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Prevalence of sensitization to molecular food allergens in Europe: A systematic review

Prevalence of sensitization to molecular food allergens in Europe: A systematic review
Prevalence of sensitization to molecular food allergens in Europe: A systematic review

Background: Recent reports indicate that the prevalence of food allergy is increasing, but accurate estimates remain a challenge due to cross-reactivity and limited use of precise diagnostic methods. Molecular allergy diagnostics, in which sensitization to individual molecular allergens is measured, is emerging as a promising tool for evaluation of sensitization profiles. In this systematic review, we summarized estimates of prevalence of sensitization to molecular food allergens in the general population in Europe.

Methods: Following a protocol prospectively registered with the International Prospective Register of Systematic Reviews (PROSPERO; reference CRD42021266657), we searched seven databases with no restrictions on publication date or language. Two reviewers independently screened the literature, extracted data, and appraised the risk of bias in the included studies. The findings were synthesized narratively.

Results: From 4776 de-duplicated records, five studies, with low to moderate overall risk of bias, were included. Forty-six molecular allergens from 18 foods were investigated. Overall, the prevalence of sensitization was low, particularly for major allergens, and non-existent for 10 molecular allergens (0% [95% CI 0-0.8]). The highest prevalence was seen for PR-10 proteins, such as Cor a 1.04 (13.6% [95% CI 10.9-16.9]).

Conclusions: Available data, primarily from North-western Europe, indicate that sensitization to molecular food allergens is overall low. The highest estimates were found for cross-reactive PR-10 proteins. There were not enough studies to discern regional differences or perform meta-analysis, highlighting the need for more population-representative studies in order to elucidate patterns of sensitization to molecular food allergens in Europe.

epidemiology, food allergy, molecular allergen, sensitization, systematic review
2045-7022
Lisik, Daniil
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Ioannidou, Athina
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Spolidoro, Giulia
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Ali, Mohamed
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Nyassi, Sungkutu
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Amera, Yohanes
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Rovner, Graciela
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Khaleva, Ekaterina
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Venter, Carina
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van Ree, Ronald
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Worm, Margitta
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Vlieg-Boerstra, Berber
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Sheikh, Aziz
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Muraro, Antonella
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Roberts, Graham
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Nwaru, Bright I
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Lisik, Daniil
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Ioannidou, Athina
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Spolidoro, Giulia
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Ali, Mohamed
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Nyassi, Sungkutu
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Amera, Yohanes
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Rovner, Graciela
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Khaleva, Ekaterina
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Venter, Carina
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van Ree, Ronald
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Worm, Margitta
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Vlieg-Boerstra, Berber
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Sheikh, Aziz
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Muraro, Antonella
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Roberts, Graham
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Nwaru, Bright I
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Lisik, Daniil, Ioannidou, Athina, Spolidoro, Giulia, Ali, Mohamed, Nyassi, Sungkutu, Amera, Yohanes, Rovner, Graciela, Khaleva, Ekaterina, Venter, Carina, van Ree, Ronald, Worm, Margitta, Vlieg-Boerstra, Berber, Sheikh, Aziz, Muraro, Antonella, Roberts, Graham and Nwaru, Bright I (2022) Prevalence of sensitization to molecular food allergens in Europe: A systematic review. Clinical and Translational Allergy, 12 (7), [e12175]. (doi:10.1002/clt2.12175).

Record type: Review

Abstract

Background: Recent reports indicate that the prevalence of food allergy is increasing, but accurate estimates remain a challenge due to cross-reactivity and limited use of precise diagnostic methods. Molecular allergy diagnostics, in which sensitization to individual molecular allergens is measured, is emerging as a promising tool for evaluation of sensitization profiles. In this systematic review, we summarized estimates of prevalence of sensitization to molecular food allergens in the general population in Europe.

Methods: Following a protocol prospectively registered with the International Prospective Register of Systematic Reviews (PROSPERO; reference CRD42021266657), we searched seven databases with no restrictions on publication date or language. Two reviewers independently screened the literature, extracted data, and appraised the risk of bias in the included studies. The findings were synthesized narratively.

