scholarly journals Late Type of Bronchial Response to Milk Ingestion Challenge: A Comparison of Open and Double-Blind Challenge

2012 ◽  
Vol 2012 ◽  
pp. 1-11
Author(s):  
Zdenek Pelikan
Keyword(s):  
Food Allergy ◽  
Food Challenge ◽  
Diagnostic Value ◽  
Skin Tests ◽  
Natural Food ◽  
Double Blind ◽  
Positive Skin ◽  
Asthma Patients ◽  
Natural Foods ◽  
Milk Ingestion

Background. In some asthmatics the food allergy, for example, to milk, can participate in their bronchial complaints. The role of food allergy should be confirmed definitively by food ingestion challenge performed by an open challenge with natural foods (OFICH) or by a double-blind placebo-controlled food challenge (DBPCFC). Objectives. To investigate the diagnostic value of these techniques for confirmation of a suspected milk allergy in bronchial asthma patients. Methods. In 54 asthmatics with a positive history and/or positive skin tests for milk the 54 OFICH, and DBPCFC, were performed in combination with spirometry. Results. The 54 patients developed 39 positive late asthmatic responses (LAR) and 15 negative asthmatic responses to OFICH and 40 positive LARs and 14 negative responses to DBPCFC. The overall correlation between the OFICH and DBPCFC was statistically significant (). Conclusions. This study has confirmed the existence of LAR to milk ingestion performed by OFICH and DBPCFC in combination with spirometry. The results obtained by both the techniques did not differ significantly. The OFICH with natural food combined with monitoring of objective parameter(s), such as spirometry, seems to be a suitable method for detection of the food allergy in asthmatics. The DBPCFC can be performed as an additional check, if necessary.

scholarly journals Influence of Antihistamines on Basophil Activation Test in Food Allergy to Milk and Egg

Diagnostics ◽  
2020 ◽  
Vol 11 (1) ◽  
pp. 44
Author(s):  
Eleonora Nucera ◽  
Riccardo Inchingolo ◽  
Rosario Nicotra ◽  
Manuela Ferraironi ◽  
Anna Giulia Ricci ◽  
...  
Keyword(s):  
Food Allergy ◽  
Food Challenge ◽  
Basophil Activation Test ◽  
Basophil Activation ◽  
Double Blind ◽  
Positive Skin ◽  
Activation Test ◽  
History Of ◽  
Ige Mediated ◽  
Food Allergy Diagnosis

Background: The basophil activation test (BAT) is used to improve the accuracy of food allergy diagnosis. To date, the influence of antiallergic drugs on BAT reactivity is poorly investigated. The aim of the study was to investigate if BAT results were influenced by antihistamine intake for 3 months in a cohort of patients with IgE-mediated food allergy to milk or egg. Methods: A retrospective, single-center, observational study was performed. We enrolled subjects with history of hypersensitivity reaction after specific food ingestion, positive skin prick tests and specific IgEs, concomitant allergic rhinitis, and, contraindication to the double-blind, placebo-controlled food challenge due to personal history of systemic reactions related to the ingestion of culprit food. Validated allergens (α-lactoalbumin, β-lactoglobulin, casein, egg white, and yolk) for BAT were used. Results: Thirty-nine patients with well-documented food symptoms and positive allergological workup were included in the study. BAT was positive in 29 patients. The mean percentages of CD63+ expression to specific culprit allergen did not change after the administration of drugs. Conclusions: This was the first study assessing the effects of oral antihistamines on basophil reactivity in cow’s milk and egg food allergy. Antihistamines do not interfere with BAT results.

scholarly journals Oral immunotherapy for treatment of peanut allergy

2020 ◽  
Vol 68 (6) ◽  
pp. 1152-1155
Author(s):  
Joan H Dunlop
Keyword(s):  
Food Allergy ◽  
Peanut Allergy ◽  
Food Challenge ◽  
Oral Immunotherapy ◽  
Peanut Protein ◽  
Subcutaneous Immunotherapy ◽  
Double Blind ◽  
The Us ◽  
Allergy Prevalence

