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Tree nut allergy: risk factors for development, mitigation of reaction risk and current efforts in desensitization.

Abstract
Allergy to tree nuts has grown widespread among patients, specifically in the pediatric population, in recent years. In this review, we evaluate and summarize the literature specific to development and treatment of tree nut allergy. The cause of tree nut allergy, such as most food allergies, is unknown; there are theories regarding maternal dietary factors as well as sensitization related to cross-reactivity to peanut allergens. The gold standard for the diagnosis of tree nut allergy is the double-blind, placebo-controlled, oral food challenge; however, simpler and more cost-effective diagnostic methods, such as the skin prick test and serum-specific IgE are often used as a supplement for diagnosis. Management of tree nut allergy consists of dietary avoidance and using epinephrine to manage serious allergic reactions. Alternative therapeutic methods, such as oral and sublingual immunotherapy and modification of allergenic proteins are being explored to develop safer, more effective and long-lasting management of tree nut allergy. We comment on the current studies involving risk factors for sensitization, diagnosis and management of tree nut allergy.
AuthorsMona Liu, A Wesley Burks, Todd D Green
JournalExpert review of clinical immunology (Expert Rev Clin Immunol) Vol. 11 Issue 5 Pg. 673-9 (May 2015) ISSN: 1744-8409 [Electronic] England
PMID25824522 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Review)
Chemical References
  • Epinephrine
Topics
  • Anaphylaxis (diagnosis, etiology, prevention & control)
  • Animals
  • Child
  • Desensitization, Immunologic
  • Diet
  • Epinephrine (administration & dosage)
  • Humans
  • Immunization
  • Nut Hypersensitivity (complications, diagnosis, therapy)
  • Risk Factors
  • Skin Tests

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