title: Position paper of the EAACI: food allergy due to immunological cross-reactions with common inhalant allergens.
abstract: In older children, adolescents, and adults, a substantial part of all IgE-mediated food allergies is caused by cross-reacting allergenic structures shared by inhalants and foods. IgE stimulated by a cross-reactive inhalant allergen can result in diverse patterns of allergic reactions to various foods. Local, mild, or severe systemic reactions may occur already after the first consumption of a food containing a cross-reactive allergen. In clinical practice, clinically relevant sensitizations are elucidated by skin prick testing or by the determination of specific IgE in vitro. Component-resolved diagnosis may help to reach a diagnosis and may predict the risk of a systemic reaction. Allergy needs to be confirmed in cases of unclear history by oral challenge tests. The therapeutic potential of allergen immunotherapy with inhalant allergens in pollen-related food allergy is not clear, and more placebo-controlled studies are needed. As we are facing an increasing incidence of pollen allergies, a shift in sensitization patterns and changes in nutritional habits, and the occurrence of new, so far unknown allergies due to cross-reactions are expected.
authors.affiliation: Department of Dermatology and Allergy, Hannover Medical University, Hannover, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Werfel
authors.affiliation: Ambulatorio di Allergologia, Clinica San Carlo, Paderno Dugnano, Milan, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Asero
authors.affiliation: Allergy Unit, Department of Dermatology, University Hospital Zürich, Zürich, Switzerland.
authors.forename: B K
authors.initials: BK
authors.lastname: Ballmer-Weber
authors.affiliation: Division of Paediatric Pneumology and Immunology, Charité University Hospital, Berlin, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Beyer
authors.affiliation: Allergy Division, Hospital General de Castellón, Castellón, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Enrique
authors.affiliation: Department of Dermatology/Allergology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: A C
authors.initials: AC
authors.lastname: Knulst
authors.affiliation: Associated Center for Molecular Allergology (CAAM), Latina, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Mari
authors.affiliation: The Referral Centre for Food Allergy Diagnosis and Treatment Veneto Region, Department of Mother and Child Health, University of Padua, Padua, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Muraro
authors.affiliation: Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg and Department of Dermatology and Allergy, Biederstein, Technische Universität München (TUM), Munich, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Ollert
authors.affiliation: Allergy Clinic Copenhagen University Hospital at Gentofte, Copenhagen, Denmark.
authors.forename: L K
authors.initials: LK
authors.lastname: Poulsen
authors.affiliation: Division of Allergology, Paul-Ehrlich Institute, Langen, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Vieths
authors.affiliation: Department of Dermatology and Allergy, of Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Worm
authors.affiliation: Department of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria.
authors.forename: K
authors.initials: K
authors.lastname: Hoffmann-Sommergruber
mesh_terms: D000485:Allergens / Q000276:immunology*; D000818:Animals; D003429:Cross Reactions / Q000276:immunology*; D005512:Food Hypersensitivity / Q000175:diagnosis / Q000276:immunology* / Q000628:therapy; D006801:Humans; D001239:Inhalation; D012106:Research / Q000639:trends; D012882:Skin Tests
chemical_list: D000485:Allergens
keywords: IgE; allergens; cross-reactive; food allergy; inhalant; sensitization