Epidemiology
*Studies on the incidence and prevalence of HSRs to PPI reactions, especially in children *Randomized controlled studies for cause-and-effect statements between PPIs and allergic diseases. *Additional investigations on the influence of different PPIs in OIT maintenance phase
Pathogenesis
*Pathogenesis of PPI induced- HSRs especially after 3-24 hours, as well as co-factors’ impact on the type and severity of reactions (fasting, food intake, infection, simultaneously intake of NSAID), route of administration, dose, type of coating and metabolism. *Role of IgE in PPI induced immediate HSRs
Immediate type HSRs Immediate type HSRs
Skin tests
*The factors related to skin test positivity *Larger scale multicenter studies to confirm optimal test concentrations *Unified algorithm for testing with culprit and alternative PPIs
DPT
*Larger scale multicenter studies to confirm optimal test doses and provide the risk stratification *The exact degree of cross-reactivity between different PPIs
In vitro tests
*Determination of specific IgE antibodies to PPIs *The role of BAT in the diagnosis of HSRs to PPIs
Management
*Drug antigenic determinants responsible for cross-reactivity *More data regarding desensitization to PPIs *The role of risk factors and co-factors in the type of reaction as in cross-reactivity determination
Delayed type HSRs Delayed type HSRs
Skin tests
* Role of patch tests and delayed readings of IDTs in diagnosis * Optimal concentrations and vehicles for patch tests, method of skin testing protocol * To study cross-reactivity profiles
DPT * The role of DPT in the diagnosis
In vitro tests * The roles of LTT and LAT in the diagnosis
Management * More data about PPI-induced delayed HSRs