Allergieprävention
Editorial
Imke Reese und Torsten Schäfer
Jahrgang 38 p. 373 - 374
Abstract
AllergieprävenAllergologie, Jahrgang 38, Nr. 8/2015, S. 373-374
Editorial
Imke Reese und Torsten Schäfer
Guideline
Update of the S2k guideline on the management of IgE-mediated food allergies
Margitta Worm, Imke Reese, Barbara Ballmer-Weber, Kirsten Beyer, Stephan C. Bischoff, Barbara Bohle, Knut Brockow, Martin Claßen, Peter J. Fischer, Eckard Hamelmann, Uta Jappe, Jörg Kleine-Tebbe, Ludger Klimek, Berthold Koletzko, Lars Lange, Susanne Lau, Ute Lepp, Vera Mahler, Katja Nemat, Martin Raithel, Joachim Saloga, Christiane Schäfer, Sabine Schnadt, Jens Schreiber, Zsolt Szépfalusi, Regina Treudler, Martin Wagenmann, Thomas Werfel, and Torsten Zuberbier
Volume 5 (2021) p. 195 - 243
Abstract
Allergologie select, Vol. 5/2021 (195-243)
Update of the S2k guideline on the management of IgE-mediated food allergies
Margitta Worm1, Imke Reese2, Barbara Ballmer-Weber3, Kirsten Beyer4, Stephan C. Bischoff5, Barbara Bohle6, Knut Brockow7, Martin Claßen8, Peter J. Fischer9, Eckard Hamelmann10, Uta Jappe11#12, Jörg Kleine-Tebbe13, Ludger Klimek14, Berthold Koletzko15, Lars Lange16, Susanne Lau4, Ute Lepp17, Vera Mahler18, Katja Nemat19, Martin Raithel20, Joachim Saloga21, Christiane Schäfer22, Sabine Schnadt23, Jens Schreiber24, Zsolt Szépfalusi25, Regina Treudler26, Martin Wagenmann27, Thomas Werfel28, and Torsten Zuberbier29
1Allergology and Immunology, Department of Dermatology, Venereology, and Allergology, Charité – Universitätsmedizin Berlin, Germany, 2Nutritional Counseling and Therapy, Focus on Allergology, Munich, Germany, 3University Hospital Zurich, Department of Dermatology, Zurich, Switzerland, and Cantonal Hospital St. Gallen, Department of Dermatology and Allergology, St. Gallen, Switzerland, 4Clinic of Pediatrics m. S. Pneumology, Immunology and Intensive Care Medicine, Charité – Universitätsmedizin Berlin, Germany, 5Institute of Nutritional Medicine and Prevention, University of Hohenheim, Stuttgart, Germany, 6Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Austria, 7Department of Dermatology and Allergology, Biederstein, Klinikum rechts der Isar, Technical University of Munich, Germany, 8Klinik für Kinder und Jugendmedizin/Päd. Intensivmedizin, Eltern-Kind-Zentrum Prof. Hess Klinikum Bremen-Mitte, 9Practice for Pediatric and Adolescent Medicine m. S. Allergology and Pediatric Pneumology, Schwäbisch Gmünd, 10University Clinic for Pediatric and Adolescent Medicine, Evangelisches Klinikum Bethel gGmbH, Bielefeld, 11Research Group Clinical and Molecular Allergology, Research Center Borstel, Airway Research Center North (ARCN), member of the German Center for Lung Research (DZL), Borstel, 12Interdisciplinary Allergy Outpatient Clinic, Medical Clinic III, University Hospital Schleswig-Holstein, Lübeck, 13Allergy and Asthma Center Westend, Berlin, 14Center for Rhinology and Allergology, Wiesbaden, 15Pediatric Clinic and Pediatric Polyclinic, Dr. von Haunersches Kinderspital, Department of Metabolic and Nutritional Medicine, Ludwig-Maximilians-University, Munich, 16Pediatric and Adolescent Medicine, St.- Marien-Hospital, Bonn, 17Practice for Pulmonary Medicine and Allergology, Buxtehude, 18Paul-Ehrlich-Institut, Langen, 19Practice for Pediatric Pneumology/Allergology at the Children’s Center Dresden (Kid), Dresen, 20Medical Clinic II, Malteser Waldkrankenhaus, Erlangen, 21Department of Dermatology, University Medical Center, Johannes Gutenberg-University Mainz, 22Nutritional Therapy, Focus on Allergology and Gastroenterology, Schwarzenbek, Germany, 23German Allergy and Asthma Association, Mönchengladbach, Germany, 24Pneumology, University Hospital of Otto von Guericke University, Magdeburg, Germany, 25University Hospital for Pediatrics and Adolescent Medicine, Medical University of Vienna, Austria, 26Clinic of Dermatology, Venereology and Allergology, University Medical Center Leipzig, Germany, 27Nose and Throat Clinic, University Hospital Düsseldorf, Germany, 28Clinic of Dermatology, Allergology and Venerology, Hannover Medical School, Germany, and 29Department of Dermatology, Venerology and Allergology, Charité – Universitätsmedizin Berlin
Correspondence to:
Univ.-Prof. Dr. med. Margitta Worm, Allergologie und Immunologie, Klinik für Dermatologie, Venerologie, und Allergologie, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, 10117 Berlin
Email: [email protected]
Guideline
Guideline on management of suspected adverse reactions to ingested histamine - Guideline of the German Society for Allergology and Clinical Immunology (DGAKI), the Society for Pediatric Allergology and Environmental Medicine (GPA), the Medical Association
