Food Anaphylaxis: Eight Food Allergens Without Mandatory Labelling Highlighted by the French Allergy-Vigilance...

Area of Science:

• Food allergy research
• Clinical immunology
• Public health regulations

Background:

• European food regulations mandate labeling for 14 allergens.
• Other foods frequently cause food-induced anaphylaxis (FIA).

Purpose of the Study:

• Identify emerging food allergens (EFA) implicated in FIA.
• Assess EFA frequency, severity, recurrence, and hidden presence.
• Determine which EFA warrant inclusion on mandatory allergen lists.

Main Methods:

• Analyzed 2999 FIA cases reported to the Allergy Vigilance Network (2002-2023).
• Identified allergens involved in ≥1% of cases and not on the current EU list.
• Evaluated reaction severity (Ring classification), recurrence, and hidden exposure.

Main Results:

• Eight EFA groups were identified: goat's/sheep's milk, buckwheat, peas/lentil, alpha-gal, pine nut, kiwi, beehive products, and apple.
• Goat's/sheep's milk, buckwheat, peas/lentil, and alpha-gal showed high rates of severe reactions (Ring grades 3-4).
• Goat's/sheep's milk and buckwheat exhibited significant recurrence and hidden exposure.

Conclusions:

• Eight foods are frequently involved in FIA and not on the current EU mandatory labeling list.
• Goat's/sheep's milk, buckwheat, peas/lentil, and pine nut are proposed for inclusion due to frequency, severity, and recurrence.
• Updated allergen labeling is crucial for managing food-induced anaphylaxis risks.