Hazelnut allergens by the numbers. a14

Transcription

1 Hazelnut allergen component testing Hazelnut allergens by the numbers a1 a8 a9 a14 Testing for whole allergen proteins can help you better diagnose allergies and prepare personalized management plans.

2 High levels of hazelnut IgE can predict the likelihood of hazelnut sensitivity, but may not be solely predictive of reactions or allergic response.1 Hazelnut allergen component testing Measurement of specific IgE by blood test that provides objective assessment of sensitization to hazelnut is only the first step in discovering the likelihood of a systemic reaction and the necessary precautions that may be prescribed. Allergen components, in conjunction with whole-allergen test results, help you better diagnose allergies, allowing you to prepare more comprehensive management plans.

3 Hazelnut allergen component test results can help determine which specific proteins your patient is sensitized to. a1 a8 a9 a14 LOWER RISK of systemic reaction primarily associated with local reactions 2 Heat and digestion labile 3 Cross-reactive with pollens (e.g., birch) 1,4 VARIABLE RISK associated with local and systematic reactions including anaphylaxis 2,5,6 Heat and digestion stabile 7 Indicates cross-reactivity, often from a primary peach sensitization 5 HIGHER RISK of systemic reaction including anaphylaxis 1,2,8,9 Heat and digestion stabile 10 Sensitization to these can appear early in life and indicates a primary hazelnut allergy 1 Take the diagnosis and management of hazelnut-sensitized patients to a whole new level. RISK ASSESSMENT TEST INTERPRETATIONS AND NEXT STEPS IgE antibodies for Indication Patient Suggestions a14 a9 a8 a14 and/or a9 a8 Associated with systemic reactions in hazelnutsensitized patients. 1,2,8,9 Both local oral symptoms and systemic reactions may occur. 2,6 Test for sensitization to peanuts and other tree nuts (e.g., walnuts and Brazil nuts), as cross-reactivity may occur. 10,12 If both, avoid raw as well as roasted/ heated hazelnuts. 7 a1 a1 Mono-sensitization Typically associated with local reactions although systemic reactions to raw hazelnuts may occur in some cases, especially in adults. 2 Often tolerate roasted or heated hazelnuts. 7 As in all diagnostic testing, a diagnosis must be made by the physician based on test results, individual patient history, the physician s knowledge of the patient, and the physician s clinical judgment.

4 Test Name Food Allergy Panel - Milk, (NTC-2802) f2; IgE Egg white, (NTC-2801) f1; IgE Peanut, (NTC- 2813) f13; IgE Walnut, (NTC-3489) f256; IgE n, (NTC-2808) f8; IgE Wheat, (NTC-2804) f4; IgE Soybean, (NTC-2814) f14; IgE Codfish, (NTC-2803) f3; IgE Clam, (NTC-8929) f207; IgE Shrimp, (NTC-2824) f24; Total IgE Food Allergy Profile - Egg white, (NTC-2801) f1; Milk, (NTC-2802) f2; Codfish, (NTC- 2803) f3; Wheat, (NTC-2804) f4; n, (NTC-2808) f8; Sesame seed, (NTC-2810) f10; Peanut, (NTC-2813) f13; Soybean, (NTC- 2814) f14; Shrimp, (NTC-2824) f24; Clam, (NTC-8929) f207; Walnut, (NTC-3489) f256; Scallop, (NTC- 273) f338 Food Allergy Profile w/reflexes - Contains all components of the Food Allergy Profile (NTC-10715) with reflex to the following components, with reflex to Egg Component Panel, (NTC-91372); Ovomucoid, (NTC-3046) f233; Ovalbumin, (NTC-2719) f232; Milk Component Panel, (NTC-91403); Casein, (NTC-2853) f78; Alphalactalbumin, (NTC-2851) f76; Beta-lactoglobulin, (NTC-2852) f77; Peanut Component Panel, (NTC-91681) Ara h1, f422; Ara h2, f423; Ara h3, f424; Ara h8, f352; Ara h9 Test Code Test Name Hazelnut w/reflexes - Hazelnut f17 IgE with reflex to component panel Nut Mix Group 18 - IgE allergy testing for: Almond, (NTC-2820) f20; Cashew nut, (NTC-2608) f202; Coconut, (NTC- 2836) f36; Hazelnut, f17; Peanut, (NTC-2813) f13; Pecan, (NTC- 2864) f201; Sesame seed, (NTC- 2810) f10 Nut Panel - Macadamia nut, (NTC-38475); Pecan, (NTC-2864); Brazil nut, (NTC-2818); Walnut, (NTC- 3489); Cashew nut, (NTC-2608); Pistachio, (NTC-2726); Hazelnut; Almond, (NTC-2820); Peanut, (NTC-2813) no reflexes Nut Panel w/reflexes - Macadamia nut, (NTC-38475); Pecan, (NTC-2864); Brazil nut, (with reflex) (NTC-94464); Walnut (with reflexes), (NTC-94467); Cashew nut (with reflexes), (NTC ); Pistachio, (NTC-2726); Hazelnut (with reflexes), (NTC ); Almond, (NTC-2820); Peanut (with reflex), (NTC-91747) Peanut Component Panel - Ara h1, f422; Ara h2, f423; Ara h3, f424; Ara h8, f352; Ara h9 Test Code Hazelnut 2817 Multiple test codes are available. Refer to the Quest Diagnostics Directory of Services or the online Test Center (QuestDiagnostics.com/testcenter) for test information. NTC = National test code

