Position paper of the EAACI: food allergy due to immunological cross-reactions with common inhalant allergens.

September 01, 2015 By:
  • Werfel T
  • Asero R
  • Ballmer-Weber BK
  • Beyer K
  • Enrique E
  • Knulst AC
  • Mari A
  • Muraro A
  • Ollert M
  • Poulsen LK
  • Vieths S
  • Worm M
  • Hoffmann-Sommergruber K.

In older children, adolescents, and adults, a substantial part of all IgE-mediated food allergies is caused by cross-reacting allergenic structures shared by inhalants and foods. IgE stimulated by a cross-reactive inhalant allergen can result in diverse patterns of allergic reactions to various foods. Local, mild, or severe systemic reactions may occur already after the first consumption of a food containing a cross-reactive allergen. In clinical practice, clinically relevant sensitizations are elucidated by skin prick testing or by the determination of specific IgE in vitro. Component-resolved diagnosis may help to reach a diagnosis and may predict the risk of a systemic reaction. Allergy needs to be confirmed in cases of unclear history by oral challenge tests. The therapeutic potential of allergen immunotherapy with inhalant allergens in pollen-related food allergy is not clear, and more placebo-controlled studies are needed. As we are facing an increasing incidence of pollen allergies, a shift in sensitization patterns and changes in nutritional habits, and the occurrence of new, so far unknown allergies due to cross-reactions are expected.

2015 Sep. Allergy.70(9):1079-90. Epub 2015 Jul 7.
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