Helen A Brough1, Jean-Christoph Caubet2, Angel Mazon3, Diab Haddad4, Marcel M Bergmann2, Jacqueline Wassenberg5, Valentina Panetta6, Rosalynd Gourgey7, Suzana Radulovic7, Maria Nieto3, Alexandra F Santos8, Antonio Nieto3, Gideon Lack7, Philippe A Eigenmann2. 1. Paediatric Allergy Group, Department of Women and Children's Health, King's College London, London, United Kingdom; Paediatric Allergy Group, Peter Gorer Dept of Immunobiology, School of Immunology & Microbial Sciences, King's College London, Guys' Hospital, London, United Kingdom; Children's Allergy Service, Evelina Children's Hospital, Guy's and St. Thomas' Hospital NHS Foundation Trust, London, United Kingdom. Electronic address: Helen.Brough@gstt.nhs.uk. 2. Department of Pediatrics Gynecology and Obstetrics, Medical School of the University of Geneva, University Hospitals of Geneva, Geneva, Switzerland. 3. Unit of Pediatric Allergy and Pneumology, Children's Hospital La Fe, Institute of Health Research La Fe, Valencia, Spain. 4. St Peter's Hospital, Chertsey, United Kingdom. 5. Unit of Pediatric Allergy and Rheumatology, Department of Pediatrics, University Hospital of Lausanne, Switzerland. 6. L'altrastatistica srl, Consultancy & Training, Biostatistics Office, Rome, Italy. 7. Paediatric Allergy Group, Department of Women and Children's Health, King's College London, London, United Kingdom; Paediatric Allergy Group, Peter Gorer Dept of Immunobiology, School of Immunology & Microbial Sciences, King's College London, Guys' Hospital, London, United Kingdom; Children's Allergy Service, Evelina Children's Hospital, Guy's and St. Thomas' Hospital NHS Foundation Trust, London, United Kingdom. 8. Paediatric Allergy Group, Department of Women and Children's Health, King's College London, London, United Kingdom; Paediatric Allergy Group, Peter Gorer Dept of Immunobiology, School of Immunology & Microbial Sciences, King's College London, Guys' Hospital, London, United Kingdom; Children's Allergy Service, Evelina Children's Hospital, Guy's and St. Thomas' Hospital NHS Foundation Trust, London, United Kingdom; Asthma UK Centre in Allergic Mechanisms of Asthma, London, United Kingdom.
Abstract
BACKGROUND: Peanut, tree nut, and sesame allergies are responsible for most life-threatening food-induced allergic reactions. Rates of coexistent allergy between these foods have been from mostly retrospective studies that include only a limited number of tree nuts or were not based on oral food challenges. OBJECTIVE: The Pronuts study is a multicenter European study (London, Geneva, and Valencia) assessing the challenge-proven rate of coexistent peanut, tree nut, and/or sesame seed allergy. METHODS: Children aged 0 to 16 years with at least 1 confirmed nut or sesame seed allergy underwent sequential diagnostic food challenges to all other nuts and sesame seed. RESULTS: Overall, the rate of coexistent peanut, tree nut, and sesame seed allergy was 60.7% (n = 74/122; 95% CI, 51.4% to 69.4%). Peanut allergy was more common in London, cashew and pistachio nut allergies were more common in Geneva, and walnut and pecan allergies were more common in Valencia. Strong correlations were found between cashew-pistachio, walnut-pecan, and walnut-pecan-hazelnut-macadamia clusters. Age (>36 months) and center (Valencia > Geneva > London) were associated with an increased odds of multiple nut allergies. By pursuing the diagnostic protocol to demonstrate tolerance to other nuts, participants were able to introduce a median of 9 nuts. CONCLUSION: We found a higher rate of coexistent nut and sesame seed allergies than previously reported. Performing sequential food challenges was labor intensive and could result in severe allergic reactions; however, it reduced dietary restrictions. Age was a significant predictor of multiple nut allergies, and thus the secondary spread of nut allergies occurred in older children.
BACKGROUND:Peanut, tree nut, and sesameallergies are responsible for most life-threatening food-induced allergic reactions. Rates of coexistent allergy between these foods have been from mostly retrospective studies that include only a limited number of tree nuts or were not based on oral food challenges. OBJECTIVE: The Pronuts study is a multicenter European study (London, Geneva, and Valencia) assessing the challenge-proven rate of coexistent peanut, tree nut, and/or sesame seed allergy. METHODS:Children aged 0 to 16 years with at least 1 confirmed nut or sesame seed allergy underwent sequential diagnostic food challenges to all other nuts and sesame seed. RESULTS: Overall, the rate of coexistent peanut, tree nut, and sesame seed allergy was 60.7% (n = 74/122; 95% CI, 51.4% to 69.4%). Peanutallergy was more common in London, cashew and pistachionutallergies were more common in Geneva, and walnut and pecanallergies were more common in Valencia. Strong correlations were found between cashew-pistachio, walnut-pecan, and walnut-pecan-hazelnut-macadamia clusters. Age (>36 months) and center (Valencia > Geneva > London) were associated with an increased odds of multiple nutallergies. By pursuing the diagnostic protocol to demonstrate tolerance to other nuts, participants were able to introduce a median of 9 nuts. CONCLUSION: We found a higher rate of coexistent nut and sesame seed allergies than previously reported. Performing sequential food challenges was labor intensive and could result in severe allergic reactions; however, it reduced dietary restrictions. Age was a significant predictor of multiple nutallergies, and thus the secondary spread of nutallergies occurred in older children.
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Authors: Paul J Turner; Nandinee Patel; Barbara K Ballmer-Weber; Joe L Baumert; W Marty Blom; Simon Brooke-Taylor; Helen Brough; Dianne E Campbell; Hongbing Chen; R Sharon Chinthrajah; René W R Crevel; Anthony E J Dubois; Motohiro Ebisawa; Arnon Elizur; Jennifer D Gerdts; M Hazel Gowland; Geert F Houben; Jonathan O B Hourihane; André C Knulst; Sébastien La Vieille; María Cristina López; E N Clare Mills; Gustavo A Polenta; Natasha Purington; Maria Said; Hugh A Sampson; Sabine Schnadt; Eva Södergren; Stephen L Taylor; Benjamin C Remington Journal: J Allergy Clin Immunol Pract Date: 2021-08-23
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Authors: Lars Lange; Ludger Klimek; Kirsten Beyer; Katharina Blümchen; Natalija Novak; Eckard Hamelmann; Andrea Bauer; Hans Merk; Uta Rabe; Kirsten Jung; Wolfgang Schlenter; Johannes Ring; Adam Chaker; Wolfgang Wehrmann; Sven Becker; Norbert Mülleneisen; Katja Nemat; Wolfgang Czech; Holger Wrede; Randolf Brehler; Thomas Fuchs; Thilo Jakob; Tobias Ankermann; Sebastian M Schmidt; Michael Gerstlauer; Torsten Zuberbier; Thomas Spindler; Christian Vogelberg Journal: Allergo J Int Date: 2021-09-28