CoChat
Sign Up
Cited by 15

The DOI matches its Crossref record.

Diagnosis and Management of Pollen Food Allergy Syndrome to Nuts

Giovannini, Mattia, Skypala, Isabel J., Caubet, Jean Christoph, Du Toit, George, Nowak-Wegrzyn, Anna·2024·The Journal of Allergy and Clinical Immunology: In Practice
DOI 10.1016/j.jaip.2024.01.025
Open this paper in CoChat — free account

Abstract

Oral allergy syndrome or pollen food allergy syndrome (PFAS) represents a common clinical conundrum when the reported trigger food is a tree nut (usually almond or hazelnut) or peanut. The PFAS may give rise to uncertainty about the potential severity of the future reactions, indications for prescribing epinephrine, and the extent of the necessary dietary avoidance. As a food allergy, secondary to cross-reactivity with airborne pollen, PFAS usually manifests toward the end of the first decade of life as contact urticaria of the oropharyngeal mucous membranes. Molecular allergology facilitates diagnosis and risk stratification by establishing the profile of sensitization. Exclusive sensitization to pathogenesis-related proteins family 10 (PR10) and profilins indicates that signs and symptoms are due to PFAS, whereas sensitization to seed storage proteins with or without sensitization to PR10 and profilins may indicate a more severe primary nut allergy phenotype. Management relies on avoidance of the specific nut trigger, advice on the likelihood of more severe local or systemic symptoms, and treatment of reactions according to the severity. Future studies are needed to better delineate the risk of systemic reactions in individuals with nut PFAS and to establish the role of food or pollen allergen immunotherapy for the prevention or moderation of this condition.

Overview

Integrity signals

Registry

Crossref · 10.1016/j.jaip.2024.01.025

Cites

Statistics

Recomputing p-values needs the paper’s full text.

Verification

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Citations

Cites

No references could be resolved yet.

