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 Allergy Advisor Digest - May 2017
Editor: Dr. Harris A. Steinman

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This is a monthly digest of interesting information that is being added to Allergy Advisor. While we add a great deal of information every month, here we highlight some of the more interesting articles.
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Snippets NOT posted in the May 2017 Advisor Digest Newsletter

Read Disappearance of severe oral allergy syndrome following omalizumab treatment.
Read Minimal impact of extensive heating of hen's egg and cow's milk in a food matrix on threshold dose-distribution curves.
Read Amb a 1 isoforms: unequal siblings with distinct immunological features.
Read Levodropropizine-Induced anaphylaxis: case series and literature review.
Read Impact of high serum Immunoglobulin E levels on the risk of atherosclerosis in humans.
Read New perspectives on the diagnosis of allergy to Anisakis spp.
Read Mold allergy: is it real and what do we do about it?
Read The clinical impact of Bet v 6 in birch pollen-sensitized patients.
Read A case of recurrent facial angioedema associated with elevated tree pollen counts.
Read Fatal anaphylaxis to yellow jacket stings in mastocytosis: options for identification and treatment of at-risk patients.
Read Precision allergy: Separate allergies to male and female dogs.
Read Positive skin test or specific IgE to penicillin does not reliably predict penicillin allergy.
Read Oral challenge without skin testing safely excludes clinically significant delayed-onset penicillin hypersensitivity.
Read Current knowledge and management of hypersensitivity to perioperative drugs and radiocontrast media.
Read Current knowledge and management of hypersensitivity to aspirin and nsaids.
Read Practical management of antibiotic hypersensitivity in 2017.
Read Cockroach allergy and urban asthma.
Read ImmunoCAP cellulose displays cross-reactive carbohydrate (CCD) epitopes and can cause false-positive test results in patients with high anti-CCD IgE antibody levels.
Read Allergen-specific IgG antibodies signaling via FcgammaRIIb promote food tolerance.
Read Cross-reactivity in fish allergy: a double-blind placebo-controlled food challenge trial.
Read Glycans and glycan-specific IgE in clinical and molecular allergology - sensitization, diagnostics and clinical symptoms.

Snippets posted in the May 2017 Advisor Digest Newsletter

Read Allergenicity of vertebrate tropomyosins: Challenging an immunological dogma.
Read Skin prick test is more useful than specific IgE for diagnosis of buckwheat allergy
Read Ara h2 levels in dust from homes of individuals with peanut allergy and individuals with peanut tolerance.
Read Characteristics of tree nut challenges in tree nut allergic and tree nut sensitized individuals.
Read Evidence that eating baked egg or milk influences egg or milk allergy resolution: a systematic review.
Read Natural evolution of IgE responses to mite allergens and relationship to progression of allergic disease: a review.
Read Quantitative analysis of species specificity of two anti-parvalbumin antibodies for detecting southern hemisphere fish species demonstrating strong phylogenetic association.
Read Detection of peanut allergen in human blood after consumption of peanuts is skewed by endogenous immunoglobulins.
Read Early introduction of food reduces food allergy - Does it?
Read Progestogen hypersensitivity: heterogeneous manifestations with a common trigger.

Allergy and Intolerance Abstracts
Disappearance of severe oral allergy syndrome following omalizumab treatment.
The first case of disappearance of apple-induced oral allergy syndrome in a birch pollen-allergic patient following omalizumab treatment is reported. This observation in a case of type 2 food allergy suggests that omalizumab is potentially an effective preventive treatment for patients with severe, type 1 food allergies

Disappearance of severe oral allergy syndrome following omalizumab treatment.  
Asero R.
Eur Ann Allergy Clin Immunol 2017 May;49(3):143-144

Click to view abstract

Index
Allergy and Intolerance Abstracts
Minimal impact of extensive heating of hen's egg and cow's milk in a food matrix on threshold dose-distribution curves.
We analyzed reaction threshold data from 352 children undergoing open food challenges to hen's egg or cow's milk, either fresh or extensively heated into a muffin. There was no significant shift in dose-distribution curves due to the baking process, implying that existing threshold data for these allergens can be applied to allergen risk management, even when these allergens are heat-processed into baked foods.

Minimal impact of extensive heating of hen's egg and cow's milk in a food matrix on threshold dose-distribution curves.  
Remington BC, Westerhout J, Campbell DE, Turner PJ.
Allergy 2017 May 5;

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Index
Allergy and Intolerance Abstracts
Amb a 1 isoforms: unequal siblings with distinct immunological features.
The physicochemical and immunological properties of three most important Amb a 1 isoforms were compared. Amb a 1 isoforms exhibited distinct patterns of IgE-binding and immunogenicity. Compared to Amb a 1.02 or 03 isoforms, Amb a 1.01 showed higher IgE-binding activity. Isoforms 01 and 03 were the most potent stimulators of patients' T cells. These findings should be considered when selecting sequences for molecule-based diagnosis and therapy of ragweed allergy. Due to its high IgE-binding activity, isoform Amb a 1.01 should be included in diagnostic tests. In contrast, due to their limited B and T cell cross-reactivity patterns, a combination of different isoforms might be a more attractive strategy for ragweed immunotherapy.

