Al·lèrgens recombinants en resolució diagnòstica

Antecedents. Els extractes obtinguts a partir de les fonts al·lergògenes completes sovint són barreges mal definides d'al·lèrgens principals, al·lèrgens de reactivitat encreuada (RE) i material no al·lergogen. Quan són utilitzades en els mètodes diagnòstics de sensibilització al·lèrgica ("in vivo" i/o "in vitro"), sovint no permeten un diagnòstic precís de l'al·lergen responsable de la simptomatologia, sobretot en els pacients sensibilitzats a més d'una font al·lergògena. Els avenços en la caracterització d'al·lèrgens (biologia molecular i tècniques de DNA recombinant) han permès que disposem de noves eines diagnòstiques, com els al·lèrgens recombinants i els naturals purificats. Objectius. Capítol I. Definir el patró molecular específic de sensibilització al·lergènica en pacients adults polisensibilitzats a diferents espècies de pol·len de la zona de Barcelona i Roma (Itàlia). Capítol II. Definir patrons moleculars específics de sensibilització al·lergènica en pacients pediàtrics amb al·lèrgia alimentària polisensibilitzats de la regió Mediterrània (Barcelona).Mètodes. 156 pacients adults amb símptomes respiratoris sensibilitzats mitjançant proves cutànies intraepidèrmiques (SPT) a tres o més espècies botàniques de diferent pol·len i, 192 pacients pediàtrics diagnosticats d'al·lèrgia alimentària sensibilitzats a tres o més espècies d'aliments diferents mitjançant SPT. L'SPT es va realitzar amb extractes estandarditzats d'al·lèrgens alimentaris i ambientals. Es va mesurar la Immunoglobulina E (IgE) total sèrica, les IgE específiques (ImmunoCAP, Phadia) als al·lèrgens que foren positius mitjançant SPT i enfront una micromatriu d'al·lèrgens recombinants i naturals purificats (ImmunoCAP ISAC®). Resultats. Capítol I. Els pacients polisensibilitzats de la nostra zona són veritablement al·lèrgics a diverses espècies botàniques de pol·len ja que el percentatge de la sensibilització a al·lèrgens de RE és baix. La sensibilització a proteïnes de la família de les polcalcines s'associava a sensibilització a múltiples espècies de pol·len (≥ 7 espècies botàniques) (p 0,05). A més a més, Bet v 4 i Phl p 7 mostraven correlació estadísticament significativa (p 0,05). Per altra banda, la sensibilització a molècules de la família de les profilines s'associava a sensibilització al pol·len de gramínies i de Mercurialis (p 0,05). En tots els casos s'objectivà positivitat enfront les cinc molècules profilines presents a la micromatriu comercial ISAC® 103 (Phl p 12, Mer a 1, Bet v 2, Ole e 2 i Hev b 8). En els pacients amb al·lèrgia alimentària, la sensibilització a proteïnes transferidores de lípids (LTP) va resultar ser un factor de risc per patir anafilaxi (p 0,05). Tanmateix, no es varen objectivar diferències estadísticament significatives en els nivells mitjans de Pru p 3 entre els pacients amb síndrome d'al·lèrgia oral d'aquells que havien patit clínica d'anafilaxi. Capítol II. La sensibilització més freqüent va ser enfront la proteïna LTP (33%), seguida de la sensibilització a molècules tropomiosines (22%) i parvalbúmines (19%). Pel que fa a la sensibilització a LTP, la molècula més freqüent determinada va ser Pru p 3 (49%), seguida de Jug r 3 (48%), Pla a 3 (42%) i Ara h 9 (78%). En aquesta població d'estudi pediàtrica no es va objectivar associació estadísticament significativa entre la sensibilització a Pru p 3 i la clínica d'anafilaxi deguda a aliments vegetals (p=0,40). Tanmateix, a major edat del pacient, la prevalença d'anafilaxi causada per aliments vegetals també augmentava (p 0,05). Conclusions. L'ús d'al·lèrgens recombinants i naturals purificats per a l'estudi de la sensibilització al·lèrgica en població adulta i pediàtrica polisensibilitzada permet definir les sensibilitzacions genuïnes i les que són conseqüència dels fenòmens de RE amb més precisió diagnòstica. El diagnòstic molecular mitjançant l'ús de micromatrius d'al·lèrgens recombinants i/o naturals purificats (plataforma ISAC®) proporciona informació addicional per aconseguir un millor control de la patologia al·lèrgica. La identificació exacte de l'al·lergen sensibilitzant és un requeriment essencial per obtenir un diagnòstic òptim en el pacient al·lèrgicBackground. Extracts obtained from complete allergenic sources are usually badly defined mixtures of major allergens, cross reactive allergens and non-allergenic material. These extracts often do not allow a precise diagnosis of the allergen responsible for the symptoms ("in vivo" or "in vitro"), especially in patients sensitized to more than one allergenic source. Advances in the characterization of allergens (molecular biology and recombinant DNA techniques), have allowed the development of new diagnostic tools based on purified and recombinant allergens. Objectives. Chapter I. The primary aim of the study was to define specific molecular allergic sensitization patterns in adult patients allergic to multiple pollen species from the area of Barcelona and Rome (Italy). Chapter II. The aim of the study was to define specific molecular allergic sensitisation patterns in paediatric poly-sensitised patients with food allergy from the Mediterranean area (Barcelona). Methods. 156 adult patients referring respiratory symptoms sensitized to three or more botanical species by means of skin prick test (SPT) and 192 pediatric patients referring food allergy sensitized to three or more different food species by means of SPT were included. SPT were performed with standardized food and inhalant allergen extracts. Total serum IgE, specific IgE (sIgE) (ImmunoCAP, Phadia) to those allergens shown positive on the SPT and specific IgE to a panel of recombinant allergens by ImmunoCAP ISAC® platform were measured. Results. Chapter I. Poly-sensitized patients in our area are truly allergic to several botanical species since the percentage of sensitization to panallergens is low. Sensitization to calcium binding proteins was associated to poly-pollen sensitization (≥ 7 botanical species) (p 0,05). Moreover, Bet v 4 and Phl p 7 were correlated (p 0,05).On the other hand, sensitization to profilins was associated to grass pollen and Mercurialis sensitization (p 0,05). In all cases, positivity to the 5 profilin present on the ISAC® platform (Phl p 12, Mer a 1, Bet v2, Ole e 2 and Hev b 8) was found. In patients with food allergy, lipid transfer protein (LTP) sensitization was found to be a risk factor for anaphylaxis (p 0,05). However, differences in mean levels of Pru p 3 did not differ significantly between patients with oral allergy syndrome (OAS) and anaphylaxis. Chapter II. LTP was the most prevalent protein sensitization in our population (33%), followed by tropomyosins (22%) and parvalbumins (19%). Regarding LTP sensitization, the most frequent molecule determined was Pru p 3 (49%), followed by Jug r 3 (48%), Pla a 3 (42%) and Ara h 9 (41%). There was no statistical association between sensitization to Pru p 3 and anaphylaxis due to vegetable foods (p=0.40). However, as the patient's age increases, the rate of anaphylaxis caused by vegetable foods rises (p 0.05). Conclusions. The use of recombinant and purified allergens for the study of the allergic sensitization of polysensitized adult and pediatric patients and patients with complex allergic disease may help discern genuine sensitization of the patient from cross-reactivity with greater diagnostic accuracy. Multiplexed molecular diagnosis (ISAC® platform) delivers added information useful for the management of allergic patients since the identification of the exact allergen sensitizing the patient is an essential requirement for the optimal diagnosis

