scholarly journals Component-Resolved Diagnosis in Food Allergies

Medicina ◽  
2019 ◽  
Vol 55 (8) ◽  
pp. 498 ◽  
Author(s):  
Elisabetta Calamelli ◽  
Lucia Liotti ◽  
Isadora Beghetti ◽  
Valentina Piccinno ◽  
Laura Serra ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Unmet Needs ◽  
Food Challenge ◽  
Specific Ige ◽  
Oral Food Challenge ◽  
Food Allergies ◽  
Specificity And Sensitivity ◽  
Sensitization Pattern ◽  
Molecular Components ◽  
Work Up

Component-resolved diagnostics (CRD) in food allergies is an approach utilized to characterize the molecular components of each allergen involved in a specific IgE (sIgE)-mediated response. In the clinical practice, CRD can improve diagnostic accuracy and assist the physician in many aspects of the allergy work-up. CRD allows for discriminatory co-sensitization versus cross-sensitization phenomena and can be useful to stratify the clinical risk associated with a specific sensitization pattern, in addition to the oral food challenge (OFC). Despite this, there are still some unmet needs, such as the risk of over-prescribing unnecessary elimination diets and adrenaline auto-injectors. Moreover, up until now, none of the identified sIgE cutoff have shown a specificity and sensitivity profile as accurate as the OFC, which is the gold standard in diagnosing food allergies. In light of this, the aim of this review is to summarize the most relevant concepts in the field of CRD in food allergy and to provide a practical approach useful in clinical practice.

scholarly journals Oral Food Challenge

Medicina ◽  
2019 ◽  
Vol 55 (10) ◽  
pp. 651
Author(s):  
Calvani ◽  
Bianchi ◽  
Reginelli ◽  
Peresso ◽  
Testa
Keyword(s):  
Food Allergy ◽  
Food Challenge ◽  
Clinical History ◽  
Specific Ige ◽  
Oral Food Challenge ◽  
Food Allergies ◽  
Pediatric Allergy ◽  
Expert Review ◽  
Ige Mediated ◽  
Food Specific Ige

: Oral food challenge (OFC) is the gold standard for diagnosis of IgE-mediated and non-IgE mediated food allergy. It is usually conducted to make diagnosis, to monitor for resolution of a food allergy, or to identify the threshold of responsiveness. Clinical history and lab tests have poor diagnostic accuracy and they are not sufficient to make a strict diagnosis of food allergy. Higher concentrations of food-specific IgE or larger allergy prick skin test wheal sizes correlate with an increased likelihood of a reaction upon ingestion. Several cut-off values, to make a diagnosis of some food allergies (e.g., milk, egg, peanut, etc.) without performing an OFC, have been suggested, but their use is still debated. The oral food challenge should be carried out by experienced physicians in a proper environment equipped for emergency, in order to carefully assess symptoms and signs and correctly manage any possible allergic reaction. This review does not intend to analyse comprehensively all the issues related to the diagnosis of food allergies, but to summarize some practical information on the OFC procedure, as reported in a recent issue by The Expert Review of Food Allergy Committee of Italian Society of Pediatric Allergy and Immunology (SIAIP)

scholarly journals Eliciting dose is associated with tolerance development in peanut and cow’s milk allergic children

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
C. Nitsche ◽  
C. D. Westerlaken-van Ginkel ◽  
B. J. Kollen ◽  
A. B. Sprikkelman ◽  
G. H. Koppelman ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Food Challenge ◽  
Specific Ige ◽  
Food Allergies ◽  
Milk Allergy ◽  
Egg Allergy ◽  
Tolerance Development ◽  
Double Blind ◽  
Gold Standard Method

Abstract Background Tolerance development rates differ between food allergies. Almost all previous studies have not used the gold standard method, the double-blind, placebo-controlled food challenge (DBPCFC), which may affect the reported prevalence rates. Little is known about the association of the eliciting dose (ED) obtained during the initial DBPCFC with later tolerance development. Methods This was a retrospective, tertiary care study of children who had a positive DBPCFC to either peanut, milk or egg, and at least one follow-up food challenge (open or DBPCFC) with the same food. The association between ED and negative (tolerant) follow-up food challenge outcome was analyzed by logistic regression, with adjustment for confounders. Suspected confounders were initial DBPCFC test characteristics, atopic comorbidities and serum specific IgE (sIgE) levels. Results In 47 peanut allergic children, tolerance developed in 27.7% (median follow-up duration of 43 months). In 80 milk (follow-up 23 months) and 55 egg (follow-up 37 months) allergic children, tolerance developed in 55.0% and 65.5%. The ED obtained during the initial DBPCFC was significantly associated with tolerance development in peanut and milk allergy, but not in egg allergy. Conclusion Approximately 1 out of 4 children with DBPCFC confirmed peanut allergy developed tolerance, compared to more than half of the children with milk or egg allergy, respectively. Tolerance development in peanut and milk allergy is significantly associated with ED at initial DBPCFC.

The relationship of allergen-specific IgE levels and oral food challenge outcome

2004 ◽  
Vol 114 (1) ◽  
pp. 144-149 ◽  
Author(s):  
Tamara T Perry ◽  
Elizabeth C Matsui ◽  
Mary Kay Conover-Walker ◽  
Robert A Wood
Keyword(s):  
Food Challenge ◽  
Specific Ige ◽  
Oral Food Challenge ◽  
Relationship Of ◽  
The Relationship

scholarly journals Increased ratio of pollock roe-specific IgE to salmon roe-specific IgE levels is associated with a positive reaction to cooked pollock roe oral food challenge

2018 ◽  
Vol 67 (3) ◽  
pp. 364-370 ◽  
Author(s):  
Eishi Makita ◽  
Noriyuki Yanagida ◽  
Sakura Sato ◽  
Tomoyuki Asaumi ◽  
Motohiro Ebisawa
Keyword(s):  
Positive Reaction ◽  
Food Challenge ◽  
Specific Ige ◽  
Oral Food Challenge

scholarly journals Milk and cow’s meat allergy in a child: A clinical case

2021 ◽  
Vol 29 (4) ◽  
Author(s):  
Maria Marques ◽  
◽  
Inês Falcão ◽  
Moisés Labrador-Horrillo ◽  
Helena Falcão ◽  
...  
Keyword(s):  
Bovine Serum Albumin ◽  
Serum Albumin ◽  
Bovine Serum ◽  
Milk Proteins ◽  
Food Challenge ◽  
Specific Ige ◽  
Oral Food Challenge ◽  
Cow’S Milk ◽  
Cow's Milk ◽  
Cow’S Milk Proteins

Allergy to bovine serum albumin is the main predictor of beef allergy associated with cow’s milk proteins allergy. We report a case of a 3-year-old child with cow’s milk proteins allergy since the age of 6 months who, after some ingestions of beef, developed episodes of irritability, urticaria and syncope. Specific IgE to beef, oral food challenge with medium rare cooked beef and specific IgE to bovine serum albumin were all positive, but an oral food challenge with well cooked beef was tolerated. Allergy to bovine serum albumin is not usually associated with severe reactions, since it is a thermolabile protein, however, the process of cooking meat may be insufficient to have an effect on the complex matrix of meat and associated serum albumins. The irregular pattern of the episodes and the previous diagnosis of cow’s milk proteins allergy may act as confounding factors leading to a delayed diagnosis.

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