Amb a 1 isoforms: unequal siblings with distinct immunological features.  
Wolf M, Twaroch TE, Huber S, Reithofer M, Steiner M, Aglas L, Hauser M, Aloisi I, Asam C, Hofer H, Parigiani MA, Ebner C, Bohle B, Briza P, Angela N, Stolz F, Jahn-Schmid B, Wallner M, Ferreira F.
Allergy 2017 May 2;

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Index
Allergy and Intolerance Abstracts
Levodropropizine-Induced anaphylaxis: case series and literature review.
Levodropropizine is commonly used as an antitussive drug for acute and chronic cough. It is a non-opioid agent with peripheral antitussive action via the modulation of sensory neuropeptide levels in the airways. Thus, levodropropizine has a more tolerable profile than opioid antitussives. However, we experienced 3 cases of levodropropizine-induced anaphylaxis. Three patients commonly presented with generalized urticaria, dyspnea, and collapse after taking cold medication including levodropropizine. To find out the culprit drug, we performed skin tests, oral provocation tests (OPTs), and basophil activation tests (BATs). Two patients were confirmed as having levodropropizine-induced anaphylaxis by OPTs, and one of them showed positive to skin prick tests (SPTs). The other patient was confirmed by skin tests and BATs. When we analyzed pharmacovigilance data related to levodropropizine collected for 5 years, most cases (78.9%) had allergic reactions, such as rash, urticaria, angioedema, and anaphylaxis. Therefore, physicians should consider that levodropropizine can be a culprit drug, when anaphylaxis occurs after taking anti-cough or common cold medication

Levodropropizine-Induced anaphylaxis: case series and literature review.  
Song JW, Jang YS, Jung MC, Kim JH, Choi JH, Park S, Hwang YI, Jang SH, Jung KS.
Allergy Asthma Immunol Res 2017 May;9(3):278-280

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Index
Allergy and Intolerance Abstracts
Impact of high serum Immunoglobulin E levels on the risk of atherosclerosis in humans.
Epidemiological studies show that immunoglobulin E (IgE) levels were higher in subjects with acute coronary events. However, it is unknown if the increased IgE level is a marker of future coronary incidents and whether it may be regarded as a risk factor of an ischemic heart disease. The authors aim was to investigate the relationship between IgE levels and some atherosclerotic markers in patients without known atherosclerotic disease. They conclude that the results showed that CFR as an early marker of endothelial dysfunction was significantly lower in patients with high IgE levels. This finding seems to support the role of IgE in the vascular pathology of atherosclerosis

Impact of high serum Immunoglobulin E levels on the risk of atherosclerosis in humans.  
Unal D, Gelincik A, Elitok A, Demir S, Olgac M, Coskun R, Kocaaga M, Colakoglu B, Buyukozturk S.
Asia Pac Allergy 2017 Apr;7(2):74-81

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Index
Allergy and Intolerance Abstracts
New perspectives on the diagnosis of allergy to Anisakis spp.
New perspectives on the diagnosis of allergy to Anisakis spp. Isolated allergens help in the diagnosis of truly sensitized patients avoiding false positives due to cross-reactions. Their use is therefore highly recommended, especially when used as a combination of several relevant allergens. The use of purified allergens allows an accurate diagnosis and this has led to three important findings: (1) in addition to the digestive route of sensitization, occupational and non-digestive exposure seems to be clinically relevant. (2) The parasite appears as an important agent for chronic urticaria. And (3) in endemic countries, the amount of highly sensitized subjects in the general population could be as high as 7%. Adequate information to asymptomatic patients on fish consumption habits would avoid new contacts with parasite allergens and decrease their specific IgE levels and consequently the appearance of acute or chronic episodes induced by the parasite

New perspectives on the diagnosis of allergy to Anisakis spp.  
Moneo I, Carballeda-Sangiao N, Gonzalez-Munoz M.
Curr Allergy Asthma Rep 2017 May;17(5):27

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Allergy and Intolerance Abstracts
Mold allergy: is it real and what do we do about it?
In this review we cover both innate and adaptive immune responses to fungi. Some fungal products can activate both innate and adaptive responses and in doing so, cause an intense and complex health effects. Methods of testing for fungal allergy and evidence for clinical treatment including environmental control are also discussed. In addition, we describe controversial issues including the role of Stachybotrys and mycotoxins in adverse health effects. Expert commentary: Concerns about long-term exposure to fungi have led some patients, attorneys and fungus advocates to promote fears about a condition that has been termed toxic mold syndrome. This syndrome is associated with vague symptoms and is believed to be due to exposure to mycotoxins, though this connection has not been proven.

Mold allergy: is it real and what do we do about it?  
Rudert A, Portnoy J.
Expert Rev Clin Immunol 2017 May 17;1-13

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Index
Allergy and Intolerance Abstracts
The clinical impact of Bet v 6 in birch pollen-sensitized patients.
Bet v 6, a minor birch pollen allergen, is commercially available for allergen-specific IgE antibody testing. However, there is hardly any literature on the clinical impact of Bet v 6. The aim of the present study was to analyze if testing specific IgE against Bet v 6 can add valuable benefit to the standard diagnostics of birch pollen-sensitized patients, especially in patients with unknown sensitization-eliciting allergens. Of 57 cases with missing reactivity against the standard birch pollen allergens, 2 patients were positive for Bet v 6. In the representative sample, 3 patients showed specific IgE against Bet v 6 - resulting in a total prevalence of 5%. None of the Bet v 6-positive patients showed allergic symptoms after exposure to birch pollen or an oral allergy syndrome. An increased prevalence of asthma and a higher degree of sensitization were the only distinctive clinical features in Bet v 6-positive patients. Conclusions: Among birch pollen-sensitized patients, the prevalence of specific IgE against Bet v 6 is low. Further, sensitization to Bet v 6, which shows characteristics of a panallergen, remains clinically silent. Therefore, determination of anti-Bet v 6 is not considered useful in the clinical routine