5 Hazelnut is among the top 5 causes of serious food allergic reactions.11 Optimize management Make a substantiated decision Better differentiation helps you distinguish between primary and cross-reactive sensitization. Make a precise assessment Allergen-component test results can help you asses your patient s risk for systemic reactions. Make a difference Better differentiation gives relevant information that helps you determine optimal treatments.

6 For more information about hazelnut component testing, contact your local sales representative. References 1. Masthoff L, et al. Sensitization to a 9 and a 14 is highly specific for a severe hazelnut allergy in Dutch children and adults. J Allergy Clin Immunol. 2013(In press). 2. De Knop KJ, et al. Age-related sensitization profiles for hazelnut (ylus avellana) in a birch-endemic region. Pediatr Allergy Immunol Feb; 22(1Pt 2): e Hansen KS, et al. Roasted hazelnuts-allergenic activity evaluated by double-blind, placebo-controlled food challenge. Allergy Feb; 58(2): Pastorello EA, et al. Identification of hazelnut major allergens in sensitive patients with positive double-blind, placebo-controlled food challenge results. J Allergy Clin Immunol. 2002; 109(3): Lauer I, et al. The non-specific lipid transfer protein, Ara h 9, is an important allergen in peanut. Clinical & Experimental Allergy. 39: Schocker F, et al. Recombinant lipid transfer protein a 8 from hazelnut: A new tool for in vitro diagnosis of potentially severe hazelnut allergy. J Allergy Clin Immunol. 2004;113: Masthoff L, et al. A systematic review of the effect of thermal processing on the allergenicity of tree nuts. Allergy. 2013; 68: Hansen KS, et al. Component-resolved in vitro diagnosis of hazelnut allergy in Europe. J Allergy Clin Immunol Apr 1; 123(5): Garino C, et al. Isolation, cloning, and characterization of the 2S albumin: A new allergen from hazelnut. Mol Nutr Food Res. 2010; 54: Asero R, et al. Walnut-induced anaphylaxis with cross-reactivity to hazelnut and Brazil nut. J Allergy Clin Immunol Feb; 113(2): Flinterman AE, et al. Hazelnut allergy: from pollen-associated mild allergy to severe anaphylactic reactions. Curr Opin Allergy Clin Immunol Jun; 8(3): Verweij M, et al. Young infants with atopic dermatitis can display sensitization to a 9, an 11S legumin-like seed-storage protein from hazelnut (ylus avellana). Pediatric Allergy Immnol. 2011; 22: QuestDiagnostics.com Quest, Quest Diagnostics, any associated logos, and all associated Quest Diagnostics registered or unregistered trademarks are the property of Quest Diagnostics. All third-party marks and are the property of their respective owners Quest Diagnostics Incorporated. All rights reserved. SB /2017