Mast Cell Degranulation Triggered by Plant Foods

Introduction to Mast Cell Degranulation

The American Academy of Allergy, Asthma, and Immunology recommends that patients with food allergies avoid specific allergens to prevent mast cell degranulation, which can cause symptoms such as edema, bronchoconstriction, and vascular permeability 1, 2.
The European Academy of Allergy and Clinical Immunology states that common plant-based allergens, including peanuts, tree nuts, wheat, and soy, can trigger an allergic response in sensitized individuals 2.

The American College of Allergy, Asthma, and Immunology recommends that diagnosis of IgE-mediated food allergy requires both clinical history of reaction and positive food-specific IgE testing or skin prick tests, with a strength of evidence rated as high 1, 2.
The American Academy of Allergy, Asthma, and Immunology advises that all food-allergic patients must be prescribed antihistamines for mild reactions and epinephrine autoinjectors for severe reactions, with a strength of evidence rated as high 1, 2.

The British Society for Allergy and Clinical Immunology recommends that all patients with mast cell disorders carry two epinephrine autoinjectors at all times due to increased anaphylaxis risk, with a strength of evidence rated as moderate 6, 8.
The European Academy of Allergy and Clinical Immunology states that standard anti-mediator therapy with H1 and H2 antihistamines (at 2-4 times FDA-approved doses) plus mast cell stabilizers forms the treatment foundation for mast cell disorders, with a strength of evidence rated as moderate 6, 7.

The American College of Allergy, Asthma, and Immunology recommends determining if a patient has documented IgE-mediated food allergy through clinical history and positive testing, and if present, strict avoidance of specific allergen and prescription of epinephrine autoinjector, with a strength of evidence rated as high 1, 2.
The British Society for Allergy and Clinical Immunology advises assessing for underlying mast cell disorder through elevated baseline tryptase and clonal markers, and if present, initiation of H1/H2 antihistamines at high doses and prescription of two epinephrine autoinjectors, with a strength of evidence rated as moderate 6, 8.