Imke Reese, Barbara Ballmer-Weber, Kirsten Beyer, Sabine Dölle-Bierke, Jörg Kleine-Tebbe, Ludger Klimek, Sonja Lämmel, Ute Lepp, Joachim Saloga, Christiane Schäfer, Zsolt Szepfalusi, Regina Treudler, Thomas Werfel, Torsten Zuberbier, and Margitta Worm
Volume 5 (2021) p. 305 - 314
Abstract
Allergologie select, Vol. 5/2021 (305-314)
Guideline on management of suspected adverse reactions to ingested histamine - Guideline of the German Society for Allergology and Clinical Immunology (DGAKI), the Society for Pediatric Allergology and Environmental Medicine (GPA), the Medical Association
Imke Reese1, Barbara Ballmer-Weber2, Kirsten Beyer3, Sabine Dölle-Bierke4, Jörg Kleine-Tebbe5, Ludger Klimek6, Sonja Lämmel7, Ute Lepp8, Joachim Saloga9, Christiane Schäfer10, Zsolt Szepfalusi11, Regina Treudler12, Thomas Werfel13, Torsten Zuberbier14, and Margitta Worm4
1Nutrition Therapy, Munich, Germany, 2Clinic for Dermatology and Allergology, Cantonal Hospital St. Gallen and Department of Dermatology, University Hospital Zurich, Switzerland, 3Clinic for Pediatrics with focus on Pneumology and Immunology, Charité-Universitätsmedizin – Campus Virchow-Klinikum, Berlin, 4Allergology and Immunology, Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, 5Allergy and Asthma Center Westend, Berlin, 6Center for Rhinology and Allergology, Wiesbaden, 7German Allergy and Asthma Association (DAAB), Mönchengladbach, 8Practice for Pulmonary Medicine and Allergology, Stade, 9Department of Dermatology, University Medical Center, Johannes Gutenberg University, Mainz, 10Nutrition Therapy, Schwarzenbek, 11Department of Pediatrics, Division of Pediatric Pulmonology, Allergology and Endocrinology, Comprehensive Center Pediatrics, Medical University of Vienna, Vienna, Austria, 12Department of Dermatology, Venereology and Allergology, Leipzig University Medical Center, 13Department of Dermatology and Allergy, Hannover Medical School, and 14Comprehensive Allergy Centre Charité, Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Germany
Adverse reactions to food or food ingredients are more often perceived than objectively verifiable. However, reliable laboratory tests are often lacking. As a result, people with perceived adverse reactions to food often follow extensive elimination diets for years and unnecessarily restrict their diet, as in the case of the frequently suspected histamine intolerance. In this condition, laboratory parameters such as the determination of diamine oxidase in serum have been shown to be inconclusive. The lack of symptom reproducibility calls into question the clinical picture of adverse reactions to ingested histamine. In order to approach persons with perceived histamine intolerance and to support them in moving from blanket restrictions, which are often unnecessarily strict, to effective personalized therapeutic strategies, the present guideline of the Working Group on Food Allergy of the German Society of Allergology and Clinical Immunology (DGAKI) in cooperation with the Medical Association of German Allergists (AeDA), the Pediatric Allergology and Environmental Medicine (GPA) as well as the Swiss Society of Allergology and Immunology (SGAI) and the Austrian Society of Allergology and Immunology (ÖGAI) recommends a practicable diagnostic and therapeutic approach.Correspondence to:
Dr. Imke Reese, Ernährungsberatung und -therapie, Schwerpunkt Allergologie, Ansprengerstr. 19, 80803 München
Email: [email protected]
Guideline
S3 Guideline Allergy Prevention
Matthias V. Kopp, Cathleen Muche-Borowski, Michael Abou-Dakn, Birgit Ahrens, Kirsten Beyer, Katharina Blümchen, Petra Bubel, Adam Chaker, Monika Cremer, Regina Ensenauer, Michael Gerstlauer, Uwe Gieler, Inga-Marie Hübner, Fritz Horak, Ludger Klimek, Berthold V. Koletzko, Sybille Koletzko, Susanne Lau, Thomas Lob-Corzilius, Katja Nemat, Eva M.J. Peters, Antonio Pizzulli†, Imke Reese, Claudia Rolinck-Werninghaus, Elien Rouw, Bianca Schaub, Sebastian Schmidt, Jens-Oliver Steiß, Anne Kathrin Striegel, Zsolt Szépfalusi, Dietmar Schlembach, Thomas Spindler, Christian Taube, Valérie Trendelenburg, Regina Treudler, Ulrich Umpfenbach, Christian Vogelberg, Martin Wagenmann, Anke Weißenborn, Thomas Werfel, Margitta Worm, Helmut Sitter, and Eckard Hamelmann
Volume 6 (2022) p. 61 - 97
Abstract
Allergologie select, Vol. 6/2022 (61-97)
S3 Guideline Allergy Prevention
