Relationship between eliciting doses and the severity of allergic reactions to food

• Published in: Current opinion in allergy and clinical immunology Vol. 23; no. 3; p. 226
• Main Authors: Yanagida, Noriyuki, Sato, Sakura, Ebisawa, Motohiro
• Format: Journal Article
• Language: English
• Published: United States 01.06.2023
• Subjects: Allergens; Anaphylaxis - diagnosis; Anaphylaxis - epidemiology; Anaphylaxis - etiology; Food Hypersensitivity - complications; Food Hypersensitivity - diagnosis; Food Hypersensitivity - epidemiology; Humans; Immunoglobulin E; Quality of Life
• ISSN: 1473-6322
• DOI: 10.1097/aci.0000000000000906

Food allergies with low thresholds are associated with frequent accidental allergic reactions. Severe reactions attributable to accidental ingestion often result in a poor quality of life. Nevertheless, no evidence of a relationship between a low threshold dose and the severity of symptoms exists. Therefore, we evaluated recent data regarding the threshold of food allergies based on the oral food challenge (OFC). We also proposed a stepwise OFC method to identify threshold and consumable doses. A higher specific IgE level and a history of food-induced anaphylaxis were related to low threshold doses and severe reactions during the OFC. In addition, a low threshold dose was not directly correlated with severe reactions. Performing a stepwise OFC may help safely clarify consumable doses and prevent the complete avoidance of allergy-causing foods. Severe food allergies with high specific IgE levels are associated with lower thresholds and more severe reactions. However, the threshold is not directly related to the severity of food-induced allergic symptoms. Identifying a well tolerated consumable dose using a stepwise OFC may help manage food allergies.