Prevalence Of Oral Allergy Syndrome Research Articles

Regional differences in the prevalence of oral allergy syndrome among Japanese children: A questionnaire-based survey.

Oral allergy syndrome (OAS) is characterized by an immediate allergic reaction that mainly or partially affects the oral mucosa, pharynx, or lips, and it is usually caused by ingesting fresh fruits or vegetables. Most patients with OAS also have allergic rhinitis due to pollen. As allergic rhinitis is increasingly prevalent in the Japanese population and the age at disease development is decreasing, morbidity associated with OAS among the younger population is likely to increase. However, there is little information about the prevalence of this disease among Japanese children, specifically the influences of residency in regions with different environments. To investigate the prevalence of OAS and seasonal allergic rhinitis (SAR) among Japanese children and evaluate the relationship between OAS and SAR. We administered a questionnaire-based survey among children aged 7-15 years, living in 4 cities in central Japan. The questionnaires were administered to 4103 children and completed by 3365 (82.0%). Overall, 524 children (15.6%) reported OAS-like symptoms after ingesting fruits or vegetables. The prevalence of seasonal SAR and oral symptoms significantly differed among the 4 cities. The total prevalence of oral symptoms co-occurring with SAR was 24.4%, which was significantly higher than the prevalence of symptoms occurring without SAR (10.2%, p < 0.001). Herein, oral symptoms were more likely to occur in patients with SAR than in those without SAR. The prevalence of SAR and food-induced oral symptoms significantly differed among the regions, suggesting they might be affected by regional differences in lifestyles and flora.

Oral allergy syndrome. Literature review

Objective — to improve the methods of differential diagnosis and management of patients with oral allergy syndrome (OAS).&#x0D; Materials and methods. A literature review is presented and diagnostic approaches and principles of management of patients with OAS are analyzed.&#x0D; Results and discussion. OAS is a type of food allergy limited to the oral mucosa and triggered primarily by raw fruits, vegetables, flavorings, and nuts. Data on the prevalence of OAS vary considerably from study to study due to the use of different patient inclusion and exclusion criteria. However, there are reports of its frequency from 4.7 to more than 20 % in children and from 13 to 53.8 % in adults. It is reliably known that among the children’s population, OAS is mostly diagnosed in teenagers. Etiologically, OAS is caused by food allergens; mostly these are unprocessed fruits and raw vegetables that enter the patient’s oropharynx. Food allergens that cause OAS are actually inactivated by the gastric juice, so the reaction usually stops after the food is swallowed.&#x0D; Conclusions. OAS is a subtype of food allergy that can be found in the practice of allergists, dermatologists, general practitioners. After contact with food, patients experience the following symptoms: itching of the lips and oropharynx; paresthesia; angioedema of the mucous membrane of the oral cavity, tongue, palate and oropharynx; sometimes hoarseness is possible. Modern therapy of OAS involves the use of a complex approach, which includes adherence to an elimination diet, pharmacotherapy, and allergen-specific immunotherapy. Antihistamines, corticosteroids, and adrenaline (intramuscular) are most often used in pharmacotherapy.

Food allergy in early childhood increases the risk of oral allergy syndrome in schoolchildren: A birth cohort study.

The level of pollen in Korea has increased over recent decades. Research suggests that oral allergy syndrome (OAS) may be more frequent in childhood than previously recognized. We aimed to investigate the prevalence and characteristics of OAS in children aged 6-10years from a general-population-based birth cohort. We analyzed 930 children from the cohort for childhood origin of asthma and allergic diseases (COCOA). Allergic diseases were diagnosed annually by pediatric allergists. The skin prick tests were performed with 14 common inhalant allergens and four food allergens for the general population of children aged 3 and 7years. Of the 930 eligible children, 44 (4.7%) aged 6-10years were diagnosed with OAS. The mean age at onset was 6.74years. OAS prevalence was 7.2% among children with allergic rhinitis (AR) and 19.1% among those with pollinosis, depending on comorbidity. OAS was more prevalent in schoolchildren with atopic dermatitis, food allergy, and sensitization to food allergens and grass pollen in early childhood. In schoolchildren with AR, only a history of food allergy until the age of 3years increased the risk of OAS (aOR 2.971, 95% CI: 1.159-7.615). Food allergy and food sensitization in early childhood were associated with OAS in schoolchildren with AR. Further study is required to elucidate the mechanism by which food allergy in early childhood affects the development of OAS.