Matthias V. Kopp1, Cathleen Muche-Borowski2, Michael Abou-Dakn3, Birgit Ahrens4, Kirsten Beyer5, Katharina Blümchen4, Petra Bubel6, Adam Chaker7, Monika Cremer8, Regina Ensenauer9, Michael Gerstlauer10, Uwe Gieler11, Inga-Marie Hübner12, Fritz Horak13, Ludger Klimek14, Berthold V. Koletzko15, Sybille Koletzko16, Susanne Lau5, Thomas Lob-Corzilius17, Katja Nemat18, Eva M.J. Peters11, Antonio Pizzulli†19, Imke Reese20, Claudia Rolinck-Werninghaus21, Elien Rouw22, Bianca Schaub23, Sebastian Schmidt24, Jens-Oliver Steiß25, Anne Kathrin Striegel26, Zsolt Szépfalusi27, Dietmar Schlembach28, Thomas Spindler29, Christian Taube30, Valérie Trendelenburg5, Regina Treudler31, Ulrich Umpfenbach32, Christian Vogelberg33, Martin Wagenmann34, Anke Weißenborn35, Thomas Werfel36, Margitta Worm37, Helmut Sitter38, and Eckard Hamelmann39
1Airway Research Center North, University of Lübeck, Member of Deutsches Zentrum für Lungenforschung, Universitätsklinik für Kinderheilkunde, Inselspital, Bern, Schweiz, 2Institut für Allgemeinmedizin, University Medical Center Hamburg-Eppendorf, Hamburg, Deutschland, 3Clinic for Gynecology and Obstetrics, St. Joseph-Krankenhaus Berlin-Tempelhof, Deutschland, 4Children’s Hospital, University Hospital Frankfurt, Deutschland, 5Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité Universitätsmedizin Berlin, Deutschland, 6HNO-Facharztpraxis, Eisleben, Deutschland, 7HNO-Klinik, Klinikum rechts der Isar, Technical University of Munich, Munich, Deutschland, 8Ökotrophologin, Journalistin, Idstein/Taunus, Deutschland, 9Institut für Kinderernährung, Max Rubner-Institut, Karlsruhe, Deutschland, 10Kinderklinik, Universitätsklinikum Augsburg, Deutschland, 11Klinik für Psychosomatik und Psychotherapie des UKGM, Universitätsklinik, Giessen, Deutschland, 12Arbeitsgemeinschaft Dermatologiche Prävention e.V., Hamburg, Deutschland, 13Allergiezentrum Wien West, Wien, Österreich, 14Zentrum für Rhinologie und Allergologie, Wiesbaden, Deutschland, 15Integriertes Sozialpädiatrisches Zentrum, Dr. von Haunerschen Kinderspital, LMU Klinikum der Universität München, München, Deutschland, 16Abteilung für Stoffwechsel und Ernährung, Dr. von Haunersches Kinderspital, LMU Klinikum der Universität München, München, Deutschland, 17Kinder- und Jugendmedizin, Christliches Kinderhospital Osnabrück, Deutschland, 18Kinderzentrum Dresden-Friedrichstadt, Dresden, Deutschland, 19Schwerpunktpraxis für Allergologie und Lungenheilkunde im Kinder- und Jugendalter, Berlin, Deutschland, 20Ernährungsberatung und -therapie mit Schwerpunkt Allergologie, München, Deutschland, 21Praxis für Kinder- und Jugendmedizin, Teltow, Deutschland, 22Kinderarztpraxis, Bühl, Deutschland, 23Asthma- und Allergieambulanz, Dr. von Haunersches Kinderspital, LMU Klinikum der Universität, München, Deutschland, 24Allgemeine Pädiatrie, Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsmedizin Greifswald, Greifswald, Deutschland, 25Facharztpraxis für Kinder- und Jugendmedizin, Fulda, Deutschland, 26Kinder- und Jugendmedizin, Universitätsklinikum, Köln, Deutschland, 27Universitätsklinik für Kinder- und Jugendheilkunde, Medizinische Universität Wien, Wien, Österreich, 28Klinik für Geburtsmedizin, Vivantes Klinikum Neukölln, Berlin, 29Hochgebirgsklinik Davos, Schweiz, 30Klinik für Pneumologie, Ruhrlandklinik, Westdeutsches Lungenzentrum am Universitätsklinikum, Essen, Deutschland, 31Klinik für Dermatologie, Venerologie und Allergologie, Leipziger Allergie-Centrum LICA – CAC, Universitätsmedizin, Leipzig, Deutschland, 32Praxis für Kinder- und Jugendmedizin, Dülken, Deutschland, 33Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Carl Gustav Carus an der Technischen Universität, Dresden, Deutschland, 34HNO-Klinik, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland, 35German Federal Institute for Risk Assessment, Berlin, Deutschland, 36Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover, Hannover, Deutschland, 37Klinik für Dermatologie, Allergologie und Venerologie, Campus Charité Mitte, Universitätsmedizin Berlin, Berlin, Deutschland, 38Institut für Chirurgische Forschung, Philipps-Universität, Marburg, Deutschland, and 39Kinder-Zentrum Bethel, Evangelisches Klinikum Bethel, Universitätsklinik für Kinder- und Jugendmedizin, Universitätsklinikum OWL, Universität Bielefeld, Bielefeld, Deutschland
Background: The persistently high prevalence of allergic diseases in Western industrial nations and the limited possibilities of causal therapy make evidence-based recommendations for primary prevention necessary. Methods: The recommendations of the S3 Guideline Allergy Prevention, published in its last version in 2014, were revised and consented on the basis of a current systematic literature search. The evidence search was conducted for the period 06/2013 – 11/2020 in the electronic databases Cochrane and MEDLINE, as well as in the reference lists of current reviews and through references from experts. The literature found was screened in two filtering processes, first by title and abstract, and the remaining papers were screened in the full text for relevance. The studies included were sorted by