Risk factors for severe reactions in food allergy: Rapid evidence review with meta‐analysis

This rapid review summarizes the most up to date evidence about the risk factors for severe food‐induced allergic reactions. We searched three bibliographic databases for studies published between January 2010 and August 2021. We included 88 studies and synthesized the evidence narratively, undertak...

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Veröffentlicht in:Allergy (Copenhagen) Jg. 77; H. 9; S. 2634 - 2652
Hauptverfasser: Turner, Paul J., Arasi, Stefania, Ballmer‐Weber, Barbara, Baseggio Conrado, Alessia, Deschildre, Antoine, Gerdts, Jennifer, Halken, Susanne, Muraro, Antonella, Patel, Nandinee, Van Ree, Ronald, de Silva, Debra, Worm, Margitta, Zuberbier, Torsten, Roberts, Graham
Format: Journal Article
Sprache:Englisch
Veröffentlicht: Denmark Blackwell Publishing Ltd 01.09.2022
Schlagworte:
Adolescent
Adult
Allergens
Anaphylaxis
Anaphylaxis - diagnosis
Anaphylaxis - epidemiology
Anaphylaxis - etiology
Asthma
biomarkers
Child
Child, Preschool
Cofactors
Food - adverse effects
Food allergies
food allergy
Food Hypersensitivity - complications
Food Hypersensitivity - diagnosis
Food Hypersensitivity - epidemiology
Health risks
Humans
Immunoglobulin E
Meta-analysis
risk assessment
Risk Factors
severity
Teenagers
Young Adult
severity
risk assessment
anaphylaxis
food allergy
biomarkers
ISSN:0105-4538, 1398-9995, 1398-9995
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Zusammenfassung:This rapid review summarizes the most up to date evidence about the risk factors for severe food‐induced allergic reactions. We searched three bibliographic databases for studies published between January 2010 and August 2021. We included 88 studies and synthesized the evidence narratively, undertaking meta‐analysis where appropriate. Significant uncertainties remain with respect to the prediction of severe reactions, both anaphylaxis and/or severe anaphylaxis refractory to treatment. Prior anaphylaxis, an asthma diagnosis, IgE sensitization or basophil activation tests are not good predictors. Some molecular allergology markers may be helpful. Hospital presentations for anaphylaxis are highest in young children, yet this age group appears at lower risk of severe outcomes. Risk of severe outcomes is greatest in adolescence and young adulthood, but the contribution of risk taking behaviour in contributing to severe outcomes is unclear. Evidence for an impact of cofactors on severity is lacking, although food‐dependent exercise‐induced anaphylaxis may be an exception. Some medications such as beta‐blockers or ACE inhibitors may increase severity, but appear less important than age as a factor in life‐threatening reactions. The relationship between dose of exposure and severity is unclear. Delays in symptom recognition and anaphylaxis treatment have been associated with more severe outcomes. An absence of prior anaphylaxis does not exclude its future risk.
Bibliographie:Funding information
2
This review was conducted as part of the development of food allergy guidelines for GA
LEN, where contributors volunteered their time. This research was part‐funded by the UK Medical Research Council (grant references MR/K010468/1 and MR/W018616/1) to PJT. NP and PJT are supported through the NIHR Biomedical Research Centre based at Imperial College Healthcare NHS Trust and Imperial College London. The views expressed in this article are those of the author(s) and do not necessarily reflect those of the NHS, NIHR, or the UK Departments of Health
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ObjectType-Evidence Based Healthcare-1
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ISSN:0105-4538
1398-9995
1398-9995
DOI:10.1111/all.15318