Andrea Costanzi, Sabine Pfeifer, Emiliano De Dominicis, Chiara Rafaiani, Yin-Hua Cheng, Elida Nikolla, Ignacio García Núñez, Diego Faggian, Lieve Coorevits, Ayelet Rimon, Erika Jensen-Jarolim, Jacqueline J.M. Castenmiller, Kristin Verbeke, Sean Bennett, Paraskevi Xepapadaki, Glauce Hiromi Yonamine, Anna Wawrzeńczyk, Rusudan Karseladze, Emmanouil Manousakis, Fiona Ward, Ivana Filipovic, Marie Bodinier, Viviana Moschese, Pedro Giavina Bianchi, Alice Coimbra, Alena Berger, Anton A. Shekhetov, Monica Maćków, Philippe Egenmann, Oscar Asensio, Lidia Hanna Markiewicz, Chun-Wei Tung, Zsolt Szépfalusi, Jan Knol, Frits Koning, Carolina S. Aranda, Annick Bastiaensen, Giovanni Battista Pajno, Leticia Pérez-Rodríguez, Ewout W. Steyerberg, Riccardo Sibilano, Valérie Verhasselt, Roberta Lupi, Lukasz Sokolowski, Adam Wawrzeńczyk, Dimitris I. Mitsias, Andreia Forno, Antoine Magnan, Christian Schwager, Ioanna Manolaraki, Alessandro Fiocchi, Tanja Rouhani Rankouhi, Carla Jones, Ana Pereira, Hannah M. Kansen, Michael Clausen, D. Bignardi, Assad M. Butt, Julie C. Locklear, Katrine Lindholm Bøgh, Valery Muhortnich, María Teresa Giner, Juan Miguel Garcia, Maria Luisa Somoza, Raditsa Sokolova, Maria Pasioti, Mirjana Zupancic, Joana Vitte, Duncan Brown, Arnaldo Porto, M. Turfkruyer, Lau Fabricius Larsen, Filipe Benito-Garcia, Mayra Coutinho Andrade, Meltem Ugras, Ingrid Sutic, Rand K. Arnaout, Etienne Cavalier, Marta Neto, Grégory Bouchaud, Elena Varin, Bushra Javed, Carla Camerotto, Monica Bronkowska, Cristiano Caruso, Luís Amaral, Jackeline F. Motta, Sahar Elshorbagi, Cornelis K. van der Ent, Alexandra Rodrigues, Silvia Peveri, Juan Heber Castellanos, Muriel Totis, Joan Bartra, Gjustina Loloci, Ivana Giangrieco, Ekaterina Khaleva, Joaquín Navarro, Kayoko Matsunaga, Jlenia Fresta, Jonathan O'b Hourihane, Sabina Bijlsma, Ana Rodriguez-Fernandez, Rosita Aitoro, Daniela Manila Bianchi, Rosa Jimenez-Feijoo, Mario Plebani, Marleen T. J. Van Ampting, Anthony E.J. Dubois, Clémence Mordacq, Simone Frediani, Martin Chapman, Helena Larramona, Fabrícia Carolino, Yanne Boloh, Ivona Baricevic-Jones, Mathilde Claude, Caroline Thumerelle, Päivi Vähäsarja, Mareen R. Datema, Abdullah Alfhaid, Diana Perez Alzate, Laura Santos-Diez, Graham King, Maria Teresa Guerra Perez, Jean-Marie Renaudin, Frieke Kuper, Josué Alejandro Huertas Guzmán, Harry Wichers, Thomas Keil, A. Haddi, Jennifer Santos, Regina Selb, Aida del Campo García, Maria Basagaña, Valentino Pavišić, Angela Simpson, Chris H. Bridts, Susana Piedade, Silvia Gallina, Isabella Pali-Schöll, Inês Pádua, Margaretha A. Faber, Frédéric de Blay, Luís Câmara Pestana, Ben Remington, Anna S. Pelkonen, Sandra Lucarelli, Ivana Šutić, Olivier Tranquet, Montserrat López Onieva, Antonio Amoroso, Paola Minale, Katia Basello, George Du Toit, Daniela Adriano, Adnan Custovic, Zbikowska-Gotz M, Domingo Barber, Inmaculada Doña, Christine Breynaert, Hanan Sharif, Manon M. Oude Nijhuis, Sandra Denery, Bertine M. J. Flokstra-de Blok, Rinkesh Kumar Gupta, Pieter-Jan de Kam, Dianne E. Campbell, Carmen M. D'Amelio, Nunzia Maiello, Ingo Marenholz, José María Ignacio García, Helen Lindqvist, Lilian Moraes, Cleonir Lui de Moraes Beck, Eunice Dias de Castro, Cono Casale, Barbara Majkowska-Wojciechowska, Maria Petrodimopoulou, Andrea Mikkelsen, Hub P. J. M. Noteborn, Hulya Ercan Saricoban, Moira Austin, Martinus Løvik, Graham Roberts, Isabella Annesi-Maesano, Aeilko H. Zwinderman, Sigrun H. Lund, Anouska D. Michelsen-Huisman, Fernando Bandrés Sánchez-Cruz, Francisco Javier Ruano, Valérie Liabeuf, Eman Madbouly, Pasquale Comberiati, Maria Isabel Garcimartin, Stephan Scheurer, Inna A. Larkova, Jean Tratt, Renata Rodrigues Cocco, Younes Belabbas, Lorella Paparo, Elizabeth Griffiths, Gian Lodovico Rapaccini, Audrey Dunn Galvin, Zizi Cojocariu, Isidor Hutteger, Claire Claverie, S.M. Nedelska, Anna Kuklinska-Pijanka, Jenny Badas, Mónica Piquer, Iztok Devetak, A.K.F. Gushken, Frans Timmermans, Adriana Machinena, Francisco Javier Monteseirin, Amaranta Traversa, Fátima Cabral Duarte, Tomaž Poredoš, Peter Meyer, Cristina Arêde, Rosa Muñoz-Cano, Barbara Pfitzner, Alejandro Joral, Juan Carlos Daza, Laurent L. Reber, Olga Chernyak, and Maria Antonetta Ciardiello