The US Food and Drug Administration’s approval of a peanut oral immunotherapy product in January 2020 is a landmark development in the field of food allergy therapy. While food allergy prevalence has been increasing, this product is the first approved therapy for food allergy. Oral immunotherapy has many similarities to subcutaneous immunotherapy and drug desensitization protocols, but does not lead to sustained unresponsiveness. The studies leading to approval of the Palforzia product demonstrated increase in the amount of peanut protein able to be consumed, with 67% of subjects randomized to the treatment arm able to consume 600 mg of peanut protein in double-blind placebo-controlled food challenge at study exit. However, side effects are an important consideration, and dropout rates in studies of Palforzia ranged from 11% to 21%. Postmarketing surveillance of this product will be critical in assessing its long-term risks and benefits.

Evaluation of prick skin tests (PSTs) to predict the outcome of double-blind, placebo-controlled food challenge (DBPCFC) to egg when egg-specific serum IgE is low

2005 ◽  
Vol 115 (2) ◽  
pp. S55
Author(s):  
A.K. Knight ◽  
W. Shreffler ◽  
H. Sampson ◽  
S. Sicherer ◽  
S. Noone ◽  
...  
Keyword(s):  
Food Challenge ◽  
Skin Tests ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Serum Ige ◽  
Specific Serum

scholarly journals Prevalence and Clinical Impact of IgE-Mediated Food Allergy in School Children With Asthma: A Double-Blind Placebo-Controlled Food Challenge Study

2015 ◽  
Vol 7 (6) ◽  
pp. 547 ◽  
Author(s):  
Aneta Krogulska ◽  
Jarosław Dynowski ◽  
Marzena Funkowicz ◽  
Beata Małachowska ◽  
Krystyna Wąsowska-Królikowska
Keyword(s):  
Food Allergy ◽  
School Children ◽  
Food Challenge ◽  
Clinical Impact ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Challenge Study ◽  
Children With Asthma ◽  
Ige Mediated

scholarly journals Alergia Alimentaria, puntos clave para la práctica clínica

2021 ◽  
Vol 67 (3) ◽  
Author(s):  
BLANCA E DEL RIO NAVARRO ◽  
Omar Josúe Saucedo Ramírez ◽  
Joaquín A. Pimentel Hayashi
Keyword(s):  
Food Allergy ◽  
Food Challenge ◽  
Elimination Diet ◽  
Oral Immunotherapy ◽  
Industrialized Countries ◽  
Double Blind ◽  
Immunological Mechanisms ◽  
Hen’S Egg ◽  
Ige Mediated

Food allergy is an immune reaction that occurs frequently in pediatric age, its prevalence is higher in industrialized countries, affecting 8% of the population, the most frequently involved foods are milk, hen’s egg, soybeans, peanuts, fish, wheat, seafood and tree nuts. Food allergy can be divided into three groups: IgE-mediated, non-IgE-mediated, and mixed food allergy. The symptoms will depend on the immunological mechanisms and can be divided into immediate or no immediate, the immediate symptoms appear in the first two hours of intake and the no immediate symptoms after the second hour and up to 72 hours. Diagnosis of food allergy requires a medical history, physical examination and laboratory tests; misdiagnosis can lead to unnecessary elimination diets. The gold standard is the double-blind placebo controlled oral food challenge. The main treatment is food restriction, the nutritional and psychological implications that this entails must be taken into account; Another treatment option is oral immunotherapy, it is recommended in patients who cannot carry out an elimination diet and it has a significant impact on quality of life.

scholarly journals Oral food challenges

2020 ◽  
Vol 2 (1) ◽  
pp. 31-34
Author(s):  
Amal H. Assa’ad
Keyword(s):  
Food Allergy ◽  
Peanut Allergy ◽  
Food Challenge ◽  
Oral Food Challenge ◽  
Allergic Reactions ◽  
Double Blind ◽  
Trained Personnel ◽  
Open Food Challenge ◽  
Food Challenges ◽  
Shed Light