level of evidence, and the study quality was indicated in terms of potential bias (low/high). The revised recommendations were formally agreed and consented upon with the participation of representatives of the relevant professional societies and (self-help) organizations (nominal group process). Of 5,681 hits, 286 studies were included and assessed. Results: Recommendations on maternal nutrition during pregnancy and breastfeeding as well as on infant nutrition in the first months of life again play an important role in the updated guideline: Many of the previous recommendations were confirmed by the current data. It was specified that breastfeeding should be exclusive for the first 4 – 6 months after birth, if possible, and that breastfeeding should continue with the introduction of complementary foods. A new recommendation is that supplementary feeding of cow’s milk-based infant formula should be avoided in the first days of life if the mother wishes to breastfeed. Furthermore, it was found that the evidence for a clear recommendation for hydrolyzed infant formula in nonbreastfed infants at risk of atopic diseases is currently insufficient. It is therefore recommended to check whether an infant formula with proven efficacy, demonstrated in allergy prevention studies, is available until the introduction of complementary feeding. Finally, based on the EAACI guideline, recommendations were made for the prevention of hen’s egg allergy by introducing and regularly giving thoroughly heated (e.g., baked or hard-boiled) but not “raw” hen’s egg (also no scrambled egg) with the complementary food. The recommendation to introduce peanut in complementary feeding was formulated cautiously for the German-speaking countries: In families with regular peanut consumption, the regular administration of peanut-containing foods in ageappropriate form (e.g., peanut butter) with the complementary diet can be considered for the primary prevention of peanut allergy in infants with atopic dermatitis (AD). Before introduction, a clinically relevant peanut allergy must be ruled out, especially in infants with moderate to severe AD. There is still insufficient evidence for an allergy-preventive efficacy of prebiotics or probiotics, vitamin D, or other vitamins in the form of supplements so that recommendations against their supplementation were adopted for the first time in the current guideline. Biodiversity plays an important role in the development of immunological tolerance to environmental and food allergens: there is clear evidence that growing up on a farm is associated with a lower risk of developing asthma and allergic diseases. This is associated with early non-specific immune stimulation due to, among other things, the greater microbial biodiversity of house dust in this habitat. This aspect is also reflected in the recommendations on animal husbandry, on which a differentiated statement was made: In families without a recognizable increased allergy risk, pet keeping with cats or dogs should not generally be restricted. Families with an increased allergy risk or with children with already existing AD should not acquire a new cat – in contrast, however, dog ownership should not be discouraged. Interventions to reduce exposure to dust mite allergens in the home, such as the use of mite allergen-proof mattress covers (“encasings”), should be restricted to patients with already proven specific sensitization against house dust mite allergen. Children born by caesarean section have a slightly increased risk of asthma – this should be taken into account when advising on mode of delivery outside of emergency situations. Recent work also supports the recommendations on air pollutants: Active and passive exposure to tobacco smoke increase the risk of allergies, especially asthma, and should therefore be avoided. Exposure to nitrogen oxides, ozone, and small particles (PM 2.5) is associated with an increased risk, especially for asthma. Therefore, exposure to emissions of nitrogen oxides, ozone, and small particles (PM 2.5) should be kept low. The authors of this guideline are unanimously in favor of enacting appropriate regulations to minimize these air pollutants. There is no evidence that vaccinations increase the risk of allergies, but conversely there is evidence that vaccinations can reduce the risk of allergies. All children, including children at risk, should be vaccinated according to the current recommendations of the national public health institutes, also for allergy prevention. Conclusion: The consensus of recommendations in this guideline is based on an extensive evidence base. The update of the guideline enables evidence-based and up-to-date recommendations for the prevention of allergic diseases including asthma and atopic dermatitis.Correspondence to:
Prof. Dr. med. Matthias Kopp, Medizinbereich Kinder und Jugendliche, Insel Gruppe AG, Inselspital, Universität Bern, Freiburgstraße 15, 3010 Bern,
or
Prof. Dr. med. Eckard Hamelmann, Kinder-Zentrum Bethel, Evangelisches Klinikum Bethel, Universität Bielefeld, Burgsteig 13, 33617 Bielefeld
Email: [email protected]
Review
Non-IgE mediated food allergies in breastfed children: A clinical challenge
Rosan Meyer and Imke Reese
Volume 6 (2022) p. 241 - 247
Abstract
Allergologie select, Vol. 6/2022 (241-247)
Non-IgE mediated food allergies in breastfed children: A clinical challenge
Rosan Meyer1,2,3 and Imke Reese4
1Department Medicine, Imperial College London, London, 2Department Nutrition and Dietetics, Winchester University, Winchester, Great Britain, 3Faculty of Medicine, KU Leuven, Belgium, 4Nutrition therapy, Munich, Germany
The prevalence of non-immunoglobulin E (IgE) mediated food allergy is poorly established outside of cow’s milk allergy, with a challenge-proven adjusted incidence ranging between 0.13 and 0.72%. The presence and presentation of non-IgE mediated allergy in exclusively breastfed infants is highly debated. The dilemma this poses for healthcare professionals and parents, is on the one hand the unwarranted elimination and therefore health risk to the breastfeeding mother and on the other hand under-recognition of a food allergen being a culprit in the non-IgE mediated symptoms of breastfed infants. Current international guidelines recommend exclusive breastfeeding ideally until ~ 6 months of age and the German guidelines 4 – 6 months. It is also acknowledged that breastfeeding should be promoted also within the population of food-allergic infants. This review paper aims to assess non-IgE mediated food allergies in breastfed infants using an evidence-based approach and provides clinicians working with these patients with practical guidance.Correspondence to:
Rosan Meyer, RD, MSc Nutrition, PhD, Department Medicine, Imperial College London, Lpndon, GB
Email: [email protected]
Position Paper
Vegan diets from an allergy point of view – Position paper of the DGAKI working group on food allergy
Imke Reese, Christiane Schäfer, Barbara Ballmer-Weber, Kirsten Beyer, Sabine Dölle-Bierke, Suzanne van Dullemen, Uta Jappe, Sabine Müller, Sabine Schnadt, Regina Treudler, and Margitta Worm
Volume 7 (2023) p. 57 - 83
Abstract
Allergologie select, Vol. 7/2023 (57-83)
Vegan diets from an allergy point of view – Position paper of the DGAKI working group on food allergy
Imke Reese1, Christiane Schäfer2, Barbara Ballmer-Weber3,4, Kirsten Beyer5, Sabine Dölle-Bierke6, Suzanne van Dullemen7, Uta Jappe8,9, Sabine Müller10, Sabine Schnadt11, Regina Treudler12, and Margitta Worm6
1Nutrition Therapy, Munich, 2NutritionTherapy, Schwarzenbek, Germany, 3Clinic for Dermatology and Allergology, Cantonal Hospital St. Gallen, St. Gallen, 4Department of Dermatology, University Hospital Zürich, Switzerland, 5Clinic for Pediatrics with focus on Pneumology and Immunology, Charité-Universitätsmedizin – Campus Virchow-Klinikum, 6Allergology and Immunology, Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Berlin, 7University Clinic Frankfurt, Clinic for Pediatrics, Frankfurt, 8Division of Clinical and Molecular Allergology, Research Center Borstel, German Center for Lung Research (DZL) Airway Research Center North (ARCN), Borstel, 9Interdisciplinary Allergy Outpatient Clinic, Department of Pneumology, University of Lübeck, Lübeck, 10Department of Dermatology and Venereology, University Clinic Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, 11German Allergy and Asthma Association (DAAB), Mönchengladbach, and 12Department of Dermatology, Venereology and Allergology, Leipzig University Medical Center, Leipzig, Germany
Vegan diets are currently attracting a great deal of attention. However, avoiding animal-based foods restricts the diet and is associated with risks, the extent and medical implications of which are at present not sufficiently understood. Elimination diets represent the usual therapeutic long-term management in the presence of food allergy. In order to understand the risks of vegan diets and to discuss these critically from the perspective of food allergies, the expertise of a nutritionist/dietitian with expertise in this area is indispensable. This position paper deals with the incentives behind and the benefits of a plant-based diet. The knowledge required to cover macro- and micronutrient dietary requirements is presented. Using the avoidance of cow’s milk as an example, the challenges of adequately meeting nutritional needs are identified and (so-called) milk alternatives are evaluated from an allergy and nutritional point of view. Finally, other plant-based (substitute) products are evaluated from the same perspective, as significant protein sources in vegan diets (e.g., legumes, nuts, and seeds) are at the same time potential and potent triggers of allergic reactions. However, the allergic potential of many substitute products cannot be fully assessed at present due to gaps in research. Wheat as the most important trigger for anaphylaxis in adults is also evaluated. Finally, the increase in ultra-processed products in the (vegan) food sector and their potential consequences for the immune system are discussed.