Understanding the challenges faced by adolescents and young adults with allergic conditions:a systematic review

BACKGROUND: Adolescence represents a vulnerable time for individuals with asthma and allergic conditions. They suffer an unexpected degree of morbidity. This systematic review aimed to understand the challenges faced by adolescents and young adults with these conditions. METHODS: A systematic literature search was undertaken across eight databases. References were checked by two reviewers for inclusion. Study data were extracted, and their quality was assessed in duplicate. A narrative meta-synthesis was undertaken. RESULTS: A total of 108 papers describing 106 studies were retrieved, most focused on asthma. Five themes were identified across studies: (a) Health-related quality of life-impairment was associated with poor disease control, psychosocial issues, adolescent-onset allergic disease and female sex; (b) Psychological factors-asthma and food allergy were associated with anxiety and depression, atopic dermatitis was associated with suicidal ideation, and that parental emotional support may be protective; (c) Adherence-suboptimal adherence was associated with older age, barriers to medication usage, poor symptom perception and failure to take responsibility, and positive factors were routines, simpler treatment regimes, better knowledge and perceptions about medications; (d) Self-management-facilitated by education, knowledge and a positive attitude; and (e) Supportive relationships-families could modify barriers to adherence and foster positive views about self-management, adolescents suggested that their peers should be more involved in supporting them, and adolescents also wished to have support from nonjudgemental healthcare professionals. CONCLUSIONS: We have some understanding of the challenges faced by adolescents with asthma, less so for other allergic conditions. This knowledge will be used to support guidelines for managing adolescents