The clinical impact of Bet v 6 in birch pollen-sensitized patients.  
Gellrich D, Eder K, San NM, Berghaus A, Groger M.
Int Arch Allergy Immunol 2017 May 12;173(1):34-43

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Allergy and Intolerance Abstracts
A case of recurrent facial angioedema associated with elevated tree pollen counts.
An 8-year-old girl who was evaluated for atopic dermatitis and 3 discrete episodes of perioral and periorbital angioedema during the spring season. All 3 episodes of angioedema were preceded by a few hours of worsening atopic dermatitis with associated pruritus and occurred soon after playing outside. This child’s first episode of angioedema was associated with an acute spike in cedar/juniper pollens; the second episode with elevated oak pollen; and the third episode with high concentrations of pine pollen. Skin prick testing exclusively for the 3 relevant pollen species was correspondingly positive to mountain cedar, oak, and pine. Given the temporal correlation with angioedema and the presence of sensitization to these pollens, the authors hypothesize that exposures to spikes in mountain cedar, oak, and pine pollen were responsible for her recurrent episodes.

A case of recurrent facial angioedema associated with elevated tree pollen counts.  
Jayaraman D, Bratton DL, Harbeck RJ, Wolf M, Rabinovitch N.
J Allergy Clin Immunol Pract 2017 May 11;

Index
Allergy and Intolerance Abstracts
Fatal anaphylaxis to yellow jacket stings in mastocytosis: options for identification and treatment of at-risk patients.
Patients with indolent systemic mastocytosis (ISM) are at risk for severe anaphylactic reactions to yellow jacket (YJ) stings while demonstration of sensitization can be challenging because specific IgE (sIgE) levels are regularly below 0.35 kUA/L. The implication of missing YJ allergy is illustrated by a case of fatal anaphylaxis. The objective was to explore the natural course of YJ venom allergy and the diagnostic accuracy and therapeutic consequence of YJ venom sIgE in patients with ISM. A total of 153 patients with ISM were stung during adult life. The first systemic reaction was more often severe in patients with ISM than in patients without mastocytosis (69.9% vs 22.0%) and reactions recurred in 40 of 41 re-stung patients with ISM. ISM reactors showed lower YJ venom sIgE levels than nonmastocytosis reactors (0.61 vs 4.83 kUA/L; P < .001) and asymptomatic sensitization was exceedingly rare. In ISM the current clinical threshold of 0.35 kUA/L yields a sensitivity and specificity of 77.6% and 87.5%, respectively. The optimal diagnostic accuracy is achieved at 0.17 kUA/L (sensitivity, 83.6%; specificity, 85.0%). The high rate of severe reactions and the fatal case underscore the importance of adequate diagnostic sensitivity of sIgE in patients with ISM. The sensitivity of sIgE can be ameliorated by lowering the threshold to 0.17 kUA/L, retaining good specificity. We recommend sIgE screening in all patients with ISM and discussing immunotherapy when YJ venom sIgE exceeds 0.17 kUA/L

Fatal anaphylaxis to yellow jacket stings in mastocytosis: options for identification and treatment of at-risk patients.  
Vos BJPR, van AB, van Doormaal JJ, Dubois AEJ, Oude Elberink JNG.
J Allergy Clin Immunol Pract 2017 May 10;

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Allergy and Intolerance Abstracts
Precision allergy: Separate allergies to male and female dogs.
Dog-allergic patients monosensitized to Can f 5 seem to tolerate female dogs. This particular type of dog allergy can be confirmed using skin prick test or ocular provocation test using male and female dog extract separately. A 54-year-old woman presented with a longstanding history of dog allergy with asthma-like symptoms (wheezing and difficulty breathing) after exposure to dogs. She had noticed that her symptoms occurred only when exposed to male dogs, and she was now considering purchasing a female dog. Specific IgE to dog dander (e5) was 0.27 kUA/L and <0.1 to rCan f 1, rCan f 2, rCan f 3, and 0.31 to rCan f 5. Total IgE (kU/L) was 50.4.

Precision allergy: Separate allergies to male and female dogs.  
Schoos AM, Bonnelykke K, Chawes BL, Stokholm J, Bisgaard H, Kristensen B.
J Allergy Clin Immunol Pract 2017 May 9;

Index
Allergy and Intolerance Abstracts
Positive skin test or specific IgE to penicillin does not reliably predict penicillin allergy.
This study concludes that the best predictor for a clinically significant (IgE-mediated) penicillin allergy is a combination of a positive case history with simultaneous positive ST result and s-IgE or a positive challenge result

Positive skin test or specific IgE to penicillin does not reliably predict penicillin allergy.  
Tannert LK, Mortz CG, Skov PS, Bindslev-Jensen C.
J Allergy Clin Immunol Pract 2017 May;5(3):676-683

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Allergy and Intolerance Abstracts
Oral challenge without skin testing safely excludes clinically significant delayed-onset penicillin hypersensitivity.
A 5-day oral challenge without preceding ST is safe and sufficient to exclude penicillin allergy after NIR developing during penicillin treatment

Oral challenge without skin testing safely excludes clinically significant delayed-onset penicillin hypersensitivity.  
Confino-Cohen R, Rosman Y, Meir-Shafrir K, Stauber T, Lachover-Roth I, Hershko A, Goldberg A.
J Allergy Clin Immunol Pract 2017 May;5(3):669-675

