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Abstract

Allergologie select, Vol. 9/2025 (21-27)

Recent findings from the anaphylaxis registry: Where are we, where do we want to go?

Margitta Worm, Sabine Dölle-Bierke, Lea Faust, and Veronika Höfer

Allergology and Immunology, Clinic for Dermatology, Venereology and Allergology, Campus Charité Mitte, Universitätsmedizin Berlin, Berlin, Germany
The anaphylaxis registry collects structured data across Europe regarding elicitors, accompanying circumstances and other diseases as well as the treatment of severe allergic reactions. By March 2024, 16,988 cases had been registered, of which ~ 1/3 were children and 2/3 were adults. Among children, boys are most frequent affected, while among adults, women are most frequently affected. The most common elicitors depend on age and continue to be dominated by the food allergens in children and by insect venom in adults. The occurrence of anaphylaxis without skin symptoms is not uncommon and occurs in children in the range of 5%, regardless of the trigger, while in adults the frequency is generally higher (up to 15%) and there are triggerdependent differences. The analysis of the rare food allergens that trigger anaphylaxis shows, for example, spices such as saffron and sumac and vegetables such as chicory or spring onions. One case was elicited by a mealworm. Food shows an increase in triggering anaphylaxis in children. The trigger spectrum of foods is large and relevant due to the increasing plant-based diets. Rare allergens can cause anaphylaxis and should be further considered and monitored in the coming years to determine their frequency as triggers of severe reactions.Correspondence to:
Prof. Dr. med. Margitta Worm, Klinik für Dermatologie, Venerologie und Allergologie, Allergologie und Immunologie, Charité – Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
Email: [email protected]

Abstract

Allergologie select, Vol. 10/2026 (16-27)

Quality-of-life assessment may support the correct diagnosis of adult wheat allergy

Florian Schusta, Anna Neyer, Sabine Dölle-Bierke, Josefine Grünhagen, Veronika Höfer, and Margitta Worm

Division of Allergy and Immunology, Department of Dermatology, Venereology and Allergology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
Background: Wheat is a frequent cause of food-induced allergic reactions in adults. In this study we aimed to assess the diagnostic value of skin prick test (SPT), specific immunoglobulin E (sIgE), but also quality of life in wheat-sensitized and allergic patients. Materials and methods: In this prospective, clinical study 80 patients were screened for eligibility. Subsequently, 36 wheat-sensitized patients underwent oral food challenges (OFCs) with supraphysiological amounts of gluten at rest and in combination with exercise. The challenge was stopped when objective symptoms occurred. Prior to the challenge, sIgE measurement and a SPT were conducted. The Food Allergy Quality of Life Questionnaire (FAQLQ), Food Allergy Independent Measure (FAIM), and Beck Anxiety Inventory (BAI) were used to assess the quality of life, perceived disease severity, and anxiety of the patients. Results: The OFC was performed with increasing amounts of gluten reaching a supraphysiological level. 24 patients (67%) were OFC positive with 21 reacting at rest. 3 patients reacted after the implementation of exercise. 60% of patients with a self-reported exercise dependency reacted in the OFC at rest. 8 of 21 patients who reacted at rest were rechallenged with exercise and lower doses of gluten, of which 5 reacted again. Exercise lowered the reaction threshold by 50% in these 5 patients. OFC-positive patients had stronger sensitization to gluten and its constituents and showed higher impairment in their quality of life and perceived burden of disease than OFC-negative patients. The receiver operator characteristics model including gluten SPT, omega-5-gliadin sIgE, and the FAIM score to predict OFC positivity yielded a 95.2% sensitivity and 83.3% specificity. Males displayed a higher degree of sensitization, but females had higher FAQLQ and FAIM scores. Conclusion: Although a high rate of exercise dependency was reported, most reactions were elicited at rest when the amount of gluten was upscaled. However, the eliciting amount and reaction threshold was lowered in the presence of exercise. Food allergy-related quality-of-life data can indicate psychological impairment due to the disease but may also serve as a patient-reported outcome tool which can support the diagnostic accuracy of wheat allergy.Correspondence to:
Prof. Dr. med. Margitta Worm, Division of Allergy and Immunology, Department of Dermatology, Venerology and Allergy, Charité – Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
Email: [email protected]

Abstract

Allergologie select, Vol. 10/2026 (28-35)

Experts’ perspectives on allergic reactions to emerging food sources, pollen and insects

Lea Faust¹, Sabine Dölle-Bierke¹, Veronika Höfer¹,², and Margitta Worm¹

¹Division of Allergy and Immunology, Department Dermatology, Venereology and Allergy, Campus Charité Mitte, Universitätsmedizin Berlin, Berlin, Germany, and ²Division of Allergy, University Children’s Hospital and Children’s Research Center, University of Zurich (UZH), Zurich, Switzerland
The rising demand for sustainable diets has led to an increased consumption of alternative protein sources. While ecologically promising, these foods may pose new allergenic risks. We surveyed 127 European allergy experts regarding their clinical perception towards emerging allergenic food sources. Allergic reactions to non-priority allergenic foods were most frequently reported for legumes (83%), followed by hemp (33%), edible insects (21%), and jackfruit (20%). Experts highlighted risks related to cross-reactivity, particularly between edible insects and crustaceans or house dust mites, and between non-priority legumes and peanut, soy, or lupine. Legumes other than peanut, soy, and lupine, as well as edible insects and hempseeds/cannabis, were also rated as most clinically relevant for future practice. Experts also noted rising symptoms due to changes in pollen exposure and insect distribution linked to climate change. Our data underscore the need for the diagnosis of emerging allergenic sources.Correspondence to:
Prof. Dr. med. Margitta Worm, Division of Allergy and Immunology, Department of Dermatology, Venerology and Allergy, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
Email: [email protected]

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