How does dose impact on the severity of food-induced allergic reactions, and can this improve risk assessment for allergenic foods?

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dc.contributor.authorDubois, Anthony E. J.
dc.contributor.authorTurner, Paul J.
dc.contributor.authorHourihane, Jonathan O'B.
dc.contributor.authorBallmer-Weber, Barbara
dc.contributor.authorBeyer, Kirsten
dc.contributor.authorChun-Han, Chan
dc.contributor.authorGowland, M. Hazel
dc.contributor.authorO'Hagan, Sue
dc.contributor.authorRegent, Lynne
dc.contributor.authorRemington, Ben
dc.contributor.authorSchnadt, Sabine
dc.contributor.authorStroheker, Thomas
dc.contributor.authorCrevel, René W. R.
dc.contributor.funderInternational Life Sciences Institute Research Foundationen
dc.date.accessioned2018-01-19T10:02:45Z
dc.date.available2018-01-19T10:02:45Z
dc.date.issued2018-01-13
dc.date.updated2018-01-18T15:40:38Z
dc.description.abstractQuantitative risk assessment for food allergens has made considerable progress in recent years, yet acceptability of its outcomes remains stymied because of the limited extent to which it has been possible to incorporate severity as a variable. Reaction severity, particularly following accidental exposure, depends on multiple factors, related to the allergen, the host and any treatments which might be administered. Some of these factors are plausibly still unknown. Quantitative risk assessment shows that limiting exposure through control of dose reduces the rates of reactions in allergic populations, but its impact on the relative frequency of severe reactions at different doses is unclear. Food challenge studies suggest that the relationship between dose of allergenic food and reaction severity is complex even under relatively controlled conditions. Because of these complexities, epidemiological studies provide very limited insight into this aspect of the dose-response relationship. Emerging data from single-dose challenges suggest that graded food challenges may overestimate the rate of severe reactions. It may be necessary to generate new data (such as those from single dose-challenges) to reliably identify the effect of dose on severity for use in quantitative risk assessment. Success will reduce uncertainty in the susceptible population and improve consumer choice.en
dc.description.sponsorshipInternational Life Sciences Institute Research Foundation (ILSI Europe, Food Allergy Task Force)en
dc.description.statusPeer revieweden
dc.description.versionPublished Version en
dc.format.mimetypeapplication/pdfen
dc.identifier.citationDubois, A. E.J., et al (2018) 'How does dose impact on the severity of food-induced allergic reactions, and can this improve risk assessment for allergenic foods?', Allergy, 73(7), pp. 1383-1392. doi:10.1111/all.13405en
dc.identifier.doi10.1111/all.13405
dc.identifier.endpage1392en
dc.identifier.issn1398-9995
dc.identifier.issued7
dc.identifier.journaltitleAllergyen
dc.identifier.startpage1383en
dc.identifier.urihttps://hdl.handle.net/10468/5296
dc.identifier.volume73
dc.language.isoenen
dc.publisherWileyen
dc.rights© 2018. the Authors. Allergy Published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in anymedium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.en
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectAllergenic foodsen
dc.subjectEliciting dose (ED)en
dc.subjectPrecautionary allergen labelling (PAL)en
dc.subjectRisk assessmenten
dc.subjectSeverityen
dc.titleHow does dose impact on the severity of food-induced allergic reactions, and can this improve risk assessment for allergenic foods?en
dc.typeArticle (peer-reviewed)en
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