Hazelnut allergy across Europe dissected molecularly: A EuroPrevall outpatient clinic survey.

Mareen R Datema, Laurian Zuidmeer-Jongejan, Riccardo Asero, Laura Barreales, Simona Belohlavkova, Frédéric de Blay, Peter Bures, Michael Clausen, Ruta Dubakiene, David Gislason, Monika Jedrzejczak-Czechowicz, Marek L Kowalski, André C Knulst, Tanya Kralimarkova, Thuy-My Le, Alison Lovegrove, Justin Marsh, Nikolaos G Papadopoulos, Todor Popov, Náyade Del PradoAshok Purohit, Gerald Reese, Isabel Reig, Suranjith L Seneviratne, Athanasios Sinaniotis, Serge A Versteeg, Stefan Vieths, Aeilko H Zwinderman, Clare Mills, Jonas Lidholm, Karin Hoffmann-Sommergruber, Montserrat Fernández-Rivas, Barbara Ballmer-Weber, Ronald van Ree

    Research output: Contribution to journalArticlepeer-review


    BACKGROUND: Hazelnut allergy is birch pollen-driven in Northern/Western Europe and lipid transfer protein-driven in Spain and Italy. Little is known about other regions and other allergens. OBJECTIVE: Establishing a molecular map of hazelnut allergy across Europe. METHODS: In 12 European cities, subjects reporting reactions to hazelnut (n = 731) were evaluated and sensitization to 24 foods, 12 respiratory allergen sources, and latex was tested by using skin prick test and ImmunoCAP. A subset (124 of 731) underwent a double-blind placebo-controlled food challenge to hazelnut. Sera of 423 of 731 subjects were analyzed for IgE against 7 hazelnut allergens and cross-reactive carbohydrate determinants by ImmunoCAP. RESULTS: Hazelnut allergy was confirmed in 70% of those undergoing double-blind placebo-controlled food challenges. Birch pollen-driven hazelnut sensitization (Cor a 1) dominated in most cities, except in Reykjavik, Sofia, Athens, and Madrid, where reporting of hazelnut allergy was less frequent anyhow. In Athens, IgE against Cor a 8 dominated and strongly correlated with IgE against walnut, peach, and apple and against Chenopodium, plane tree, and mugwort pollen. Sensitization to seed storage proteins was observed in less than 10%, mainly in children, and correlated with IgE to nuts, seeds, and legumes. IgE to Cor a 12, observed in all cities (10% to 25%), correlated with IgE to nuts, seeds, and pollen. CONCLUSIONS: In adulthood, the importance of hazelnut sensitization to storage proteins, oleosin (Cor a 12), and Cor a 8 is diluted by the increased role of birch pollen cross-reactivity with Cor a 1. Cor a 8 sensitization in the Mediterranean is probably driven by diet in combination with pollen exposure. Hazelnut oleosin sensitization is prevalent across Europe; however, the clinical relevance remains to be established.
    Original languageEnglish
    JournalThe Journal of allergy and clinical immunology
    Issue number2
    Publication statusPublished - 13 Mar 2015


    • EuroPrevall
    • component-resolved diagnosis
    • hazelnut allergy
    • outpatient clinic


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