Interdisciplinary Significance of Food-Related Adverse Reactions in Adulthood.

Background: Adults frequently interpret food-associated adverse reactions as indicators of a food allergy. However, the public perception of food allergy may differ from a clinician’s point of view. The prevalence of patient-reported food allergy tends to be higher than physician-confirmed cases. Dermatological manifestations (urticaria, pruritus, dermatitis, and edema) are frequently reported by patients. Objective: The aim of this study was to describe patient-reported symptoms related to suspected food allergies and particularly to characterize and highlight the volume of patients who visit Budapest allergy clinics with suspected food allergies. Methods: In this prospective study, adult (≥18 years) patients were examined at the Allergology Outpatient Unit of the Dept. of Dermatology, Venereology, and Dermatooncology, Semmelweis University, Budapest. The examination included a detailed medical history; physical examination; and when necessary the measurement of allergen-specific serum immunoglobulin E (IgE) levels. Results: Data from 501 patients (393 women, 108 men) were analyzed. Intolerance to dietary biogenic amines occurred in 250 cases (250/501, 50%). Oral allergy syndrome was confirmed in 71 patients (71/501, 14%). Allergy to food preservatives was diagnosed in 14 (14/501, 3%) cases by a dermatologist-allergist specialist. Five individuals (5/501, 1%) were diagnosed with IgE-mediated food allergy. In some cases (28/501, 6%), edema-inducing/enhancing side effects of drugs were observed which patients had misattributed to various foods. Among the food groups considered to be provoking factors, the most frequently mentioned were fruits (198/501, 40%), milk/dairy products (174/501, 35%), and nuts/oilseeds (144/501, 29%). Overwhelmingly, urticaria (47%) was the most common dermatological diagnosis, followed by dermatitis (20%) and allergic contact dermatitis (8%). Conclusion: Improvement is needed in food allergy, food intolerance, and general nutritional knowledge among the general public. According to our data, perceived/self-reported food allergies were overestimated by adults when compared against physician-confirmed food allergies; however, other diseases potentially responsible for food-related problems were underestimated. The prevalence of oral allergy syndrome was high in the cohort. Intolerance to dietary biogenic amines was common, and although the role of dietary histamine and biogenic amine is not entirely understood in eliciting patients’ symptoms, improvements in complaints were reported during the control visits.

Clinical Characteristics of Oral Allergy Syndrome in Children with Atopic Dermatitis and Birch Sensitization: a Single Center Study.

BackgroundOral allergy syndrome (OAS) is an immunoglobulin E (IgE)-mediated hypersensitivity that occurs frequently in older children with pollen sensitization. This study focused on the clinical characteristics of OAS in children with atopic dermatitis (AD) and birch sensitization.Methods: A total of 186 patients aged 2–18 years with AD and birch sensitization were enrolled in this study between January 2016 and March 2017. Their levels of serum total IgE and birch- and ragweed-specific IgE (sIgE) were measured using ImmunoCAP (Thermo Fisher Scientific, Uppsala, Sweden). Information regarding causative foods and symptoms were obtained via interviews. The patients were divided into 3 groups according to their ages (group 1, 2–6 years; group 2, 7–12 years; and group 3, 13–18 years).ResultsEighty-one of the 186 (43.5%) children with AD who were sensitized to birch pollen were diagnosed as having OAS. The prevalence of OAS in group 1 (the children who had AD and birch sensitization aged 2–6 years) was 36.6%. A greater predominance of men was noted in the non-OAS group (77.1%) compared to the OAS group (60.5%). Apples were the most common causative food in group 2 and 3 while kiwis were the most common cause of OAS in group 1. There was a statistically significant correlation between birch-sIgE levels and the prevalence of OAS (P = 0.000). The cut-off value was 6.77 kUA/L with 55.6% sensitivity and 79.0% specificity (area under the curve 0.653).ConclusionIn our study, the prevalence of OAS in children with AD and birch sensitization was 43.5%. Even in the preschool age group, the prevalence of OAS was considerable. Patients with high levels of birch-sIgE were more likely to have OAS. Clinicians should therefore be vigilant about OAS in patients with a high degree of sensitization to birch pollen and even young children if they have birch sensitization.

