Scientific Study

Tree nut (TN) allergy is one of the most common IgE-mediated food allergies (FAs) during late childhood and cause severe hypersensitivity reactions.1, 2, 3, 4 TNs share common components/epitopes leading to multiple sensitizations and allergies in up to 96.7 and 60.7% of the patients, respectively. It is common practice to exclude all nuts from the diet in case of a single nut allergy/sensitization; this evasion has its merits because of the inherent risks of oral food challenge (OFC), as well as labor-intensive and time-consuming aspects. There is a definite requirement for a safe, reliable, and cost-effective diagnostic method for accurate diagnosis and measurement of component-specific IgE (sIgE)s has been reported to have this potential. Singleplex tests have demonstrated the usefulness of measuring Ana o 3 for cashew and pistachio, Cor a 9/Cor a 14 for hazelnut, and Jug r 1/Jug r 4 for walnut allergies. However, the list is still incomplete, and the substantial homology between components and the cross-reactivity among them have not been satisfactorily considered. https://doi.org/10.1016/j.alit.2021.10.001