Food Allergy In Europe Research Articles

Test–retest reliability of the Food Allergy Quality of Life Questionnaires (FAQLQ) for children, adolescents and adults

The self-administered Food Allergy Quality of Life Questionnaire-Child Form (FAQLQ-CF), -Teenager Form (FAQLQ-TF) and -Adult Form (FAQLQ-AF) were recently developed within EuroPrevall, a multi-centred study of food allergy in Europe. The primary aim of this study was to evaluate the test-retest reliability of the FAQLQ-CF, -TF and -AF. One hundred and one Dutch patients (31 children, 34 adolescents and 36 adults) completed the FAQLQ twice with a 10-14 day interval. The intraclass correlation coefficient (ICC), Lin's concordance correlation coefficient (CCC) and Bland-Altman plots were used to assess test-retest reliability. Test-retest reliability was excellent with ICCs and CCCs above 0.907, 0.975 and 0.951 for the FAQLQ-CF, -TF and -AF, respectively. Bland-Altman plots showed that the mean differences of the test and re-test were all close to zero for the FAQLQs. The FAQLQs are reliable over a short time interval. The FAQLQs are not only excellent tools for group comparison studies, but also for monitoring individual patients.

REDALL (Reduced allergenicity of processed foods) – allergeninduzierte Nahrungsmittel als Alternative zur Karenz bei Nahrungsmittelallergie?

Background: For patients with food allergy there has been no alternative treatment to food allergen avoidance. In a study supported by the European union, a new approach aimed to reduce the allergenicity of foods of animal origin to achieve better tolerance. Patients and methods: the prevalence of food allergy was assessed by telephone interviews with more than 40000 persons in 10 European countries. By thermal and enzymatic the allergenicity of the animal food allergens hen's egg, cow's milk, beef and poultry was reduced. Patients with proven food allergy to those foods of animal origin were recruited and assessed allergologically. In-vitro cellular test systems were established. The allergenicity of food products were investigated before and after allergen reduction. Results: The prevalence of food allergy in Europe is 3% with considerable regional differences. In 41.1% of food allergic patients, food allergens of animal origin were thought to be responsible for eliciting symptoms. In total, 249 patients with food allergy were recruited. The threshold for eliciting symptoms was below the lowest test dose (e.g. 10μg egg powder) in the double-blind placebo-controlled food challenge in 53 of 249 (21%) of patients, whereas 50 of 249 patients (20%) only reacted to the highest given dose (e.g. one full egg). Symptoms in the provocation test developed predominantly on the skin and in the gastrointestinal tract, however, also involved respiratory tract and cardiovascular system. Allergen-reduced cow's milk and hen's egg were produced and in part tolerated by patients in the skin prick test and provocation test. The extent of allergen reduction was characterized, also by cellular test systems involving mast cell lines. Conclusions: the concept of allergen reduction in food allergy is a new approach, which could reduce dietary interventions and support tolerance in food allergic patients.

A framework for measuring the social impact of food allergy across Europe: a EuroPrevall state of the art paper

This state of the art paper has been developed through EuroPrevall, a European multicentre research project funded by the European Union which aims to improve quality of life for food allergic individuals. Food allergy (whether clinically diagnosed or self-perceived) represents a major health issue in Western societies and may have a considerably greater impact on society than was previously believed. However, the social impact of food allergy has never been systematically investigated using validated instruments. Combining the information from studies on health-related quality of life (HRQoL) with epidemiological data on prevalence will ultimately give some indication of the magnitude of the social impact of food allergy in Europe. HRQoL can be assessed with disease-specific questionnaires, which are being developed in EuroPrevall. These instruments will be used to identify HRQoL problems associated with food allergy, and to assess the effectiveness of interventions and to guide the development of regulatory policies.

Hazelnut allergy: A double-blind, placebo-controlled food challenge multicenter study

Background: Tree nuts are a common cause of food allergy in Europe. However, few studies deal with real food allergy to hazelnuts in subjects believed to be allergic to this food. Objective: We sought to select subjects with a history of allergic reactions on ingestion of hazelnut and determine how many of these have true allergy by means of the double-blind, placebo-controlled food challenge (DBPCFC). Methods: Eighty-six subjects with a history of symptoms after hazelnut ingestion were recruited from 3 allergy centers (Milan, Zurich, and Copenhagen). All subjects underwent skin prick tests (SPTs) with aeroallergens and hazelnut, as well as having their specific hazelnut IgE levels determined. Diagnosis of clinical relevant food allergy was made on the basis of the DBPCFC. Results: Sixty-seven (77.9%) of 86 subjects had a positive DBPCFC result; 8 were placebo responders, and 11 were nonresponders. Of the 11 nonresponders, 4 had positive open-challenge test results. Of the DBPCFC-positive subjects, 87% also had positive skin test responses to birch pollen extract. Specific IgE determination for hazelnut (positive CAP response ≥0.7 kU/L [ie, class 2]) showed a sensitivity of 0.75, a positive predictive value (PPV) of 0.92, a specificity of 0.16, and a negative predictive value (NPV) of 0.05. Skin tests with commercial hazelnut extract produced a sensitivity of 0.89, a PPV of 0.92, a specificity of 0.05, and an NPV of 0.05. Skin tests with natural food produced a sensitivity of 0.88, a PPV of 0.94, a specificity of 0.27, and an NPV of 0.15. Conclusion: This study shows that hazelnut is an allergenic source that can cause real food allergy, as confirmed by DBPCFC. Skin and IgE tests demonstrated reasonable sensitivity and PPV but a very low specificity and NPV, thus implying that these should not be used to validate the diagnosis of food allergy to hazelnut. (J Allergy Clin Immunol 2000;105:577-81.)

Atopic dermatitis and food allergy in Europe--prevalence and risk factors.

Atopic dermatitis and food allergy in Europe--prevalence and risk factors.