TY - JOUR
TI - Walnut Allergy Across Europe: Distribution of Allergen Sensitization Patterns and Prediction of Severity
AU - Lyons, S.A.
AU - Datema, M.R.
AU - Le, T.-M.
AU - Asero, R.
AU - Barreales, L.
AU - Belohlavkova, S.
AU - de Blay, F.
AU - Clausen, M.
AU - Dubakiene, R.
AU - Fernández-Perez, C.
AU - Fritsche, P.
AU - Gislason, D.
AU - Hoffmann-Sommergruber, K.
AU - Jedrzejczak-Czechowicz, M.
AU - Jongejan, L.
AU - Kowalski, M.L.
AU - Kralimarkova, T.Z.
AU - Lidholm, J.
AU - Papadopoulos, N.G.
AU - Pontoppidan, B.
AU - Popov, T.A.
AU - Prado, N.D.
AU - Purohit, A.
AU - Reig, I.
AU - Seneviratne, S.L.
AU - Sinaniotis, A.
AU - Vassilopoulou, E.
AU - Versteeg, S.A.
AU - Vieths, S.
AU - Zwinderman, A.H.
AU - Welsing, P.M.J.
AU - Mills, E.N.C.
AU - Ballmer-Weber, B.K.
AU - Knulst, A.C.
AU - Fernández-Rivas, M.
AU - Van Ree, R.
JO - The Journal of Allergy and Clinical Immunology: In Practice
PY - 2021
VL - 9
TODO - 1
SP - 225-235.e10
PB - American Academy of Allergy, Asthma and Immunology
SN - 2213-2198
TODO - 10.1016/j.jaip.2020.08.051
TODO - immunoglobulin E;  plant protein;  profilin;  seed storage protein;  allergen;  plant antigen, adult;  Article;  atopic dermatitis;  atopy;  clinical assessment;  cross reaction;  disease severity;  Europe;  family history;  female;  geographic distribution;  human;  major clinical study;  male;  molecular diagnosis;  nut allergy;  outpatient;  pollen;  prevalence;  prick test;  sensitization;  walnut;  animal;  cat;  dog;  epidemiology;  food allergy;  hypersensitivity, Allergens;  Animals;  Antigens, Plant;  Cats;  Cross Reactions;  Dogs;  Europe;  Food Hypersensitivity;  Humans;  Hypersensitivity;  Immunoglobulin E;  Juglans
TODO - Background: Walnut allergy is common across the globe, but data on the involvement of individual walnut components are scarce. Objectives: To identify geographical differences in walnut component sensitization across Europe, explore cosensitization and cross-reactivity, and assess associations of clinical and serological determinants with severity of walnut allergy. Methods: As part of the EuroPrevall outpatient surveys in 12 European cities, standardized clinical evaluation was conducted in 531 individuals reporting symptoms to walnut, with sensitization to all known walnut components assessed in 202 subjects. Multivariable Lasso regression was applied to investigate predictors for walnut allergy severity. Results: Birch-pollen–related walnut sensitization (Jug r 5) dominated in Northern and Central Europe and lipid transfer protein sensitization (Jug r 3) in Southern Europe. Profilin sensitization (Jug r 7) was prominent throughout Europe. Sensitization to storage proteins (Jug r 1, 2, 4, and 6) was detected in up to 10% of subjects. The walnut components that showed strong correlations with pollen and other foods differed between centers. The combination of determinants best predicting walnut allergy severity were symptoms upon skin contact with walnut, atopic dermatitis (ever), family history of atopic disease, mugwort pollen allergy, sensitization to cat or dog, positive skin prick test result to walnut, and IgE to Jug r 1, 5, 7, or carbohydrate determinants (area under the curve = 0.81; 95% CI, 0.73-0.89). Conclusions: Walnut-allergic subjects across Europe show clear geographical differences in walnut component sensitization and cosensitization patterns. A predictive model combining results from component-based serology testing with results from extract-based testing and information on clinical background allows for good discrimination between mild to moderate and severe walnut allergy. © 2020 The Authors
ER -