Food Allergy in Adults: Substantial Variation in Prevalence and Causative Foods Across Europe.


Journal

The journal of allergy and clinical immunology. In practice
ISSN: 2213-2201
Titre abrégé: J Allergy Clin Immunol Pract
Pays: United States
ID NLM: 101597220

Informations de publication

Date de publication:
Historique:
received: 13 12 2018
revised: 28 01 2019
accepted: 13 02 2019
pubmed: 23 3 2019
medline: 25 9 2020
entrez: 23 3 2019
Statut: ppublish

Résumé

According to the community-based EuroPrevall surveys, prevalence of self-reported food allergy (FA) in adults across Europe ranges from 2% to 37% for any food and 1% to 19% for 24 selected foods. To determine the prevalence of probable FA (symptoms plus specific IgE-sensitization) and challenge-confirmed FA in European adults, along with symptoms and causative foods. In phase I of the EuroPrevall project, a screening questionnaire was sent to a random sample of the general adult population in 8 European centers. Phase II consisted of an extensive questionnaire on reactions to 24 preselected commonly implicated foods, and measurement of specific IgE levels. Multiple imputation was performed to estimate missing symptom and serology information for nonresponders. In the final phase, subjects with probable FA were invited for double-blind placebo-controlled food challenge. Prevalence of probable FA in adults in Athens, Reykjavik, Utrecht, Lodz, Madrid, and Zurich was respectively 0.3%, 1.4%, 2.1%, 2.8%, 3.3%, and 5.6%. Oral allergy symptoms were reported most frequently (81.6%), followed by skin symptoms (38.2%) and rhinoconjunctivitis (29.5%). Hazelnut, peach, and apple were the most common causative foods in Lodz, Utrecht, and Zurich. Peach was also among the top 3 causative foods in Athens and Madrid. Shrimp and fish allergies were relatively common in Madrid and Reykjavik. Of the 55 food challenges performed, 72.8% were classified as positive. FA shows substantial geographical variation in prevalence and causative foods across Europe. Although probable FA is less common than self-reported FA, prevalence still reaches almost 6% in parts of Europe.

Sections du résumé

BACKGROUND
According to the community-based EuroPrevall surveys, prevalence of self-reported food allergy (FA) in adults across Europe ranges from 2% to 37% for any food and 1% to 19% for 24 selected foods.
OBJECTIVE
To determine the prevalence of probable FA (symptoms plus specific IgE-sensitization) and challenge-confirmed FA in European adults, along with symptoms and causative foods.
METHODS
In phase I of the EuroPrevall project, a screening questionnaire was sent to a random sample of the general adult population in 8 European centers. Phase II consisted of an extensive questionnaire on reactions to 24 preselected commonly implicated foods, and measurement of specific IgE levels. Multiple imputation was performed to estimate missing symptom and serology information for nonresponders. In the final phase, subjects with probable FA were invited for double-blind placebo-controlled food challenge.
RESULTS
Prevalence of probable FA in adults in Athens, Reykjavik, Utrecht, Lodz, Madrid, and Zurich was respectively 0.3%, 1.4%, 2.1%, 2.8%, 3.3%, and 5.6%. Oral allergy symptoms were reported most frequently (81.6%), followed by skin symptoms (38.2%) and rhinoconjunctivitis (29.5%). Hazelnut, peach, and apple were the most common causative foods in Lodz, Utrecht, and Zurich. Peach was also among the top 3 causative foods in Athens and Madrid. Shrimp and fish allergies were relatively common in Madrid and Reykjavik. Of the 55 food challenges performed, 72.8% were classified as positive.
CONCLUSIONS
FA shows substantial geographical variation in prevalence and causative foods across Europe. Although probable FA is less common than self-reported FA, prevalence still reaches almost 6% in parts of Europe.