The effectiveness of interventions to improve self-management for adolescents and young adults with allergic conditions:a systematic review

BACKGROUND: This systematic review aimed to review the literature on interventions for improving self-management and well-being in adolescents and young adults (11-25 years) with asthma and allergic conditions. METHODS: A systematic literature search was undertaken across eight databases. References were checked by two reviewers for inclusion. Study data were extracted, and their quality was assessed in duplicate. A narrative synthesis was undertaken. RESULTS: A total of 30 papers reporting data from 27 studies were included. Interventions types were psychological (k = 9); e-health (k = 8); educational (k = 4); peer-led (k = 5); breathing re-training (k = 1). All interventions were for asthma. Psychological interventions resulted in significant improvements in the intervention group compared with the control group for self-esteem, quality of life, self-efficacy, coping strategies, mood and asthma symptoms. E-Health interventions reported significant improvements for inhaler technique, adherence and quality of life. General educational interventions demonstrated significantly improved quality of life, management of asthma symptoms, controller medication use, increased use of a written management plan and reduction in symptoms. The peer-led interventions included the Triple A (Adolescent Asthma Action) programme and a peer-led camp based on the Power Breathing Programme. Improvements were found for self-efficacy, school absenteeism and quality of life. CONCLUSION: Although significant improvements were seen for all intervention types, many were small feasibility or pilot studies, few studies reported effect sizes and no studies for allergic conditions other than asthma met the inclusion criteria. Research using large longitudinal interventional designs across the range of allergic conditions is required to strengthen the evidence base

A practical toolbox for the effective transition of adolescents and young adults with asthma and allergies - an EAACI Position paper

Adolescence is a critical stage of rapid biological, emotional and social change and development. Adolescents and young adults (AYA) with asthma and allergies need to develop the knowledge and skills to self-manage their health independently. Healthcare professionals (HCP), parents and their wider network play an essential role in supporting AYA in this process. Previous work showed significant limitations in transition care across Europe. In 2020, the first evidence-based guideline on effective transition for AYA with asthma and allergies was published by EAACI. We herein summarize practical resources to support this guideline's implementation in clinical practice. For this purpose, multi-stakeholder Task Force members searched for resources in peer review journals and grey literature. These resources were included if relevant and of good quality, and were pragmatically rated for their evidence-basis and user friendliness. Resources identified covered a range of topics and targeted healthcare professionals, AYA, parents/carers, schools, workplace, and wider community. Most resources were in English, web-based and had limited evidence-basis. This position paper provides a valuable selection of practical resources for all stakeholders to support effective transitional care for AYA with asthma and allergies. Future research should focus on developing validated, patient-centred tools to further assist evidence-based transition care

