Piletta-Zanin Alexandre, Scherl Alexander, Benhamou Avigael, Braendle Gabriel, Caubet Jean-Christoph, Graham François, Grosgurin Olivier, Harr Thomas, Manzano Sergio, Nigolian Haig, Ortelli Didier, Pahud Jean-Pierre, la Tour Aude Tonson, Spechbach Hervé, Edder Patrick, Eigenmann Philippe A
Pediatric Allergy Unit, Department of Woman, Child and Adolescent, University Hospitals of Geneva (HUG), Geneva, Switzerland.
Official Food Control Authority of the State of Geneva (SCAV), Health Department, Geneva, Switzerland.
Allergy. 2025 Jan;80(1):238-247. doi: 10.1111/all.16413. Epub 2024 Nov 28.
Patients with food allergies need personalized information on their risk of reaction in "real-life" situations. This multicentric study aimed to investigate the link during accidental reactions between the nature and amount of food allergens consumed in "real-life situation" and the severity of the symptoms.
Patients were prospectively recruited from December 1, 2020, to December 31, 2021, at the emergency departments in the Geneva University Hospitals and local pediatric emergency facilities, through an allergy outpatient clinic, at school and daycare facilities and trough their primary care physicians. Medical history of patients presenting reactions suggestive with immediate food allergy and suspected food samples were collected. Allergy diagnostic tests were retrospectively and prospectively collected. The samples were analyzed for their allergen content.
We recruited 147 subjects with an accidental immediate-type allergic reaction to a food. We were able to collect 115 reaction-eliciting food samples allowing to quantify the allergen amount causing the reaction, as well as correlating this amount to the severity of the reaction. Children represented a large part of the reactors, and most reactions were to common food allergens such as tree nuts, cow's milk as well as peanuts and hen's egg. Reactions were mostly to prepackaged foods and seven reactions were to products with precautionary allergy labeling, or without labelling to the eliciting allergen. Reactions were of various degrees of severity, and independent to the amount of allergen ingested.
The severity of reactions did not show a direct correlation with allergen quantity, emphasizing individual sensitivity. Some reactions occurred with allergen amounts significantly below the legal limit for mandatory labelling of 1 g/kg (1000 ppm) in Switzerland. The study also highlighted considerable variability in allergen concentrations in foods labeled with possible "contaminations" or "traces". These findings raise questions about the accuracy of allergen labeling and regulations in Switzerland.
食物过敏患者需要关于其在“现实生活”中发生反应风险的个性化信息。这项多中心研究旨在调查在“现实生活”中意外发生反应时，所摄入食物过敏原的性质和数量与症状严重程度之间的联系。
2020年12月1日至2021年12月31日期间，在日内瓦大学医院的急诊科和当地儿科急诊设施、通过过敏门诊、在学校和日托设施以及通过其初级保健医生，前瞻性招募患者。收集出现提示速发型食物过敏反应的患者的病史以及可疑食物样本。回顾性和前瞻性收集过敏诊断测试结果。对样本进行过敏原含量分析。
我们招募了147名对食物发生意外速发型过敏反应的受试者。我们能够收集到115份引发反应的食物样本，从而能够量化引发反应的过敏原数量，并将该数量与反应的严重程度相关联。儿童占反应者的很大一部分，大多数反应针对常见的食物过敏原，如坚果、牛奶以及花生和鸡蛋。反应大多针对预包装食品，有7例反应针对带有预防性过敏标签或未标明引发过敏的过敏原的产品。反应的严重程度各不相同，且与摄入的过敏原量无关。
反应的严重程度与过敏原数量没有直接相关性，强调了个体敏感性。一些反应发生时的过敏原量明显低于瑞士强制标签规定的1克/千克（1000 ppm）的法定限值。该研究还突出了标有可能“污染”或“痕迹”的食品中过敏原浓度的显著差异。这些发现引发了关于瑞士过敏原标签和法规准确性的问题。