Oral food challenge (OFC) is a procedure that is conducted most commonly by allergist/immunologists in their office or in food allergy centers to confirm a food allergy or to confirm tolerance to the food. The procedure as conducted in clinical practice is mostly open food challenge and, in research, a double-blind, placebo controlled food challenge. OFC has associated risks that can be minimized by having the challenges conducted by trained personnel who are prepared to treat allergic reactions and who have rescue medications available. However, OFCs have tremendous benefits to the patients and their families, including the potential to determine that a food is no longer an allergen and can be introduced into the diet. Even OFCs that result in clinical reactions have the benefit of confirming the food allergy and demonstrating the therapeutic effect of the rescue medications. The study of the outcomes of OFC has shed light on food allergy reactions and characteristics of the patients with food allergy as well as on the value of other diagnostic tests compared with OFC. OFCs have helped establish food allergy thresholds, confirm that subjects enrolled in research studies have the allergy, and demonstrate the response to the therapies tested in terms of ameliorating the allergic response or raising the reaction threshold. OFCs have also been used to promote the recent guidelines for the prevention of peanut allergy by identifying the infants at risk for peanut allergy but who are not allergic yet.

MILESTONES MARKING THE KNOWLEDGE OF ADVERSE REACTIONS TO FOOD IN THE DECADE OF THE 1980s

PEDIATRICS ◽  
1995 ◽  
Vol 96 (2) ◽  
pp. 380-381
Author(s):  
Betty Miller
Keyword(s):  
Food Allergy ◽  
Adverse Reactions ◽  
Food Additives ◽  
Food Challenge ◽  
Cross Reactivity ◽  
Allergic Reactions ◽  
Double Blind ◽  
Specific Patient ◽  
Clinical Sensitivity ◽  
A Prospective Study

Purpose of the Study. This study outlines the significant advances made to our understanding of adverse reactions to foods and food additives in the last decade. The milestones are listed in order of overall importance and are discussed in depth in the review. 1. Establishing double-blind, placebo-controlled food challenge (DBPCFC) as the "gold-standard" for defining specific patient population to be used in scientific studies. (VanMetre, May, Bock) 2. Recognition of the key role food allergy plays in the pathogenesis of atopic dermatitis. (Sampson, May) 3. Identifying the group of foods most likely to be associated with true allergic reactions. Analysis of DBPCFC in children has shown that 93% of allergic reactions occurred to eight foods (in order of frequency): egg, peanut, milk, soy, tree nuts, crustacean-type shellfish, fish, and wheat. Corn and chocolate allergy was rarely found. (Bock, Sampson, Atkins) 4. Food allergy has a natural history. In a prospective study of 501 children, Bock found that, of 15 cases of allergy proven by DBPCFC in the first year of life, none of the 15 cases was reactive beyond 24 months of age. In contrast, long-term follow-up of patients who have experienced peanut anaphylaxis revealed that clinical sensitivity lasts for at least 14 years. (Bock, Atkins) 5. Food allergy cross-sensitivity (clinical reactivity) does not extend equally to all members of a biologic food family. Although immunologic cross-reactivity between peanut, soy, and other peas/beans could be regularly found in allergic patients, clinically important cross-reactions demonstrated by DBPCFC were rare. (Bernhisel -Broadbent, Sampson)

scholarly journals The Effect of Wheat Allergy on the Course of Atopic Eczema in Patients over 14 Years of Age

2011 ◽  
Vol 54 (4) ◽  
pp. 157-162 ◽  
Author(s):  
Jarmila Čelakovská ◽  
Květuše Ettlerová ◽  
Karel Ettler ◽  
Jaroslava Vaněčková ◽  
Josef Bukač
Keyword(s):  
Food Allergy ◽  
Wheat Flour ◽  
Atopic Eczema ◽  
Challenge Test ◽  
Food Challenge ◽  
Wheat Allergy ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Food Challenge Test