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Allergy and Intolerance Abstracts
Current knowledge and management of hypersensitivity to perioperative drugs and radiocontrast media.
Perioperative anaphylaxis is an iatrogenic clinical condition, most often after anesthetic induction. Several mechanisms are implicated, including IgE- and non-IgE-mediated mechanisms. Perioperative anaphylaxis tends to be severe and has a higher mortality rate than anaphylaxis in other settings. This is partly due to factors that impair early recognition of anaphylaxis. Neuromuscular blocking agents, latex containing products, and antibiotics are the most common etiology. Chlorhexidine and dyes are increasingly culprits. The newest emerging cause is sugammadex, which is used for reversal of the effects of steroidal neuromusclar agents, such as rocuronium. Latex-induced allergy is becoming less common than in the 1980s due to primary and secondary prevention measures. Serum tryptase levels during the time of anaphylaxis and skin testing to suspected agents as an outpatient are necessary to confirm the diagnosis. Management includes epinephrine and aggressive fluid therapy. With radiocontrast media allergy, patients with a history of immediate hypersensitivity reactions to radiocontrast media should receive steroid and antihistamine premedication before re-exposure. Because IgE-mediated anaphylaxis to radiocontrast media is rare, there is a universal consensus that routinely skin testing all patients with a past reaction is not effective

Current knowledge and management of hypersensitivity to perioperative drugs and radiocontrast media.  
Hsu Blatman KS, Hepner DL.
J Allergy Clin Immunol Pract 2017 May;5(3):587-592

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Allergy and Intolerance Abstracts
Current knowledge and management of hypersensitivity to aspirin and nsaids.
Aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) are some of the most common culprits of drug-induced hypersensitivity reactions, and can lead to a wide array of adverse effects. The accurate and timely diagnosis of aspirin and NSAID-induced hypersensitivity reactions is important for both patient safety and for the initiation of appropriate disease-specific management and treatment. Because there are no reliably validated in vitro tests available, aspirin and NSAID challenges are considered to be the criterion standard for the diagnosis of these hypersensitivity reactions, though in some patients the diagnosis can be made on the basis of a clear clinical history

Current knowledge and management of hypersensitivity to aspirin and nsaids.  
Laidlaw TM, Cahill KN.
J Allergy Clin Immunol Pract 2017 May;5(3):537-545

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Allergy and Intolerance Abstracts
Practical management of antibiotic hypersensitivity in 2017.
Antibiotics are the most common class of medications that individuals report allergy or intolerance to. Adverse reactions are reported at a predictable rate with all antibiotic use that vary by antibiotic. Antibiotic allergy incidence rates are sex dependent, higher in females than in males. Most of these events are not reproducible or immunologically mediated. Antibiotic allergy prevalence increases with increasing age and is more common in hospitalized populations and in populations that use more antibiotics. Determining potential mechanisms for the observed symptoms of the adverse reactions is the starting point for effective management of antibiotic hypersensitivity. Skin testing and direct challenges are the primary tools used to determine acute tolerance in 2017. Commercially available in vitro testing is not currently clinically useful in determining antibiotic hypersensitivity, with rare exceptions. Desensitization can be used when acute-onset immunologically mediated hypersensitivity is confirmed to safely administer a needed antibiotic. Desensitization is not possible when clinically significant T-cell-mediated delayed-type hypersensitivity is present. Effective management of antibiotic allergy is an important part of a comprehensive antibiotic stewardship program

Practical management of antibiotic hypersensitivity in 2017.  
Macy E, Romano A, Khan D.
J Allergy Clin Immunol Pract 2017 May;5(3):577-586

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Allergy and Intolerance Abstracts
Cockroach allergy and urban asthma.
The article in this month’s Journal by Rabito and colleagues (1) provides evidence that cockroach extermination can be accomplished in urban homes and that cockroach numbers can be reduced for a year. This finding is not new, but they also show that disease control in asthmatic children living in these homes is improved – and this is new. They emphasize that placing insecticidal baits in the home is statistically more effective than letting families pursue their own pest control; but the difference was surprisingly small and I would emphasize that both strategies led to a striking and prolonged reduction in cockroach infestation.

Cockroach allergy and urban asthma.  
Eggleston PA.
J Allergy Clin Immunol 2017 May 18;

Index
Allergy and Intolerance Abstracts
ImmunoCAP cellulose displays cross-reactive carbohydrate (CCD) epitopes and can cause false-positive test results in patients with high anti-CCD IgE antibody levels.
Cross-reactive carbohydrate determinants (CCDs) in plants and insect venoms are a common cause of irrelevant positive test results during in-vitro allergy diagnosis. The authors observed that some CCD-positive sera show non-specific IgE-binding even with CCD-free recombinant allergens when using the Phadia ImmunoCAP platform and therefore, investigated investigated if cellulose used as allergen carrier in the ImmunoCAP harbors residual N-glycans causing non-specific background-binding in CCD-positive sera. IgE binding to six samples of blank ImmunoCAPs coupled with either streptavidin (SA-CAP 1-2) or non-allergenic maltose-binding protein (MBP-CAP 1-4) and to a panel of four recombinant allergens was compared in CCD-positive sera before and after inhibition with a CCD inhibitor (MUXF-HSA). Out of 52 CCD-positive sera (bromelain 1.01-59.6 kUa/L) tested on SA-CAP-1, 35 (67%) showed IgE-binding greater than 0.35 kUa/L (0.41-4.22 kUa/L). Among those with anti-CCD IgE levels >7.0 kUa/L, 90% (26/29) were positive. IgE-binding to SA-CAP-1 correlated with IgE-binding to bromelain (r=0.68) and was completely abolished by serum pre-incubation with the CCD inhibitor (n=15). IgE reactivity of 10 CCD-positive sera (14.0-52.5 kUa/L) with the recombinant allergens rPhl p12, rFel d1, rAra h2, and rPru p3 was positive to at least one allergen in 8/10 (0.36-1.63 kUa/L) and borderline in 2/10 (0.21-0.25 kUa/L). Binding correlated with antibody binding to bromelain (r=0.61) and to all blank ImmunoCAPs (r>0.90) and could be completely blocked by the CCD inhibitor. The study concludes that cellulose used as a solid phase allergen carrier may contain varying amounts of CCDs sufficient to cause false-positive test results up to 2 kUa/L with non-glycosylated recombinant allergens in patients with high levels of anti-CCD IgE antibodies.

