Stepwise single-dose oral egg challenge: a multicenter prospective study

Yanagida, Noriyuki; Sato, Sakura; Takahashi, Kyohei; Ohtani, Kiyotaka; Emura, Shigehito; Shibukawa, Yasuko; Murano, Akiko; Komata, Takatsugu; Ishida, Wako; Fujita, Hidetoshi; Asaumi, Tomoyuki; Nagakura, Ken‐ichi; Ogura, Kiyotake; Ebisawa, Motohiro

doi:10.1016/j.jaip.2018.11.020

Cited by 15 publications

(24 citation statements)

References 13 publications

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“…Based on in vitro data, the antigenicities of low-dose egg juice and egg yolk-containing pumpkin cake are similar. 11 This study is the first to confirm that clinical reproducibility is also similar between these two products. This study has several limitations.…”

Section: Ta B L E 1 Background Characteristics Of the Participantssupporting

confidence: 53%

“…As a part of a multicenter prospective study, we collected children's data for stepwise OFC, starting from low‐dose egg OFC (250 mg egg protein, equivalent to 1/25 of a heated whole egg; UMIN000013026; Supinfo S1, Figure , Table ). The study was undertaken at Sagamihara National Hospital as a part of a multicenter study between 2017 and 2018, as previously described 11 …”

Section: Methodsmentioning

confidence: 99%

“…9 This disadvantage is overcomed by performing an OFC with 1/25 of a heated whole egg (low-dose egg) as egg juice, a product with a stable protein dose that varies only by 10%. 10,11 Almost 80% of children with egg allergies can safely consume low-dose egg. 11 In vitro data of enzymelinked immunosorbent assay (ELISA) showed that low-dose egg juice has antigenicity (265.8 mg) similar to that of pumpkin cake, containing EY with scEW (213.2 mg).…”

Section: Introductionmentioning

confidence: 99%

“…10,11 Almost 80% of children with egg allergies can safely consume low-dose egg. 11 In vitro data of enzymelinked immunosorbent assay (ELISA) showed that low-dose egg juice has antigenicity (265.8 mg) similar to that of pumpkin cake, containing EY with scEW (213.2 mg). 11 Nevertheless, whether children who tolerate low-dose egg OFC can safely consume EY with scEW is unknown.…”

Section: Introductionmentioning

confidence: 99%

“…Nevertheless, the challenge foods used in egg yolk OFC have the disadvantage of a variable amount of egg white 5 because egg yolk is separated manually from the whole egg 9 . This disadvantage is overcomed by performing an OFC with 1/25 of a heated whole egg (low‐dose egg) as egg juice, a product with a stable protein dose that varies only by 10% 10,11 . Almost 80% of children with egg allergies can safely consume low‐dose egg 11 .…”

Section: Introductionmentioning

confidence: 99%

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Safe egg yolk consumption after a negative result for low‐dose egg oral food challenge

Yanagida

Sato

Takahashi

et al. 2020

Pediatric Allergy Immunology

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Section: Ta B L E 1 Background Characteristics Of the Participantssupporting

confidence: 53%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Safe egg yolk consumption after a negative result for low‐dose egg oral food challenge

Yanagida

Sato

Takahashi

et al. 2020

Pediatric Allergy Immunology

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Effect of Maternal Egg Intake During the Early Neonatal Period and Risk of Infant Egg Allergy at 12 Months Among Breastfeeding Mothers