Oral allergy syndrome amongst young Mexicans: prevalence and associated factors.

Background. Oral allergy syndrome (OAS) is the most common food allergy manifestation amongst adults. However, population studies aimed at estimating its prevalence and associated factors are scarce in Mexi-co. Objectives. To establish the prevalence of OAS in a sample of university students and to describe their clinical characteristics and its associated factors. Methods. From a sample group made up of 25,269 university students, the data corresponding to 1,200 students aged 18 to 25 was analyzed with a cross-sectional approach. A structured questionnaire was used to identify OAS, its symptoms and related foods, and the personal history of atopic diseases. The associations between variables were calculated through logistical regression analysis. Results. The prevalence of OAS was 3.4%, with a 95% confidence interval (95% CI) of 2.5 to 4.6. The main oral symptoms reported were lip pruritus, edema and the sensation of pharyngeal oppression. Among the extra-oral complaints were: reddish coloration of the skin, body pruritus, abdominal pain, and abdominal bloating. The foods that were most frequently associated with OAS were fruits (68.5%), vegetables (22.0%) and seafood (19.3%). Through multivariate analyses, allergy to pollen and latex were found to be associated with OAS, OR 3.29; 95%: CI 1.53 to 7.10 and OR 5.53; 95% CI: 1.08 to 28.2, respectively. Conclusions. Notably, the prevalence of OAS varies according to the geographic area. Personal histories of allergy to pollen or latex were the main factors linked to OAS.

Oral Allergy Syndrome in Birch Pollen-Sensitized Patients from a Korean University Hospital.

BackgroundOral allergy syndrome (OAS) is a type of allergic reaction that mainly occurs on oral contact with raw fruit, vegetables, or nuts. The most common type of OAS is birch pollen-related food allergy. Although OAS is a common food allergy in adults, only few epidemiologic studies have been reported in Korea. Here we investigate the prevalence and triggers of birch pollen-related food allergy.MethodsWe conducted a retrospective chart review of 1,427 patients who underwent a skin prick test for inhalant allergens at the Asthma and Allergy Clinic in Seoul National University Bundang Hospital from January 2011 to December 2016.ResultsOf 1,427 patients, 125 (8.7%) were sensitized to birch pollen. Among them, 20.0% developed OAS, which was the most common food allergy (96.2%). The prevalence of OAS was higher in females, and was 18.2% in birch pollen-sensitized allergic rhinoconjunctivitis patients. Further, 72.0% OAS patients had rhinoconjunctivitis, 20.0% had asthma, and 12.0% had chronic urticaria. Apple (68.0%), peach (56.0%), nuts (36.0%), kiwi (20.0%), persimmon (20.0%), plum (16.0%), and cherry (16.0%) were frequent triggers; however, Chinese yam, kudzu vine, bellflower root, codonopsis, and ginseng were also revealed as triggers. Patients (60.0%) showed OAS with ≥ 3 foods at the same time. Only 3 patients showed mono-sensitivity to birch pollen, while others were multi-sensitized to trees, grasses, weed, or house dust mite allergens.ConclusionOAS was the most common food allergy in birch pollen-sensitized patients. This study revealed the unique triggers of OAS in Korea in addition to well-known triggers.

