EAACI guidelines on the management of IgE-mediated food allergy
Por:
Santos AF, Riggioni C, Agache I, Akdis CA, Akdis M, Alvarez-Perea A, Alvaro-Lozano M, Ballmer-Weber B, Barni S, Beyer K, Bindslev-Jensen C, Brough HA, Buyuktiryaki B, Chu D, Del Giacco S, Dunn-Galvin A, Eberlein B, Ebisawa M, Eigenmann P, Eiwegger T, Feeney M, Fernandez-Rivas M, Fiocchi A, Fisher HR, Fleischer DM, Giovannini M, Gray C, Hoffmann-Sommergruber K, Halken S, O'B Hourihane J, Jones CJ, Jutel M, Knol EF, Konstantinou GN, Lack G, Lau S, Mejias AM, Marchisotto MJ, Meyer R, Mortz CG, Moya B, Muraro A, Nilsson C, de Oliveira LCL, O'Mahony L, Papadopoulos NG, Perrett KP, Peters R, Podesta M, Poulsen LK, Roberts G, Sampson H, Schwarze J, Smith P, Tham E, Untersmayr E, Van Ree R, Venter C, Vickery B, Vlieg-Boerstra B, Werfel T, Worm M, Du Toit G and Skypala I
Publicada:
1 ene 2025
Ahead of Print:
1 oct 2024
Resumen:
This European Academy of Allergy and Clinical Immunology (EAACI) guideline provides recommendations for the management of IgE-mediated food allergy and was developed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Following the confirmation of IgE-mediated food allergy diagnosis, allergen avoidance and dietary advice (with support of a specialised dietitian, if possible) together with the provision of a written treatment plan, education on the recognition of allergic symptoms and prescription of medication including adrenaline using an auto-injector are essential. Patients with significant anxiety and requirement for coping strategies may benefit from support from a clinical psychologist. As immunomodulatory interventions, omalizumab is suggested for treatment of IgE-mediated food allergy in children from the age of 1 and adults; and oral allergen-specific immunotherapy is recommended for children and adolescents with peanut allergy and suggested for milk and egg allergies (generally after 4 years of age for milk and egg). Sublingual and epicutaneous immunotherapy are suggested for peanut allergy but are not yet available at the point of care. Future research into disease modifying treatments for IgE-mediated food allergy are highly needed, with standardised and patient-focused protocols and outcomes.
Filiaciones:
Santos AF:
Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, UK
Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' Hospital, London, UK
Riggioni C:
Division of Immunology and Allergy, The Hospital for Sick Children and the SickKids Food Allergy and Anaphylaxis Program, Toronto, Ontario, Canada
Department of Paediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
Agache I:
Faculty of Medicine, Transylvania University, Brasov, Romania
Akdis CA:
Swiss Institute of Allergy and Asthma Research (SIAF), University Zurich, Davos, Switzerland
Akdis M:
Swiss Institute of Allergy and Asthma Research (SIAF), University Zurich, Davos, Switzerland
Alvarez-Perea A:
Hospital General Universitario Gregorio Marañón, Madrid, Spain
Gregorio Marañón Health Research Institute, Madrid, Spain
Alvaro-Lozano M:
Pediatric Allergy and Clinical Immunology Department, Hospital Sant Joan de Déu, Barcelona, Spain
Institut de Recerca Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
Ballmer-Weber B:
Clinic for Dermatology and Allergology, Kantonsspital St. Gallen, St. Gallen, Switzerland
Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
Barni S:
Allergy Unit, Meyer Children's Hospital IRCCS, Florence, Italy
Beyer K:
Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany
Bindslev-Jensen C:
Department of Dermatology and Allergy Centre, Odense Research Centre for Anaphylaxis (ORCA), Odense University Hospital, University of Southern Denmark, Odense, Denmark
Brough HA:
Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' Hospital, London, UK
Buyuktiryaki B:
Department of Pediatrics, Division of Pediatric Allergy, Koc University School of Medicine, Istanbul, Türkiye
Chu D:
McMaster University, Hamilton, Canada
Del Giacco S:
Department of Medical Sciences and Public Health and Unit of Allergy and Clinical Immunology, University Hospital "Duilio Casula", University of Cagliari, Cagliari, Italy
Dunn-Galvin A:
Paediatrics and Child Health, INFANT Centre, HRB-CRF, University College Cork, Cork, Ireland
Paediatrics and Child Health, Royal College of Surgeons in Ireland, Children's Health Ireland, Dublin, Ireland
Eberlein B:
Department of Dermatology and Allergy, Technical University of Munich, School of Medicine, Munich, Germany
Ebisawa M:
Clinical Research Center for Allergy and Rheumatology, NHO Sagamihara National Hospital, Kanagawa, Japan
Eigenmann P:
Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland
Eiwegger T:
Karl Landsteiner University of Health Sciences, Krems an der Donau, Austria
Department of Pediatric and Adolescent Medicine, University Hospital St. Pölten, St.Pölten, Austria
Translational Medicine Program, Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada
Department of Immunology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
Feeney M:
Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
Fernandez-Rivas M:
Allergy Department, Hospital Clinico San Carlos, Madrid, Spain
Facultad de Medicina, Universidad Complutense, IdISSC, ARADyAL, Madrid, Spain
Fiocchi A:
Allergy Department, Pediatric Hospital Bambino Gesù IRCCS, Rome, Italy
Fisher HR:
Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
Fleischer DM:
