The Prevalence of Sensitization to Food Allergens from the Group of “Big Eight” in Children with Atopic Phenotype: Cross-Sectional Study

Background. Food allergy (FA) is a common chronic disease. There are no official data on the prevalence of FA in Russia. The results of only a few Russian studies of FA and anaphylaxis in children have been published.

The aim of the study is to study the prevalence of sensitization to food allergens from the group of “big eight” in children with atopic phenotype living in the Moscow agglomeration.

Methods. The cross-sectional study included children aged 0 to 17 years with complaints of seasonal manifestations of allergies / diagnosed with seasonal allergic rhinitis (pollinosis); with complaints of allergic reactions when eating any food; with complaints of atopic dermatitis. The determination of sensitization to allergens was carried out using ImmunoCAP technology, ImmunoCAP ISAC / ALEX2 allergy chips.

Results. 240 children were included in the study. Sensitization to extracts of food allergens of the “big eight”, detected by the ImmunoCAP monoplex method, was determined in 1.5 (for fish) — 5 (for wheat) several times more often than with multiplex allergodiagnostics. In molecular allergodiagnosis, sensitization to hazelnut allergens was found in 57%, peanuts — in 47%, soy — in 39%, walnut — in 24%, chicken egg — in 18%, cow’s milk — in 12%, fish — in 9.7%, cashews — in 7.6%, shrimp — in 6.3%, wheat — in 4.6% of children. The frequency of food allergy symptoms, based on the assessment of the patients’ parents, was up to 7 times higher than the detected frequency of sensitization, accompanied by complaints of symptoms when eating the appropriate foods. Among the products causing symptoms in such patients, hazelnuts, cow’s milk, chicken egg and peanuts were in the lead.

Conclusion. More than half of Russian children are sensitized to the allergens of the “big eight”, while clinically significant sensitization was noted 2 times less often. Sensitization to the allergen components of the PR-10 group of hazelnuts, peanuts and soybeans was most often detected. The frequency of FA diagnosed by a doctor is significantly lower than the frequency of the disease detected by the results of a survey of patients’ parents.

1. Baseggio Conrado A, Ierodiakonou D, Gowland MH, et al. Food anaphylaxis in the United Kingdom: analysis of national data, 1998–2018. BMJ. 2021;372:n251. doi: https://doi.org/10.1136/bmj.n251

2. Santos AF, Riggioni C, Agache I, et al. EAACI guidelines on the diagnosis of IgE-mediated food allergy. Allergy. 2023;78(12):3057– 3076. doi: https://doi.org/10.1111/all.15902

3. Johansson SG, Hourihane JO, Bousquet J, et al. A revised nomenclature for allergy. An EAACI position statement from the EAACI nomenclature task force. Allergy. 2001;56(9):813–824. doi: https://doi.org/10.1034/j.1398-9995.2001.t01-1-00001.x

4. DunnGalvin A, Dubois AE, Flokstra-de Blok BM, Hourihane JO. The effects of FA on quality of life. Chem Immunol Allergy. 2015;101:235–252. doi: https://doi.org/10.1159/000375106

5. Riggioni C, Ricci C, Moya B, et al. Systematic review and metaanalyses on the accuracy of diagnostic tests for IgE-mediated food allergy. Allergy. 2024;79(2):324–352. doi: https://doi.org/10.1111/all.15939

6. Spolidoro GCI, Amera YT, Ali MM, et al. Frequency of food allergy in Europe: An updated systematic review and meta-analysis. Allergy. 2023;78(2):351–368. doi: https://doi.org/10.1111/all.15560

7. Spolidoro GCI, Ali MM, Amera YT, et al. Prevalence estimates of eight big food allergies in Europe: Updated systematic review and meta-analysis. Allergy. 2023;78(9):2361–2417. doi: https://doi.org/10.1111/all.15801

8. Fomina DS, Lebedkina MS, Nikitina EA, et al. Analysis of the sensitization spectrum in patients with severe allergic diseases using the ImmunoCAP ISAC method. Russian Journal of Allergy. 2024;21(1):55–73. (In Russ). doi: https://doi.org/10.36691/RJA15994

9. Elisyutina O, Lupinek C, Fedenko E, et al. IgE-reactivity profiles to allergen molecules in Russian children with and without symptoms of allergy revealed by micro-array analysis. Pediatr Allergy Immunol. 2021;32(2):251–263. doi: https://doi.org/10.1111/pai.13354

10. Lepeshkova TS. Causative allergens and sensitization spectrum in children with the history of food-induced anaphylaxis. Russian Medical Inquiry. 2023;7(2):75–80. (In Russ). doi: https://doi.org/10.32364/2587-6821-2023-7-2-75-80

11. Lepeshkova TS. Analysis of the prevalence of food hypersensitivity and food anaphylaxis in the children’s population of Ekaterinburg. Russian Journal of Allergy. 2021;18(2):46–54. (In Russ). doi: https://doi.org/10.36691/RJA1427

12. Esakova NV, Zimin SB, Кovtun EI, et al. Severe anaphylaxis in children: clinical features and triggers. Pediatria. Journal n.a. G.N. Speransky. 2024;103(2):8–17. (In Russ). doi: https://doi.org/10.24110/0031-403X-2024-103-2-8-17

13. Palisade study: phase 3 clinical trial studied Palforzia. In: Palforzia: Official website. Available online: https://www.palforziapro.com/palisade. Accessed on October 26, 2024.

14. Khaitov M, Shilovskiy I, Valenta R, et al. Recombinant PreSfusion protein vaccine for birch pollen and apple allergy. Allergy. 2024;79(4):1001–1017. doi: https://doi.org/10.1111/all.15919

15. Levina JG, Kalugina VG, Namazova-Baranova LS, et al. Identification of Pollen and Food Sensitization Prevalence in Children with Different Atopic Phenotype Variants (Intermediate Study Results). Pediatricheskaya farmakologiya — Pediatric pharmacology. 2022;19(5):394–403. (In Russ). doi: https://doi.org/10.15690/pf.v19i5.2464

16. Левна Ю.Г., Калугина В.Г., Эфендиева К.Е. и др. Распространенность профилей сенсибилизации к различным аллергенам у детей в Московской агломерации // Вестник Российской академии медицинских наук. — 2023. — Т. 78. — № 5. — C. 467–482. — doi: https://doi.org/10.15690/vramn10923 [Levina JG, Kalugina VG, Efendieva KE, et al. The Prevalence of Sensitization Profiles to Various Allergens in Children in the Moscow Metropolitan Area. Annals of the Russian academy of medical sciences. 2023;78(5):467–482. (In Russ). doi: https://doi.org/10.15690/vramn10923

17. Allen KJ, Koplin JJ. The epidemiology of IgE-mediated food allergy and anaphylaxis. Immunol Allergy Clin North Am. 2012;32(1):35– 50. doi: https://doi.org/10.1016/j.iac.2011.11.008

18. Spergel JM. Natural history of cow’s milk allergy. J Allergy Clin Immunol. 2013;131(3):813–814. doi: https://doi.org/10.1016/j.jaci.2013.01.027

19. Peters RL, Dharmage SC, Gurrin LC, et al. The natural history and clinical predictors of egg allergy in the first 2 years of life: a prospective, population-based cohort study. J Allergy Clin Immunol. 2014;133(2):485–491. doi: https://doi.org/10.1016/j.jaci.2013.11.032

20. Jeon YH. Pollen-food allergy syndrome in children. Clin Exp Pediatr. 2020;63(12):463–468. doi: https://doi.org/10.3345/cep.2019.00780