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. 2021 Nov;51(11):1429-1437.
doi: 10.1111/cea.13994. Epub 2021 Aug 6.

Prevalence and early-life risk factors for tree nut sensitization and allergy in young adults

Jessica Bager  1 , Sandra G Tedner  1   2 , Niklas Andersson  3 , Natalia Ballardini  4   5   6 , Magnus P Borres  7 , Jon R Konradsen  1   2 , Caroline Nilsson  4   5 , Marit Westman  8   9 , Inger Kull  4   5 , Anna Bergström  3   10 , Marianne van Hage  8 , Erik Melen  3   4   5 , Anna Asarnoj  1   2
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Prevalence and early-life risk factors for tree nut sensitization and allergy in young adults

Jessica Bager et al. Clin Exp Allergy. 2021 Nov.

Abstract

Background: Tree nut allergy may cause anaphylaxis. There are limited population-based studies on prevalence and early-life risk factors.

Methods: We evaluated the prevalence of reported symptoms and allergic sensitization to tree nuts at age 24 years in the BAMSE population-based cohort study and assessed early-life factors associated with the development of tree nut allergy. We estimated tree nut allergy prevalence, by analysing questionnaire data on tree nut ingestion and symptoms at age 12, 16 and 24 years, and IgE sensitization at age 24 years to hazelnut, walnut, pecan, cashew, pistachio, Brazil nut, almond extracts and allergen molecules Cor a 1, 9, 14 (hazelnut), Jug r 1 (walnut) and Ana o 3 (cashew). We evaluated eczema, asthma, food allergies, inherited risk of allergy and gender as potential early-life risk factors.

Results: Data were available for 2215/4089 (54%) BAMSE study participants, for estimation of the prevalence of tree nut sensitization (21.2%), tree nut allergy symptoms (9.8%) and combined sensitization and symptoms (7.9%, 2.1% for storage protein sensitization and symptoms, 4.3% for any sensitization and non-mild symptoms). Sixty-three per cent of sensitized individuals (295/470) were asymptomatic, but only 76/470 (16%) storage protein sensitized individuals. Egg allergy (ORadj 8.50 95% CI 2.15-33.6), eczema (ORadj 2.53 95% CI 1.21-5.32) and asthma (ORadj 5.59 95% CI 2.35-13.3)) at pre-school age were associated with future development of tree nut symptoms and storage protein sensitization. At age 24 years, tree nut allergy was associated with current eczema and with markers of current asthma severity. Sensitization to storage proteins was more strongly associated with symptoms than sensitization to whole extract for all tree nuts evaluated.

Conclusions: In this Swedish cohort, we found tree nut whole extract sensitization is common but usually asymptomatic. Storage protein sensitization is a more reliable indicator of tree nut symptoms. Tree nut allergy is associated with early onset, persistent and severe atopic disease.

Keywords: Ana o 3; BAMSE; Cor a 1; Cor a 14; Cor a 9; Jug r 1; birth cohort; molecular allergology; sensitization; tree nut allergy.

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References

REFERENCES

    1. McWilliam V, Koplin J, Lodge C, Tang M, Dharmage S, Allen K. The Prevalence of tree nut allergy: A systematic review. Curr Allergy Asthma Rep. 2015;15(9):54.
    1. Weinberger T, Sicherer S. Current perspectives on tree nut allergy: a review. J Asthma Allergy. 2018;11:41-51.
    1. McWilliam VL, Perrett KP, Dang T, Peters RL. Prevalence and natural history of tree nut allergy. Ann Allergy Asthma Immunol. 2020;124(5):466-472. https://doi.org/10.1016/j.anai.2020.01.024
    1. Matricardi PM, Kleine-Tebbe J, Hoffmann HJ, et al. EAACI Molecular Allergology User's Guide. Pediatr Allergy Immunol. 2016;27(Suppl 23):1-250.
    1. Sampson HA. Utility of food-specific IgE concentrations in predicting symptomatic food allergy. J Allergy Clin Immunol. 2001;107(5):891-896.

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