Oral allergy syndrome in children with pollen sensitization in Tomsk region

Background. Oral allergy syndrome (OAS) is defined as immediate IgE-mediated allergic reaction localized in the oral mucosa and developing after consuming raw fruits, vegetables, nuts, legumes in pollen sensitized patients. Objective. To study the prevalence of OAS in children in the Tomsk region. Material. The cross-sectional study in random groups of primary schoolchildren aged 7-10 years (n=13 010) from the Tomsk region, Russia, was performed in frames of (EuroPrevall, № FP6-2006-TTC-TU-5 Proposal 045879). During the screening phase a survey with standardized questionnaire was carried out. Clinical stage (n=1288) included clinical interviewing with parents/guardians, the clinical examination of patients, skin prick testing with extracts of food and pollen allergens (ALK-Abello, Spain), measurement of specific IgE level in serum to food and pollen allergens, component resolved diagnostics (ImmunoCAP, Phadia, Sweden). Results. OAS registered in 13,71% of children with pollen sensitization. The main triggers were apples, carrots, peaches, peanuts. Main cause of OAS in the Tomsk region was cross-reactivity to Bet v 1 - homologues belonging to PR-10 family: to apple - Mal d 1 (r=0,92; p=0,01); to peach - Pru p1 (r=0,87; p=0,01); to peanut - Ara h 8 (r=0,74; p=0,01); to hazelnut - Cor a 1 (r=0,76; p=0,01); to carrot - Dau c 1 (r=0,54; p=0,01). Conclusion. OAS was observed in 13,71% of children with pollen sensitization and was developesed due to crossreactivity to the birch allergen Bet v 1.

Prevalence of oral allergy syndrome in children with allergic diseases

IntroductionThe oral allergy syndrome (OAS) is a particular type of food allergy rarely explored in the paediatric population that is already considered an adult problem. ObjectiveIdentify the prevalence of OAS, symptoms and pollen species associated with its presence in children affected by allergic diseases. MethodsA cross-sectional study was conducted. Consecutive sampling included children from 6 to 14 years who needed allergy treatment for the first time. A structured questionnaire was carried out to collect demographic and clinical data and history of OAS. Besides sensitisation to various allergens, the skin prick-by-prick test was performed to corroborate sensitisation to food related to OAS. Prevalence of OAS and its association with pollens was established following the covariate adjusted logistic regression. Results267 subjects were included. Overall prevalence of OAS was 8.9% (95%CI 6.1–13.1%). Prevalence of OAS for allergic rhinitis and asthma were 8.8% and 9.1%, respectively. In patients sensitised to pollen, the prevalence ranged from 9.6% to 12.2% depending on the type of pollen. 62.5% of children with OAS were sensitive to pineapple. After adjusting for gender and family history of atopic disease, trees from the Quercus species showed an association with OAS (OR=2.7, 95%CI 1.2–6.2). ConclusionsOAS is not uncommon in our environment. Pineapple, a typical fruit from the region, was the main food related. Quercus sp., but not birch nor olive, was the pollen associated with this syndrome.

The Prevalence of Tree Nut Allergy: A Systematic Review.

Tree nuts are one of the most common foods causing acute allergic reactions and nearly all tree nuts have been associated with fatal allergic reactions. Despite their clinical importance, tree nut allergy epidemiology remains understudied and the prevalence of tree nut allergy in different regions of the world has not yet been well characterised. We aimed to systematically review the population prevalence of tree nut allergy in children and adults. We searched three electronic databases (OVID MEDLINE, EMBASE and PubMed) from January 1996 to December 2014. Eligible studies were categorised by age, region and method of assessment of tree nut allergy. Of the 36 studies identified most were in children (n = 24) and from Europe (n = 18), UK (n = 8) or USA (n = 5). Challenge-confirmed IgE-mediated tree nut allergy prevalence was less than 2 % (although only seven studies used this gold standard) while probable tree nut allergy prevalence ranged from 0.05 to 4.9 %. Prevalence estimates that included oral allergy syndrome (OAS) reactions to tree nut were significantly higher (8-11.4 %) and were predominantly from Europe. Prevalence of individual tree nut allergies varied significantly by region with hazelnut the most common tree nut allergy in Europe, walnut and cashew in the USA and Brazil nut, almond and walnut most commonly reported in the UK. Monitoring time trends of tree nut allergy prevalence (both overall and by individual nuts) as well as the prevalence of OAS should be considered given the context of the overall recent rise in IgE-mediated food allergy prevalence in the developed world.