Al·lèrgens recombinants en resolució diagnòstica

Antecedents. Els extractes obtinguts a partir de les fonts al·lergògenes completes sovint són barreges mal definides d’al·lèrgens principals, al·lèrgens de reactivitat encreuada (RE) i material no al·lergogen. Quan són utilitzades en els mètodes diagnòstics de sensibilització al·lèrgica (“in vivo” i/o “in vitro”), sovint no permeten un diagnòstic precís de l’al·lergen responsable de la simptomatologia, sobretot en els pacients sensibilitzats a més d’una font al·lergògena. Els avenços en la caracterització d’al·lèrgens (biologia molecular i tècniques de DNA recombinant) han permès que disposem de noves eines diagnòstiques, com els al·lèrgens recombinants i els naturals purificats. Objectius. Capítol I. Definir el patró molecular específic de sensibilització al·lergènica en pacients adults polisensibilitzats a diferents espècies de pol·len de la zona de Barcelona i Roma (Itàlia). Capítol II. Definir patrons moleculars específics de sensibilització al·lergènica en pacients pediàtrics amb al·lèrgia alimentària polisensibilitzats de la regió Mediterrània (Barcelona).Mètodes. 156 pacients adults amb símptomes respiratoris sensibilitzats mitjançant proves cutànies intraepidèrmiques (SPT) a tres o més espècies botàniques de diferent pol·len i, 192 pacients pediàtrics diagnosticats d’al·lèrgia alimentària sensibilitzats a tres o més espècies d'aliments diferents mitjançant SPT. L’SPT es va realitzar amb extractes estandarditzats d'al·lèrgens alimentaris i ambientals. Es va mesurar la Immunoglobulina E (IgE) total sèrica, les IgE específiques (ImmunoCAP, Phadia) als al·lèrgens que foren positius mitjançant SPT i enfront una micromatriu d’al·lèrgens recombinants i naturals purificats (ImmunoCAP ISAC®). Resultats. Capítol I. Els pacients polisensibilitzats de la nostra zona són veritablement al·lèrgics a diverses espècies botàniques de pol·len ja que el percentatge de la sensibilització a al·lèrgens de RE és baix. La sensibilització a proteïnes de la família de les polcalcines s’associava a sensibilització a múltiples espècies de pol·len (≥ 7 espècies botàniques) (p<0,05). A més a més, Bet v 4 i Phl p 7 mostraven correlació estadísticament significativa (p<0,05). Per altra banda, la sensibilització a molècules de la família de les profilines s'associava a sensibilització al pol·len de gramínies i de Mercurialis (p<0,05). En tots els casos s’objectivà positivitat enfront les cinc molècules profilines presents a la micromatriu comercial ISAC® 103 (Phl p 12, Mer a 1, Bet v 2, Ole e 2 i Hev b 8). En els pacients amb al·lèrgia alimentària, la sensibilització a proteïnes transferidores de lípids (LTP) va resultar ser un factor de risc per patir anafilaxi (p<0,05). Tanmateix, no es varen objectivar diferències estadísticament significatives en els nivells mitjans de Pru p 3 entre els pacients amb síndrome d'al·lèrgia oral d’aquells que havien patit clínica d’anafilaxi. Capítol II. La sensibilització més freqüent va ser enfront la proteïna LTP (33%), seguida de la sensibilització a molècules tropomiosines (22%) i parvalbúmines (19%). Pel que fa a la sensibilització a LTP, la molècula més freqüent determinada va ser Pru p 3 (49%), seguida de Jug r 3 (48%), Pla a 3 (42%) i Ara h 9 (78%). En aquesta població d’estudi pediàtrica no es va objectivar associació estadísticament significativa entre la sensibilització a Pru p 3 i la clínica d’anafilaxi deguda a aliments vegetals (p=0,40). Tanmateix, a major edat del pacient, la prevalença d'anafilaxi causada per aliments vegetals també augmentava (p<0,05). Conclusions. L'ús d'al·lèrgens recombinants i naturals purificats per a l'estudi de la sensibilització al·lèrgica en població adulta i pediàtrica polisensibilitzada permet definir les sensibilitzacions genuïnes i les que són conseqüència dels fenòmens de RE amb més precisió diagnòstica. El diagnòstic molecular mitjançant l’ús de micromatrius d’al·lèrgens recombinants i/o naturals purificats (plataforma ISAC®) proporciona informació addicional per aconseguir un millor control de la patologia al·lèrgica. La identificació exacte de l’al·lergen sensibilitzant és un requeriment essencial per obtenir un diagnòstic òptim en el pacient al·lèrgic.Background. Extracts obtained from complete allergenic sources are usually badly defined mixtures of major allergens, cross reactive allergens and non-allergenic material. These extracts often do not allow a precise diagnosis of the allergen responsible for the symptoms (“in vivo” or “in vitro”), especially in patients sensitized to more than one allergenic source. Advances in the characterization of allergens (molecular biology and recombinant DNA techniques), have allowed the development of new diagnostic tools based on purified and recombinant allergens. Objectives. Chapter I. The primary aim of the study was to define specific molecular allergic sensitization patterns in adult patients allergic to multiple pollen species from the area of Barcelona and Rome (Italy). Chapter II. The aim of the study was to define specific molecular allergic sensitisation patterns in paediatric poly-sensitised patients with food allergy from the Mediterranean area (Barcelona). Methods. 156 adult patients referring respiratory symptoms sensitized to three or more botanical species by means of skin prick test (SPT) and 192 pediatric patients referring food allergy sensitized to three or more different food species by means of SPT were included. SPT were performed with standardized food and inhalant allergen extracts. Total serum IgE, specific IgE (sIgE) (ImmunoCAP, Phadia) to those allergens shown positive on the SPT and specific IgE to a panel of recombinant allergens by ImmunoCAP ISAC® platform were measured. Results. Chapter I. Poly-sensitized patients in our area are truly allergic to several botanical species since the percentage of sensitization to panallergens is low. Sensitization to calcium binding proteins was associated to poly-pollen sensitization (≥ 7 botanical species) (p<0,05). Moreover, Bet v 4 and Phl p 7 were correlated (p<0,05).On the other hand, sensitization to profilins was associated to grass pollen and Mercurialis sensitization (p<0,05). In all cases, positivity to the 5 profilin present on the ISAC® platform (Phl p 12, Mer a 1, Bet v2, Ole e 2 and Hev b 8) was found. In patients with food allergy, lipid transfer protein (LTP) sensitization was found to be a risk factor for anaphylaxis (p<0,05). However, differences in mean levels of Pru p 3 did not differ significantly between patients with oral allergy syndrome (OAS) and anaphylaxis. Chapter II. LTP was the most prevalent protein sensitization in our population (33%), followed by tropomyosins (22%) and parvalbumins (19%). Regarding LTP sensitization, the most frequent molecule determined was Pru p 3 (49%), followed by Jug r 3 (48%), Pla a 3 (42%) and Ara h 9 (41%). There was no statistical association between sensitization to Pru p 3 and anaphylaxis due to vegetable foods (p=0.40). However, as the patient’s age increases, the rate of anaphylaxis caused by vegetable foods rises (p<0.05). Conclusions. The use of recombinant and purified allergens for the study of the allergic sensitization of polysensitized adult and pediatric patients and patients with complex allergic disease may help discern genuine sensitization of the patient from cross-reactivity with greater diagnostic accuracy. Multiplexed molecular diagnosis (ISAC® platform) delivers added information useful for the management of allergic patients since the identification of the exact allergen sensitizing the patient is an essential requirement for the optimal diagnosis

