Risk factors and severity
Improving the identification and management of children and adults at risk of experiencing a severe reaction was one of iFAAM’s aims.
Novel scoring systems, including a numerical score for severity of reactions, were developed and used to mine historic EuroPrevall data sets to identify risk factors and biomarkers of severe reactions to hazelnut.
A mathematical model combining component resolved diagnosis (CRD; where IgE responses towards individual food allergen molecules is determined) with clinical background and extract-based serology (the examination of blood serum) was found superior to CRD alone in assessing the risk of severe reactions to hazelnut, particular in ruling out severe reactions.
Managing reactions to foods
It has been suggested that IgG4 antibodies might have a protective effect and be associated with tolerance and/or less severe reactions to foods. However, this proved not to be the case when samples from a group of peanut-allergic subjects were analysed.
A study of intrinsic and extrinsic factors that may modify severity suggests that the food matrix and viral infections may modify sensitivity, while antacids such as proton pump inhibitors have no significant effect on threshold dose.
The outcomes of these interconnected studies were then assessed as to how they are likely to impact on the ability of clinicians to identify individuals at risk of severe reactions and improve their management.
- Datema M R, van Ree R, Asero R, et al (2018) Component-resolved diagnosis and beyond: Multivariable regression models to predict severity of hazelnut allergy
- Datema M R, Zuidmeer-Jongejan L, Asero R, et al. Hazelnut allergy across Europe dissected molecularly: A EuroPrevall outpatient clinic survey (2015) Hazelnut allergy across Europe dissected molecularly: A EuroPrevall outpatient clinic survey
- Datema M R, Eller E, Zwinderman A H, et al (2019) Ratios of specific IgG4 over IgE antibodies do not improve prediction of peanut allergy nor of its severity compared to specific IgE alone
- Roberts G, Allen K, Ballmer-Weber B, et al (2019) Identifying and managing patients at risk of severe allergic reactions to food: Report from two iFAAM workshops