Threshold dose for peanut: Risk characterization based upon published results from challenges of peanut-allergic individuals

Taylor, Steve L.; Crevel, René; Sheffield, David; Kabourek, Jamie; Baumert, Joseph L.

doi:10.1016/j.fct.2009.02.011

Cited by 107 publications

(61 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…But, a hallmark of the food allergic response is the remarkable variability in threshold doses across sensitized individuals (i.e., the relevant population). As noted previously, individual thresholds for elicitation of response to peanut range from 0.5 mg to 8000–10,000 mg (Taylor et al, 2009). Moreover, within a given individual, the threshold dose can vary over time.…”

Section: Discussionmentioning

confidence: 67%

“…The reasons for this breakdown or non- or underdevelopment are unclear because even food-allergic individuals are reactive to only one or a few of the many hundreds of thousands of proteins that are ingested with the diet. Moreover, there is a wide range of responses to a particular allergenic food (e.g., individual threshold doses for peanut can range from 0.5 up to 8000–10,000 mg of peanut (0.125 to 2000–2500 mg of total peanut protein) (Taylor et al, 2009)) and this may partially be due to individual differences in the degree of oral tolerance. Thus, sensitization can perhaps be viewed as a spectrum ranging from complete oral tolerance to various degrees of non-tolerance as evidenced by ever decreasing individual threshold doses.…”

Section: Introductionmentioning

confidence: 99%

“…A very wide range of individual thresholds is known to exist, e.g. from 0.5 to 10,000 mg for peanut (Taylor et al, 2009; Taylor and Hourihane, 2008; Bindslev-Jensen et al, 2002). For most foods, however, the distribution of individual thresholds within the sensitive population has not yet been well established.…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, the existing human data have not been assembled yet for use in risk assessment approaches. However, the potential does exist for progress in this regard (see Taylor et al, 2009). …”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

The Key Events Dose-Response Framework: A Foundation for Examining Variability in Elicitation Thresholds for Food Allergens

Taylor

Gendel

Houben

et al. 2009

Critical Reviews in Food Science and Nutrition

Self Cite

View full text Add to dashboard Cite

Food allergies are caused by immunological reactions in individuals sensitized to normal protein components of foods. For any given sensitized individual, the severity of a reaction is generally assumed to be proportional to the dose of allergenic protein. There is substantial clinical evidence that “threshold” doses exist for the elicitation of an allergic reaction; however, the threshold (i.e., lowest dose that elicits a reaction) varies substantially across the sensitized population. Current approaches to protecting sensitized individuals from exposure to food allergens are highly qualitative (i.e., they rely on food avoidance). The Key Events Dose-Response Framework is an analytical approach for refining understanding of the biological basis of the dose-response. Application of this approach to food allergy provides a foundation for a more rigorous quantitative understanding of variability in allergic response. This study reviews the allergic disease process and the current approaches to identifying thresholds for food allergens. The pathway of key biological events occurring between food intake and allergic response is considered, along with factors that may determine the nature and severity of response to food allergens. Data needs, as well as implications for identifying thresholds, and for characterizing variability in thresholds, are also discussed.

show abstract

Section: Discussionmentioning

confidence: 67%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The Key Events Dose-Response Framework: A Foundation for Examining Variability in Elicitation Thresholds for Food Allergens

Taylor

Gendel

Houben

et al. 2009

Critical Reviews in Food Science and Nutrition

Self Cite

View full text Add to dashboard Cite

show abstract

“…It is not always possible to determine whether a reaction has occurred to a discrete threshold dose of allergen or alternatively has been the result of the cumulative dose consumed by the allergic individual at the time of reaction. Statistical methods can be used to model the dose-distribution of the peanut-allergic population when the precise threshold dose is known to fall within a defined dosing interval but the exact threshold value is unknown [2,3]. Since the ED05 is derived from statistical dose-distribution models of the peanut-allergic population, it is important to clinically validate that this dose is predictive of the allergenic response in a further unselected group of peanut-allergic individuals.…”

Section: Introductionmentioning

confidence: 99%

Peanut Allergen Threshold Study (PATS): validation of eliciting doses using a novel single-dose challenge protocol

Zurzolo

Allen

Taylor

et al. 2013

All Asth Clin Immun

View full text Add to dashboard Cite

BackgroundThe eliciting dose (ED) for a peanut allergic reaction in 5% of the peanut allergic population, the ED05, is 1.5 mg of peanut protein. This ED05 was derived from oral food challenges (OFC) that use graded, incremental doses administered at fixed time intervals. Individual patients’ threshold doses were used to generate population dose-distribution curves using probability distributions from which the ED05 was then determined. It is important to clinically validate that this dose is predictive of the allergenic response in a further unselected group of peanut-allergic individuals.Methods/AimsThis is a multi-centre study involving three national level referral and teaching centres. (Cork University Hospital, Ireland, Royal Children’s Hospital Melbourne, Australia and Massachusetts General Hospital, Boston, U.S.A.) The study is now in process and will continue to run until all centres have recruited 125 participates in each respective centre.A total of 375 participants, aged 1–18 years will be recruited during routine Allergy appointments in the centres. The aim is to assess the precision of the predicted ED05 using a single dose (6 mg peanut = 1.5 mg of peanut protein) in the form of a cookie. Validated Food Allergy related Quality of Life Questionnaires-(FAQLQ) will be self-administered prior to OFC and 1 month after challenge to assess the impact of a single dose OFC on FAQL. Serological and cell based in vitro studies will be performed.ConclusionThe validation of the ED05 threshold for allergic reactions in peanut allergic subjects has potential value for public health measures. The single dose OFC, based upon the statistical dose-distribution analysis of past challenge trials, promises an efficient approach to identify the most highly sensitive patients within any given food-allergic population.

show abstract

Processing Foods without Peanuts and Tree Nuts

Rajamohamed

Boye

2010

Allergen Management in the Food Industry

View full text Add to dashboard Cite

Threshold dose for peanut: Risk characterization based upon published results from challenges of peanut-allergic individuals

Cited by 107 publications

References 24 publications

The Key Events Dose-Response Framework: A Foundation for Examining Variability in Elicitation Thresholds for Food Allergens

The Key Events Dose-Response Framework: A Foundation for Examining Variability in Elicitation Thresholds for Food Allergens

Peanut Allergen Threshold Study (PATS): validation of eliciting doses using a novel single-dose challenge protocol

Processing Foods without Peanuts and Tree Nuts

Contact Info

Product

Resources

About