Results: From 4776 de-duplicated records, five studies, with low to moderate overall risk of bias, were included. Forty-six molecular allergens from 18 foods were investigated. Overall, the prevalence of sensitization was low, particularly for major allergens, and non-existent for 10 molecular allergens (0% [95% CI 0-0.8]). The highest prevalence was seen for PR-10 proteins, such as Cor a 1.04 (13.6% [95% CI 10.9-16.9]).

Conclusions: Available data, primarily from North-western Europe, indicate that sensitization to molecular food allergens is overall low. The highest estimates were found for cross-reactive PR-10 proteins. There were not enough studies to discern regional differences or perform meta-analysis, highlighting the need for more population-representative studies in order to elucidate patterns of sensitization to molecular food allergens in Europe.

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e-pub ahead of print date: 6 July 2022
Published date: July 2022
Additional Information: Funding Information: BIN acknowledges the support of Knut and Alice Wallenberg Foundation, the Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Sweden, and the VBG Group Herman Krefting Foundation on Asthma and Allergy. The study was funded through an unrestricted grant from DBV Technologies SA. The funders had no influence on the design of the study, interpretation of findings, or the decision to publish. Funding Information: Carina Venter reports: grants (Reckitt Benckiser, Food Allergy Research and Education, and National Peanut Board) and personal fees (Reckitt Benckiser, Nestle Nutrition Institute, Danone, Abbott Nutrition, Else Nutrition, Sifter, and Before Brands). Ronald van Ree reports: consultancies (HAL Allergy BV, Citeq BV, Angany Inc., Reacta Healthcare Ltd., Mission MightyMe, and AB Enzymes), speaker's fees (HAL Allergy BV, ThermoFisher Scientific, and ALK), and stock options (Angany Inc.). Margitta Worm reports: grants and personal fees (Stallergens, HAL Allergie, Bencard Allergie, Allergopharma, ALK‐Abello, Mylan Germany, Actelion Pharmaceuticals Deutschland, Biotest, AbbVie Deutschland, Lilly Deutschland Aimmune, DBV Technologies SA, Regeneron Pharmaceuticals, Sanofi Aventis, Leo Pharma, Novartis, and Viatris) outside of the submitted work and being past WAO co‐chair of the anaphylaxis committee and past chair of the food allergy interest group of EAACI. Berber Vlieg‐Boerstra reports: personal fees (Marfo Food Group, Nestlé, and Nutricia) and grants (Nutricia). Antonella Muraro reports: grants and speaker's fees (Aimmune), speaker's fees (DVB Technologies SA, Viatris [Mylan], ALK, and Nestlé), and being member of the Executive Committee of GA2LEN and past president of EAACI. Graham Roberts reports grants (Asthma UK and National Institutes of Health Research). Bright Nwaru reports unrestricted grants and personal fees from DBV Technologies and AstraZeneca, respectively. The other authors report no conflicting interests related to this work. The funder played no role in the content and decision to submit this manuscript. Publisher Copyright: © 2022 The Authors. Clinical and Translational Allergy published by John Wiley & Sons Ltd on behalf of European Academy of Allergy and Clinical Immunology.
Keywords: epidemiology, food allergy, molecular allergen, sensitization, systematic review

Identifiers

Local EPrints ID: 469512
URI: http://eprints.soton.ac.uk/id/eprint/469512
ISSN: 2045-7022
PURE UUID: 89632446-4ed1-4a20-8cea-a35d81328b19
ORCID for Ekaterina Khaleva: ORCID iD orcid.org/0000-0002-2220-7745
ORCID for Graham Roberts: ORCID iD orcid.org/0000-0003-2252-1248

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Date deposited: 16 Sep 2022 16:41
Last modified: 17 Mar 2024 04:02

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Contributors

Author: Daniil Lisik
Author: Athina Ioannidou
Author: Giulia Spolidoro
Author: Mohamed Ali
Author: Sungkutu Nyassi
Author: Yohanes Amera
Author: Graciela Rovner
Author: Ekaterina Khaleva ORCID iD
Author: Carina Venter
Author: Ronald van Ree
Author: Margitta Worm
Author: Berber Vlieg-Boerstra
Author: Aziz Sheikh
Author: Antonella Muraro
Author: Graham Roberts ORCID iD
Author: Bright I Nwaru

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