BACKGROUND: The severity of allergic reactions to food appears to be affected by many interacting factors. It is uncertain whether challenge-based reactions reflect the severity of past reactions or can predict future risk. OBJECTIVE: To explore the relationship of a subject's clinical history of past reactions to the severity of reaction elicited by a low-dose, double-blind, placebo-controlled food challenge (DBPCFC) with peanut. METHOD: Cross-sectional questionnaire assessment of community-based allergic reactions and low-dose DBPCFCin self-selected peanut-allergic subjects. Reaction severity was assessed using a novel scoring system, taking account of the dose of allergen ingested. RESULTS:Forty subjects (15 males, 23 children, 23 asthmatics by history) were studied. Only the most recent community reaction predicted the severity of reaction in the DBPCFC, but even this association was weak (r=0.37, P=0.03). Peanut-specific IgE (PsIgE) and skin prick test (SPT) weal size were not associated with community score but PsIgE level correlated well with the challenge score (r=0.6, P=0.001). Asthma did not affect the eliciting dose or challenge score directly but the association of PsIgE and challenge score was stronger in those without asthma (r=0.72, P=0.001) than in those with asthma (r=0.48, P=0.02). CONCLUSIONS: The scoring system developed appears to improve the sensitivity of assessment of reactions induced by DBPCFC. This is the first prospective study showing an association between PsIgE levels and clinical reactivity in DBPCFC, an effect that is more pronounced in non-asthmatics. This finding has important implications for the clinical care of subjects with food allergy. There is a poor correlation between the severity of reported reactions in the community and the severity of reaction elicited during low-dose DBPCFC with peanut.
RCT Entities:
BACKGROUND: The severity of allergic reactions to food appears to be affected by many interacting factors. It is uncertain whether challenge-based reactions reflect the severity of past reactions or can predict future risk. OBJECTIVE: To explore the relationship of a subject's clinical history of past reactions to the severity of reaction elicited by a low-dose, double-blind, placebo-controlled food challenge (DBPCFC) with peanut. METHOD: Cross-sectional questionnaire assessment of community-based allergic reactions and low-dose DBPCFC in self-selected peanut-allergic subjects. Reaction severity was assessed using a novel scoring system, taking account of the dose of allergen ingested. RESULTS: Forty subjects (15 males, 23 children, 23 asthmatics by history) were studied. Only the most recent community reaction predicted the severity of reaction in the DBPCFC, but even this association was weak (r=0.37, P=0.03). Peanut-specific IgE (PsIgE) and skin prick test (SPT) weal size were not associated with community score but PsIgE level correlated well with the challenge score (r=0.6, P=0.001). Asthma did not affect the eliciting dose or challenge score directly but the association of PsIgE and challenge score was stronger in those without asthma (r=0.72, P=0.001) than in those with asthma (r=0.48, P=0.02). CONCLUSIONS: The scoring system developed appears to improve the sensitivity of assessment of reactions induced by DBPCFC. This is the first prospective study showing an association between PsIgE levels and clinical reactivity in DBPCFC, an effect that is more pronounced in non-asthmatics. This finding has important implications for the clinical care of subjects with food allergy. There is a poor correlation between the severity of reported reactions in the community and the severity of reaction elicited during low-dose DBPCFC with peanut.
Authors: Larisa C Lotoski; F Estelle R Simons; Rishma Chooniedass; Joel Liem; Isha Ostopowich; Allan B Becker; Kent T HayGlass Journal: PLoS One Date: 2010-06-17 Impact factor: 3.240
Authors: Nandinee Patel; Daniel C Adelman; Katherine Anagnostou; Joseph L Baumert; W Marty Blom; Dianne E Campbell; R Sharon Chinthrajah; E N Clare Mills; Bushra Javed; Natasha Purington; Benjamin C Remington; Hugh A Sampson; Alexander D Smith; Ross A R Yarham; Paul J Turner Journal: J Allergy Clin Immunol Date: 2021-02-09 Impact factor: 10.793
Authors: Montserrat Fernández-Rivas; Ismael Gómez García; Alejandro Gonzalo-Fernández; Manuel Fuentes Ferrer; Sabine Dölle-Bierke; Guadalupe Marco-Martín; Barbara K Ballmer-Weber; Riccardo Asero; Simona Belohlavkova; Kirsten Beyer; Frédéric de Blay; Michael Clausen; Mareen R Datema; Ruta Dubakiene; Kate E C Grimshaw; Karin Hoffmann-Sommergruber; Jonathan O'B Hourihane; Monika Jedrzejczak-Czechowicz; André C Knulst; Tanya Kralimarkova; Thuy-My Le; Nikolaos G Papadopoulos; Todor A Popov; Lars K Poulsen; Ashok Purohit; Suranjith L Seneviratne; Angela Simpson; Atanasios Sinaniotis; Mirjana Turkalji; Sonia Vázquez-Cortés; Rosialzira N Vera-Berrios; Antonella Muraro; Margitta Worm; Graham Roberts; Ronald van Ree; Cristina Fernández-Pérez; Paul J Turner; Elizabeth N Clare Mills Journal: Allergy Date: 2021-11-12 Impact factor: 14.710