Ratings promoted by other food allergies may reveal potential sesame allergies

Phoenix — Studies show that many patients with sesame allergies are tested for sesame allergies only after being diagnosed with other food allergies, and only one-third of patients have previously responded to sesame.

Presented at the American Annual Meeting of Allergies, Asthma and Immunology, the results of this study, the largest retrospective study of sesame allergic patients, could eliminate sesame allergies among patients with both peanut and nut allergies. It also showed low sex. ..

“Sesame allergies are becoming more of a concern in the United States and elsewhere, and their prevalence is rising.” Lima Rachid, MD, He told Healio, director of the Allergen Immunotherapy Program and co-director of the Food Allergy Program at Boston Children’s Hospital.

Rachid quoted data from a 2010 cross-sectional study that estimated a prevalence of sesame allergies of 0.1%. Cross-sectional study in 2019 It showed a 0.49% rate of self-reported sesame allergies between adults and children in the United States.

“Sesame is now recognized by the FDA as the ninth most common food allergen in the United States,” she added. ” The FDA recently mandated labeling Use of sesame as a food allergen that came into effect in January 2023. However, little is known about the natural history and consequences of the symptoms of sesame allergies. “

To further characterize sesame allergies and understand their symptoms and consequences, Rachid et al. Searched the i2b2 dataset to identify all sesame allergy patients evaluated in the Boston Children’s Hospital Allergy Program.

The analysis included 1,394 patients (38.1% of women) diagnosed with sesame allergies with an average age of 4.2 years.

The average follow-up period was 4 years (range, 0-20.5).

More than half (53%) of patients underwent a sesame test for another food allergy, and 94% had a nut or peanut allergy.

“Previous studies have demonstrated serological or clinical cross-reactivity between peanuts, nuts, and sesame allergies,” said Principal Investigator. Farida Abi Farraj, MD, Postdoctoral fellow at Boston Children’s Hospital told Healio. “Other studies have shown cross-reactive allergens between sesame seeds and nuts, or between sesame seeds and peanuts, which may explain why these allergies occur at the same time.

Farida Abi Farage

“We also believe that if a patient is allergic to peanuts and / or nuts, we are more likely to have more tests for sesame allergies,” she added.

In addition, only 37.2% of patients experienced at least one previously confirmed allergic reaction to sesame and 9.8% experienced anaphylaxis.

Researchers have also found that patients generally have allergic rhinitis (67%) and eczema (73%).

Only 8.4% of patients recorded a sesame allergy resolution, and patients with a history of peanut or nut allergy allergies are less likely to have a resolution (resolve).P P = .035).

Patients who underwent a sesame prick test with a wheal of 8 mm or larger were more likely to have a history of allergic reaction or anaphylaxis to sesame (P < Both .001) and eczema (P = .016).

Also, sesame IgE above 10 kU / L appeared to be associated with the use of epinephrine (P = .022), emergency visit (P = .031), allergic rhinitis (P = .006), eczema (= .006)P = .001) and asthma (P = .013).

“To assess the natural elimination rate of sesame allergies and further assess the positive predictions of 50% and 95% serum IgE levels for sesame-specific skin test wheal size and sesame food failure, on a larger scale. Long-term research is needed. A challenge, “Rakid said.

Further research is needed to investigate the fact that many patients with sesame allergies had allergies to peanuts and nuts without prior sesame reactions, Abi Farage said. ..

“How many of these patients are sensitized without clinical responsiveness (ie they give false positive results, are misdiagnosed and do not respond when given sesame seeds), and how many are truly allergic I don’t know if it is, “she said. “It is important to perform a food challenge to further evaluate these patients, especially if the sesame skin test wheal results are not too high and / or serum sesame IgE is not too high.

“A small number of patients receive food challenges, which means that further discussion with patients and their families is needed to determine the likelihood of doing food challenges and why they do not,” she adds. rice field.

reference:

perspective

Back to top

Dr. Christopher M. Warren

Broadly speaking, these data are based on a survey conducted by our group at the Northwestern University Food Allergy and Asthma Research Center a few years ago from a large, nationally representative sample of US households. Very consistent. Our survey data also showed that the proportion of coexisting atopy, including allergies to peanuts and nuts, was high, the proportion of anaphylaxis was comparable (slightly higher), and the rate of elimination of sesame allergies was low.

The only major surprise of the findings is the fact that girls with sesame allergies are relatively predominant compared to boys, given that there is generally a male bias in food allergies in children, our findings. Suggested that this was also the case for pediatric sesame allergies.

There is some evidence that the prevalence of sesame allergies has increased. A 2008 national survey of 13,534 people conducted by Sicherer et al. Estimated a self-reported prevalence of sesame allergies of 0.1%, but a recent survey by our group reported allergies in about 0.5%. However, less than half were more likely to have a true IgE-mediated allergy.This suggests that prevalence is increasing, at least in the United States.

However, at least part of this apparent increase in prevalence is due to successful food allergy advocacy efforts and ongoing efforts to expand federal labeling laws to include sesame, sesame allergies and general food allergies. It may be the result of increased awareness of. These efforts have recently led to the enactment of the FASTER Act of 2021 which has expanded the definition of major food allergens for specific food labeling requirements, including sesame seeds in particular.

Many questions remain about sesame allergies. One of the key issues is sesame allergy, which causes a serious allergic reaction to sesame in the United States due to accidental consumption of unlabeled sesame products, consumption of labeled sesame products, and intentional consumption. The number of people.

The other is to accurately predict the sesame-induced dose for a particular patient. This can provide useful guidance on how much a patient needs to be concerned about the risks associated with consuming small amounts of sesame seeds (eg, cross-contact or a small number of sesame seeds). Sow the dumplings or sprinkle them on a plate).

Finally, given the increasing consumption of hummus and tahini in the United States, can early introduction of sesame-containing foods such as tahini prevent sesame allergies in high-risk infants? If so, what is the minimum dose, frequency, and optimal timing needed to maximize this protective effect for a given patient?

reference:

Safer SH, et al. J Clin Allergy Immunol.. 2010; doi: 10.1016 /j.jaci.2010.03.029.

Warren CM etc. JAMA Netw Open.. 2019; doi: 10.1001 /jamanetworkopen.2019.9144.

Dr. Christopher M. Warren

Assistant Professor of Preventive Medicine

Director of Population Health Research Department

Food Allergy and Asthma Research Center

Northwestern University School of Medicine Fineberg

Ann & Robert H. Lurie Children’s Hospital Chicago

Disclosure: Warren has not reported disclosure of relevant financial information.

Add topics to email alerts

Receive an email when a new article is posted

Please enter your email address to receive emails when new articles are posted ..

“data-action =” subscribe “> Subscribe

The request could not be processed. Please try again later.If you continue to have this issue, please contact us [email protected]..

Return to Healio

American Allergy / Asthma / Immunology Annual Meeting