Cross-reactive aeroallergens: which need to cross our mind in food allergy diagnosis?

Publication date: Available online 29 August 2018

Source: The Journal of Allergy and Clinical Immunology: In Practice

Author(s): Margaretha A. Faber, Athina L. Van Gasse, Ine I. Decuyper, Vito Sabato, Margo M. Hagendorens, Christel Mertens, Chris H. Bridts, Luc S. De Clerck, Didier G. Ebo

Abstract

Secondary food allergies due to cross-reactivity between inhalant- and food allergens are a significant and increasing global health issue. Cross-reactive food allergies predominantly involve plant-derived foods resulting from a prior sensitization to cross-reactive components present in pollen (grass, tree, weeds) and natural rubber latex (NRL). But also primary sensitisation to allergens present in fungi, insects and both non-mammalian and mammalian meat might induce cross-reactive food allergic syndromes. Correct diagnosis of these associated food allergies is not always straight forward and can pose a difficult challenge. As a matter of fact, cross-reactive allergens might hamper food allergy diagnosis, as they can cause clinically irrelevant positive tests to cross-reacting foods that are safely consumed.

This review summarizes the most relevant cross-reactivity syndromes between inhalant and food allergens. Particular focus is paid to the potential and limitations of confirmatory testing such as skin testing, sIgE assays, molecular diagnosis (CRD) and basophil activation test (BAT).