Research works printed but not linked: 55

  1. Spolidoro, 2024, Prevalence of tree nut allergy in Europe: a systematic review and meta-analysis, Allergy, 79, 302, 10.1111/all.15905 · DOI
  2. Labrosse, 2022, Recent advances in the diagnosis and management of tree nut and seed allergy, Curr Opin Allergy Immunol, 22, 194, 10.1097/ACI.0000000000000826 · DOI
  3. McWilliam, 2020, Prevalence and natural history of tree nut allergy, Ann Allergy Asthma Immunol, 124, 466, 10.1016/j.anai.2020.01.024 · DOI
  4. McWilliam, 2015, The prevalence of tree nut allergy: a systematic review, Curr Allergy Asthma Rep, 15, 54, 10.1007/s11882-015-0555-8 · DOI
  5. Brough, 2021, Latest developments in the management of nut allergies, Curr Treat Options Allergy, 8, 97, 10.1007/s40521-021-00290-2 · DOI
  6. Chu, 2022, Tree nut allergy: a systematic review, Curr Opin Pediatr, 34, 600, 10.1097/MOP.0000000000001180 · DOI
  7. Cox, 2021, Clinical relevance of cross-reactivity in food allergy, J Allergy Clin Immunol Pract, 9, 82, 10.1016/j.jaip.2020.09.030 · DOI
  8. Uotila, 2018, Component-resolved diagnostics demonstrates that most peanut-allergic individuals could potentially introduce tree nuts to their diet, Clin Exp Allergy, 48, 712, 10.1111/cea.13101 · DOI
  9. Mastrorilli, 2019, Pollen-food allergy syndrome: a not so rare disease in childhood, Medicina (Kaunas), 55, 641, 10.3390/medicina55100641 · DOI · Paper page
  10. Lipp, 2021, Heterogeneity of pollen food allergy syndrome in seven Southern European countries: the @IT.2020 multicenter study, Allergy, 76, 3041, 10.1111/all.14742 · DOI · Paper page
  11. Fuhrmann, 2021, From allergen molecules to molecular immunotherapy of nut allergy: a hard nut to crack, Front Immunol, 12, 10.3389/fimmu.2021.742732 · DOI
  12. Letner, 2018, Pollen-food allergy syndrome is a common allergic comorbidity in adults with eosinophilic esophagitis, Dis Esophagus, 31, dox122, 10.1093/dote/dox122 · DOI
  13. Skypala, 2020, Can patients with oral allergy syndrome be at risk of anaphylaxis?, Curr Opin Allergy Clin Immunol, 20, 459, 10.1097/ACI.0000000000000679 · DOI · Paper page
  14. Borres, 2022, Recent advances in diagnosing and managing nut allergies with focus on hazelnuts, walnuts, and cashew nuts, World Allergy Organ J, 15, 10.1016/j.waojou.2022.100641 · DOI
  15. Midun, 2021, Recent advances in the management of nut allergy, World Allergy Organ J, 14, 10.1016/j.waojou.2020.100491 · DOI
  16. Elizur, 2020, Clinical and molecular characterization of walnut and pecan allergy (NUT CRACKER study), J Allergy Clin Immunol Pract, 8, 157, 10.1016/j.jaip.2019.08.038 · DOI
  17. Dramburg, 2023, EAACI molecular allergology user's guide 2.0, Pediatr Allergy Immunol, 34
  18. Chan, 2019, Managing cross-reactivity in those with peanut allergy, J Allergy Clin Immunol Pract, 7, 381, 10.1016/j.jaip.2018.11.012 · DOI
  19. Uotila, 2016, Cross-sensitization profiles of edible nuts in a birch-endemic area, Allergy, 71, 514, 10.1111/all.12826 · DOI
  20. Skypala, 2011, Development and validation of a structured questionnaire for the diagnosis of oral allergy syndrome in subjects with seasonal allergic rhinitis during the UK birch pollen season, Clin Exp Allergy, 41, 1001, 10.1111/j.1365-2222.2011.03759.x · DOI
  21. Vieths, 2002, Current understanding of cross-reactivity of food allergens and pollen, Ann N Y Acad Sci, 964, 47, 10.1111/j.1749-6632.2002.tb04132.x · DOI
  22. Skypala, 2022, BSACI guideline for the diagnosis and management of pollen food syndrome in the UK, Clin Exp Allergy, 52, 1018, 10.1111/cea.14208 · DOI
  23. Scott, 2019, Evaluation of the epidemiology of peanut allergy in the United Kingdom, Expert Rev Clin Immunol, 15, 1333, 10.1080/1744666X.2020.1693264 · DOI
  24. Peters, 2022, The natural history of peanut and egg allergy in children up to age 6 years in the HealthNuts population-based longitudinal study, J Allergy Clin Immunol, 150, 657, 10.1016/j.jaci.2022.04.008 · DOI
  25. Dyer, 2015, Epidemiology of childhood peanut allergy, Allergy Asthma Proc, 36, 58, 10.2500/aap.2015.36.3819 · DOI
  26. Takemura, 2020, Association between fruit and vegetable allergies and pollen-food allergy syndrome in Japanese children: a multicenter cross-sectional case series, Asia Pac Allergy, 10, e9, 10.5415/apallergy.2020.10.e9 · DOI
  27. Valcour, 2019, Sensitization profiles to hazelnut allergens across the United States, Ann Allergy Asthma Immunol, 122, 111, 10.1016/j.anai.2018.09.466 · DOI
  28. Bager, 2021, Prevalence and early-life risk factors for tree nut sensitization and allergy in young adults, Clin Exp Allergy, 51, 1429, 10.1111/cea.13994 · DOI
  29. Erhard, 2021, Primary and pollen-associated hazelnut allergy in school-aged children in Germany: a birth cohort study, Allergol Int, 70, 463, 10.1016/j.alit.2021.05.006 · DOI
  30. Kansen, 2021, Accurate prediction of peanut allergy in one-third of adults using a validated Ara h 2 cutoff, J Allergy Clin Immunol Pract, 9, 1667, 10.1016/j.jaip.2020.11.024 · DOI
  31. Brettig, 2021, The accuracy of diagnostic testing in determining tree nut allergy: a systematic review, J Allergy Clin Immunol Pract, 9, 2028, 10.1016/j.jaip.2020.12.048 · DOI