Few studies concerning the importance of wheat allergy affecting the course of atopic eczema in adolescents and adult patients exist. Aim: The evaluation if wheat allergy can deteriorate the course of atopic eczema. Follow-up of patients with confirmed food allergy to wheat. Method: Altogether 179 persons suffering from atopic eczema were included in the study: 51 men and 128 women entered the study with an average age of 26.2 (s.d. 9.5 years) Dermatological and allergological examinations were performed, including skin prick tests, atopy patch tests, and specific serum IgE for wheat, open exposure test and double-blind, placebo-controlled food challenge test with wheat flour. Results: Wheat allergy affecting the coures of atopic eczema was confirmed in eight patients (4.5%) out of 179 patients enrolled in this study by double-blind, placebo controlled food challenge test. The course of atopic eczema showed a positive trend in patients with confirmed food allergy at 3, 6, 9, 12 month follow-up (statistical evaluation with paired t-test) after the elimination of wheat flour. Conclusion: Wheat allergy may play an important role in the worsening of atopic eczema (acting as a triggering exacerbating factor) only in a minority of adolescents and adult patients (4.5% in our study). The diagnostic methods (skin prick test, specific IgE, atopy patch test, history) cannot be used as separated tests for the determination of food allergy to wheat in patients with atopic eczema.Open exposure tests and double-blind, placebo-controlled food challenge should be used for the confirmation of wheat allergy affecting the course of atopic eczema.

scholarly journals Analysis of a Large Standardized Food Challenge Data Set to Determine Predictors of Positive Outcome Across Multiple Allergens

2018 ◽  
Vol 9 ◽  
Author(s):  
Sayantani Sindher ◽  
Andrew J. Long ◽  
Natasha Purington ◽  
Madeleine Chollet ◽  
Sara Slatkin ◽  
...  
Keyword(s):  
Food Allergy ◽  
Food Challenge ◽  
Diagnostic Methods ◽  
Population Characteristics ◽  
Food Allergies ◽  
Double Blind ◽  
Data Set ◽  
Prick Test ◽  
Increased Risk ◽  
Food Challenges

Background: Double-blind placebo-controlled food challenges (DBPCFCs) remain the gold standard for the diagnosis of food allergy; however, challenges require significant time and resources and place the patient at an increased risk for severe allergic adverse events. There have been continued efforts to identify alternative diagnostic methods to replace or minimize the need for oral food challenges (OFCs) in the diagnosis of food allergy.Methods: Data was extracted for all IRB-approved, Stanford-initiated clinical protocols involving standardized screening OFCs to a cumulative dose of 500 mg protein to any of 11 food allergens in participants with elevated skin prick test (SPT) and/or specific IgE (sIgE) values to the challenged food across 7 sites. Baseline population characteristics, biomarkers, and challenge outcomes were analyzed to develop diagnostic criteria predictive of positive OFCs across multiple allergens in our multi-allergic cohorts.Results: A total of 1247 OFCs completed by 427 participants were analyzed in this cohort. Eighty-five percent of all OFCs had positive challenges. A history of atopic dermatitis and multiple food allergies were significantly associated with a higher risk of positive OFCs. The majority of food-specific SPT, sIgE, and sIgE/total IgE (tIgE) thresholds calculated from cumulative tolerated dose (CTD)-dependent receiver operator curves (ROC) had high discrimination of OFC outcome (area under the curves > 0.75). Participants with values above the thresholds were more likely to have positive challenges.Conclusions: This is the first study, to our knowledge, to not only adjust for tolerated allergen dose in predicting OFC outcome, but to also use this method to establish biomarker thresholds. The presented findings suggest that readily obtainable biomarker values and patient demographics may be of use in the prediction of OFC outcome and food allergy. In the subset of patients with SPT or sIgE values above the thresholds, values appear highly predictive of a positive OFC and true food allergy. While these values are relatively high, they may serve as an appropriate substitute for food challenges in clinical and research settings.

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