File Download

There are no files associated with this item.

  Links for fulltext
     (May Require Subscription)
Supplementary

Article: Development of a tool predicting severity of allergic reaction during peanut challenge

TitleDevelopment of a tool predicting severity of allergic reaction during peanut challenge
Authors
Keywordsadolescent
allergic reaction
challenge severity score
child
clinical assessment tool
Issue Date2018
PublisherElsevier Inc. The Journal's web site is located at http://www.annallergy.org
Citation
Annals of Allergy, Asthma & Immunology, 2018, v. 121 n. 1, p. 69-76.e2 How to Cite?
AbstractBACKGROUND: Reliable prognostic markers for predicting severity of allergic reactions during oral food challenges (OFCs) have not been established. OBJECTIVE: To develop a predictive algorithm of a food challenge severity score (CSS) to identify those at higher risk for severe reactions to a standardized peanut OFC. METHODS: Medical history and allergy test results were obtained for 120 peanut allergic participants who underwent double-blind, placebo-controlled food challenges. Reactions were assigned a CSS between 1 and 6 based on cumulative tolerated dose and a severity clinical indicator. Demographic characteristics, clinical features, peanut component IgE values, and a basophil activation marker were considered in a multistep analysis to derive a flexible decision rule to understand risk during peanut of OFC. RESULTS: A total of 18.3% participants had a severe reaction (CSS >4). The decision rule identified the following 3 variables (in order of importance) as predictors of reaction severity: ratio of percentage of CD63(hi) stimulation with peanut to percentage of CD63(hi) anti-IgE (CD63 ratio), history of exercise-induced asthma, and ratio of forced expiratory volume in 1 second to forced vital capacity (FEV(1)/FVC) ratio. The CD63 ratio alone was a strong predictor of CSS (P < .001). CONCLUSION: The CSS is a novel tool that combines dose thresholds and allergic reactions to understand risks associated with peanut OFCs. Laboratory values (CD63 ratio), along with clinical variables (exercise-induced asthma and FEV(1)/FVC ratio) contribute to the predictive ability of the severity of reaction to peanut OFCs. Further testing of this decision rule is needed in a larger external data source before it can be considered outside research settings. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT02103270.
Persistent Identifierhttp://hdl.handle.net/10722/288140
ISSN
2023 Impact Factor: 5.8
2023 SCImago Journal Rankings: 0.970
PubMed Central ID
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorChinthrajah, RS-
dc.contributor.authorPurington, N-
dc.contributor.authorAndorf, S-
dc.contributor.authorRosa, JS-
dc.contributor.authorMukai, K-
dc.contributor.authorHamilton, R-
dc.contributor.authorSmith, BM-
dc.contributor.authorGupta, R-
dc.contributor.authorGalli, SJ-
dc.contributor.authorDesai, MD-
dc.contributor.authorNadeau, KC-
dc.date.accessioned2020-10-05T12:08:27Z-
dc.date.available2020-10-05T12:08:27Z-
dc.date.issued2018-
dc.identifier.citationAnnals of Allergy, Asthma & Immunology, 2018, v. 121 n. 1, p. 69-76.e2-
dc.identifier.issn1081-1206-
dc.identifier.urihttp://hdl.handle.net/10722/288140-
dc.description.abstractBACKGROUND: Reliable prognostic markers for predicting severity of allergic reactions during oral food challenges (OFCs) have not been established. OBJECTIVE: To develop a predictive algorithm of a food challenge severity score (CSS) to identify those at higher risk for severe reactions to a standardized peanut OFC. METHODS: Medical history and allergy test results were obtained for 120 peanut allergic participants who underwent double-blind, placebo-controlled food challenges. Reactions were assigned a CSS between 1 and 6 based on cumulative tolerated dose and a severity clinical indicator. Demographic characteristics, clinical features, peanut component IgE values, and a basophil activation marker were considered in a multistep analysis to derive a flexible decision rule to understand risk during peanut of OFC. RESULTS: A total of 18.3% participants had a severe reaction (CSS >4). The decision rule identified the following 3 variables (in order of importance) as predictors of reaction severity: ratio of percentage of CD63(hi) stimulation with peanut to percentage of CD63(hi) anti-IgE (CD63 ratio), history of exercise-induced asthma, and ratio of forced expiratory volume in 1 second to forced vital capacity (FEV(1)/FVC) ratio. The CD63 ratio alone was a strong predictor of CSS (P < .001). CONCLUSION: The CSS is a novel tool that combines dose thresholds and allergic reactions to understand risks associated with peanut OFCs. Laboratory values (CD63 ratio), along with clinical variables (exercise-induced asthma and FEV(1)/FVC ratio) contribute to the predictive ability of the severity of reaction to peanut OFCs. Further testing of this decision rule is needed in a larger external data source before it can be considered outside research settings. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT02103270.-
dc.languageeng-
dc.publisherElsevier Inc. The Journal's web site is located at http://www.annallergy.org-
dc.relation.ispartofAnnals of Allergy, Asthma & Immunology-
dc.subjectadolescent-
dc.subjectallergic reaction-
dc.subjectchallenge severity score-
dc.subjectchild-
dc.subjectclinical assessment tool-
dc.titleDevelopment of a tool predicting severity of allergic reaction during peanut challenge-
dc.typeArticle-
dc.identifier.emailRosa, JS: jsrduque@hku.hk-
dc.identifier.authorityRosa, JS=rp02340-
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1016/j.anai.2018.04.020-
dc.identifier.pmid29709643-
dc.identifier.pmcidPMC6026554-
dc.identifier.scopuseid_2-s2.0-85048931241-
dc.identifier.hkuros315817-
dc.identifier.volume121-
dc.identifier.issue1-
dc.identifier.spage69-
dc.identifier.epage76.e2-
dc.identifier.isiWOS:000436596100014-
dc.publisher.placeUnited States-
dc.identifier.issnl1081-1206-

Export via OAI-PMH Interface in XML Formats


OR


Export to Other Non-XML Formats