@article{3001651,
    title = "Hazelnut allergy across Europe dissected molecularly: A EuroPrevall outpatient clinic survey",
    author = "Datema, M.R. and Zuidmeer-Jongejan, L. and Asero, R. and Barreales, L. and Belohlavkova, S. and De Blay, F. and Bures, P. and Clausen, M. and Dubakiene, R. and Gislason, D. and Jedrzejczak-Czechowicz, M. and Kowalski, M.L. and Knulst, A.C. and Kralimarkova, T. and Le, T.-M. and Lovegrove, A. and Marsh, J. and Papadopoulos, N.G. and Popov, T. and Del Prado, N. and Purohit, A. and Reese, G. and Reig, I. and Seneviratne, S.L. and Sinaniotis, A. and Versteeg, S.A. and Vieths, S. and Zwinderman, A.H. and Mills, C. and Lidholm, J. and Hoffmann-Sommergruber, K. and Fernández-Rivas, M. and Ballmer-Weber, B. and Van Ree, R.",
    journal = "Allergy: European Journal of Allergy and Clinical Immunology",
    year = "2015",
    volume = "136",
    number = "2",
    pages = "382-391",
    publisher = "Mosby Year Book Inc",
    doi = "10.1016/j.jaci.2014.12.1949",
    keywords = "carbohydrate;  food allergen;  immunoglobulin E antibody;  latex;  oleosin;  pollen antigen;  seed storage protein;  unclassified drug;  allergen;  carrier protein;  Cor a 8 allergen, Corylus avellana;  immunoglobulin E;  lipid transfer protein;  oleosin, Corylus avellana;  plant antigen, adolescent;  allergy rapid test;  anaphylaxis;  Article;  birch;  child;  clinical evaluation;  cross reaction;  Europe;  female;  hazelnut allergy;  human;  major clinical study;  male;  nut allergy;  outpatient department;  prick test;  priority journal;  provocation test;  sensitization;  adult;  blood;  chemistry;  double blind procedure;  hazelnut;  immunology;  middle aged;  molecular epidemiology;  Nut Hypersensitivity;  pathophysiology;  pollen;  skin test;  statistics and numerical data, Adolescent;  Adult;  Allergens;  Ambulatory Care Facilities;  Antigens, Plant;  Betula;  Carrier Proteins;  Corylus;  Cross Reactions;  Double-Blind Method;  Europe;  Female;  Humans;  Immunoglobulin E;  Male;  Middle Aged;  Molecular Epidemiology;  Nut Hypersensitivity;  Pollen;  Skin Tests",
    abstract = "Background Hazelnut allergy is birch pollen-driven in Northern/Western Europe and lipid transfer protein-driven in Spain and Italy. Little is known about other regions and other allergens. Objective Establishing a molecular map of hazelnut allergy across Europe. Methods In 12 European cities, subjects reporting reactions to hazelnut (n = 731) were evaluated and sensitization to 24 foods, 12 respiratory allergen sources, and latex was tested by using skin prick test and ImmunoCAP. A subset (124 of 731) underwent a double-blind placebo-controlled food challenge to hazelnut. Sera of 423 of 731 subjects were analyzed for IgE against 7 hazelnut allergens and cross-reactive carbohydrate determinants by ImmunoCAP. Results Hazelnut allergy was confirmed in 70% of those undergoing double-blind placebo-controlled food challenges. Birch pollen-driven hazelnut sensitization (Cor a 1) dominated in most cities, except in Reykjavik, Sofia, Athens, and Madrid, where reporting of hazelnut allergy was less frequent anyhow. In Athens, IgE against Cor a 8 dominated and strongly correlated with IgE against walnut, peach, and apple and against Chenopodium, plane tree, and mugwort pollen. Sensitization to seed storage proteins was observed in less than 10%, mainly in children, and correlated with IgE to nuts, seeds, and legumes. IgE to Cor a 12, observed in all cities (10% to 25%), correlated with IgE to nuts, seeds, and pollen. Conclusions In adulthood, the importance of hazelnut sensitization to storage proteins, oleosin (Cor a 12), and Cor a 8 is diluted by the increased role of birch pollen cross-reactivity with Cor a 1. Cor a 8 sensitization in the Mediterranean is probably driven by diet in combination with pollen exposure. Hazelnut oleosin sensitization is prevalent across Europe; however, the clinical relevance remains to be established. © 2015 American Academy of Allergy, Asthma & Immunology."
}