R J B Klemans1, W M Blom2, F C van Erp3, L J N Masthoff1, C M Rubingh2, C K van der Ent3, C A F M Bruijnzeel-Koomen1, G F Houben2, S G M A Pasmans1,4, Y Meijer3, A C Knulst1. 1. Department of Dermatology and Allergology, University Medical Center Utrecht, Utrecht, The Netherlands. 2. The Netherlands Organisation for Applied Scientific Research (TNO), Zeist, The Netherlands. 3. Department of Pediatric Pulmonology and Allergology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands. 4. Department of Pediatric Dermatology and Allergology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands.
Abstract
BACKGROUND: To improve food labelling strategies, information regarding eliciting doses (EDs) and the effect of patient characteristics on these EDs is necessary. OBJECTIVE: To establish EDs for objective and subjective symptoms and analyse the effect of sensitization levels and other patient characteristics on threshold distribution curves (TDCs). METHODS: Threshold data from 100 adults and 262 children with a positive food challenge were analysed with interval-censoring survival analysis (ICSA) and fitted to a TDC from which EDs could be extracted. Possible influencing factors were analysed as covariates by ICSA. A hazard ratio (HR) was calculated in case of a significant effect. RESULTS:TDCs for both objective and subjective symptoms were significantly different between adults and children (P < 0.001). Objective ED05 values, however, were comparable (2.86 mg peanut protein in adults and 6.38 mg in children). Higher levels of sIgE to Ara h 2 and peanut extract were associated with a larger proportion of patient groups reacting to a dose increase with objective symptoms (adults and children) or subjective symptoms (adults, in children a trend). Age had a similar effect in children (HR 1.05 for objective symptoms and 1.09 for subjective symptoms). Gender had no effect on TDCs. CONCLUSION AND CLINICAL RELEVANCE: Subjective and objective TDCs were different between adults and children, but objective ED05 values were comparable, meaning that threshold data from children and adults can be combined for elaboration of reference doses for risk assessment. Higher sIgE levels to Ara h 2 and peanut extract were associated with a larger proportion of both patient groups to react to a certain dose increase.
RCT Entities:
BACKGROUND: To improve food labelling strategies, information regarding eliciting doses (EDs) and the effect of patient characteristics on these EDs is necessary. OBJECTIVE: To establish EDs for objective and subjective symptoms and analyse the effect of sensitization levels and other patient characteristics on threshold distribution curves (TDCs). METHODS: Threshold data from 100 adults and 262 children with a positive food challenge were analysed with interval-censoring survival analysis (ICSA) and fitted to a TDC from which EDs could be extracted. Possible influencing factors were analysed as covariates by ICSA. A hazard ratio (HR) was calculated in case of a significant effect. RESULTS: TDCs for both objective and subjective symptoms were significantly different between adults and children (P < 0.001). Objective ED05 values, however, were comparable (2.86 mg peanut protein in adults and 6.38 mg in children). Higher levels of sIgE to Ara h 2 and peanut extract were associated with a larger proportion of patient groups reacting to a dose increase with objective symptoms (adults and children) or subjective symptoms (adults, in children a trend). Age had a similar effect in children (HR 1.05 for objective symptoms and 1.09 for subjective symptoms). Gender had no effect on TDCs. CONCLUSION AND CLINICAL RELEVANCE: Subjective and objective TDCs were different between adults and children, but objective ED05 values were comparable, meaning that threshold data from children and adults can be combined for elaboration of reference doses for risk assessment. Higher sIgE levels to Ara h 2 and peanut extract were associated with a larger proportion of both patient groups to react to a certain dose increase.
Authors: Shelley Dua; Monica Ruiz-Garcia; Simon Bond; Stephen R Durham; Ian Kimber; Clare Mills; Graham Roberts; Isabel Skypala; James Wason; Pamela Ewan; Robert Boyle; Andrew Clark Journal: J Allergy Clin Immunol Date: 2019-07-15 Impact factor: 10.793
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