Please notice: There is an erratum to this article, which can be found at: https://www.dustri.com/nc/de/article-response-page.html?artId=191243&doi=10.5414%2FALX02400ECorr.Correspondence to:
Dr. Imke Reese, Ernährungsberatung und -therapie, Schwerpunkt Allergologie, Ansprengerstr. 19, 80803 Munich, Germany
Email: [email protected]
Review
“Climate-friendly” diets from an allergy point of view
Imke Reese
Volume 8 (2024) p. 199 - 205
Abstract
Allergologie select, Vol. 8/2024 (199-205)
“Climate-friendly” diets from an allergy point of view
Imke Reese
Private Practice for Dietary Advice and Nutrition Therapy with Special Interest in Adverse Reactions to Food, Munich, Germany
Since the EAT-Lancet Commission’s call for a change in diet towards more plant-based foods, especially protein sources, this so called “Planetary Health Diet (PHD)” has been widely discussed. While for some the reduction in animal foods is not enough and vegan diets are advocated to save the climate, others are sounding the alarm that the reduction is too drastic and that the PHD makes it impossible to provide a diet that meets our needs (of essential nutrients). In addition to climate aspects, health benefits often cited to justify the PHD do not take into account that vegetarians/vegans differ from the general population by far more factors than the reduction or elimination of animal foods. Also not sufficiently discussed is the fact that a diet which excludes or severely restricts animal foods is also associated with health risks if critical nutrients are not adequately covered. Moreover, the challenge of meeting protein requirements is underestimated by many. The food industry has responded to the trend towards more plant-based foods by massively expanding the range of highly processed or ultra-processed vegan foods. These – vegan or not vegan – are suspected of being partly responsible for the development of non-communicable diseases. In addition to general criticism regarding the usefulness of advertising the PHD, the replacement of animal protein sources with plant-based sources notably harbors a number of additional relevant risks for allergy sufferers so that the latter should be classified as an unfavorable target group for the implementation of the PHD recommendations.Correspondence to:
Dr. Imke Reese, Ernährungsberatung und -therapie, Schwerpunkt Allergologie, Ansprengerstr. 19, 80803 Munich, Germany
Email: [email protected]
Corrigendum
Corrigendum to Article Vegan diets from an allergy point of view – Position paper of the DGAKI working group on food allergy. Allergol Select. 2023; 7: 57-83
Imke Reese on behalf of the DGAKI working group on food allergy
Volume 8 (2024) p. 228 - 228
Abstract
Allergologie select, Vol. 8/2024 (228)
Corrigendum to Article Vegan diets from an allergy point of view – Position paper of the DGAKI working group on food allergy. Allergol Select. 2023; 7: 57-83
Imke Reese on behalf of the DGAKI working group on food allergy
Regarding the article by Reese I, Schäfer C, Ballmer-Weber B, Beyer K, Dölle-Bierke S, van Dullemen S, Jappe U, Müller S, Schnadt S, Treudler R, Worm M. Vegan diets from an allergy point of view – Position paper of the DGAKI working group on food allergy. Allergol Select. 2023; 7: 57-83, the authors would like to apologize for an unfortunate error that occurred during translation of the German position paper into English: not vitamin B12 but vitamin B2 was only met to a limited extent by the vegan group of the VeChi Diet Study (page 60, left column, 3rd paragraph). Please find the correct version of the sentence below:
The results of the VeChi Diet Study (Vegetarian and Vegan Children Study), a German cross-sectional study of young children aged between 1 and 3 years with different diets (vegan, vegetarian, omnivorous) show that the requirements of critical micronutrients such as calcium and iodine as well as the long-chain omega-3 fatty acids are not met in vegans and those of vitamin B2 and iron (due to poorer availability from plant sources) are only met to a limited extent [17].