  32. Giannetti, 2023, Natural history of hazelnut allergy and current approach to its diagnosis and treatment, Children (Basel), 10, 585
  33. Baker, 2019, Review of 400 consecutive oral food challenges to almond, Ann Allergy Asthma Immunol, 122, 189, 10.1016/j.anai.2018.10.025 · DOI
  34. Kabasser, 2022, Pru du 1, the Bet v 1-homologue from almond, is a major allergen in patients with birch pollen associated almond allergy, Clin Transl Allergy, 12, 10.1002/clt2.12177 · DOI
  35. Ridout, 2006, The diagnosis of Brazil nut allergy using history, skin prick tests, serum-specific immunoglobulin E and food challenges, Clin Exp Allergy, 36, 226, 10.1111/j.1365-2222.2006.02426.x · DOI
  36. Rayes, 2016, Specific IgE to recombinant protein (Ber e 1) for the diagnosis of Brazil nut allergy, Clin Exp Allergy, 46, 654, 10.1111/cea.12693 · DOI
  37. Lyons, 2021, Walnut allergy across Europe: distribution of allergen sensitization patterns and prediction of severity, J Allergy Clin Immunol Pract, 9, 225, 10.1016/j.jaip.2020.08.051 · DOI
  38. Bastiaan-Net, 2020, Identification and in silico bioinformatics analysis of PR10 proteins in cashew nut, Protein Sci, 29, 1581, 10.1002/pro.3856 · DOI
  39. Brettig, 2022, Ana o 3 sIgE and diagnostic algorithms reduce cost of cashew allergy diagnosis in children compared with skin prick test: a cost comparison analysis, Pediatr Allergy Immunol, 33, 10.1111/pai.13839 · DOI
  40. Kallen, 2023, Component Ana o 3 versus extract for cashew nut allergy: a diagnostic test accuracy study in adults, Clin Exp Allergy, 53, 880, 10.1111/cea.14331 · DOI
  41. Dang, 2022, Ana o 3 sIgE testing increases the accuracy of cashew allergy diagnosis using a two-step model, Pediatr Allergy Immunol, 33, 10.1111/pai.13705 · DOI
  42. Costa, 2019, Pistachio nut allergy: an updated overview, Crit Rev Food Sci Nutr, 59, 546, 10.1080/10408398.2017.1379947 · DOI
  43. Siew, 2018, Macadamia sensitisation and not allergy is common in peanut allergic, tree nut allergic and pollen food syndrome, Clin Exp Allergy, 48, 1539
  44. Ekbote, 2010, Macadamia nut allergy: potentially misleading specific IgE results, Allergy, 65, 1345, 10.1111/j.1398-9995.2010.02354.x · DOI
  45. Kubota, 2022, Macadamia nut-specific IgE levels for predicting anaphylaxis, Pediatr Allergy Immunol, 33, 10.1111/pai.13852 · DOI
  46. Magnusdottir, 2019, Ara h 1 and Ara h 6 sensitization causes clinical peanut allergy in Ara h 2-negative individuals, Int Arch Allergy Immunol, 178, 66, 10.1159/000493327 · DOI
  47. Krause, 2009, Lipid transfer protein (Ara h 9) as a new peanut allergen relevant for a Mediterranean allergic population, J Allergy Clin Immunol, 124, 10.1016/j.jaci.2009.06.008 · DOI
  48. Skypala, 2021, The diagnosis and management of allergic reactions in patients sensitized to non-specific lipid transfer proteins, Allergy, 76, 2433, 10.1111/all.14797 · DOI
  49. Olivieri, 2022, Anaphylaxis across Europe: are pollen food syndrome and lipid transfer protein allergy so far apart?, Curr Opin Allergy Clin Immunol, 22, 291, 10.1097/ACI.0000000000000847 · DOI
  50. Sampson, 2014, Food allergy: a practice parameter update-2014, J Allergy Clin Immunol, 134, 1016, 10.1016/j.jaci.2014.05.013 · DOI · Paper page
  51. Ma, 2003, A survey on the management of pollen-food allergy syndrome in allergy practices, J Allergy Clin Immunol, 112, 784, 10.1016/S0091-6749(03)02008-6 · DOI
  52. Nothegger, 2021, Oral birch pollen immunotherapy with apples: results of a phase II clinical pilot study, Immun Inflamm Dis, 9, 503, 10.1002/iid3.410 · DOI
  53. Paudel, 2021, Increased duration of pollen and mold exposure are linked to climate change, Sci Rep, 11, 10.1038/s41598-021-92178-z · DOI
  54. Loraud, 2021, Emergence of pollen food allergy syndrome in asthmatic children in Paris, Pediatr Allergy Immunol, 32, 702, 10.1111/pai.13435 · DOI
  55. Protudjer, 2020, Veganism and paediatric food allergy: two increasingly prevalent dietary issues that are challenging when co-occurring, BMC Pediatr, 20, 341, 10.1186/s12887-020-02236-0 · DOI

Cited by

Sorted by citations

See all 15

Metadata

Authors
Giovannini, M., Skypala, I. J., Caubet, J. C., Du Toit, G., & Nowak-Wegrzyn, A.
ORCID
Skypala, Isabel J.
Venue
The Journal of Allergy and Clinical Immunology: In Practice
Publisher
Elsevier BV
Published
2024-03
Volume
12
Issue
3
Pages
599-604
ISSN
2213-2198
DOI
10.1016/j.jaip.2024.01.025
Cited by
15
References
0
Language
en
Licence

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

How to cite

Cite CoChat for the checks on this page, and the paper for its own findings.

This page
CoChat. (2026). Citation check: Diagnosis and Management of Pollen Food Allergy Syndrome to Nuts. https://app.cochat.ai/papers/10.1016/j.jaip.2024.01.025
The paper
Giovannini, M., Skypala, I. J., Caubet, J. C., Du Toit, G., & Nowak-Wegrzyn, A. (2024). Diagnosis and Management of Pollen Food Allergy Syndrome to Nuts. The Journal of Allergy and Clinical Immunology: In Practice. https://doi.org/10.1016/j.jaip.2024.01.025