Factors affecting the determination of threshold doses for allergenic foods: how much is too much?
BACKGROUND
Ingestion of small amounts of an offending food can elicit adverse reactions in individuals with IgE-mediated food allergies. The threshold dose for provocation of such reactions is often considered to be zero. However, because of various practical limitations in food production and processing, foods may occasionally contain trace residues of the offending food. Are these very low, residual quantities hazardous to allergic consumers? How much of the offending food is too much? Very little quantitative information exists to allow any risk assessments to be conducted by the food industry.


OBJECTIVE
We sought to determine whether the quality and quantity of existing clinical data on threshold doses for commonly allergenic foods were sufficient to allow consensus to be reached on establishment of threshold doses for specific foods.


METHODS
In September 1999, 12 clinical allergists and other interested parties were invited to participate in a roundtable conference to share existing data on threshold doses and to discuss clinical approaches that would allow the acquisition of that information.


RESULTS
Considerable data were identified in clinical files relating to the threshold doses for peanut, cows' milk, and egg; limited data were available for other foods, such as fish and mustard.


CONCLUSIONS
Because these data were often obtained by means of different protocols, the estimation of a threshold dose was very difficult. Development of a standardized protocol for clinical experiments to allow determination of the threshold dose is needed.
Taylor
Steve L
SL
University of Nebraska, Food Allergy Research and Resource Program, Lincoln 68583-0919, USA.
Hefle
Susan L
SL
Bindslev-Jensen
Carsten
C
Bock
S Allan
SA
Burks
A Wesley
AW
Christie
Lynn
L
Hill
David J
DJ
Host
Arne
A
Hourihane
Jonathan O'b
JO
Lack
Gideon
G
Metcalfe
Dean D
DD
Moneret-Vautrin
Denise Anne
DA
Vadas
Peter A
PA
Rance
Fabienne
F
Skrypec
Daniel J
DJ
Trautman
Thomas A
TA
Yman
Ingrid Malmheden
IM
Zeiger
Robert S
RS
D000485:Allergens / Q000276:immunology; D005512:Food Hypersensitivity / Q000209:etiology*; D019649:Food Industry; D006801:Humans; D019055:No-Observed-Adverse-Effect Level
D000485:Allergens