Oral allergy syndrome in children

Oral allergy syndrome (OAS) is an allergic reaction that occurs after consumption of fresh fruits and vegetables in patients with allergy to pollen. It is mediated by immunoglobulin E (IgE) antibodies and symptoms arise as a result of cross-reactivity between pollen and plant-derived food. OAS is rarely seen in young children, but the prevalence increases with age. The objectives of the study were to identify the prevalence of OAS and probable risk factors in children and adolescents with seasonal allergic rhinitis (AR). One-hundred and twenty patients with seasonal AR were included. Patients were diagnosed based on their clinical history, skin prick test outcome and specific IgE. In patients describing OAS, prick-by-prick tests with fresh fruit or vegetables were carried out. Thirty-two patients had OAS and it was more frequent in female patients than in male patients. OAS was more frequent in adolescents than in small children and in patients with higher total IgE. OAS was significantly more prevalent in patients with AR and asthma (P=0.0016), as was the case in patients with AR and atopic dermatitis (P=0.0004). OAS is rarely diagnosed in small children, partly because of an inadequate clinical history. Patients with OAS may have some risk factors in addition to pollen allergy, and those with more severe atopy are more likely to develop OAS.

Síndrome de alergia oral en adultos de un hospital de tercer nivel

Oral allergy syndrome (OAS) is the mildest form of an allergic reaction to foods. It is characterized by the presence of IgE mediated symptoms restricted to oral mucosa after intake of fresh fruits and vegetables. OAS diagnosis is based on suggestive clinical manifestations and can be confirmed with tests such as prick-to-prick skin test with the food implicated, which have a sensitivity > 90%, specificity 30-60%, positive predictive value (PPV) of 40% and negative predictive value (NPV) > 95%. To know the prevalence of OAS in adult patients attending a third level hospital in southern Mexico City, and also describe the demographics of these patients and comorbidities more frequently associated. We studied 44 patients (40 women and 4 men), with an average age of 33.4 years, with suggestive clinical features of OAS, evaluated with prick-by-prick skin tests with fresh food. There was a predominance of OAS in woman (91%) and a prevalence of asthma and allergic rhinitis of 54% among this population. We found that 60.4% of these patients had positive prick-by-prick skin tests, being the most frequently involved families of foods: rosaceae (60%), crustaceans (25%), musaceae (23%), actinidacea (21%), lauraceae (16%) and cucurbitaceae (16%). Only 5 patients presented adverse reactions with prick-by-prick skin tests, in 4 of the cases with grade 3 and grade 4 anaphylaxis, while testing with banana-watermelon, peach, papaya and peanut, respectively. Oral allergy syndrome affects more women than men, the most frequent comorbidities in patients with oral allergy syndrome are allergic rhinitis and asthma, thus, in patients with asthma and allergic rhinitis, sensitized to pollens we have to ask about symptoms suggestive of oral allergy syndrome.

Oral allergy syndrome and risk of food-related anaphylaxis: a cross-sectional survey analysis

Background Oral Allergy Syndrome (OAS) is an IgE-mediated allergic response to fresh fruits, nuts and vegetables caused by cross-reactivity between pollen allergens and structurally similar food proteins. Alder pollen is a prominent allergen in coastal British Columbia, present at high levels from FebruaryApril. We hypothesized that this exposure may lead to increased prevalence of Alder pollen allergy and OAS. We sought to determine our population-based prevalence, cross-reactivity patterns, and incidence of food-related anaphylaxis.

