L’allergie au cannabis et les syndromes de réactivité croisée : une feuille de route pour un diagnostic et une prise en charge corrects

Abstract

With the expansion of access to cannabis and the decriminalization of its use, cases of IgE-dependent cannabis allergy and cannabis-associated food syndromes have been increasingly reported. However, the exact prevalence of cannabis allergy and associated cross-reactivity syndromes remains unknown and is likely to be underestimated due to a lack of awareness and knowledge of the subject among healthcare professionals. This practical roadmap therefore aims to familiarize readers with the early recognition and correct management of cannabis-related IgE-dependent allergies. The aim is to understand the mechanisms underlying these cross-reactivity syndromes and to enable personalised diagnosis and management. Although there are as yet no commercially available molecular cannabis allergens, a more personalized approach can be achieved by using homologs and the recombinant Can s 3 (non-specific lipid transfer protein) available as a research allergen. The predominant symptoms of cannabis allergy are rhinoconjunctivitis and contact urticaria/angioedema, but severe life-threatening anaphylaxis is also possible, as well as cross-food allergy syndromes, mainly involving fruit, vegetables, nuts and cereals. At present, diagnosis generally begins with prick tests using buds, leaves or seeds of the cannabis plant. The road to a clear understanding of food allergy and the cross-reactive food syndromes associated with it is still long and winding, but it deserves to be explored further.