Print Email Facebook Twitter Potential cofactors in accidental food allergic reactions are frequently present but may not influence severity and occurrence Title Potential cofactors in accidental food allergic reactions are frequently present but may not influence severity and occurrence Author Versluis, A. van Os-Medendorp, H. Blom, W.M. Michelsen-Huisman, A.D. Castenmiller, J.J.M. Noteborn, H.P.J.M. Houben, G.F. Knulst, A.C. Publication year 2019 Abstract Background: Cofactors, such as physical exercise and alcohol intake, might be associated with the severity or occurrence of food allergic reactions. Objective: To gain insight into the frequency of presence of potential cofactors in accidental food allergic reactions in adults and to what extent these factors influence the severity and occurrence of allergic reactions. Methods: A prospective cohort study was conducted, with a 1-year follow-up in adult patients with a physician-diagnosed food allergy. Patients were required to fill in a questionnaire after every accidental allergic reactions to food over a 1-year period. The primary outcome measure was the frequency that potential cofactors were present in these allergic reactions. Results: A total of 157 patients were included, of which 46% reported a total of 153 reactions during a 1-year follow-up period. In 74% of the reactions, ≥1 potential cofactor was reported to be present: tiredness (38%), alcohol intake (16%), stress (14%), symptoms of pollinosis (16%), symptoms of asthma (9%), sickness/flu (3%), physical exercise (3%) and use of analgesics (2%). More than one potential cofactor was reported in almost half of all reactions (47%). There was no significant difference in the presence of these factors between mild, moderate and severe reactions (P = 0.522). In the total study population, 9% of the patients used medication that might act as cofactor (antacids, angiotensin receptor blockers [ARBs], beta blockers and angiotensin-converting enzyme inhibitors [ACEIs]) on a daily basis, which however did not influence the occurrence of reactions. Furthermore, 38% daily used allergy-suppressing medication. Conclusions: Although factors suggested to be cofactors were frequently present during accidental food allergic reactions, we found no evidence for an association between the potential cofactors examined and reaction severity, in a population where most reactions were of mild to moderate severity.Background: Cofactors, such as physical exercise and alcohol intake, might be associated with the severity or occurrence of food allergic reactions. Subject accidental reactionalcoholcofactorangiotensin receptor antagonistantacid agentbeta adrenergic receptor blocking agentdipeptidyl carboxypeptidase inhibitorfood allergenaccidental injuryalcohol consumptionatopic dermatitiscohort analysisdisease severityexercisefollow upfood allergyfruithazelnutlongitudinal studymajor clinical studynutoutcome assessmentpollen allergyprospective studyadverse eventclinical trialdrinking behaviorAdolescentAdultAgedAlcohol DrinkingExerciseFemaleFollow-Up StudiesFood HypersensitivityHumansLongitudinal StudiesMaleMiddle AgedProspective StudiesRisk FactorsSeverity of Illness IndexLifeRAPID - Risk Analysis for Products in Development To reference this document use: http://resolver.tudelft.nl/uuid:ffcc136d-2343-4d00-a949-6b4a22815759 DOI https://doi.org/10.1111/cea.13282 TNO identifier 955155 ISSN 0954-7894 Source Clinical and Experimental Allergy, 49 (49), 207-215 Document type article Files To receive the publication files, please send an e-mail request to TNO Library.