title: Release of mast cell tryptase into saliva: a tool to diagnose food allergy by a mucosal challenge test?
abstract: BACKGROUND
  Our aim was to examine whether measurement of the saliva mast cell tryptase (MCT) concentrations before and after a mucosal challenge test with the offending food would be helpful in diagnosing food allergy.
  
  
  METHODS
  We performed a retrospective analysis of 44 food challenge tests performed in 38 patients between 2006 and 2009. Patients with a suspected history of food allergy chewed the food until they developed symptoms or until the amount of time known from the patients' history to usually be required for the provocation of symptoms had passed. In 5 patients, saliva samples for the measurement of MCT were collected at minutes 0, 1, 4, 8, 11, and 16 after the first onset of symptoms. The remainder of the patients only had samples taken before chewing and 4 min after the end of the test period.
  
  
  RESULTS
  During repeated measurements, MCT peaked about 4 min after the onset of symptoms (p = 0.028). During 33 of the 44 tests (75.0%), we observed oral symptoms during testing; after 25 of the 33 (75.8%) tests evoking symptoms, the saliva MCT concentration increased. The MCT increase was negative in all other tests where no oral symptoms could be provoked.
  
  
  CONCLUSIONS
  The measurement of saliva MCT 4 min after the onset of symptoms may be helpful to diagnose food allergy. Because of numerous confounding variables, however, a negative saliva MCT increase does not exclude food allergy.
authors.affiliation: Klinik und Poliklinik für Dermatologie und Allergologie, Ludwig-Maximilians-Universität, München, Deutschland. Franziska.Rueff@med.uni-muenchen.de
authors.forename: Franziska
authors.initials: F
authors.lastname: Ruëff
authors.forename: Tanja
authors.initials: T
authors.lastname: Friedl
authors.forename: Alexander
authors.initials: A
authors.lastname: Arnold
authors.forename: Matthias
authors.initials: M
authors.lastname: Kramer
authors.forename: Bernhard
authors.initials: B
authors.lastname: Przybilla
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D005512:Food Hypersensitivity / Q000175:diagnosis*; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D008297:Male; D008407:Mast Cells / Q000201:enzymology*; D008875:Middle Aged; D012189:Retrospective Studies; D012463:Saliva / Q000201:enzymology*; D055815:Young Adult
chemical_list: D007073:Immunoglobulin E