Sabouraud-Leclerc D, Mariotte D, Bradatan E, Divaret-Chauveau A, Metz-Favre C, et al.
Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology •
The European Regulation list on mandatory labelling of foods includes 14 allergenic foods; however, other foods are also frequently implicated in food-induced anaphylaxis (FIA). We analysed FIA cases reported to the Allergy Vigilance Network from 2002 to 2023. Allergenic foods involved in ≥ 1% of cases and not included in the list were assessed as emerging food allergens (EFA). We assessed their frequency, severity (Ring classification), recurrence, and potential presence in hidden form to determine which allergens might warrant inclusion on the list. Among 2999 FIA cases (Ring grades 2-4), 413 cases (13.8%) met the selection criteria, divided into eight allergenic foods or food groups: goat's and sheep's milk (GSM, n = 84; 2.8% of the cases), buckwheat (n = 71; 2.4%), peas and lentil (n = 55; 1.8%), alpha-gal (n = 50; 1.7%), pine nut (n = 49; 1.6%), kiwi (n = 44; 1.5%), beehive products (n = 30; 1.0%), and apple (n = 30; 1.0%). Severe reactions (Ring grades 3 and 4) were reported with GSM (46.8% and 4.8%, respectively, including two fatalities), buckwheat (46.5% and1.4%), peas-lentil (20% and 1.8%), alpha-gal (54% and 8%), and Grade 3 reactions were reported with pine nut in 49%, kiwi 54.5%, beehive products 33.3% and apple 46.7%. Recurrent reactions and hidden exposures were reported with GSM (56% and 15.5%), buckwheat (49.3% and 16.9%), peas-lentil (7.3% and 9.0%) and pine nut (12.2% and 4.1%). We identified eight foods frequently involved in FIA and not currently listed in the European regulation. Given their frequency, severity, recurrence, and potential for hidden exposure, we propose that four-goat's and sheep's milk, buckwheat, peas-lentil, and pine nut-be considered for inclusion in the list.
Leyva-Castillo JM, Strakosha M, Smith SEM, Vega-Mendoza D, Elkins M, et al.
bioRxiv : the preprint server for biology •
Tick bites often promote local allergic reactions in the skin and predispose to red meat allergy. The mechanisms involved in these processes are not fully understood. Here we investigated the local changes to the skin and intestine induced by tick bites. C3H/HEN or Balb/c mice were subjected to either tick bites by ( ) or mechanical skin injury. Skin or intestine was analyzed a different time point by transcriptomic and histological techniques. Our results indicate that bites promote epidermal hyperplasia, spongiosis and an accumulation of eosinophils and mast cells in the bitten skin. In addition, bites promote the expression of genes and activate pathways also induced by mechanical skin injury elicited by tape stripping. Remarkably, similar to tape stripping, bites promote an increase in total serum IgE, and intestinal tuft cell and mast cell expansion. bites in mice promote cutaneous inflammation that resembles allergic skin inflammation, as well as intestinal changes that could play a role in the predisposition to red meat allergy.
Cetuximab is an anti-epidermal growth factor receptor antibody used for the treatment of metastatic colorectal cancer and head and neck cancer. Hypersensitivity reactions (HSRs) are associated with cetuximab use. The aim of the study was to evaluate the utility of anti-cetuximab immunoglobulin E (IgE) detection in order to identify patients at risk of HSR to cetuximab. We included patients ready to receive a first cetuximab infusion in a prospective cohort carried out at nine French centres. Pretreatment anti-cetuximab IgE levels were measured. We compared the proportion of severe HSRs in the low anti-cetuximab IgE levels (≤29 IgE arbitrary units) subgroup with that in a historical cohort of 213 patients extracted from a previous study. Of the 301 assessable patients (mean age: 60.9 ± 9.3 years, head-and-neck cancer: 77%), 66 patients (22%) had high anti-cetuximab IgE levels, and 247 patients received cetuximab (including 38 with high anti-cetuximab levels). Severe HSRs occurred in eight patients (five grade 3 and three grade 4). The proportion of severe HSRs was lower in the low anti-cetuximab IgE levels subgroup vs. the historical cohort (3/209 [1.4%] vs. 11/213 [5.2%], odds ratio, 0.27, 95% confidence interval, 0.07-0.97), and higher in high vs. low anti-cetuximab IgE levels subgroup (5/38 [13.2%] vs. 3/209 [1.4%]; odds ratio, 10.4, 95% confidence interval, 2.4-45.6). Patients with severe HSRs had higher anti-cetuximab IgE levels than patients without reaction (median, 45 vs. 2 IgE arbitrary units, P = 0.006). Detection of pretreatment anti-cetuximab IgE is feasible and helpful to identify patients at risk of severe cetuximab-induced HSRs.
