title: Factors affecting the determination of threshold doses for allergenic foods: how much is too much?
abstract: 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.
authors.affiliation: University of Nebraska, Food Allergy Research and Resource Program, Lincoln 68583-0919, USA.
authors.forename: Steve L
authors.initials: SL
authors.lastname: Taylor
authors.forename: Susan L
authors.initials: SL
authors.lastname: Hefle
authors.forename: Carsten
authors.initials: C
authors.lastname: Bindslev-Jensen
authors.forename: S Allan
authors.initials: SA
authors.lastname: Bock
authors.forename: A Wesley
authors.initials: AW
authors.lastname: Burks
authors.forename: Lynn
authors.initials: L
authors.lastname: Christie
authors.forename: David J
authors.initials: DJ
authors.lastname: Hill
authors.forename: Arne
authors.initials: A
authors.lastname: Host
authors.forename: Jonathan O'b
authors.initials: JO
authors.lastname: Hourihane
authors.forename: Gideon
authors.initials: G
authors.lastname: Lack
authors.forename: Dean D
authors.initials: DD
authors.lastname: Metcalfe
authors.forename: Denise Anne
authors.initials: DA
authors.lastname: Moneret-Vautrin
authors.forename: Peter A
authors.initials: PA
authors.lastname: Vadas
authors.forename: Fabienne
authors.initials: F
authors.lastname: Rance
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Skrypec
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Trautman
authors.forename: Ingrid Malmheden
authors.initials: IM
authors.lastname: Yman
authors.forename: Robert S
authors.initials: RS
authors.lastname: Zeiger
mesh_terms: D000485:Allergens / Q000276:immunology; D005512:Food Hypersensitivity / Q000209:etiology*; D019649:Food Industry; D006801:Humans; D019055:No-Observed-Adverse-Effect Level
chemical_list: D000485:Allergens