Summary
A large proportion of immunoglobulin E (IgE)-mediated food allergies in older children, adolescents and adults are caused by cross-reactive allergenic structures. Primary sensitization is most commonly to inhalant allergens (e.g. Bet v 1, the major birch pollen allergen). IgE can be activated by various cross-reactive allergens and lead to a variety of clinical manifestations. In general, local and mild — in rare cases also severe and systemic — reactions occur directly after consumption of the food containing the cross-reactive allergen (e. g. plant-derived foods containing proteins of the Bet v 1 family). In clinical practice, sensitization to the primary responsible inhalant and/or food allergen can be detected by skin prick tests and/or in vitro detection of specific IgE. Component-based diagnostic methods can support clinical diagnosis. For individual allergens, these methods may be helpful to estimate the risk of systemic reactions. Confirmation of sensitization by oral provocation testing is important particulary in the case of unclear case history. New, as yet unrecognized allergens can also cause cross-reactions.
The therapeutic potential of specific immunotherapy (SIT) with inhalant allergens and their effect on pollen-associated food allergies is currently unclear: results vary and placebo-controlled trials will be necessary in the future. Pollen allergies are very common. Altogether allergic sensitization to pollen and cross-reactive food allergens are very common in our latitudes. The actual relevance has to be assessed on an individual basis using the clinical information.
Cite this as Worm M, Jappe U, Kleine-Tebbe J, Schäfer C, Reese I, Saloga J, Treudler R, Zuberbier T, Wassmann A, Fuchs T, Dölle S, Raithel M, Ballmer-Weber B, Niggemann B, Werfel T. Food allergies resulting from immunological cross-reactivity with inhalant allergens. Allergo J Int 2014; 23: 1–16 DOI 10.1007/s40629-014-0004-6
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Abbreviations
- AD:
-
Atopic dermatitis
- CCD:
-
Cross-reactive carbohydrate determinants
- EAACI:
-
European Academy of Allergy and Clinical Immunology
- FEV1:
-
Forced expiratory volume in one second
- FVC:
-
Forced vital capacity
- IgE:
-
Immunoglobulin E
- IgG:
-
Immunoglobulin G
- LFS:
-
Latex-fruit syndrome
- LTP:
-
Lipid transfer protein
- NSAID:
-
Nonsteroidal anti-inflammatory drug
- PR-10:
-
Pathogenesis-related protein family 10
- SCORAD:
-
Scoring atopic dermatitis
- sIgE:
-
Specific immunoglobulin E
- SIT:
-
Specific immunotherapy
- TLP:
-
Thaumatin-like proteins (PR-5)
- VCin:
-
Inspiratory vital capacity
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Level of development
S1
AWMF-guidelineregister-number
061/019
Finalised
August 27, 2013
Valid until
Oktober 31, 2018
Check
Oktober 30, 2016
ICD-10-numbers
T78.1, T78.0, L27.2, T78.2
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www.springermedizin.de/allergo-journal
Methodology of guideline development
Literature reviews and expert consensus (February 20, 2013)
Coordinator
Prof. Dr. Margitta Worm
Cite this as Worm M, Jappe U, Kleine-Tebbe J, Schäfer C, Reese I, Saloga J, Treudler R, Zuberbier T, Wassmann A, Fuchs T, Dölle S, Raithel M, Ballmer-Weber B, Niggemann B, Werfel T. Food allergies resulting from immunological cross-reactivity with inhalant allergens. Allergo J Int 2014; 23: 1–16 DOI 10.1007/s40629-014-0004-6
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Worm, M., Jappe, U., Kleine-Tebbe, J. et al. Food allergies resulting from immunological cross-reactivity with inhalant allergens. Allergo J Int 23, 1–16 (2014). https://doi.org/10.1007/s40629-014-0004-6
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DOI: https://doi.org/10.1007/s40629-014-0004-6