PWE-036 Allergy in orofacial granulomatosis and inflammatory bowel disease

<h3>Introduction</h3> Orofacial granulomatosis (OFG), including oral Crohn9s disease (CD) is a chronic inflammatory condition presenting characteristically with lip swelling but also affecting a number of other sites in the oral cavity. Bouts of acute swelling and frequently reported atopy suggest an allergic component. There is evidence for dietary triggers with objective improvement on a cinnamon and benzoate-free diet.1 The Oral Allergy Syndrome (OAS) is a well recognised condition with a clear immunological pathogenesis.2 There are similarities between OAS and OFG in terms of symptoms, triggers and treatment regimes. The role of allergy in inflammatory bowel disease (IBD) remains unclear with conflicting data in the literature. <h3>Methods</h3> We performed skin prick tests to common allergens in a cohort of 88 patients with biopsy proven OFG between August 2007 and July 2009. We measured Specific serum IgE levels to relevant allergens and total serum IgE levels. The prevalence of OAS in patients with OFG was also determined. For comparison, a group of 121 consecutive patients with a confirmed diagnosis of IBD without oral involvement were also studied. <h3>Results</h3> The incidence of clinical allergy of 82% in the OFG cohort was considerably higher than the 4–20% incidence reported in the general population. OAS incidence was 28%, also significantly higher than population estimates. OFG patients with disease onset below 30 years and no concomitant CD had a significantly higher incidence of allergy (95%) and OAS (38%). ImmunCAP and total serum IgE levels also confirmed increased allergy. Allergy in CD (39%) was higher than the general population, especially in the colonic (43%) and ileocolonic (52%) compared to the ileal group (24%). Allergy in Ulcerative colitis was comparable to population estimates (18%). <h3>Conclusion</h3> Patients with OFG have an astonishingly high incidence of allergy. A large proportion of patients have OAS. A novel subepithelial dendritic B cell population demonstrating class switching to IgE, described in oral biopsies from patients with OFG by our group, could provide the link between dietary antigens, chronic oral inflammation and symptoms of hypersensitivity.3 The comparative significance of the differences in allergy in the different IBD groups remains unclear.

Correlation of oral allergy syndrome due to plant-derived foods with pollen sensitization in Japan

The clinical features of patients with oral allergy syndrome (OAS) due to plant-derived foods related to pollen allergy have been rarely reported in Japan. To evaluate the characteristics of OAS and to investigate whether pollen sensitizations are correlated with the prevalence of OAS in Japan. We measured specific IgE antibodies against 5 pollens in 622 outpatients (277 males and 345 females; mean age, 37 years) with atopic dermatitis, urticaria, angioedema, and food allergy during a 2-year period. Furthermore, OAS is diagnosed based on anamnesis and positive skin prick test reactions to suspected foods. Eighteen of the 436 patients (4.1%) sensitized to pollens were diagnosed as having OAS. Rates of specific IgE antibody-positive responses against Japanese cedar, ragweed, orchard grass, mugwort, and alder pollen were 69.8%, 35.3%, 29.1%, 24.1%, and 19.6%, respectively. The prevalence of OAS showed a significant positive correlation with sensitization to alder (P < .001). In addition, the most frequent causative foods were found to be apple, peach, and melon. The prevalence of OAS due to apple showed a significant positive correlation with sensitization to alder (P < .001) pollen, due to peach showed a significant positive correlation with sensitization to alder (P < .001) and orchard grass (P < .05) pollen, and due to melon showed a significant positive correlation with sensitization to alder (P < .005), orchard grass (P < .05), and ragweed (P < .05) pollen. Sensitization to pollens from species in the Betulaceae family is most strongly implicated in causing OAS in Japan.

How long does the effect of birch pollen injection SIT on apple allergy last?

Recent studies showed that injection specific immunotherapy (SIT) with birch pollen extract greatly reduces or cures the associated apple allergy in a large proportion of birch pollen-allergic patients. However, the long-term efficacy of SIT for apple allergy has not been assessed. To evaluate the duration of the effect of injection SIT with birch pollen extract on apple allergy in birch pollen-allergic patients. Thirty birch pollen-allergic patients showing both the clinical disappearance of apple allergy and a negative SPT with fresh apple at the end of their injection SIT course were followed-up at 12-month intervals from 6 months after SIT was stopped. Apple tolerance as well as SPT was assessed on all occasions. Fifty-seven birch pollen-allergic subjects without apple allergy and not submitted to SIT regularly followed-up for the onset of oral allergy syndrome (OAS) were used as controls. The overall prevalence of OAS after 30 months of follow-up did not differ between patients and controls. Although most patients became re-sensitized to apple by SPT over time, >50% of them were still able to tolerate eating the fruit at the 30-month follow-up visit. Although most patients show a 'natural', gradual propensity to apple re-sensitization (a consequence of prolonged and repeated inhalation of birch pollen responsible for primary sensitization?), the clinical effects of injection SIT on food allergy seem rather long lasting.