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Allergens tested in all centers included pollens (grass, mugwort, ragweed, Hormones antagonist pellitory, plantain, birch, olive, and cypress), molds (Alternaria, Aspergillus, Cladosporium), house dust mites (Dermatophagoides pteronissynus; Dermatophagoides farinae), and animal dander (cat and dog). Each center was left free to test further allergens (e.g., local causes of seasonal airborne allergy, different dander for specific cases, etc.) Hypersensitivity to food allergens was detected by commercial food extracts (ALK-Abell��, Madrid, Spain). The selected battery of allergens tested in all patients with suspect food allergy in all participating centers included egg white, egg yolk, cow��s milk, shrimp, codfish, wheat, maize, soybean, peanut, sunflower seed, bean, walnut, hazelnut, tomato, carrot, orange, peach, celery, almond, sesame seed, kiwi, and banana. In case of suspect allergy to foods not included in this battery, commercial extracts (where available) and/or fresh foods were used for skin testing. Fresh foods were tested by the prick-prick technique. All SPTs were carried SB203580 mouse out on the volar side of the forearm using disposable prick lancets (ALK-Abell��). SPTs with saline and histamine 10?mg/ml were used as negative and positive control, respectively. Readings were taken at 15?min; wheals with a mean diameter >3?mm were considered positive (24). Food allergy was diagnosed if a suggestive clinical history was confirmed by a clear-cut positive SPT. Patients whose clinical history of food allergy, even if suggestive, was not confirmed by either in vivo or in vitro diagnostic tests were considered as nonallergic. Patients with a positive SPT to food allergens and without a positive clinical history were considered as sensitized but not clinically allergic. Anisakis simplex allergy was considered to be highly likely in the presence of a history of one or more allergic reactions that unequivocally followed the ingestion of fish in the presence of a positive SPT to Anisakis Alizarin and a negative SPT to fish. Patients with a positive SPT to Anisakis but without a clinical history of fish-induced adverse reactions were considered as sensitized but nonallergic to the parasite. In view of the epidemiological nature of this study and the fear of possibly severe adverse reactions, plus the fact that some participating centers lacked the necessary facilities and experience, diagnosis of food allergy was not confirmed by DBPCFC. In the presence of doubtful histories or of marked discrepancies between clinical histories and in vivo diagnostic tests, single centers carried out open challenges with suspected offending foods. Percentages were compared by chi-square test with Yates�� correction. Probability values