Kutane Symptome nach Genuss pollenassoziierter Nahrungsmittel

Zusammenfassung: Die pollenassoziierte Nahrungsmittelallergie beruht auf einer Struktur- und Sequenzähnlichkeit allergener Proteine in Pollen und pflanzlichen Nahrungsmitteln. Die primäre IgE-Antwort richtet sich bei betroffenen Patienten in der Regel primär gegen Epitope auf Pollenproteinen mit sekundärer Erkennung homologer Epitope auf Nahrungsmittelallergenen. So leiden z.B. in Zentral- und Nordeuropa bis zu 80% der Birkenpollenallergiker gleichzeitig unter einer Nahrungsmittelallergie insbesondere gegen Stein- und Kernobst sowie gegen verschiedene Nüsse und Gemüse. Die Hauptmanifestation der pollenassoziierten Nahrungsmittelallergie ist das orale Allergiesyndrom, eine Kontakturtikaria der Mundschleimhaut. Neben der Kontakturtikaria insbesondere der Hände bei Berührung der allergenen Nahrungsmittel entwickeln Patienten mit pollenassoziierter Nahrungsmittelallergie bei deren Einnahme v.a. generalisierte Urtikaria und Angioödeme als kutane Symptome. Der Einfluss einer pollenassoziierten Nahrungsmittelallergie auf die Ausprägung und den Verlauf des atopischen Ekzems ist bis heute noch nicht definitiv geklär

Is benzyl alcohol a significant contact sensitizer?

Background: Benzyl alcohol is a widely used preservative, solvent and fragrance material. According to published data, it is a rare sensitizer in humans. Objectives: To identify characteristics and sensitization patterns of patients with positive patch test reactions to benzyl alcohol and to check the reliability of the patch test preparation benzyl alcohol 1% pet. Patients and methods: Retrospective analysis of data from the Information Network of Departments of Dermatology (IVDK), 2010-2019. Results: Of 70 867 patients patch tested with benzyl alcohol 1% pet., 146 (0.21%) showed a positive reaction, most of them (89%) only weakly positive. The number of doubtful and irritant reactions significantly exceeded the number of positive reactions. Reproducibility of positive test reactions was low. Among benzyl alcohol-positive patients, compared to benzyl alcohol-negative patients, there were significantly more patients with leg dermatitis (17.8% vs. 8.6%), more patients aged 40 years or more (81.5% vs. 70.5%) and more patients who were tested because of a suspected intolerance reaction to topical medications (34.9% vs. 16.6%). Concomitant positive reactions were mainly seen to fragrances, preservatives and ointment bases. Conclusions: Sensitization to benzyl alcohol occurs very rarely, mainly in patients with stasis dermatitis. In view of our results, benzyl alcohol cannot be regarded as a significant contact allergen, and therefore marking it as skin sensitizer 1B and labelling it with H 317 is not helpful

Threshold Dose for Shrimp: A Risk Characterization Based on Objective Reactions in Clinical Studies

A DBPCFC [double-blind, placebo-controlled food challenge] of shrimp-allergic adults was conducted to obtain individual threshold doses. Results of this study and published research were combined and a population threshold for shrimp was determined from dose-distribution modeling. The shrimp-allergic population seems to have a higher threshold compared to other populations for other food allergens. Additional shrimp challenges should be done to confirm these initial results

How does dose impact on the severity of food-induced allergic reactions, and can this improve risk assessment for allergenic foods?

Funding informationThis work was conducted by an expert group of the European branch of the International Life Sciences Institute, ILSI Europe. This publication was coordinated by the Food Allergy Task Force. Industry members of this task force are listed on the ILSI Europe website at http://ilsi.eu/task-forces/food-safety/food-allergy/. Experts are not paid for the time spent on this work; however, the nonindustry members within the expert group were offered support for travel and accommodation costs from the Food Allergy Task Force to attend meetings to discuss the manuscript and a small compensatory sum (honorarium) with the option to decline. The expert group carried out the work, that is collecting/analysing data/information and writing the scientific paper separate to other activities of the task force. The research reported is the result of a scientific evaluation in line with ILSI Europe's framework to provide a precompetitive setting for public‐private partnership. ILSI Europe facilitated scientific meetings and coordinated the overall project management and administrative tasks relating to the completion of this work. For further information about ILSI Europe, please email [email protected] or call +3227710014. The opinions expressed herein and the conclusions of this publication are those of the authors and do not necessarily represent the views of ILSI Europe nor those of its member companies or any regulatory authority

Standardization of double blind placebo controlled food challenge with soy within a multicentre trial

Background: Multicentre trials investigating food allergies by double blind placebo controlled food challenges (DBPCFC) need standardized procedures, challenge meals and evaluation criteria. We aimed at developing a standardized approach for identifying patients with birch related soy allergy by means of DBPCFC to soy, including determination of threshold levels, in a multicentre setting. Methods: Microbiologically stable soy challenge meals were composed of protein isolate with consistent Gly m 4 levels. Patients sensitized to main birch allergen Bet v 1 and concomitant sensitization to its soy homologue Gly m 4 underwent DBPCFC. Outcome was defined according to presence and/or absence of ten objective signs and intensity of eight subjective symptoms as measured by visual analogue scale (VAS). Results: 138 adult subjects (63.8% female, mean age 38 years) underwent DBPCFC. Challenge meals and defined evaluation criteria showed good applicability in all centres involved. 45.7% presented with objective signs and 65.2% with subjective symptoms at soy challenge. Placebo challenge meals elicited non-cardiovascular objective signs in 11.6%. In 82 (59.4%) subjects DBPCFC was judged as positive. 70.7% of DPBCFC+ showed objective signs and 85.4% subjective symptoms at soy challenge. Subjective symptoms to soy challenge meal in DBPCFC+ subjects started at significantly lower dose levels than objective signs (p < 0.001). Median cumulative eliciting doses for first objective signs in DBPCFC+ subjects were 4.7 g [0.7–24.7] and 0.7 g [0.2–4.7] total soy protein for first subjective symptoms (p = 0.01). Conclusions: We present the hitherto largest group of adults with Bet v 1 and Gly m 4 sensitization being investigated by DBPCFC. In this type of food allergy evaluation of DBPCFC outcome should not only include monitoring of objective signs but also scoring of subjective symptoms. Our data may contribute to standardize DBPCFC in pollen-related food allergy in multicentre settings. Trial registration EudraCT: 2009-011737-27