The error has been corrected in the HTML and PDF versions of the article -> response page of the article
Imke Reese on behalf of the DGAKI working group on food allergy
Response
Response to Letter to the Editor from Christian Koeder
Imke Reese, Christiane Schäfer, Barbara Ballmer-Weber, Kirsten Beyer, Sabine Dölle-Bierke, Suzanne van Dullemen, Uta Jappe, Sabine Schnadt, and Regina Treudler
Volume 9 (2025) p. 18 - 20
Abstract
Allergologie select, Vol. 9/2025 (18-20)
Response to Letter to the Editor from Christian Koeder
Imke Reese1, Christiane Schäfer2, Barbara Ballmer-Weber3,4, Kirsten Beyer5, Sabine Dölle-Bierke6, Suzanne van Dullemen7, Uta Jappe8,9, Sabine Schnadt10, and Regina Treudler11
1Nutrition Therapy, Munich, 2NutritionTherapy, Schwarzenbek, Germany, 3Clinic for Dermatology and Allergology, Cantonal Hospital St. Gallen, St. Gallen, 4Department of Dermatology, University Hospital Zürich, Switzerland, 5Clinic for Pediatrics with focus on Pneumology and Immunology, Charité-Universitätsmedizin – Campus, Virchow-Klinikum, 6Allergology and Immunology, Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Berlin, 7University Clinic Frankfurt, Clinic for Pediatrics, Frankfurt/Main, 8Division of Clinical and Molecular Allergology, Research, Center Borstel, German Center for Lung Research (DZL) Airway Research Center North (ARCN), Borstel, 9Interdisciplinary Allergy Outpatient Clinic, Department of Pneumology, University of Lübeck, Lübeck, 10German Allergy and Asthma Association (DAAB), Mönchengladbach, and 11Department of Dermatology, Venereology and Allergology, Leipzig University Medical Center, Leipzig, Germany
Correspondence to:
Dr. Imke Reese, Ernährungsberatung und -therapie, Schwerpunkt Allergologie, Ansprengerstr. 19, 80803 Munich, Germany
Email: [email protected]
Guideline
Update of the evidence- and consensus-based S3 guideline on atopic dermatitis: Systemic therapy with biologics or Janus kinase inhibitors and specific aspects of systemic therapy in pregnancy and lactation
Thomas Werfel, Annice Heratizadeh, Matthias Augustin, Christine Bangert, Andrea Bauer, Tilo Biedermann, Richard Brans, Nadine Domröse, Uwe Gieler, Oliver Gießler-Fichtner, Eckard Hamelmann, Selina Hampe, Ruben Heuer, Julia Kahle, Maria Kinberger, Markus Koch, Meike Köhler, Franz Legat, Katja Nemat, Irena Neustädter, Eva M. J. Peters, Susanne Radonjic-Hoesli, Imke Reese, Peter Schmid-Grendelmeier, Uta-Katharina Schmidt-Göhrich, Jochen Schmitt, Christina Schnopp, Thomas Schwennesen, Dagmar Simon, Kristina Stamos, Christian Termeer, Regina Treudler, Ralph von Kiedrowski, Iris Wagner, Anja Waßmann-Otto, Gesine Weckmann, Ricardo Niklas Werner, Andreas Wollenberg, Margitta Worm, and Hagen Ott
Volume 10 (2026) p. 120 - 144
Abstract
Allergologie select, Vol. 10/2026 (120-144)
Update of the evidence- and consensus-based S3 guideline on atopic dermatitis: Systemic therapy with biologics or Janus kinase inhibitors and specific aspects of systemic therapy in pregnancy and lactation
Thomas Werfel1, Annice Heratizadeh1, Matthias Augustin2, Christine Bangert3, Andrea Bauer4, Tilo Biedermann5, Richard Brans6, Nadine Domröse1, Uwe Gieler7, Oliver Gießler-Fichtner8, Eckard Hamelmann9, Selina Hampe10, Ruben Heuer11, Julia Kahle10, Maria Kinberger11, Markus Koch12, Meike Köhler13, Franz Legat14, Katja Nemat15,16, Irena Neustädter17, Eva M. J. Peters18, Susanne Radonjic-Hoesli19, Imke Reese20, Peter Schmid-Grendelmeier21, Uta-Katharina Schmidt-Göhrich22, Jochen Schmitt23, Christina Schnopp5, Thomas Schwennesen24, Dagmar Simon19, Kristina Stamos16, Christian Termeer25,26, Regina Treudler27, Ralph von Kiedrowski28, Iris Wagner24, Anja Waßmann-Otto29, Gesine Weckmann30, Ricardo Niklas Werner11, Andreas Wollenberg31,32, Margitta Worm33, and Hagen Ott13,34
