Double-blind placebo-controlled food challenges in children with alleged cow’s milk allergy: prevention of unnecessary elimination diets and determination of eliciting doses

Dambacher, Wendy M; Kort, Ellen H.M. de; Blom, W. Marty; Houben, Geert F.; Vries, Esther de

doi:10.1186/1475-2891-12-22

Cited by 35 publications

(56 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Однако, показано, что даже при отсутствии реакции на однократ-ную пробу, длительная переносимость молочных продук-тов может отсутствовать, что связано, по всей видимости, с наличием реакций замедленного типа [41]. Кроме того, у отдельных пациентов формируется частичная перено-симость молочных продуктов.…”

Section: диагностическое введение продуктаunclassified

“…Кроме того, у отдельных пациентов формируется частичная перено-симость молочных продуктов. Так, в ряде случаев отме-чается переносимость небольшого количества молоч-ного белка [41] или только термически обработанных молочных продуктов, например сухого молока в составе выпечки [42,43].…”

Section: диагностическое введение продуктаunclassified

“…При изучении формирования толерантности к БКМ по мере роста ребенка показано, что многие дети с аллергией к молоку со временем могут переносить молочный белок, подвергшийся высокотемпературной обработке [2,41,47]. Так, продемонстрировано, что до 75% детей с аллергией к БКМ с возрастом начинают переносить кипяченое или термически обработанное другим образом коровье молоко, в том числе в соста-ве выпечки [47].…”

Section: в практику педиатраunclassified

See 2 more Smart Citations

Concerning Diet Duration at Cow’s Milk Protein Allergy. How and When Should Dairy Products Be Introduced Again?

Макарова¹,

Намазова-Баранова²,

Новик³

et al. 2015

Pediatr. farmakol.

View full text Add to dashboard Cite

show abstract

Section: диагностическое введение продуктаunclassified

Section: в практику педиатраunclassified

See 1 more Smart Citation

Concerning Diet Duration at Cow’s Milk Protein Allergy. How and When Should Dairy Products Be Introduced Again?

Макарова¹,

Намазова-Баранова²,

Новик³

et al. 2015

Pediatr. farmakol.

View full text Add to dashboard Cite

show abstract

“…The ED 01 for subjective reactions was more than 10 times lower than the ED 01 for objective reactions. Blom et al (2013) calculated ED 01 , ED 05 , and ED 10 for cow's milk, hen's egg, peanut, hazelnut, and cashew nut based on discrete threshold doses using two threshold distributions: one for objective reactions and one for any reaction (objective and subjective, whichever happened first). Individual threshold data were obtained from DBPCFCs conducted in children routinely tested to diagnose food allergy.…”

Section: The Bench Mark Dose Approachmentioning

confidence: 99%

“…The terms lowest observed adverse effect level (LOAEL) and minimum eliciting dose (MED) have been used to describe individual allergen exposure levels below which an allergic individual is unlikely to react. The MED used for allergenic foods is similar to the LOAEL used for chemicals (Spanjersberg et al, 2007;Blom et al, 2013). The true (rather than tested) individual MED for an allergenic food, which is the individual (elicitation) threshold, lies between the NOAEL and the MED, by definition.…”

