Thymic stromal lymphopoietin downregulates filaggrin expression by signal transducer and activator of transcription 3 (STAT3) and extracellular signal-regulated kinase (ERK) phosphorylation in keratinocytes.

Reintroduction failure is a common problem in children after negative peanut challenge. To guide reintroduction and identify potential peanut-related symptoms at home, careful follow-up after negative DBPCFC is advised. When symptoms occur or persist, food challenge outcome needs to be reconsidered.

Abbreviations: DBPCFC, double-blind placebo-controlled food challenge; FAQL-PB, food allergy quality of life-parental burden questionnaire; FAQLQ-AF, food allergy quality of life questionnaire-adult form; FAQLQ-CF, food allergy quality of life questionnaire-child form; FAQLQ-PF, food allergy quality of life questionnaire-parent form; FAQLQ-TF, food allergy quality of life questionnaire-teen form; HRQL, health-related quality of life; MCID, minimal clinically important difference; MD, mean difference; OFC, oral food challenge; PedsQL™ 4.0, pediatric quality of life inventory 4.0; sIgE, specific immunoglobulin E; SMD, standardized mean difference; SPT, skin prick testing; WHOQOL-BREF, World Health Organization generic quality of life scale.

Although predictors of positive FCO could be identified, none of the studied risk factors could predict a severe reaction during peanut challenge. When challenging a child sensitized to peanut, clinicians should be prepared and equipped to handle any reaction in all cases.

No abstract