INMUNOCAT study: The impact of molecular diagnosis on immunotherapy prescription in pollen polysensitized patients from Catalonia

Abstract Background Recognition of specific allergens triggering immune response is key for the appropriate prescription of allergen‐specific immunotherapy (SIT). This study aimed at evaluating the impact of using the commercially available microarray ImmunoCAPTM ISAC 112 (Thermo Fisher Scientific) on the etiological diagnosis and SIT prescription compared to the conventional diagnostic methods in patients with allergic rhinitis/rhinoconjunctivitis and/or asthma. Methods 300 patients with respiratory allergic disease, sensitized to three or more pollen aeroallergens from different species, as assessed by a skin prick test (SPT) and specific IgE assays (sIgE), were included in this multicentric, prospective observational study. SPT and a blood test were performed to all patients. Total serum IgE and sIgE (ImmunoCAPTM) for allergens found positive in the SPT and sIgE allergen components (ImmunoCAPTM ISAC 112) were measured. Results According to SPT results, the most prevalent pollen sensitizers in our population were Olea europaea followed by grass, Platanus acerifolia and Parietaria judaica. The molecular diagnosis (MD) revealed Ole e 1 as the most prevalent pollen sensitizer, followed by Cup a 1, Phl p 1, Cyn d 1, Par j 2, Pla a 1, 2, and 3 and Phl p 5. Immunotherapy prescription changed, due to MD testing, in 51% of the cases, with an increase of prescription of SIT from 39% to 65%. Conclusion The identification of the allergen eliciting the respiratory disease is essential for a correct immunotherapy prescription. The advances in allergen characterization using methods, such as the commercial microarray ImmunoCAPTM ISAC 112, can help clinicians to improve SIT prescription

EAACI Guidelines on the effective transition of adolescents and young adults with allergy and asthma

Adolescent and young adult (AYA) patients need additional support while they experience the challenges associated with their age. They need specific training to learn the knowledge and skills required to confidently self-manage their allergies and/or asthma. Transitional care is a complex process which should address the psychological, medical, educational and vocational needs of AYA in the developmentally appropriate way. The European Academy of Allergy and Clinical Immunology has developed a clinical practice guideline to provide evidence-based recommendations for healthcare professionals to support the transitional care of AYA with allergy and/or asthma. This guideline was developed by a multi-disciplinary working panel of experts and patient representatives based on two recent systematic reviews. It sets out a series of general recommendations on operating a clinical service for AYA, which include: (i) starting transition early (11-13 years), (ii) using a structured, multidisciplinary approach, (iii) ensuring AYA fully understand their condition and have resources they can access, (iv) active monitoring of adherence and (v) discussing any implications for further education and work. Specific allergy and asthma transition recommendations include (i) simplifying medication regimes and using reminders; (ii) focusing on areas where AYA are not confident and involving peers in training AYA patients; (iii) identifying and managing psychological and socioeconomic issues impacting disease control and quality of life; (iv) enrolling the family in assisting AYA to undertake self-management and (v) encouraging AYA to let their friends know about their allergies and asthma. These recommendations may need to be adapted to fit into national healthcare systems

