title: Food allergies resulting from immunological cross-reactivity with inhalant allergens: Guidelines from the German Society for Allergology and Clinical Immunology (DGAKI), the German Dermatology Society (DDG), the Association of German Allergologists (AeDA) and the Society for Pediatric Allergology and Environmental Medicine (GPA).
abstract: A large proportion of immunoglobulin E (IgE)-mediated food allergies in older children, adolescents and adults are caused by cross-reactive allergenic structures. Primary sensitization is most commonly to inhalant allergens (e.g. Bet v 1, the major birch pollen allergen). IgE can be activated by various cross-reactive allergens and lead to a variety of clinical manifestations. In general, local and mild - in rare cases also severe and systemic - reactions occur directly after consumption of the food containing the cross-reactive allergen (e. g. plant-derived foods containing proteins of the Bet v 1 family). In clinical practice, sensitization to the primary responsible inhalant and/or food allergen can be detected by skin prick tests and/or in vitro detection of specific IgE. Component-based diagnostic methods can support clinical diagnosis. For individual allergens, these methods may be helpful to estimate the risk of systemic reactions. Confirmation of sensitization by oral provocation testing is important particulary in the case of unclear case history. New, as yet unrecognized allergens can also cause cross-reactions. The therapeutic potential of specific immunotherapy (SIT) with inhalant allergens and their effect on pollen-associated food allergies is currently unclear: results vary and placebo-controlled trials will be necessary in the future. Pollen allergies are very common. Altogether allergic sensitization to pollen and cross-reactive food allergens are very common in our latitudes. The actual relevance has to be assessed on an individual basis using the clinical information.Cite this asWorm M, Jappe U, Kleine-Tebbe J, Schäfer C, Reese I, Saloga J, Treudler R, Zuberbier T, Wassmann A, Fuchs T, Dölle S, Raithel M, Ballmer-Weber B, Niggemann B, Werfel T. Food allergies resulting from immunological cross-reactivity with inhalant allergens. Allergo J Int 2014; 23: 1-16DOI 10.1007/s40629-014-0004-6.
authors.affiliation: Allergie-Centrum-Charité Klinik für Dermatologie, Allergologie und Venerologie Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany.
authors.forename: Margitta
authors.initials: M
authors.lastname: Worm
authors.affiliation: Klinik für Dermatologie, Allergologie und Venerologie, Universität Lübeck, Germany ; Forschungsgruppe Klinische und Molekulare Allergologie, Forschungszentrum Borstel, Germany.
authors.forename: Uta
authors.initials: U
authors.lastname: Jappe
authors.affiliation: Allergie- und Asthma-Zentrum Westend, Berlin, Germany.
authors.forename: Jörg
authors.initials: J
authors.lastname: Kleine-Tebbe
authors.affiliation: Ernährungstherapie, Allergologische Schwerpunktpraxis, Hamburg, Germany.
authors.forename: Christiane
authors.initials: C
authors.lastname: Schäfer
authors.affiliation: Ernährungsberatung und -therapie, Schwerpunkt Allergologie, München, Germany.
authors.forename: Imke
authors.initials: I
authors.lastname: Reese
authors.affiliation: Hautklinik, Universitätsmedizin der Johannes Gutenberg-Universität, Mainz, Germany.
authors.forename: Joachim
authors.initials: J
authors.lastname: Saloga
authors.affiliation: Klinik für Dermatologie, Venerologie und Allergologie Universität Leipzig, Germany.
authors.forename: Regina
authors.initials: R
authors.lastname: Treudler
authors.affiliation: Allergie-Centrum-Charité Klinik für Dermatologie, Allergologie und Venerologie Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany.
authors.forename: Torsten
authors.initials: T
authors.lastname: Zuberbier
authors.affiliation: Dermatologisches Ambulatorium Hamburg-Alstertal, Germany.
authors.forename: Anja
authors.initials: A
authors.lastname: Waßmann
authors.affiliation: Hautklinik, Georg-August-Universität, Göttingen, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Fuchs
authors.affiliation: Allergie-Centrum-Charité Klinik für Dermatologie, Allergologie und Venerologie Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany.
authors.forename: Sabine
authors.initials: S
authors.lastname: Dölle
authors.affiliation: Medizinische Klinik für Gastroenterologie, Pneumologie, Endokrinologie, Universitätsklinikum Erlangen, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Raithel
authors.affiliation: Dermatologische Klinik, Universitätsspital Zürich, Switzerland.
authors.forename: Barbara
authors.initials: B
authors.lastname: Ballmer-Weber
authors.affiliation: Klinik für Pädiatrie, Charité - Universitätsmedizin Berlin, Germany.
authors.forename: Bodo
authors.initials: B
authors.lastname: Niggemann
authors.affiliation: Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Werfel