An overview on current practices regarding the diagnosis and management of chronic urticaria in pediatrics: An EAACI Task Force report.

Background: The EAACI Task Force entitled "Improving Chronic Urticaria (CU) Management in Pediatrics" aimed to explore the differences in the diagnostic and management practices for CU in children (0-18 years).

Methods: An online clinical survey including 41 multiple choice questions on current practices for the management of childhood CU was disseminated among EAACI members.

Results: The survey was circulated to 50,472 contacts via mass email and to 2343 contacts via EAACI social media channels and answered by 161 participants from 55 countries.

Protocol: Scoping review of the association between complementary feeding, growth, and immune health in infants and toddlers-An EAACI guideline paper.

The European Academy of Allergy and Clinical Immunology (EAACI) is currently developing guidelines on immunomodulation and nutrition. To inform these recommendations, a scoping review will be conducted to synthesize and map the available empirical evidence on how complementary feeding affects immune health in infants and toddlers to explore the association between complementary feeding during the first year of life and immune health outcomes in children up to 3 years of age. The scoping review will be conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analysis Scoping Review Extension for scoping reviews (PRISMA-ScR) guidelines.

Main Processed Hypoallergenic Foods: A Potential Tool to Improve Informed Dietary Choices in Children with IgE-Mediated Food Allergies.

In the context of IgE-mediated food allergies in children, the use of hypoallergenic foods may offer an appropriate solution for enabling informed dietary choices and reducing reactivity to allergenic foods. It is well established that certain foods can alter their allergenicity depending on the method of processing. As such, processed foods may serve both as an alternative dietary option and as a useful tool in oral immunotherapy for children with IgE-mediated food allergies.

Biologics in the management of IgE-mediated food allergy. What is new?

The prevalence and the burden of food allergies (FAs) have been estimated to be increased in recent decades, particularly in urban and developed areas. In parallel, in the last decade, new treatment options have been available, including biologicals. In February 2024, the FDA approved omalizumab for IgE-mediated FA to prevent severe accidental reactions.

Trajectories of allergic diseases in children: Destination unknown?

The trajectories of allergic diseases represent one of the most currently debated topics both when referred to childhood and likewise adulthood. Data from cohorts show their heterogeneity as well as the key role of genetic and environmental factors. More insight has been recently provided in the pathophysiological mechanisms underlying the development and amplification of T2 (hyper)inflammation.

Biologics in IgE-mediated food allergy: A systematic review and meta-analysis of interventional studies.

Background And Aims: IgE-mediated food allergy (FA) is a major healthcare problem, affecting millions of children and adults worldwide. FA management usually involves elimination diets; however, there is increasing interest in alternative strategies that enable individualized optimal approaches. Yet, there is little consensus on the optimal strategies for managing FA.

Towards a common approach for managing food allergy and serious allergic reactions (anaphylaxis) at school. GALEN and EFA consensus statement.

GALEN and EFA propose minimum specifications for all industrialised countries/regions to work towards to support students with food allergies in educational settings. We reviewed research and legislation and gained feedback from over 100 patient and professional groups. We built shared expectations around: 1.

Patient-Reported Outcomes on Food Immunotherapy Differ Between Countries and Foods: Results From COFAITH.

Background: Food allergen immunotherapy (FAIT) is a consolidated treatment included in clinical guidelines that has shown efficacy in terms of researcher-defined variables, but little work has been done yet to evaluate patient perspectives.

Objective: We aimed to understand and explore the relevance of different patient-reported outcomes (PROs).

Methods: A European Academy of Allergy and Clinical Immunology task force designed a questionnaire to prospectively collect information from parents or caregivers of patients younger than 18 years on FAIT.

Use of the DEFASE score in research trials.

Purpose Of Review: To explore the potential applicability in clinical trials of the groundbreaking international consensus named DEFASE (DEfinition of Food Allergy SEverity) as the unique grading system for IgE-mediated food allergy (FA) severity embracing the different aspects of the disease in a holistic approach. Herein, we discuss its relevance in clinical trials and potential applications in research and clinical settings through a few clinical scenarios.

Recent Findings: The DEFASE score has been developed to be used in research settings as a comprehensive scoring system.

New approaches in childhood IgE-mediated food allergy treatment.

Purpose Of Review: This review aims to provide an overview of the current and future treatment options for children with food allergies (FAs), highlighting the latest research findings and the potential impact of these new approaches on improving patients' and caregivers' quality of life.

Recent Findings: In the last decade, many promising approaches have emerged as an alternative to the standard avoidance of the culprit food with the risk of severe accidental reactions. Desensitization through oral immunotherapy has been introduced in clinical settings as a therapeutic approach, and more recently also omalizumab.