EAACI Guidelines on the effective transition of adolescents and young adults with allergy and asthma

Adolescent and young adult (AYA) patients need additional support while they experience the challenges associated with their age. They need specific training to learn the knowledge and skills required to confidently self-manage their allergies and/or asthma. Transitional care is a complex process which should address the psychological, medical, educational and vocational needs of AYA in the developmentally appropriate way. The European Academy of Allergy and Clinical Immunology has developed a clinical practice guideline to provide evidence-based recommendations for healthcare professionals to support the transitional care of AYA with allergy and/or asthma. This guideline was developed by a multi-disciplinary working panel of experts and patient representatives based on two recent systematic reviews. It sets out a series of general recommendations on operating a clinical service for AYA, which include: (i) starting transition early (11-13 years), (ii) using a structured, multidisciplinary approach, (iii) ensuring AYA fully understand their condition and have resources they can access, (iv) active monitoring of adherence and (v) discussing any implications for further education and work. Specific allergy and asthma transition recommendations include (i) simplifying medication regimes and using reminders; (ii) focusing on areas where AYA are not confident and involving peers in training AYA patients; (iii) identifying and managing psychological and socioeconomic issues impacting disease control and quality of life; (iv) enrolling the family in assisting AYA to undertake self-management and (v) encouraging AYA to let their friends know about their allergies and asthma. These recommendations may need to be adapted to fit into national healthcare systems

Current transition management of adolescents and young adults with allergy and asthma:A European survey

Abstract: Background: Transition from parent-delivered to self-management is a vulnerable time for adolescents and young adults (AYA) with allergy and asthma. There is currently no European guideline available for healthcare professionals (HCPs) on transition of these patients and local/national protocols are also mostly lacking. Methods: European HCPs working with AYA with allergy and asthma were invited to complete an online survey assessing challenges of working with these patients, current transition practices and access to specific healthcare resources. Results: A total of 1179 responses from 41 European countries were collected. Most HCPs (86%) reported a lack of a transition guideline and a lack of a transition process (20% paediatric HCPs, 50% of adult HCPs, 56% HCP seeing all ages). Nearly half (48%) acknowledged a lack of an established feedback system between paediatric and adult medical services. Many respondents never routinely asked about mental health issues such as self-harm or depression and are not confident in asking about self-harm (66.6%), sexuality (64%) and depression (43.6%). The majority of HCPs (76%) had not received specific training in the care of AYA although 87% agreed that transition was important for AYA with allergy and asthma. Conclusion: Although there was agreement that transition is important for AYA with allergy and asthma, there are crucial limitations and variations in the current provision of transition services across Europe. Standardisation of AYA management and specific training are required. This should improve management and continuity of care during adolescence and into adulthood to achieve the best healthcare outcomes

Perceptions of adolescents and young adults with allergy and/or asthma and their parents on EAACI guideline recommendations about transitional care: A European survey

Background: The European Academy of Allergy and Clinical Immunology has developed a guideline to provide evidence-based recommendations for healthcare professionals to support the transitional care of adolescents and young adults (AYA) with allergy and/or asthma. The goal of this work was to ensure that the draft recommendations are also important for patients. Methods: We surveyed patients aged 11-25 years with allergy and/or asthma and their parents across Europe between 17th February and 16th March 2020. The multilingual survey was distributed through national allergy and asthma patient organisations in Europe as well as through social media. Results: A total of 1210 responses from 24 European countries were collected. There were 415 (34.3%) AYA and 795 (65.7%) parents. The majority of AYA (72.3%) and parents (81.9%) were female. Patients had a history of asthma (61.1%), allergic rhinoconjunctivitis (54.1%), food allergy (53.8%), atopic eczema (42.6%), and anaphylaxis (28.8%). All recommendations achieved the median score of either ‘important’ or ‘very important’. The least supported recommendations were the use of joint clinics with both paediatric and adult physicians attending and the use of web-based or mobile technologies for communication with the AYA. The most supported recommendation was checking that the AYA is knowledgeable and compliant with their prescribed medication. Qualitative analysis revealed conditional approval for some recommendations. Conclusions: There was agreement from patients and parents on the importance of the draft recommendations on transitional care for adolescents and young adults with allergy and/or asthma and their parents. The recommendations now need to be implemented into clinical practice across Europe