Imperial College London
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Dr Paul Turner

Faculty of Medicine, National Heart & Lung Institute

Reader in Paediatric Allergy & Clinical Immunology
 
 
 
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Contact

 

+44 (0)20 3312 7754p.turner

 
 
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Location

 

Children's Clinical Research FacilityCambridge WingSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Turner:2021:10.1111/pai.13482,
author = {Turner, P and Vazquez-Ortiz, M and Duca, B and d'Art, YM and Chastell, SA and Marco-Martin, G and Vera-Berrios, RN and Alvarez, O and Bazire, R and del, Rio PR and Baumert, JL and van, Ree R and Mills, CEN and Fernandez-Rivas, M and Hourihane, JO},
doi = {10.1111/pai.13482},
journal = {Pediatric Allergy and Immunology},
pages = {1056--1065},
title = {Single-dose oral challenges to validate eliciting doses in children with cow's milk allergy},
url = {http://dx.doi.org/10.1111/pai.13482},
volume = {32},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background: There is increasing interest in the use of eliciting doses (EDs) to inform allergen risk management. The ED can be estimated from the distribution of threshold doses for allergic subjects undergoing food challenges within a specified population. Estimated ED05 values for cow's milk (the dose expected to cause objective allergic symptoms in 5% of the milkallergic population) range from 0.5 mg to 13.9 mg cow's milk protein. We undertook a singledose challenge study to validate a predicted ED05 for cow's milk of 0.5 mg protein.Methods: Participants were recruited from 4 clinical centres. Predetermined criteria were used to identify patients reacting to 0.5 mg cow's milk protein (approximately 0.015 mL of fresh cow's milk). Children over 1 year underwent formal challenge to cow's milk to confirm clinical reactivity.Results: 172 children (median age 6.0 (IQR 0.711) years, 57% male) were included in this analysis. Twelve (7.0%, 95% CI 3.7%11.9%) children experienced objective symptoms that met the predetermined criteria. One participant had mild anaphylaxis that responded to a single dose of adrenaline, the remainder experienced only mild symptoms with no treatment required. We did not identify any baseline predictors of sensitization that were associated with objective reactivity to the singledose challenge using 0.5 mg cow's milk protein.Conclusions: These data support an estimated ED05 for cow's milk of 0.5 mg protein. Values for ED05 above 0.5 mg for cow's milk protein proposed for allergen risk management need to be reviewed.
AU  - Turner,P
AU  - Vazquez-Ortiz,M
AU  - Duca,B
AU  - d'Art,YM
AU  - Chastell,SA
AU  - Marco-Martin,G
AU  - Vera-Berrios,RN
AU  - Alvarez,O
AU  - Bazire,R
AU  - del,Rio PR
AU  - Baumert,JL
AU  - van,Ree R
AU  - Mills,CEN
AU  - Fernandez-Rivas,M
AU  - Hourihane,JO
DO  - 10.1111/pai.13482
EP  - 1065
PY  - 2021///
SN  - 0905-6157
SP  - 1056
TI  - Single-dose oral challenges to validate eliciting doses in children with cow's milk allergy
T2  - Pediatric Allergy and Immunology
UR  - http://dx.doi.org/10.1111/pai.13482
UR  - https://onlinelibrary.wiley.com/doi/10.1111/pai.13482
UR  - http://hdl.handle.net/10044/1/88176
VL  - 32
ER  -
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