Eliciting dose is associated with tolerance development in peanut and cow’s milk allergic children
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 th...
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| Format: | Article |
| Language: | English |
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Wiley
2019-11-01
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| Series: | Clinical and Translational Allergy |
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| Online Access: | http://link.springer.com/article/10.1186/s13601-019-0298-z |
| _version_ | 1818693994992893952 |
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| author | C. Nitsche C. D. Westerlaken-van Ginkel B. J. Kollen A. B. Sprikkelman G. H. Koppelman A. E. J. Dubois |
| author_facet | C. Nitsche C. D. Westerlaken-van Ginkel B. J. Kollen A. B. Sprikkelman G. H. Koppelman A. E. J. Dubois |
| author_sort | C. Nitsche |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-17T13:22:32Z |
| format | Article |
| id | doaj.art-ad109e73db3e4826a1dd164fdc16be2c |
| institution | Directory Open Access Journal |
| issn | 2045-7022 |
| language | English |
| last_indexed | 2024-12-17T13:22:32Z |
| publishDate | 2019-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Clinical and Translational Allergy |
| spelling | doaj.art-ad109e73db3e4826a1dd164fdc16be2c2022-12-21T21:46:50ZengWileyClinical and Translational Allergy2045-70222019-11-01911610.1186/s13601-019-0298-zEliciting dose is associated with tolerance development in peanut and cow’s milk allergic childrenC. Nitsche0C. D. Westerlaken-van Ginkel1B. J. Kollen2A. B. Sprikkelman3G. H. Koppelman4A. E. J. Dubois5University of OldenburgDepartment of Pediatric Pulmonology and Pediatric Allergology, University Medical Center Groningen, University of GroningenDepartment of General Practice and Elderly Care Medicine, University Medical Center Groningen, University of GroningenDepartment of Pediatric Pulmonology and Pediatric Allergology, University Medical Center Groningen, University of GroningenDepartment of Pediatric Pulmonology and Pediatric Allergology, University Medical Center Groningen, University of GroningenDepartment of Pediatric Pulmonology and Pediatric Allergology, University Medical Center Groningen, University of GroningenAbstract 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.http://link.springer.com/article/10.1186/s13601-019-0298-zFood allergyPediatricsEliciting dosePrognosisAtopic dermatitis |
| spellingShingle | C. Nitsche C. D. Westerlaken-van Ginkel B. J. Kollen A. B. Sprikkelman G. H. Koppelman A. E. J. Dubois Eliciting dose is associated with tolerance development in peanut and cow’s milk allergic children Clinical and Translational Allergy Food allergy Pediatrics Eliciting dose Prognosis Atopic dermatitis |
| title | Eliciting dose is associated with tolerance development in peanut and cow’s milk allergic children |
| title_full | Eliciting dose is associated with tolerance development in peanut and cow’s milk allergic children |
| title_fullStr | Eliciting dose is associated with tolerance development in peanut and cow’s milk allergic children |
| title_full_unstemmed | Eliciting dose is associated with tolerance development in peanut and cow’s milk allergic children |
| title_short | Eliciting dose is associated with tolerance development in peanut and cow’s milk allergic children |
| title_sort | eliciting dose is associated with tolerance development in peanut and cow s milk allergic children |
| topic | Food allergy Pediatrics Eliciting dose Prognosis Atopic dermatitis |
| url | http://link.springer.com/article/10.1186/s13601-019-0298-z |
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