Subjects
Pulmonary and Respiratory Medicine, Allergy, medicine.medical_specialty, 030504 nursing, business.industry, Immunology, RC581-607, medicine.disease, Meeting Abstracts, 03 medical and health sciences, 0302 clinical medicine, Food allergy, 030225 pediatrics, Family medicine, medicine, Immunology and Allergy, Immunologic diseases. Allergy, 0305 other medical science, business, Anaphylaxis
Published
2017

13. Specific IgE to Jug r 1 has no additional value compared with extract-based testing in diagnosing walnut allergy in adults

Author

W. Marty Blom, Mark A. Blankestijn, Joseph L. Baumert, Rob J.B. Klemans, André C. Knulst, Henny G. Otten, Carla A.F.M. Bruijnzeel-Koomen, Steve L. Taylor, and Geert F. Houben

Subjects
Allergy, biology, business.industry, Immunology, Immunoglobulin E, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, 030228 respiratory system, biology.protein, medicine, Immunology and Allergy, 030212 general & internal medicine, business, Value (mathematics)
Published
2017

14. Developments in the field of allergy in 2013 through the eyes of Clinical and Experimental Allergy

Author

Mark A. Blankestijn, Deborah Jarvis, Catherine M. Hawrylowicz, Andrew J. Wardlaw, André C. Knulst, Robert J. Boyle, and R. Gore

Subjects
medicine.medical_specialty, Allergy, business.industry, Immunology, Drug allergy, Disease, Allergens, medicine.disease, medicine.disease_cause, Allergen, Food allergy, Epidemiology, medicine, Hypersensitivity, Immunology and Allergy, Animals, Humans, Microbiome, business, Asthma
Abstract

2013 was another exciting year for allergy in general and Clinical and Experimental Allergy in particular. In the field of asthma and rhinitis, there continued to be a focus on heterogeneity and phenotypes with increasing use of biostatistical techniques to determine clusters of similar populations. Obesity- and aspirin-associated disease are intriguing associations with asthma which were explored in a number of papers. We published a number of excellent papers on mechanisms of airway inflammation and how this relates to physiology, pathology, genetics and biomarkers in both human and experimental model systems. In terms of mechanisms, there is less on individual cell types in allergic disease at the moment, but the immunology of allergic disease continued to fascinate our authors. Another area that was popular both in the mechanisms and in the epidemiology sections was early life events and how these lead to allergic disease, with an increasing focus on the role of the microbiome and how this influences immune tolerance. In the clinical allergy section, oral immunotherapy for food allergy is clearly a major topic of interest at the moment as was in vitro testing to distinguish between sensitization and allergic disease. There was less on inhalant allergy this year, but a good representation from the drug allergy community including some interesting work on non-IgE-mediated mechanisms. In the allergen section, important new allergens continue to be discovered, but the major focus as in the last couple of years was on working out how component-resolved approaches can improve diagnosis and management of food and venom allergy.

