METHODS:
We systematically searched PUBMED, SCOPUS, and the COCHRANE LIBRARY
[search terms (WALNUT OR CASHEW OR PISTACHIO OR HAZELNUT OR ALMOND OR
TREENUT OR TREE NUT OR TREE NUTS OR TREENUTS) AND (ALLERGY OR
HYPERSENSITIVITY OR ANAPHYLAXIS) AND (MANAGEMENT OR THERAPY OR TREATMENT
OR IMMUNOTHERAPY)] for active treatments of IgE-mediated allergy to
tree nuts (walnut, hazelnut, pistachio, cashew, and almond) with
allergen-specific immunotherapy (AIT) using oral (OIT), sublingual
(SLIT), epicutaneous (EPIT) or subcutaneous (SCIT) delivery or with
other disease-modifying treatments (PROSPERO registration number:
CRD42021248763). More details can be found in the Appendix S1.
This review’s main outcomes were desensitization, through the change in
the threshold of the tree nut in question required to elicit an allergic
reaction while on treatment, and sustained unresponsiveness, defined as
the ability to consume foods containing the tree nut in question after
discontinuing treatment.
The search was performed on 10/02/2020 for PUBMED and SCOPUS databases
and on 09/12/2020 for COCHRANE LIBRARY. An alert was created for further
PUBMED results.
A new search using the same terms and following the same methodology was
conducted on 13/07/2022 to include any recent studies.
Title and abstract screening and study selection were performed by three
authors (MP, PX, EE) independently. Relevant references of included
articles were also screened. Data extraction to standardized Excel forms
was performed by one investigator (MP).
The quality of included studies was assessed using the JBI Critical
Appraisal tools 15,16, by MP and EE. Case-series check
list was found more suitable than cohort check list for the assessment
of the included cohorts. We decided to use that tool instead of other
cohort studies’ appraisal tools for consistency. Discrepancies were
resolved by consensus.