Hazelnut allergy across Europe…

Hazelnut allergy across Europe…

Hazelnut allergy across Europe...


Author information

  • 1 Department of Experimental Immunology, Academic Medical Center, Amsterdam, The Netherlands.
  • 2 Ambulatorio di Allergologia, Clinica San Carlo, Paderno Dugnano, Italy.
  • 3 Clinical Epidemiology Unit, Preventive Medicine Department, Hospital Clinico San Carlos, IdISSC, Madrid, Spain.
  • 4 Pediatric Department, Faculty Hospital Bulovka, Prague, Czech Republic.
  • 5 Allergy Division, Chest Disease Department, University Hospital of Strasbourg, Strasbourg, France.
  • 7 Faculty of Medicine, University of Iceland, Landspitali University Hospital, Reykjavik, Iceland.
  • 8 Medical Faculty, Vilnius University, Vilnius, Lithuania.
  • 9 Department of Immunology, Rheumatology and Allergy, Faculty of Medicine, Medical University of Lodz, Lodz, Poland.
  • 10 Department of Dermatology and Allergology, University Medical Center Utrecht, Utrecht, The Netherlands.
  • 11 Clinic of Allergy and Asthma, Medical University of Sofia, Sofia, Bulgaria.
  • 12 Department of Plant Biology and Crop Science, Rothamsted Research, Harpenden, United Kingdom.
  • 13 Institute of Inflammation and Repair, Manchester Institute of Biotechnology, University of Manchester, Manchester, United Kingdom.
  • 14 Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece; Centre for Paediatrics and Child Health, Institute of Human Development, University of Manchester, Manchester, United Kingdom.
  • 15 Division of Allergology, Paul-Ehrlich-Insitut, Federal Institute for Vaccines and Biomedicines, Langen, Germany.
  • 16 Allergy Department, Hospital Clinico San Carlos, IdISSC, Madrid, Spain.
  • 17 Department of Clinical Immunology, St Mary’s Hospital, and Imperial College London, London, United Kingdom.
  • 18 Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece.
  • 19 Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Centre, Amsterdam, The Netherlands.
  • 20 Phadia AB, Uppsala, Sweden.
  • 21 Department of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria.
  • 22 Department of Experimental Immunology, Academic Medical Center, Amsterdam, The Netherlands; Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, The Netherlands. Electronic address: r.vanree@amc.uva.nl.


J Allergy Clin Immunol. 2015 Aug;136(2):382-91. doi: 10.1016/j.jaci.2014.12.1949. Epub 2015 Mar 13.


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.

Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.


25772593 [PubMed — indexed for MEDLINE]

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