Key Messages:

· Clinically irrelevant IgE antibodies against CCDs are found in 20-25% of atopic sera and known to interfere with proper in-vitro allergy diagnosis.

· Cellulose used as an allergen carrier in in-vitro IgE assays may contain low amounts of intact residual CCDs.

· This may cause non-specific background-binding up to 2 kUa/L even with unglycosylated recombinant allergens in serum samples with high levels of anti-CCD IgE antibodies.

ImmunoCAP cellulose displays cross-reactive carbohydrate (CCD) epitopes and can cause false-positive test results in patients with high anti-CCD IgE antibody levels.  
Hemmer W, Altmann F, Holzweber F, Gruber C, Wantke F, Wohrl S.
J Allergy Clin Immunol 2017 May 12;

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Index
Allergy and Intolerance Abstracts
Allergen-specific IgG antibodies signaling via FcgammaRIIb promote food tolerance.
These findings suggest that allergen-specific IgG antibodies can act to induce and sustain immunological tolerance to foods

Allergen-specific IgG antibodies signaling via FcgammaRIIb promote food tolerance.  
Burton OT, Tamayo JM, Stranks AJ, Koleoglou KJ, Oettgen HC.
J Allergy Clin Immunol 2017 May 4;

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Allergy and Intolerance Abstracts
Cross-reactivity in fish allergy: a double-blind placebo-controlled food challenge trial.
Cross-reactivity between fish species exists, and some patients report tolerance to certain species but data from food-challenge trials are scarce. Parvalbumin is the major fish allergen while recently fish muscle enolases and aldolases were identified as new fish allergens. This study presents the first double-blind, placebo-controlled food-challenge trial with different fish species, evaluating the correlation between clinical reactivity and IgE reactivity to fish-allergen molecules in fish-allergic patients.One third of fish-allergic patients tolerate at least one fish species. Specific IgE testing can identify most patients with fish allergy and reduce the need of oral challenges in the diagnostic work-up. 7 patients were allergic to cod only, 2 to salmon only, 6 to cod and salmon, 4 to cod and mackerel.

Cross-reactivity in fish allergy: a double-blind placebo-controlled food challenge trial.  
Sorensen M, Kuehn A, Mills ENC, Costello CA, Ollert M, Smabrekke L, Primicerio R, Wickman M, Klingenberg C.
J Allergy Clin Immunol 2017 May 4;

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Allergy and Intolerance Abstracts
Glycans and glycan-specific IgE in clinical and molecular allergology - sensitization, diagnostics and clinical symptoms.
Glycan-specific IgE antibodies are cross-reacting with highly similar or even identical carbohydrate structures on a variety of different natural allergens, the so-called cross-reactive carbohydrate determinants (CCDs). In clinical practice, CCDs often interfere with the specificity of in vitro allergy diagnostics, thus impairing allergy therapy decisions for individual patients. Strikingly, these IgE antibodies directed against CCD often do not cause clinically relevant allergy symptoms. Opposed to that, the IgE-binding glycan allergen galactose-alpha-(1,3)-galactose (alpha-Gal) is associated with IgE-mediated delayed anaphylaxis in meat allergy. The reason for this discrepancy is not known. The discovery of alpha-Gal stimulated new discussions and investigations regarding the relevance of anti-glycan IgE for allergic diseases. In this review, the impact of glycans and glycan-specific IgE on sensitization to allergens and allergy diagnosis is described. As parasite infections elicit a similar immunological environment as allergic diseases, the association of glycan-specific antibodies against parasite glycoproteins with glycan structures on allergens are discussed

Glycans and glycan-specific IgE in clinical and molecular allergology - sensitization, diagnostics and clinical symptoms.  
Homann A, Schramm G, Jappe U.
J Allergy Clin Immunol 2017 May 4;

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Index

Allergen-, Food allergy-, Intolerance-related articles

Disappearance of severe oral allergy syndrome following omalizumab treatment.  
Asero R.
Eur Ann Allergy Clin Immunol 2017 May;49(3):143-144
Click to view abstract

The Vespid Allergy Quality of Life Questionnaire - cultural adaptation and translation to Portuguese.  
Silva D, Pereira AM, Santos N, Amaral L, Delgado L, Oude Elberink JN, Coimbra A.
Eur Ann Allergy Clin Immunol 2017 May;49(3):114-121
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Body Mass Index and skin reactivity to histamine and Dermatophagoides pteronyssinus in children and adolescents followed in a pediatric allergy service.  
Keller FA, Oselka SR, Carvalho MM, Sole D.
Eur Ann Allergy Clin Immunol 2017 May;49(3):110-113
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Allergic and nonallergic rhinitis and skin sensitization to metals: is there a link?  
Gelardi M, Guarino R, Taliente S, Quaranta N, Carpentieri A, Passalacqua G.
Eur Ann Allergy Clin Immunol 2017 May;49(3):106-109
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FPIES: The dark side of food allergy.  
Sanchez-Salguero CA.
Allergol Immunopathol (Madr ) 2017 May;45(3):209-211

