@article{3a05483e469943209085a363c08e5fef,
title = "Cannabis-related allergies: An international overview and consensus recommendations",
abstract = "Cannabis is the most widely used recreational drug in the world. Cannabis sativa and Cannabis indica have been selectively bred to develop their psychoactive properties. The increasing use in many countries has been accelerated by the COVID-19 pandemic. Cannabis can provoke both type 1 and type 4 allergic reactions. Officially recognized allergens include a pathogenesis-related class 10 allergen, profilin, and a nonspecific lipid transfer protein. Other allergens may also be relevant, and recognition of allergens may vary between countries and continents. Cannabis also has the potential to provoke allergic cross-reactions to plant foods. Since cannabis is an illegal substance in many countries, research has been hampered, leading to challenges in diagnosis since no commercial extracts are available for testing. Even in countries such as Canada, where cannabis is legalized, diagnosis may rely solely on the purchase of cannabis for prick-to-prick skin tests. Management consists of avoidance, with legal issues hindering the development of other treatments such as immunotherapy. Education of healthcare professionals is similarly lacking. This review aimed to summarize the current status of cannabis allergy and proposes recommendations for the future management of this global issue.",
keywords = "allergy diagnosis, allergy treament, cannabis allergy, IgE, occupational allergies",
author = "{The International Cannabis Allergy Collaboration} and Skypala, {Isabel J.} and Samira Jeimy and Hannelore Brucker and Nayak, {Ajay P.} and Decuyper, {Ine I.} and Bernstein, {Jonathan A.} and Lori Connors and Amin Kanani and Ludger Klimek and Lo, {Shun Chi Ryan} and Murphy, {Kevin R.} and Anil Nanda and Poole, {Jill A.} and Jolanta Walusiak-Skorupa and Gordon Sussman and Zeiger, {Joanna S.} and Goodman, {Richard E.} and Ellis, {Anne K.} and Silvers, {William S.} and Ebo, {Didier G.}",
note = "Funding Information: The authors thank the support of all members of the International Cannabis Allergy Collaboration, including Donald H Beezhold, Leonard Bielory, Michael S. Blaiss, Rohit Katial, David R. Naimi, Robert S. Zeiger, Mina Abbaslou, Harold Kim, Matteo Bonini, Francisca (Paqui) G{\'o}mez, Oscar Palomares Gracia, Hans Peter Rihs, Khaldon Abbas, Tara Croston, Sylvie Franken, Shmuel Kivity, Christel Mertens, Karin Pacheco, Thomas Rustemeyer, and Umesh Singh. The authors would also like to express their very great appreciation to Miriam Standish from the ACAAI, who has supported the work of the group, arranged meetings and facilitated the progress of this document. The authors would also like to thank and acknowledge the very generous financial support for the work of the International Cannabis Allergy Collaboration from the American College of Allergy, Asthma & Immunology, the Canadian Society of Allergy & Clinical Immunology, and the European Academy of Allergy, and Clinical Immunology. Funding Information: The authors thank the support of all members of the International Cannabis Allergy Collaboration, including Donald H Beezhold, Leonard Bielory, Michael S. Blaiss, Rohit Katial, David R. Naimi, Robert S. Zeiger, Mina Abbaslou, Harold Kim, Matteo Bonini, Francisca (Paqui) G{\'o}mez, Oscar Palomares Gracia, Hans Peter Rihs, Khaldon Abbas, Tara Croston, Sylvie Franken, Shmuel Kivity, Christel Mertens, Karin Pacheco, Thomas Rustemeyer, and Umesh Singh. The authors would also like to express their very great appreciation to Miriam Standish from the ACAAI, who has supported the work of the group, arranged meetings and facilitated the progress of this document. The authors would also like to thank and acknowledge the very generous financial support for the work of the International Cannabis Allergy Collaboration from the American College of Allergy, Asthma & Immunology, the Canadian Society of Allergy & Clinical Immunology, and the European Academy of Allergy, and Clinical Immunology. Funding Information: The following authors declare they have no conflicts of interest in relation