Section: Introduction and Terminologymentioning

confidence: 99%

Untitled

2014

EFSA Journal

View full text Add to dashboard Cite

Following a request from the Food Safety Authority of Ireland, the EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA Panel) was asked to deliver a scientific opinion on the evaluation of allergenic foods and food ingredients for labelling purposes. In view of the request, the NDA Panel decided to update its previous opinions relative to food ingredients or substances with known allergenic potential listed in Annex IIIa of 2003/89/EC, as amended. These include cereals containing gluten, milk and dairy products, eggs, nuts, peanuts, soy, fish, crustaceans, molluscs, celery, lupin, sesame, mustard and sulphites. The opinion relates to immunoglobulin (Ig)E-and non-IgE-mediated food allergy, to coeliac disease and to adverse reactions to sulphites in food, and it does not address non-immune-mediated adverse reactions to food. It includes information on the prevalence of food allergy in unselected populations, proteins identified as food allergens, cross-reactivities, the effects of food processing on the allergenicity of foods and ingredients, methods for the detection of allergens and allergenic foods, doses observed to trigger adverse reactions in sensitive individuals and risk assessment methodologies that have been used to derive individual and population thresholds for selected allergenic foods. The present opinion relates to immunoglobulin (Ig)E-and non-IgE-mediated food allergy, to coeliac disease and to adverse reactions to sulphites in food, and it does not address non-immune-mediated adverse reactions to food. For each food ingredient or substance listed in Annex IIIa, it includes information on the prevalence of food allergy in unselected populations, on proteins identified as food allergens, on cross-reactivities, on the effects of food processing on the allergenicity of foods and ingredients, on methods for the detection of allergens and allergenic foods, and on doses observed to trigger adverse reactions in sensitive individuals.Immune-mediated adverse reactions to foods manifest with clinical signs and symptoms of variable severity and duration, which may affect different organs and systems. Anaphylactic reactions to food are IgE mediated and may occur at any age. Non-IgE-mediated food allergy includes a wide range of diseases, including protein-induced enterocolitis and eosinophilic oesophagitis.A careful family and clinical history are the basis for diagnosis of food allergy. Food diaries, skin prick tests (SPTs), allergen-specific IgE measurements, food elimination diets and food challenges are part of the standard protocol for the diagnosis of food allergy. A positive SPT indicates sensitisation to the tested food, but it is not diagnostic of food allergy. Allergen-specific serum IgE antibodies similarly denote sensitisation to a particular food, but they are not diagnostic without a clinical history or food challenge. The use of atopy patch tests for the diagnosis of food allergy is controversial. Other available tests have no current role in the diagnosis of food allergy. Diag...

show abstract

Successful introduction of milk after a negative double‐blind placebo‐controlled food challenge test is independent of the total dose and milk product used during the challenge test

Ven

Herpertz

Lente

et al. 2020

Immunity Inflam & Disease

View full text Add to dashboard Cite

Background: Failure of milk introduction after a negative food challenge test is reported in a substantial number of patients. For this reason, guidelines recommend that the total dose of milk protein for a food challenge test should be comparable to a normal serving. Objective: Our aim is to compare the success rate of milk introduction after a negative double-blind placebo-controlled challenge test performed with different doses of milk protein and different milk products. Methods: We conducted a retrospective chart review of 485 patients challenged with a low or high dose of milk protein. Pasteurized milk and milk protein powder were used for the low-dose challenge tests, and condensed milk for the high-dose challenge tests. Successful introduction was defined as regular milk consumption, and discontinuation of further introduction due to the reappearance of symptoms as unsuccessful introduction. We also evaluated the association between milk products and successful introduction. Results: The outcome of 288 (59.4%) double-blind placebo-controlled food challenge tests was negative. There were no significant differences between the low and high dose of milk protein in patient characteristics, percentage of patients lost to follow-up (15% vs 20%), in whom introduction had not yet been performed (4% vs 3.1%), reappearance of symptoms (18% vs 17%), and successful introduction (88.0% and 83.4%). Age, gender, specific immunoglobulin E for milk, dose of milk protein, and atopy were not associated with successful introduction. Children who experienced symptoms during the introduction were less likely to consume milk (P < .001). There was a nonsignificant trend toward higher successful introduction rate if pasteurized milk was used as test material compared to milk protein powder, and condensed milk.

show abstract

Double-blind placebo-controlled food challenges in children with alleged cow’s milk allergy: prevention of unnecessary elimination diets and determination of eliciting doses

Cited by 35 publications

References 25 publications

Concerning Diet Duration at Cow’s Milk Protein Allergy. How and When Should Dairy Products Be Introduced Again?

Concerning Diet Duration at Cow’s Milk Protein Allergy. How and When Should Dairy Products Be Introduced Again?

Untitled

Successful introduction of milk after a negative double‐blind placebo‐controlled food challenge test is independent of the total dose and milk product used during the challenge test

Contact Info

Product

Resources

About