Allergenicity of vertebrate tropomyosins: Challenging an immunological dogma.  
Gonzalez-Fernandez J, Daschner A, Cuellar C.
Allergol Immunopathol (Madr ) 2017 May;45(3):297-304
Click to view abstract

Skin prick test is more useful than specific IgE for diagnosis of buckwheat allergy: A retrospective cross-sectional study.  
Yanagida N, Sato S, Takahashi K, Nagakura KI, Ogura K, Asaumi T, Ebisawa M.
Allergol Int 2017 May 4;
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Aspergillus fumigatus in cystic fibrosis: an update on immune interactions and molecular diagnostics in ABPA.  
Carsin A, Romain T, Ranque S, Reynaud-Gaubert M, Dubus JC, Mege JL, Vitte J.
Allergy 2017 May 17;
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Minimal impact of extensive heating of hen's egg and cow's milk in a food matrix on threshold dose-distribution curves.  
Remington BC, Westerhout J, Campbell DE, Turner PJ.
Allergy 2017 May 5;
Click to view abstract

Amb a 1 isoforms: unequal siblings with distinct immunological features.  
Wolf M, Twaroch TE, Huber S, Reithofer M, Steiner M, Aglas L, Hauser M, Aloisi I, Asam C, Hofer H, Parigiani MA, Ebner C, Bohle B, Briza P, Angela N, Stolz F, Jahn-Schmid B, Wallner M, Ferreira F.
Allergy 2017 May 2;
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Ara h2 levels in dust from homes of individuals with peanut allergy and individuals with peanut tolerance.  
Shroba J, Barnes C, Nanda M, Dinakar C, Ciaccio C.
Allergy Asthma Proc 2017 May 1;38(3):192-196
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Hypersensitivity to biomedical implants: Prevention and diagnosis.  
Rosner GA, Fonacier LS.
Allergy Asthma Proc 2017 May 1;38(3):177-183
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Levodropropizine-Induced anaphylaxis: case series and literature review.  
Song JW, Jang YS, Jung MC, Kim JH, Choi JH, Park S, Hwang YI, Jang SH, Jung KS.
Allergy Asthma Immunol Res 2017 May;9(3):278-280
Click to view abstract

Vaccine allergy: A decade of experience from 2 large UK allergy centers.  
Li PH, Wagner A, Rutkowski R, Rutkowski K.
Ann Allergy Asthma Immunol 2017 Apr 27;

Higher fractional exhaled nitric oxide and Der p 1 exposure in children with asthma living in tropical environments.  
Lanz MJ, Gonzalez MM, Efaw BJ, Harbeck RJ.
Ann Allergy Asthma Immunol 2017 Apr 26;

Hypersensitivity reactions in patients receiving hemodialysis.  
Butani L, Calogiuri G.
Ann Allergy Asthma Immunol 2017 Apr 26;

Sensitization patterns among patients with atopic dermatitis evaluated in a large tertiary care pediatric center.  
Knox SM, Erwin EA, Mosser-Goldfarb JL, Scherzer R.
Ann Allergy Asthma Immunol 2017 May;118(5):645-647

Characteristics of tree nut challenges in tree nut allergic and tree nut sensitized individuals.  
Couch C, Franxman T, Greenhawt M.
Ann Allergy Asthma Immunol 2017 May;118(5):591-596

Anaphylaxis following intralesional triamcinolone acetonide (Kenacort) injection.  
Laisuan W, Wongsa C, Dchapaphapeaktak N, Tongdee M, Chatmapanrangsee J, Rerkpattanapipat T.
Asia Pac Allergy 2017 Apr;7(2):115-118
Click to view abstract

Medical certification reduces the number of children requiring allergen elimination diets for school lunches.  
Korematsu S, Toyokuni K, Handa Y, Gotoh C, Wasada R, Kato R, Kawano N, Ikeuchi M, Okamoto T, Kiriya M, Takahashi M, Takano T, Haigo A.
Asia Pac Allergy 2017 Apr;7(2):92-96
Click to view abstract

Impact of high serum Immunoglobulin E levels on the risk of atherosclerosis in humans.  
Unal D, Gelincik A, Elitok A, Demir S, Olgac M, Coskun R, Kocaaga M, Colakoglu B, Buyukozturk S.
Asia Pac Allergy 2017 Apr;7(2):74-81
Click to view abstract

Thunderstorm asthma: potential danger but a unique opportunity.  
Thien F.
Asia Pac Allergy 2017 Apr;7(2):55-56

Evidence that eating baked egg or milk influences egg or milk allergy resolution: a systematic review.  
Lambert R, Grimshaw KEC, Ellis B, Jaitly J, Roberts G.
Clin Exp Allergy 2017 May 17;
Click to view abstract

Minor allergen patterns in birch pollen allergen products - A question of pollen?  
Zimmer J, Doring S, Strecker D, Trosemeier JH, Hanschmann KM, Fuhrer F, Vieths S, Kaul S.
Clin Exp Allergy 2017 May 10;
Click to view abstract

Application of the adverse outcome pathway (AOP) concept to structure the available in vivo and in vitro mechanistic data for allergic sensitization to food proteins.  
van Bilsen JHM, Sienkiewicz-Szlapka E, Lozano-Ojalvo D, Willemsen LEM, Antunes CM, Molina E, Smit JJ, Wroblewska B, Wichers HJ, Knol EF, Ladics GS, Pieters RHH, ery-Papini S, Vissers YM.
Clin Transl Allergy 2017;713
Click to view abstract