University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado, USA
Giovannini M:
Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany
Department of Health Sciences, University of Florence, Florence, Italy
Gray C:
Red Cross Children's Hospital and Kidsallergy Centre, Cape Town, South Africa
Department of Paediatrics, University of Cape Town, Cape Town, South Africa
Hoffmann-Sommergruber K:
Dept. of pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
Halken S:
Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
O'B Hourihane J:
Royal College of Surgeons in Ireland and Childrens Health Ireland, Dublin, Ireland
Jones CJ:
School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
Jutel M:
Department of Clinical Immunology, Faculty of Medicine, Wroclaw Medical University
and ALL-MED Medical Research Institute, Wroclaw, Poland
Knol EF:
Department Center of Translational Immunology and Department Dermatology/Allergology, University Medical Center Utrecht, Utrecht, The Netherlands
Konstantinou GN:
Department of Allergy and Clinical Immunology, 424 General Military Training Hospital, Thessaloniki, Greece
Lack G:
Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, UK
Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' Hospital, London, UK
Lau S:
Department of Dermatology and Allergy Centre, Odense Research Centre for Anaphylaxis (ORCA), Odense University Hospital, University of Southern Denmark, Odense, Denmark
Mejias AM:
Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' Hospital, London, UK
Marchisotto MJ:
EAACI Patient Organisation Committee, Zurich, Switzerland
MJM Advisory, New York, New York, USA
Meyer R:
Dept. Nutrition and Dietetics, Winchester University, Winchester, UK
Department of Medicine, KU Leuven, Leuven, Belgium
Mortz CG:
Department of Pediatrics, Division of Pediatric Allergy, Koc University School of Medicine, Istanbul, Türkiye
Moya B:
Department of Allergy, Hospital Universitario 12 de Octubre, Madrid, Spain
Instituto de Investigación Sanitaria, Hospital 12 de Octubre (imas12), Madrid, Spain
Muraro A:
Food Allergy Referral Centre, Padua University Hospital, Padua, Italy
Nilsson C:
Department of Clinical Science and Education, Karolinska Institutet, Solna, Sweden
Sachs Children and Youth Hospital, South Hospital, Stockholm, Sweden
de Oliveira LCL:
Division of Allergy and Clinical Immunology, Department of Paediatrics, Federal University of São Paulo, São Paulo, Brazil
O'Mahony L:
Department of Medicine, School of Microbiology, APC Microbiome Ireland, University College Cork, Cork, Ireland
Papadopoulos NG:
Allergy Dpt, 2nd Pediatric Clinic, University of Athens, Athens, Greece
Lydia Becker Institute, University of Manchester, Manchester, UK
Perrett KP:
Population Allergy, Murdoch Children's Research Institute, Parkville, Australia
Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Australia
Peters R:
Murdoch Children's Research Institute, Parkville, Victoria, Australia
Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
Podesta M:
European Federation of Allergy and Airways Diseases Patients' Associations and the EAACI Patient Organisation Committee, Zurich, Switzerland
Poulsen LK:
Allergy Clinic, Copenhagen University Hospital at Herlev-Gentofte, Copenhagen, Denmark
Roberts G:
Paediatric Allergy and Respiratory Medicine, University of Southampton, NIHR Southampton Biomedical Research Centre and David Hide Asthma and Allergy Centre, St Mary Hospital, Isle of Wight, UK
Sampson H:
Department of Pediatrics, Division of Allergy and Immunology, Jaffe Food Allergy Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
Schwarze J:
Child Life and Health, Centre for Inflammation Research, Institute for Regeneration and Repair, The University of Edinburgh, Edinburgh, UK
Smith P:
Clinical Medicine, Griffith University, Southport, Queensland, Australia
Queensland Allergy Services Private Practice, Southport, Queensland, Australia
Tham E:
Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
Khoo Teck Puat-National University Children's Medical Institute, National University Health System (NUHS), Singapore, Singapore
Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
Untersmayr E:
Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
Van Ree R:
Department of Experimental Immunology and of Otorhinolaryngology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
Venter C:
Section of Allergy and Clinical Immunology, Children's Hospital Colorado, University of Colorado, Boulder, Colorado, USA
Vickery B:
Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia, USA
Vlieg-Boerstra B:
Department of Paediatrics, OLVG Hospital, Amsterdam, the Netherlands
Rijnstate Allergy Centre, Rijnstate Hospital, Arnhem, The Netherlands
Vlieg Dieticians, Private Practice for dietary management of food allergy, Arnhem, the Netherlands
Werfel T:
Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
Worm M:
Department of Dermatology and Allergy Centre, Odense Research Centre for Anaphylaxis (ORCA), Odense University Hospital, University of Southern Denmark, Odense, Denmark
Du Toit G:
Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' Hospital, London, UK
Skypala I:
Part of Guys and St Thomas NHS Foundation Trust, Royal Brompton and Harefield Hospitals, London, UK
Department of Inflammation and Repair, Imperial College, London, UK
Green Submitted, hybrid
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