Identifiants

pubmed: 30898689
pii: S2213-2198(19)30269-7
doi: 10.1016/j.jaip.2019.02.044
pii:
doi:

Substances chimiques

Immunoglobulin E 37341-29-0

Types de publication

Controlled Clinical Trial Journal Article Multicenter Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1920-1928.e11

Subventions

Organisme : Biotechnology and Biological Sciences Research Council
ID : BBS/E/F/00041800
Pays : United Kingdom

Informations de copyright

Copyright © 2019 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Auteurs

Sarah A Lyons (SA)

Department of Dermatology and Allergology, University Medical Center Utrecht, Utrecht, The Netherlands. Electronic address: s.a.lyons-2@umcutrecht.nl.

Peter G J Burney (PGJ)

Population Health & Occupational Disease, National Heart and Lung Institute, Imperial College London, London, United Kingdom.

Barbara K Ballmer-Weber (BK)

Allergy Unit, Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland; Faculty of Medicine, University of Zurich, Zurich, Switzerland; Clinic for Dermatology and Allergology, Kantonsspital St Gallen, St Gallen, Switzerland.

Montserrat Fernandez-Rivas (M)

Allergy Department, Hospital Clinico San Carlos, IdISSC, ARADyAL, Center RD16/0006/0009, Madrid, Spain.

Laura Barreales (L)

Servicio de Medicina Preventiva, Epidemiology Unit, Hospital Clinico San Carlos, IdISSC, Madrid, Spain.

Michael Clausen (M)

Children's Hospital, Landspitali University Hospital, Reykjavik, Iceland.

Ruta Dubakiene (R)

Medical Faculty, Vilnius University, Vilnius, Lithuania.

Cristina Fernandez-Perez (C)

Servicio de Medicina Preventiva, Epidemiology Unit, Hospital Clinico San Carlos, IdISSC, Madrid, Spain.

Philipp Fritsche (P)

Allergy Unit, Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland.

Monika Jedrzejczak-Czechowicz (M)

Department of Allergy and Immunology, Medical University of Lodz, Lodz, Poland.

Marek L Kowalski (ML)

Department of Allergy and Immunology, Medical University of Lodz, Lodz, Poland.

Tanya Kralimarkova (T)

Clinical Center of Allergology of the Alexandrovska Hospital, Medical University of Sofia, Sofia, Bulgaria.

Ischa Kummeling (I)

Department of Dermatology and Allergology, University Medical Center Utrecht, Utrecht, The Netherlands.

Tihomir B Mustakov (TB)

Clinical Center of Allergology of the Alexandrovska Hospital, Medical University of Sofia, Sofia, Bulgaria.

Ans F M Lebens (AFM)

Department of Dermatology and Allergology, University Medical Center Utrecht, Utrecht, The Netherlands.

Harmieke van Os-Medendorp (H)

Department of Dermatology and Allergology, University Medical Center Utrecht, Utrecht, The Netherlands.

Nikolaos G Papadopoulos (NG)

Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece; Division of Infection, Immunity and Respiratory Medicine, Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Manchester, United Kingdom.

Todor A Popov (TA)

University Hospital Sv. Ivan Rilski, Sofia, Bulgaria.

Alexandros Sakellariou (A)

Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece.

Paco M J Welsing (PMJ)

Division of Internal Medicine and Dermatology, University Medical Center Utrecht, Utrecht, The Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.

James Potts (J)

Population Health & Occupational Disease, National Heart and Lung Institute, Imperial College London, London, United Kingdom.

E N Clare Mills (ENC)

Division of Infection, Immunity and Respiratory Medicine, Manchester Institute of Biotechnology & Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Manchester, United Kingdom.

Ronald van Ree (R)

Department of Experimental Immunology and Department of Otorhinolaryngology, Amsterdam University Medical Center, Amsterdam, The Netherlands.

André C Knulst (AC)

Department of Dermatology and Allergology, University Medical Center Utrecht, Utrecht, The Netherlands.

Thuy-My Le (TM)

Department of Dermatology and Allergology, University Medical Center Utrecht, Utrecht, The Netherlands.

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