Hazelnut and Walnut Vicilins in Tree Nut Allergy: Co-Sensitization Patterns and Clinical Severity Associations

Area of Science:

• Allergen immunotherapy
• Food allergy diagnostics
• Molecular allergology

Background:

• Hazelnut and walnut allergies can lead to severe reactions.
• The clinical significance of specific seed storage proteins, including vicilins, is not fully understood.

Purpose of the Study:

• To investigate the association between specific hazelnut and walnut allergens and clinical reaction severity.
• To evaluate the diagnostic performance of newly available vicilin components.

Main Methods:

• Observational analysis of 114 patients with tree nut allergy (hazelnut and walnut).
• Specific IgE testing to various hazelnut and walnut components.
• Analysis of co-sensitization patterns and logistic regression for severity.

Main Results:

• Severe reactions were more common in hazelnut allergy (43.2%) than walnut allergy (24.3%).
• Cor a 14, Cor a 9, Cor a 16 (hazelnut) and Jug r 1, Jug r 2 (walnut) showed severity-related gradients.
• Cor a 14, Jug r 1, and Jug r 2 were independently associated with severe reactions after adjustment.

Conclusions:

• Individual seed storage proteins have varying associations with reaction severity in hazelnut and walnut allergies.
• Molecule-resolved diagnostics are clinically valuable.
• Integrating vicilin components may enhance molecular stratification of tree nut allergies.