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15.02.2014 | Leitlinie

Nahrungsmittelallergie infolge immunologischer Kreuzreaktivitäten mit Inhalationsallergenen

Leitlinie der Deutschen Gesellschaft für Allergologie und klinische Immunologie (DGAKI), der Deutschen Dermatologischen Gesellschaft (DDG), des Ärzteverbands Deutscher Allergologen (AeDA) und der Gesellschaft für Pädiatrische Allergologie und Umweltmedizin (GPA)

verfasst von: Univ.-Prof. Dr. Margitta Worm, Uta Jappe, Jörg Kleine-Tebbe, Christiane Schäfer, Imke Reese, Joachim Saloga, Regina Treudler, Torsten Zuberbier, Anja Waßmann, Thomas Fuchs, Sabine Dölle, Martin Raithel, Barbara Ballmer-Weber, Bodo Niggemann, Thomas Werfel

Erschienen in: Allergo Journal | Ausgabe 1/2014

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Zusammenfassung

Bei älteren Kindern, Jugendlichen und Erwachsenen wird ein großer Teil Immunglobulin-E(IgE)-vermittelter Nahrungsmittelallergien durch kreuzreaktive allergene Strukturen ausgelöst. Die primäre Sensibilisierung ist vorrangig gegen Inhalationsallergene gerichtet (z. B. Bet v 1 als Hauptallergen der Birkenpollen). IgE kann über verschiedene kreuzreaktive Allergene aktiviert werden und zu unterschiedlichen klinischen Manifestationen führen. In der Regel treten lokale und milde, selten auch schwere systemische Reaktionen direkt nach Verzehr des Nahrungsmittels auf, welches das kreuzreaktive Allergen enthält (z. B. pflanzliche Nahrungsmittel mit Proteinanteil aus der Bet-v-1-Familie). In der klinischen Praxis können Sensibilisierungen gegen die primär verantwortlichen Inhalations- und/oder Nahrungsmittelallergene mit dem Pricktest und/oder der Bestimmung von spezifischem IgE in vitro erfasst werden. Die komponentenbasierte Diagnostik kann die klinische Diagnostik unterstützen. Für einzelne Allergene ermöglicht sie eine Risikoabschätzung für das Auftreten systemischer Reaktionen. Sensibilisierungen müssen insbesondere bei unklarer Anamnese durch orale Provokationstests bestätigt werden. Auch neue, bisher unerkannte Allergene können Kreuzreaktionen hervorrufen.

Das therapeutische Potenzial der spezifischen Immuntherapie mit inhalativen Allergenen und deren Wirkung auf die pollenassoziierte Nahrungsmittelallergie ist im klinischen Alltag variabel und letztlich nicht geklärt. Placebokontrollierte Studien sind zukünftig erforderlich. Insgesamt treten allergische Sensibilisierungen gegen Pollen- und kreuzreaktive Nahrungsmittelallergene in unseren Breiten sehr häufig auf. Ihre aktuelle Relevanz ist mit Hilfe der klinischen Angaben individuell zu ermitteln.

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Titel: Nahrungsmittelallergie infolge immunologischer Kreuzreaktivitäten mit Inhalationsallergenen
Leitlinie der Deutschen Gesellschaft für Allergologie und klinische Immunologie (DGAKI), der Deutschen Dermatologischen Gesellschaft (DDG), des Ärzteverbands Deutscher Allergologen (AeDA) und der Gesellschaft für Pädiatrische Allergologie und Umweltmedizin (GPA)
verfasst von: Univ.-Prof. Dr. Margitta Worm
Uta Jappe
Jörg Kleine-Tebbe
Christiane Schäfer
Imke Reese
Joachim Saloga
Regina Treudler
Torsten Zuberbier
Anja Waßmann
Thomas Fuchs
Sabine Dölle
Martin Raithel
Barbara Ballmer-Weber
Bodo Niggemann
Thomas Werfel
Publikationsdatum: 15.02.2014
Verlag: Urban & Vogel
Erschienen in: Allergo Journal / Ausgabe 1/2014
Print ISSN: 0941-8849
Elektronische ISSN: 2195-6405
DOI: https://doi.org/10.1007/s15007-014-0483-2

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15.04.2024 | Hörsturz | Nachrichten

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Springer Medizin

Nahrungsmittelallergie infolge immunologischer Kreuzreaktivitäten mit Inhalationsallergenen

Leitlinie der Deutschen Gesellschaft für Allergologie und klinische Immunologie (DGAKI), der Deutschen Dermatologischen Gesellschaft (DDG), des Ärzteverbands Deutscher Allergologen (AeDA) und der Gesellschaft für Pädiatrische Allergologie und Umweltmedizin (GPA)

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