New perspectives on the diagnosis of allergy to Anisakis spp.  
Moneo I, Carballeda-Sangiao N, Gonzalez-Munoz M.
Curr Allergy Asthma Rep 2017 May;17(5):27
Click to view abstract

Natural evolution of IgE responses to mite allergens and relationship to progression of allergic disease: a review.  
Posa D, Hofmaier S, Arasi S, Matricardi PM.
Curr Allergy Asthma Rep 2017 May;17(5):28
Click to view abstract

Mold allergy: is it real and what do we do about it?  
Rudert A, Portnoy J.
Expert Rev Clin Immunol 2017 May 17;1-13
Click to view abstract

Quantitative analysis of species specificity of two anti-parvalbumin antibodies for detecting southern hemisphere fish species demonstrating strong phylogenetic association.  
Ji Liang, Chui Choo Tan, Steve L. Taylor, Joseph Baumert, Andreas L. Lopata, N. Alice Lee.
Food Chemistry 2017;May [In Press]
Abstract

Use of Epinephrine in Patients with Drug-Induced Anaphylaxis: An Analysis of the Beijing Pharmacovigilance Database.  
Wang T, Ma X, Xing Y, Sun S, Zhang H, Sturmer T, Wang B, Li X, Tang H, Jiao L, Zhai S.
Int Arch Allergy Immunol 2017 May 16;173(1):51-60
Click to view abstract

Expression and characterization of functional recombinant Bet v 1.0101 in the chloroplast of Chlamydomonas reinhardtii.  
Hirschl S, Ralser C, Asam C, Gangitano A, Huber S, Ebner C, Bohle B, Wolf M, Briza P, Ferreira F, Griesbeck C, Wallner M.
Int Arch Allergy Immunol 2017 May 12;173(1):44-50
Click to view abstract

The clinical impact of Bet v 6 in birch pollen-sensitized patients.  
Gellrich D, Eder K, San NM, Berghaus A, Groger M.
Int Arch Allergy Immunol 2017 May 12;173(1):34-43
Click to view abstract

Detection of peanut allergen in human blood after consumption of peanuts is skewed by endogenous immunoglobulins.  
JanssenDuijghuijsen LM, Wichers HJ, van Norren K, Keijer J, Baumert JL, de Jong GA, Witkamp RF, Koppelman SJ7.
Miscellaneous J Immunol Methods 2017 Jan;440:52-57.
Abstract

Early introduction of food reduces food allergy - Does it?  
Beyer K.
Pediatr Allergy Immunol 2017 May;28(3):212-213

Food allergy and attitudes to close interpersonal relationships: an exploratory study on attachment.  
Polloni L, Schiff S, Ferruzza E, Lazzarotto F, Bonaguro R, Toniolo A, Celegato N, Antonella M.
Pediatr Allergy Immunol 2017 May 8;
Click to view abstract

Occupational allergic contact dermatitis due to multiple tropical plant species.  
Watts TJ, Li PH, Thomas I, Haque R.
J Allergy Clin Immunol Pract 2017 May 18;

Incidence and risk factors of food allergy after umbilical cord blood transplantation in children.  
Hernandez-Ojeda A, Rojas N, Barriga F, Wietstruck MA, Morales PS, Borzutzky A.
J Allergy Clin Immunol Pract 2017 May 17;

Staphylococcus aureus colonization is associated with increased inhaled corticosteroid requirements in patients with atopic dermatitis and asthma.  
Uong P, Curran-Everett D, Leung DYM.
J Allergy Clin Immunol Pract 2017 May 16;

A case of recurrent facial angioedema associated with elevated tree pollen counts.  
Jayaraman D, Bratton DL, Harbeck RJ, Wolf M, Rabinovitch N.
J Allergy Clin Immunol Pract 2017 May 11;

Epinephrine use and training in schools for food-induced anaphylaxis among non-nursing staff.  
Tsuang A, Demain H, Patrick K, Pistiner M, Wang J.
J Allergy Clin Immunol Pract 2017 May 11;

Drug-induced enterocolitis in an adult patient.  
Garcia RR, Alfaya AT, Borja SJ, Mendez DY, Moreno LL, Extremera OA, Gomez TE.
J Allergy Clin Immunol Pract 2017 May 9;

Fatal anaphylaxis to yellow jacket stings in mastocytosis: options for identification and treatment of at-risk patients.  
Vos BJPR, van AB, van Doormaal JJ, Dubois AEJ, Oude Elberink JNG.
J Allergy Clin Immunol Pract 2017 May 10;
Click to view abstract

Seminal plasma hypersensitivity: Clinical and histopathologic features in a multipara woman.  
Jover C, Rodriguez PR, Domenech WJ, Duran GR, Garcia Teruel MJ, Santes GJ, Bartolome ZB.
J Allergy Clin Immunol Pract 2017 May 10;

Precision allergy: Separate allergies to male and female dogs.  
Schoos AM, Bonnelykke K, Chawes BL, Stokholm J, Bisgaard H, Kristensen B.
J Allergy Clin Immunol Pract 2017 May 9;

An Australian Consensus on infant feeding guidelines to prevent food allergy: outcomes from the australian infant feeding summit.  
Netting MJ, Campbell DE, Koplin JJ, Beck KM, McWilliam V, Dharmage SC, Tang MLK, Ponsonby AL, Prescott SL, Vale S, Loh RKS, Makrides M, Allen KJ.
J Allergy Clin Immunol Pract 2017 May 9;
Click to view abstract