Eosinophilic Esophagitis and Cow's Milk: Mechanisms, Challenges, and Treatment Perspectives.

Eosinophilic esophagitis is a chronic, antigen-driven, immune-mediated disease characterized by esophageal dysfunction and significant eosinophilic infiltration. Its rising incidence and prevalence over recent decades reflect both increased clinical awareness and the influence of environmental factors such as dietary patterns and allergen exposure. Among food allergens, cow's milk proteins are the most commonly implicated triggers, contributing to esophageal inflammation through complex immunological pathways involving both IgE-mediated and non-IgE-mediated mechanisms.

Oral Food Challenge Protocols in Food Protein-Induced Enterocolitis Syndrome: A Systematic Review.

Background: Oral food challenges (OFCs) are essential for the diagnosis and follow-up of acute food protein-induced enterocolitis syndrome (FPIES) because no diagnostic or prognostic biomarkers are available. However, the optimal OFC procedure remains unclear.

Objective: This systematic review aimed to assess OFC procedures' design and clinical outcomes in patients with FPIES.

Hymenoptera venom allergy in children.

From a taxonomic point of view, Hymenoptera are subclassified into families: Apidae, including honeybees (Apis mellifera) and bumblebees (Bombus), and Vespidae, which, in turn, are divided into the subfamilies of Vespinae (wasps, including hornets, vespules, dolichovespules) and Polistinae (paper wasp). Hypersensitivity to Hymenoptera venom can be linked to immunological (IgE-mediated or non-IgE-mediated) and non-immunological mechanisms. Reactions are classified into local reactions, large local reactions, systemic reactions, toxic reactions, and unusual reactions.

10 practical priorities to prevent and manage serious allergic reactions: GALEN ANACare and EFA Anaphylaxis Manifesto.

This Anaphylaxis Manifesto calls on communities to prioritise 10 practical actions to improve the lives of people at risk of serious allergic reactions. The Global Allergy and Asthma European Network and the European Federation of Allergy and Airways Diseases Patients' Associations (EFA) compiled patient-centric priorities. We used qualitative consensus methods, research evidence and feedback from over 200 patient groups, stakeholder organisations and healthcare professionals.

AAAAI-EAACI PRACTALL: Standardizing oral food challenges-2024 Update.

This common statement of the American Academy of Allergy, Asthma and Immunology (AAAAI) and The European Academy of Allergy and Clinical Immunology (EAACI) provides an update of the 2012 published guidelines on food challenges. The guidelines equally address food challenges in the research and the clinical settings. They first address the diagnostic tests which can guide the decision to conduct a challenge.

Food protein-induced enteropathy: a revision for the clinician.

Food protein-induced enteropathy (FPE) belongs to non-IgE gastrointestinal mediated food allergies. FPE is a syndrome characterized by diarrhea, weight loss and failure to thrive in young infants. Cow milk is the culprit food that most frequently causes FPE.

World Allergy Organization (WAO) Diagnosis and Rationale for Action against Cow's Milk Allergy (DRACMA) guideline update - XI - Milk supplement/replacement formulas for infants and toddlers with CMA - Systematic review.

Background: Cow's milk allergy (CMA) is the most complex and common food allergy in infants. Elimination of cow's milk from the diet and replacement with a specialized formula for infants with cow's milk allergy who cannot be breastfed is an established approach to minimize the risk of severe allergic reactions while avoiding nutritional deficiencies. Given the availability of multiple options, such as extensively hydrolyzed cow's milk-based formula (eHF-CM), aminoacid formula (AAF), hydrolyzed rice formula (HRF), and soy formula (SF), there is some uncertainty regarding which formula might represent the most suitable choice with respect to health outcomes.

Omalizumab reduces anaphylactic reactions and allows food introduction in food-allergic in children with severe asthma: An observational study.

Background: In Europe, Omalizumab (anti-IgE) is indicated for the treatment of moderate to severe asthma, but not for IgE-mediated food allergy (FA).

Objective: We assessed the impact of Omalizumab on efficacy, safety, and quality of life (FA-QoL) in patients with moderate to severe asthma and who have a history of anaphylaxis to peanut, tree nuts, fish, egg, milk, and/or wheat.

Methods: Food-allergic children (6-18 years) with moderate to severe asthma underwent oral food challenges (OFCs) to establish the threshold of reaction to the culprit food(s) at baseline (T0) and at 4-month intervals (T1, T2, and T3) during their first year of treatment with Omalizumab.