PMID- 38296769
OWN - NLM
STAT- Publisher
LR  - 20240131
IS  - 1440-1592 (Electronic)
IS  - 1323-8930 (Linking)
DP  - 2024 Jan 31
TI  - Three-year prognosis after low-dose oral food challenge for children with wheat 
      allergy.
LID - S1323-8930(24)00005-4 [pii]
LID - 10.1016/j.alit.2024.01.004 [doi]
AB  - BACKGROUND: Low-dose oral food challenge (LD-OFC) is an approach to avoid 
      complete elimination in high-risk patients with wheat allergy (WA). We examined 
      the 3-year prognosis after LD-OFC among patients who passed and failed LD-OFC. 
      METHODS: Children with immediate-type WA aged </=6 years with a history of reaction 
      to </=390 mg of wheat protein underwent their first LD-OFC with 52 mg (baseline 
      LD-OFC). After passing the LD-OFC, children stepped up to 390, 1300, and 5200 mg 
      step-by-step every 3-6 months. After failing LD-OFC, children repeated LD-OFC 
      every 6-12 months. We assessed wheat tolerance defined as consuming 5200 mg 
      without symptoms for 3 years after baseline LD-OFC. RESULTS: The median age of 
      124 children was 2.4 years, and the wheat- and omega-5-gliadin-specific 
      immunoglobulin E (IgE) levels (kU(A)/L) were 23.6 and 2.1, respectively. Upon 
      baseline LD-OFC, 57% passed (LD-tolerant), whereas 43% failed (LD-reactive). 
      Within 3 years, 38% of the LD-reactive group passed re-administered LD-OFC, and 
      70% of all participants avoided complete elimination. The percentage of the 
      participants who became capable of consuming 390 mg (87% vs. 18%), 1300 mg (78% 
      vs. 13%), and acquired tolerance (70% vs. 13%) was significantly higher in the 
      LD-tolerant group than in the LD-reactive group (p < 0.001). Predictors of 
      persistent WA in the LD-tolerant group were older age (adjusted odds ratio, 
      1.63), omega-5-gliadin-specific IgE level (1.62 per 10-fold increase), and other food 
      allergies (1.94). CONCLUSIONS: LD-tolerant patients frequently acquired wheat 
      tolerance within 3 years. Even if once positive, one-third could pass the 
      re-administered LD-OFC within 3 years.
CI  - Copyright (c) 2024 Japanese Society of Allergology. Published by Elsevier B.V. All 
      rights reserved.
FAU - Itonaga, Takaaki
AU  - Itonaga T
AD  - Department of Allergy, Clinical Research Center for Allergy and Rheumatology, NHO 
      Sagamihara National Hospital, Kanagawa, Japan; Course of Allergy and Clinical 
      Immunology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
FAU - Yanagida, Noriyuki
AU  - Yanagida N
AD  - Department of Allergy, Clinical Research Center for Allergy and Rheumatology, NHO 
      Sagamihara National Hospital, Kanagawa, Japan. Electronic address: 
      sagami@foodallergy.jp.
FAU - Nagakura, Ken-Ichi
AU  - Nagakura KI
AD  - Department of Allergy, Clinical Research Center for Allergy and Rheumatology, NHO 
      Sagamihara National Hospital, Kanagawa, Japan.
FAU - Asaumi, Tomoyuki
AU  - Asaumi T
AD  - Department of Allergy, Clinical Research Center for Allergy and Rheumatology, NHO 
      Sagamihara National Hospital, Kanagawa, Japan.
FAU - Tokunaga, Mai
AU  - Tokunaga M
AD  - Department of Allergy, Clinical Research Center for Allergy and Rheumatology, NHO 
      Sagamihara National Hospital, Kanagawa, Japan.
FAU - Nishino, Makoto
AU  - Nishino M
AD  - Department of Allergy, Clinical Research Center for Allergy and Rheumatology, NHO 
      Sagamihara National Hospital, Kanagawa, Japan.
FAU - Takahashi, Kyohei
AU  - Takahashi K
AD  - Department of Allergy, Clinical Research Center for Allergy and Rheumatology, NHO 
      Sagamihara National Hospital, Kanagawa, Japan.
FAU - Ogura, Kiyotake
AU  - Ogura K
AD  - Department of Allergy, Clinical Research Center for Allergy and Rheumatology, NHO 
      Sagamihara National Hospital, Kanagawa, Japan.
FAU - Sato, Sakura
AU  - Sato S
AD  - Department of Allergy, Clinical Research Center for Allergy and Rheumatology, NHO 
      Sagamihara National Hospital, Kanagawa, Japan.
FAU - Ebisawa, Motohiro
AU  - Ebisawa M
AD  - Department of Allergy, Clinical Research Center for Allergy and Rheumatology, NHO 
      Sagamihara National Hospital, Kanagawa, Japan; Course of Allergy and Clinical 
      Immunology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
LA  - eng
PT  - Journal Article
DEP - 20240131
PL  - England
TA  - Allergol Int
JT  - Allergology international : official journal of the Japanese Society of 
      Allergology
JID - 9616296
SB  - IM
OTO - NOTNLM
OT  - Allergens
OT  - Child
OT  - Food hypersensitivity
OT  - Prognosis
OT  - Wheat hypersensitivity
EDAT- 2024/02/01 00:42
MHDA- 2024/02/01 00:42
CRDT- 2024/01/31 22:02
PHST- 2023/08/18 00:00 [received]
PHST- 2023/12/21 00:00 [revised]
PHST- 2024/01/10 00:00 [accepted]
PHST- 2024/02/01 00:42 [medline]
PHST- 2024/02/01 00:42 [pubmed]
PHST- 2024/01/31 22:02 [entrez]
AID - S1323-8930(24)00005-4 [pii]
AID - 10.1016/j.alit.2024.01.004 [doi]
PST - aheadofprint
SO  - Allergol Int. 2024 Jan 31:S1323-8930(24)00005-4. doi: 10.1016/j.alit.2024.01.004.