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Expert Rev Clin Immunol. 2019 Jun;15(6):599-606. doi: 10.1080/1744666X.2019.1600403. Epub 2019 Apr 4.

Cannabis allergy: what the clinician needs to know in 2019.

Author information

1
a Department of Immunology-Allergology-Rheumatology , Antwerp University Hospital, University of Antwerp , Antwerp , Belgium.
2
b Department of Pediatrics , Antwerp University Hospital, University of Antwerp , Antwerp , Belgium.
3
c IPA-Institute for Prevention and Occupational Medicine, German Social Accident Insurance , Ruhr-University Bochum , Bochum , Germany.

Abstract

Although the use of cannabis dates back millennia, the first description of cannabis allergy is relatively recent (1971). Recent large-scale data show that cannabis allergy can manifest severe and generalized symptoms with extensive cross-reactions. Thus, it is essential to become familiarized with its clinical presentation, diagnostic aids, and adequate therapeutic guidance. Areas covered: Here we provide a hands-on overview on cannabis allergy focusing on symptomatology and the reliability of diagnostic options. Recent advances in proteomics are discussed in detail, elucidating the link with nsLTP-related allergies. The proteomics advancements have paved the way for more reliable diagnostics, especially component-based tools. Finally, the current experience in treatment options is highlighted. Expert opinion: Cannabis allergy is an allergy entity which can significantly impact the quality of life. For optimal diagnosis, we advise to start with a validated and standardized crude-extract based test such as sIgE hemp complemented by component-based diagnostics such as sIgE Can s 3 quantifications where available. Future research should lift the veil on the true prevalence of cannabis allergy and the importance of other cannabis allergens to further guide our practice.

KEYWORDS:

Can s 3; Cannabis; allergy; basophil activation; hemp; non-specific lipid transfer protein (nsLTP); skin prick test; specific IgE

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