Published
2014

15. Diagnostic accuracy of specific IgE to components in diagnosing peanut allergy: a systematic review

Author

H. van Os-Medendorp, Edward F. Knol, Carla A.F.M. Bruijnzeel-Koomen, Rob J.B. Klemans, André C. Knulst, and Mark A. Blankestijn

Subjects
medicine.medical_specialty, Pediatrics, Arachis, PREDICTION, Immunology, Peanut allergy, Diagnostic accuracy, SKIN PRICK, Review, Immunoglobulin E, SENSITIZED CHILDREN, FOOD ALLERGY, Sensitivity and Specificity, EXPLANATION, Food allergy, Antibody Specificity, Journal Article, Immunology and Allergy, Medicine, Humans, ARA H 2, Peanut Hypersensitivity, Skin Tests, biology, business.industry, Quality assessment, STATEMENT, fungi, food and beverages, Reproducibility of Results, ELABORATION, Allergens, Antigens, Plant, medicine.disease, Dermatology, Clinical Practice, Meta-analysis, Positive test result, biology.protein, RESOLVED DIAGNOSTICS, business, Meta-Analysis
Abstract

The diagnostic accuracy of skin prick test (SPT) and specific IgE (sIgE) to peanut extract in diagnosing peanut allergy is suboptimal. Recent studies have evaluated sIgE to peanut components as a possible new diagnostic tool. The aim of our review was to systematically search the literature to assess the diagnostic value of sIgE to peanut components in diagnosing peanut allergy. A literature search was performed in PubMed, Embase and the Cochrane Library. Results were subsequently screened for in- and exclusion criteria. The quality of eligible studies was assessed using a standardized quality assessment tool (QUADAS-2). Data on sensitivity, specificity, and positive and negative likelihood ratios were extracted or calculated for a descriptive analysis. Twenty-two studies were eligible, of which 21 studies in paediatric populations. Most studies reported on sIgE to peanut extract (15) and sIgE to Ara h 2 (12), followed by SPT (9) and sIgE to Ara h 1 (7). All studies were at risk of bias or caused applicability concerns on at least one item of the quality assessment tool. The best combination of diagnostic accuracy measures of all diagnostic tests was found for sIgE to Ara h 2. This finding was independent of geographical location. Compared to SPT and sIgE to peanut extract, sIgE to Ara h 2 was mainly superior in diagnosing peanut allergy in case of a positive test result. Worst diagnostic accuracy measures were found in general for sIgE to Ara h 8 and sIgE to Ara h 9. sIgE to Ara h 2 showed the best diagnostic accuracy of all diagnostic tests to diagnose peanut allergy. Compared to the currently used SPT and sIgE to peanut extract, sIgE to Ara h 2 was superior in diagnosing peanut allergy and should therefore replace these tests in daily clinical practice, especially in children.

Published
2014

16. Food sensitisation patterns measured by ISAC multiplex assay in the Netherlands

Author

Carla A.F.M. Bruijnzeel-Koomen, Mark A. Blankestijn, Heike Röckmann, Edward F. Knol, Henny G. Otten, André C. Knulst, and Rob J.B. Klemans

Subjects
Pulmonary and Respiratory Medicine, chemistry.chemical_classification, Allergy, education.field_of_study, biology, business.industry, Immunology, Population, biology.organism_classification, medicine.disease, Bioinformatics, medicine.anatomical_structure, chemistry, Kiwi, Food allergy, Poster Presentation, medicine, Immunology and Allergy, Storage protein, Multiplex, Food science, education, business, Plant lipid transfer proteins, Sensitization
Abstract

Results Of 943 ISAC tests, 852 showed sensitization to at least one component and were included for further analysis. Mean age was 33,4 years. The majority of patients in our population was poly-sensitized, with 66% recognizing more than ten components. The most recognized component was Bet v 1 (70%). The top 10 food allergens were: apple (Mal d 1; 65%), peach (Pru p 1; 63%), hazelnut (Cor a 1.0401; 63%), peanut (Ara h 8; 56%, Ara h 6; 23%, Ara h 2; 15%), soy (Gly m 4; 39%), celery (Api g 1; 25%), kiwi (Act d 8; 20%) and walnut (Jug r 2; 15%). 84% showed sensitization to one or more food allergens. Within this group, 84% recognized at least one PR-10 component, followed by storage proteins (35%) and non-specific lipid transfer proteins (nsLTP; 12%). The prevalence of sensitization to cross-reactive carbohydrate determinants (CCD) within the entire population was 9%. Sensitization to at least one food components of animal origin (cow’s milk/egg) was seen in 19% of all cases, with Bos d 8 recognized most frequently (8.1%). The ISAC seems to support clinical suspicion of food allergy in most cases, although sensitization together with a negative patient history is common.

Published
2015

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