1Department of Dermatology and Allergy, Hannover Medical School, Hannover, 2Competence Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany, 3Department of Dermatology, Medical University of Vienna, Vienna, Austria, 4Department of Dermatology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, 5TUM University Hospital, Department of Dermatology and Allergy, Munich, 6Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the Osnabrück University, Osnabrück, 7Department of Psychosomatic Medicine and Psychotherapy, University Hospital Gießen, Gießen, 8Gaißach Specialist Clinic of DRV Bayern Süd, Gaißach, 9Children’s Center, Evangelical Hospital Bethel, University Hospital OWL, University of Bielefeld, Bielefeld, 10German Allergy and Asthma Association (DAAB), Mönchengladbach, 11Department of Dermatology, Venereology and Allergology, Division of Evidence Based Medicine in Dermatology (dEBM), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, 12Alpenklinik Santa Maria, Bad Hindelang, 13Section for Integrated Pediatric Dermatology (iKinD), Munich Center for Children with Medical and Developmental Complexity, LMU University Hospital, Munich, Germany, 14Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria, 15Practice for pediatric pneumology and allergology, Children’s Center Dresden-Friedrichstadt (Kid), 16Department of Pediatrics, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, 17Hospital Hallerwiese, Cnopfsche Kinderklinik, Nuremberg, 18Psychoneuroimmunology Laboratory, Department of Psychosomatic Medicine and Psychotherapy, Justus-Liebig University Gießen, Gießen, Germany, 19Department of Dermatology, Inselspital Bern, Bern, Switzerland, 20Private Practice for Dietary Advice and Nutrition Therapy with Special Interest in Adverse Reactions to Food, Munich, Germany, 21Allergy Unit, Department of Dermatology, University Hospital Zurich and Christine Kuehne Center for Allergy Research and Education CK-CARE Davos, Switzerland, 22 Carus Family Practice at Dresden University Hospital, 23Center for Evidence-Based Healthcare (ZEGV), University Hospital Dresden and Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, 24German Eczema Association (DNB), Hamburg, 25Dermatology Practice at Löwenmarkt, Stuttgart-Weilimdorf, 26Department of Dermatology, University-Hospital Freiburg, Freiburg, 27Institute of Allergology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, 28Selters Dermatology Practice, Selters, 29Mensing Derma MVZ, Hamburg, 30Weckmann Institute of Medical and Healthcare Education, Rostock, 31Department of Dermatology and Allergology, University Hospital Augsburg, Augsburg, 32Clinic and Polyclinic for Dermatology and Allergology, Ludwig Maximilian University, Munich, 33Department of Dermatology, Venereology, and Allergology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, and 34Department of Pediatric Surgery, Dr. Von Hauner Children’s Hospital, LMU University Hospital, Munich, Germany
This guideline is a partial update of the S3 guideline on atopic dermatitis (AWMF register no. 013-027) published in 2023. The chapters on systemic therapy with biologics and Janus kinase inhibitors as well as the chapter on pregnancy, breastfeeding and family planning in the context of systemic therapies for atopic dermatitis have been updated. This was prompted by new approvals (lebrikizumab, nemolizumab), approval extensions (abrocitinib from 12 years of age, baricitinib from 2 years of age) and new evidence on the use of biologics before and during pregnancy. In addition, a new chapter on treatment goals, treatment expectations and criteria for treatment adjustment (“treat-to-target”) in systemic therapies has been added to the guideline. This article only presents the updated and newly added chapters. The complete guideline is available on the AWMF website.Correspondence to:
PD Dr. Annice Heratizadeh, Department of Dermatology and Allergy, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany
Email: [email protected]
