Given their nutritional features and environmental sustainability, black soldier fly (Hermetia illucens) larvae are currently being considered in Europe for commercialization as human food. The primary goal of this study is the determination of in vitro IgE-cross-reactivity to recombinant tropomyosin (_HITPM) and arginine kinase (_HIAK) of H. illucens in subjects sensitized to crustaceans and/or mites. Dot blot assays for recombinant _HITPM were carried out with the sera of 48 subjects, 30 sensitized to crustaceans (Cr+) and/or house dust mites (HDM+) (STUDY group) and 18 non-sensitized (CTRL group). A higher rate of IgE-reactivity to recombinant _HITPM was found in the STUDY group compared to non-sensitized controls (73% vs. 44%; p 0.066). No significant relationship was achieved upon dot blot assays for _HIAK. No relevant association between a positive history of food reactions and immunoreactivity to _HITPM and to _HIAK was reported (15% in _HITPM+ vs. 6% in _HITPM-, p NS; 28% in _HIAK+ vs. 50% in _HIAK-, p NS), contrary to the _HITPM+Cr+HDM+ subset (50% vs. 0%, p 0.022). Considering the wide overlap of pan-allergens within the Arthropoda phylum, concerns about allergenic potential due to the eventual consumption of H. illucens-enriched foods might be valid. Therefore, targeted studies involving basophil activation tests, skin prick tests, and a double-blind placebo-controlled oral food challenge using H. illucens are needed.

The demographic increase, environmental concerns, and heightened awareness about health has led Western countries to consider edible sources previously overlooked. The novelty of these sources implies a scarce knowledge about their allergenicity. This review has the purpose of offering an arranged view about the allergenicity of different categories of novel foods, such as edible insects, new plant-based foods and microalgae, by exploring cross-reactivity and common traits with other food allergies but also specific peculiarities. A particular regard is reserved to the framework in Western countries. Increasing efforts have been directed in the last years to identify dangerous cross-reactive allergens in novel foods, i.e. tropomyosin. On the other hand, eventual primary sensitizations should also be considered, especially for idiopathic anaphylaxis. In view of the partial knowledge about the allergenic potential of the novel sources, the education of the patient on this topic (particularly those with known food allergies), and an appropriate labeling of product's packages may reveal helpful to minimize the risk.

Background: Allergic rhinitis (AR) affects up to 50% of adults globally. This study was undertaken to evaluate cumulative incidence of chronic rhinosinusitis (CRS) in patients with AR and to investigate the association between CRS and clinical features of AR, sensitization patterns, concomitant atopic comorbidities and AR severity. Method: This retrospective, observational, multicenter study included consecutive adult patients with a diagnosis of AR without CRS at first assessment. Data covering clinical information from AR onset to the last follow-up were collected. Results: Out of the 198 patients included (54.0% female, median age at AR diagnosis 19 years old, IQR 11–30), CRS developed in 65.2% of patients during follow-up. Among those who developed CRS, 51.2% had radiological confirmation, and 31.0% were diagnosed with CRS with nasal polyposis (CRSwNP). Multivariate analysis revealed no independent predictors of CRS at the time of AR diagnosis (Hazard ratio (HR) with [95% confidence intervals (CI)] 1.24 [0.68–2.25], age at AR diagnosis (per year change) 1.00 [0.98–1.02], atopic morbidities 1.81 [0.8–4.11], and polysensitization 0.76 [0.8–1.58]). At last follow up (median 19 [IQR 9-29] years from AR diagnosis), AR was moderate-persistent in 47.4%. Patients with CRSwNP have a higher proportion of asthma (77.5% vs 43.8%, p=0.0005) and ASA hypersensitivity (27.5% vs. 5,6%, p=0.0010) as compared to CRSsNP. Overall, only CRS was independently associated to moderate-persistent AR at last follow-up (HR 2.90 [1.51, 5.56]). Conclusion: Almost two-thirds of subjects with AR develop CRS during the disease course. Years after AR diagnosis, CRS is the only independent factor associated with moderate-persistent AR, increasing almost three times its risk.