to this paper; Hannelore Brucker, Didier Ebo, Richard Goodman, Ine Decuyper, Jolanta Walusiak‐Skorupa, Anil Nanda, Amin Kanani, and Shun Chi Ryan Lo. The following authors have institutional positions or honoraria to declare; Isabel Skypala has received honoraria from ThermoFisher and is a member of the Executive Committee of the European Academy of Allergy & Clinical Immunology (EAACI); Ajay P. Nayak's institution has received grant funding from National Institutes of Health (NIH/NIAID R21AI140411) and National Institute of Allergy & Infectious Diseases; Samira Jeimy has received honoraria for speaking engagements from Sanofi Regeneron, AstraZeneca, Novartis, Aralez, Medexus Pharmaceuticals Inc and registration fees for the European Academy of Allergy & Clinical Immunology annual meetings in 2020, 2021 reimbursed by Medexus Pharmaceuticals Inc; Jonathan Bernstein has received PI, consultant, and speaker fees from—Sanofi Regeneron, AstraZeneca, Novartis, Genentech, Takeda/Shire, CSL Behring, Pharming, Biocryst, GSK; ALK; PI, consultant—Amgen, Biomarin, Kalvista; Jill Poole has received grants from NIH, Department of Defense, National Institute for Occupational Safety and Health, AstraZeneca and Takeda, is co‐editor/board member of the journal Current Allergy and Asthma Reports, receiving ~$300/year for editorial role and has had a waived registration fee for speaking at the American Academy of Asthma, Allergy and Immunology (AAAAI); William Silvers is Chief Scientific Officer of the Canna Research Foundation; Joanna S. Zeiger is the CEO of Canna Research Foundation and has received payments from EAACI, Canadian Society of Allergy & Clinical Immunology and the American College of Asthma, Allergy and Immunology for other projects run by the Cannabis Allergy Interest Group; Lori Connors has received honoraria from AstraZeneca, ALK, Novartis, has participated on advisory boards of AbbVie, GSK, Novartis, Sanofi and is the CPD Chair of the CSACI; Anne Ellis is vice president of CSACI, has participated in advisory boards for Abbvie, ALK‐Abello, AstraZeneca, Aralez, Bausch Health, Circassia, GSK, LEO Pharma, Merck, Novartis, Pfizer, and has been a speaker for ALK‐Abello, Aralez, AstraZeneca, CSL Behring, Medexus, Novartis, Mylan, Pfizer, Sanofi and Takeda, and her institution has received research grants from ALK Abelo, Aralez, AstraZeneca, Bayer LLC, Circassia, Green Cross, Merck, Medexus, Pfizer, Novartis, Sanofi and Regeneron, she has also served as an independent consultant to Bayer LLC and Regeneron and Ludger Klimek reports grants and personal fees from Allergopharma, grants and personal fees from MEDA/Mylan, personal fees from HAL Allergie, grants from ALK‐Abell{\'o}, grants and personal fees from LETI Pharma, grants from Stallergenes, grants from Quintiles, grants and personal fees from Sanofi, grants from ASIT biotech, grants from Lofarma, personal fees from Allergy Therapeutic, grants from AstraZeneca, grants from GSK, grants from Inmunotk, personal fees from Cassella med, outside the submitted work; and Membership of the following organisations: AeDA DGHNO, Deutsche Akademie f{\"u}r Allergologie und klinische Immunologie, HNO‐BV, GPA and EAACI. Gordon Sussman has received research support from Aimmune, ALK, Amgen, AstraZeneca, DBV technologies, Genentech, Leo Pharma Inc., Novartis, and Sanofi. He is a medical advisor and/or has received payment for lectures from AbbVie, Novartis, CSL Behring, Pfizer, and the Allergy and Immunology Society of Ontario; Kevin Murphy reports receiving consulting fees from AstraZeneca, Sanofi, Genzyme, Genentech, Novartis, speaker honoraria from AstraZeneca, Sanofi, Genzyme, Genentech, Novartis, GlaxoSmithKline, TEVA, Amgen, participates on Data Safety Monitoring Board or Advisory Boards for AstraZeneca and TAKEDA, and is a Board Member of the ACAAI. Publisher Copyright: {\textcopyright} 2022 European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.",
year = "2022",
month = jul,
doi = "10.1111/all.15237",
language = "English (US)",
volume = "77",
pages = "2038--2052",
journal = "Acta Allergologica",
issn = "0105-4538",
publisher = "Wiley-Blackwell",
number = "7",
}