BSACI guideline for the diagnosis and management of pollen food syndrome in the UK.


Journal

Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology
ISSN: 1365-2222
Titre abrégé: Clin Exp Allergy
Pays: England
ID NLM: 8906443

Informations de publication

Date de publication:
09 2022
Historique:
revised: 19 06 2022
received: 14 04 2022
accepted: 22 06 2022
pubmed: 18 8 2022
medline: 1 9 2022
entrez: 17 8 2022
Statut: ppublish

Résumé

Pollen food syndrome (PFS) is a highly prevalent food allergy affecting pollen-sensitized children and adults. Sufferers experience allergic symptoms when consuming raw plant foods, due to the homology between the pollen allergens and unstable proteins in these foods. The triggers involved can vary depending on the pollen sensitization, which in turn is affected by geographical location. The British Society of Allergy and Clinical Immunology (BSACI) Standards of Care Committee (SOCC) identified a need to develop a guideline for the diagnosis and management of PFS in the United Kingdom (UK). Guidelines produced by the BSACI use either the GRADE or SIGN methodology; due to a lack of high-quality evidence these recommendations were formulated using the SIGN guidelines, which is acknowledged to be less robust than the GRADE approach. The correct diagnosis of PFS ensures the avoidance of a misdiagnosis of a primary peanut or tree nut allergy or confusion with another plant food allergy to non-specific lipid transfer proteins. The characteristic foods involved, and rapid-onset oropharyngeal symptoms, mean PFS can often be diagnosed from the clinical history alone. However, reactions involving tree nuts, peanuts and soya milk or severe/atypical reactions to fruits and vegetables may require additional diagnostic tests. Management is through the exclusion of known trigger foods, which may appear to be simple, but is highly problematic if coupled with a pre-existing food allergy or for individuals following a vegetarian/vegan diet. Immunotherapy to pollens is not an effective treatment for PFS, and although oral or sublingual immunotherapy to foods seems more promising, large, controlled studies are needed. The typically mild symptoms of PFS can lead to an erroneous perception that this condition is always easily managed, but severe reactions can occur, and anxiety about the onset of symptoms to new foods can have a profound effect on quality of life.

Identifiants

pubmed: 35975576
doi: 10.1111/cea.14208
doi:

Substances chimiques

Allergens 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1018-1034

Informations de copyright

© 2022 John Wiley & Sons Ltd.

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Auteurs

Isabel J Skypala (IJ)

Department of Allergy & Clinical Immunology, Royal Brompton & Harefield Hospitals, Part of Guys & St Thomas NHS Foundation Trust, London, UK.
Inflammation, Repair & Development Section, National Heart & Lung Institute, Imperial College, London, UK.

Hannah Hunter (H)

Department of Allergy, Guys & St Thomas NHS Foundation Trust, London, UK.
Kings College, London, UK.

Mamidipudi Thirumala Krishna (MT)

Department of Allergy and Immunology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
The Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK.

Helena Rey-Garcia (H)

Department of Allergy & Clinical Immunology, Royal Brompton & Harefield Hospitals, Part of Guys & St Thomas NHS Foundation Trust, London, UK.

Stephen J Till (SJ)

Department of Allergy, Guys & St Thomas NHS Foundation Trust, London, UK.
Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, UK.

George du Toit (G)

Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, UK.
Children's Allergy Service, Evelina Children's Hospital, Guy's and St. Thomas's NHS Foundation Trust, London, UK.
Department Women and Children's Health (Paediatric Allergy), Faculty of Life Sciences and Medicine, School of Life Course Sciences, King's College London, London, UK.

Elizabeth Angier (E)

Primary Care, Population Science and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK.

Sarah Baker (S)

The Anaphylaxis Campaign, Farnborough, UK.

Kostadin V Stoenchev (KV)

Department of Allergy & Clinical Immunology, Royal Brompton & Harefield Hospitals, Part of Guys & St Thomas NHS Foundation Trust, London, UK.

David K Luyt (DK)

Leicester Royal Infirmary, Leicester, UK.

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