Penicillin Allergy: Mono-, Double-, and Multiple-Drug Hypersensitivity, or Even No Sensitivity?  
Aberer W.
J Allergy Clin Immunol Pract 2017 May;5(3):703-704

Moving toward optimizing testing for penicillin allergy.  
Aberer W, Macy E.
J Allergy Clin Immunol Pract 2017 May;5(3):684-685

Positive skin test or specific IgE to penicillin does not reliably predict penicillin allergy.  
Tannert LK, Mortz CG, Skov PS, Bindslev-Jensen C.
J Allergy Clin Immunol Pract 2017 May;5(3):676-683
Click to view abstract

Oral challenge without skin testing safely excludes clinically significant delayed-onset penicillin hypersensitivity.  
Confino-Cohen R, Rosman Y, Meir-Shafrir K, Stauber T, Lachover-Roth I, Hershko A, Goldberg A.
J Allergy Clin Immunol Pract 2017 May;5(3):669-675
Click to view abstract

Drug allergy: phenotypes, endotypes, and biomarkers.  
Castells MC.
J Allergy Clin Immunol Pract 2017 May;5(3):626-627

Addressing Inpatient Beta-Lactam Allergies: A Multihospital Implementation.  
Blumenthal KG, Shenoy ES, Wolfson AR, Berkowitz DN, Carballo VA, Balekian DS, Marquis KA, Elshaboury R, Gandhi RG, Meka P, Kubiak DW, Catella J, Lambl BB, Hsu JT, Freeley MM, Gruszecki A, .
J Allergy Clin Immunol Pract 2017 May;5(3):616-625
Click to view abstract

Immediate hypersensitivity reaction to chemotherapeutic agents.  
Giavina-Bianchi P, Patil SU, Banerji A.
J Allergy Clin Immunol Pract 2017 May;5(3):593-599
Click to view abstract

Current knowledge and management of hypersensitivity to perioperative drugs and radiocontrast media.  
Hsu Blatman KS, Hepner DL.
J Allergy Clin Immunol Pract 2017 May;5(3):587-592
Click to view abstract

Progestogen hypersensitivity: heterogeneous manifestations with a common trigger.  
Buchheit KM, Bernstein JA.
J Allergy Clin Immunol Pract 2017 May;5(3):566-574
Click to view abstract

Severe delayed cutaneous and systemic reactions to drugs: a global perspective on the science and art of current practice.  
Peter JG, Lehloenya R, Dlamini S, Risma K, White KD, Konvinse KC, Phillips EJ.
J Allergy Clin Immunol Pract 2017 May;5(3):547-563
Click to view abstract

Current knowledge and management of hypersensitivity to aspirin and nsaids.  
Laidlaw TM, Cahill KN.
J Allergy Clin Immunol Pract 2017 May;5(3):537-545
Click to view abstract

The effect of penicillin allergy testing on future health care utilization: a matched cohort study.  
Macy E, Shu YH.
J Allergy Clin Immunol Pract 2017 May;5(3):705-710
Click to view abstract

Practical management of antibiotic hypersensitivity in 2017.  
Macy E, Romano A, Khan D.
J Allergy Clin Immunol Pract 2017 May;5(3):577-586
Click to view abstract

Anaphylaxis due to progesterone hypersensitivity successfully treated with omalizumab.  
Heffler E, Fichera S, Nicolosi G, Crimi N.
J Allergy Clin Immunol Pract 2017 May;5(3):852-854

Flexible IgE epitope containing domains of Phl p 5 cause high allergenic activity.  
Gobl C, Focke-Tejkl M, Najafi N, Schrank E, Madl T, Kosol S, Madritsch C, Dorofeeva Y, Flicker S, Thalhamer J, Valenta R, Zangger K, Tjandra N.
J Allergy Clin Immunol 2017 May 19;
Click to view abstract

Additional effects of dietary advanced glycation end products.  
Miller JD.
J Allergy Clin Immunol 2017 May 18;

Cockroach allergy and urban asthma.  
Eggleston PA.
J Allergy Clin Immunol 2017 May 18;

ImmunoCAP cellulose displays cross-reactive carbohydrate (CCD) epitopes and can cause false-positive test results in patients with high anti-CCD IgE antibody levels.  
Hemmer W, Altmann F, Holzweber F, Gruber C, Wantke F, Wohrl S.
J Allergy Clin Immunol 2017 May 12;
Click to view abstract

Allergen-specific IgG antibodies signaling via FcgammaRIIb promote food tolerance.  
Burton OT, Tamayo JM, Stranks AJ, Koleoglou KJ, Oettgen HC.
J Allergy Clin Immunol 2017 May 4;
Click to view abstract

The number and affinity of productive IgE pairs determine allergen activation of mast cells.  
Hjort C, Schiotz PO, Ohlin M, Wurtzen PA, Christensen LH, Hoffmann HJ.
J Allergy Clin Immunol 2017 May 4;
Click to view abstract

Cross-reactivity in fish allergy: a double-blind placebo-controlled food challenge trial.  
Sorensen M, Kuehn A, Mills ENC, Costello CA, Ollert M, Smabrekke L, Primicerio R, Wickman M, Klingenberg C.
J Allergy Clin Immunol 2017 May 4;
Click to view abstract

Glycans and glycan-specific IgE in clinical and molecular allergology - sensitization, diagnostics and clinical symptoms.  
Homann A, Schramm G, Jappe U.
J Allergy Clin Immunol 2017 May 4;
Click to view abstract


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