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.