et al. 2023

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ImportanceEgg introduction in infants at age 4 to 6 months is associated with a lower risk of immunoglobulin E–mediated egg allergy (EA). However, whether their risk of EA at age 12 months is affected by maternal intake of eggs at birth is unknown.ObjectiveTo determine the effect of maternal egg intake during the early neonatal period (0-5 days) on the development of EA in breastfed infants at age 12 months.Design, Setting, and ParticipantsThis multicenter, single-blind (outcome data evaluators), randomized clinical trial was conducted from December 18, 2017, to May 31, 2021, at 10 medical facilities in Japan. Newborns with at least 1 of 2 parents having an allergic disease were included. Neonates whose mothers had EA or were unable to consume breast milk after the age of 2 days were excluded. Data were analyzed on an intention-to-treat basis.InterventionsNewborns were randomized (1:1) to a maternal egg consumption (MEC) group, wherein the mothers consumed 1 whole egg per day during the first 5 days of the neonate’s life, and a maternal egg elimination (MEE) group, wherein the mothers eliminated eggs from their diet during the same period.Main Outcomes and MeasuresThe primary outcome was EA at age 12 months. Egg allergy was defined as sensitization to egg white or ovomucoid plus a positive test result in an oral food challenge or an episode of obvious immediate symptoms after egg ingestion.ResultsOf the 380 newborns included (198 [52.1%] female), 367 (MEC: n = 183; MEE: n = 184) were followed up for 12 months. On days 3 and 4 after delivery, the proportions of neonates with ovalbumin and ovomucoid detection in breast milk were higher in the MEC group than in the MEE group (ovalbumin: 10.7% vs 2.0%; risk ratio [RR], 5.23; 95% CI, 1.56-17.56; ovomucoid: 11.3% vs 2.0%; RR, 5.55; 95% CI, 1.66-18.55). At age 12 months, the MEC and MEE groups did not differ significantly in EA (9.3% vs 7.6%; RR, 1.22; 95% CI, 0.62-2.40) or sensitization to egg white (62.8% vs 58.7%; RR, 1.07; 95% CI, 0.91-1.26). No adverse effects were reported.Conclusions and RelevanceIn this randomized clinical trial, EA development and sensitization to eggs were unaffected by MEC during the early neonatal period.Trial RegistrationUMIN Clinical Trials Registry: UMIN000027593

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Hospital oral food challenge tests in the coronavirus disease 2019 pandemic: A nationwide survey

Yanagida

Sugizaki

Sato

et al. 2023

Clinical & Translational All

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Oral food challenge (OFC) tests are necessary in food allergy practice. [1][2][3][4] The spread of the Omicron variant of severe acute respiratory syndrome coronavirus 2 significantly affected food allergy practice. 5,6 Universal pre-admission screening for coronavirus disease 2019 (COVID-19) may effectively identify patients with asymptomatic COVID-19. 7 However, no studies have reported the influence of the COVID-19 pandemic and pre-admission screening for COVID-19 on the number of inpatient OFC tests conducted at hospitals. This multicenter nationwide cross-sectional survey aimed to determine the number of inpatient OFC tests conducted at hospitals, infection control measures undertaken, number of nosocomial COVID-19 infections, and positive rates for coronavirus disease 2019 (COVID-19) following universal pre-admission screening. This study was approved by the Ethics Committee of the National Hospital Organization, Sagamihara National Hospital (Approval no. 2022-013). Additional details related to the methods are presented in Supplementary Materials. Of 373 pediatric training facilities contacted (Figure S1), 186 facilities responded to our online questionnaire (response rate, 50%), five were excluded due to missing data, and four were excluded because OFC tests had been suspended during the COVID-19 pandemic. The data from 177 facilities were then analyzed. Concerning OFC tests, all 177 facilities (100%) had checked body temperature, 176 (99%) had checked interview sheets, 172 (97%) had undertaken a medical check-up prior to OFC testing, and 136 (77%) had undertaken universal masking. Concerning inpatient OFC tests, 15,858 OFC tests were conducted, including 12,503 in shared rooms and 3355 in private rooms. Of 177 facilities, 110 (73%) had conducted universal preadmission screening tests for COVID-19 for patients prior to an OFC test and 64 (37%) had conducted universal pre-admission screening tests for COVID-19 for both patients and family members. Of 110 facilities that conducted universal pre-admission screening tests for COVID-19, 55 had performed polymerase chain reaction (PCR) tests, 48 had performed rapid antigen tests, and 10 had performed nucleic acid amplification (loop-mediated isothermal amplification [LAMP]) tests (including duplications). Samples were no role in the study design, collection, analysis, and interpretation of data, writing of the report, or decision to submit the article for publication. CONFLICT OF INTEREST STATEMENT

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Stepwise single-dose oral egg challenge: a multicenter prospective study

Cited by 15 publications

References 13 publications

Safe egg yolk consumption after a negative result for low‐dose egg oral food challenge

Safe egg yolk consumption after a negative result for low‐dose egg oral food challenge

Effect of Maternal Egg Intake During the Early Neonatal Period and Risk of Infant Egg Allergy at 12 Months Among Breastfeeding Mothers

Hospital oral food challenge tests in the coronavirus disease 2019 pandemic: A nationwide survey

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