title: Sesame allergy threshold dose distribution.
abstract: BACKGROUND
  Sesame is a relevant food allergen in France. Compared to other allergens there is a lack of food challenge data and more data could help sesame allergy risk management. The aim of this study is to collect more sesame challenge data and investigate the most efficient food challenge method for future studies.
  
  
  METHODS
  Records of patients at University Hospital in Nancy (France) with objective symptoms to sesame challenges were collected and combined with previously published data. An estimation of the sesame allergy population threshold was calculated based on individual NOAELs and LOAELs. Clinical dosing schemes at Nancy were investigated to see if the optimal protocol for sesame is currently used.
  
  
  RESULTS
  Fourteen patients (10 M/4 F, 22 ± 14.85 years old) with objective symptoms were added to previously published data making a total of 35 sesame allergic patients. The most sensitive patient reacted to the first dose at challenge of 1.02 mg sesame protein. The ED05 ranges between 1.2 and 4.0 mg of sesame protein (Log-Normal, Log-Logistic, and Weibull models) and the ED10 between 4.2 and 6.2 mg. The optimal food challenge dosing scheme for sesame follows semi-log dose increases from 0.3 to 3000 mg protein.
  
  
  CONCLUSIONS
  This article provides a valuable update to the existing clinical literature regarding sesame NOAELs and LOAELs. Establishment of a population threshold for sesame could help in increasing the credibility of precautionary labelling and decrease the costs associated with unexpected allergic reactions. Also, the use of an optimal dosing scheme would decrease time spent on diagnostic and thereafter on the economic burden of sesame allergy diagnosis.
authors.affiliation: EA 7299, Laboratory of Medical Hydrology and Climatology, Faculty of Medicine, Lorraine University, France; Genclis, SAS, Vandoeuvre-les-Nancy, France. Electronic address: dominique.dano@univ-lorraine.fr.
authors.forename: D
authors.initials: D
authors.lastname: Dano
authors.affiliation: Netherlands Organisation of Applied Scientific Research TNO, Utrechtseweg 48, P.O. Box 360, 3704 HE Zeist, Netherlands.
authors.forename: B C
authors.initials: BC
authors.lastname: Remington
authors.affiliation: EA 7299, Laboratory of Medical Hydrology and Climatology, Faculty of Medicine, Lorraine University, France.
authors.forename: C
authors.initials: C
authors.lastname: Astier
authors.affiliation: Food Allergy Research and Resource Program, Department of Food Science and Technology, University of Nebraska-Lincoln, Lincoln, NE, USA.
authors.forename: J L
authors.initials: JL
authors.lastname: Baumert
authors.affiliation: Netherlands Organisation of Applied Scientific Research TNO, Utrechtseweg 48, P.O. Box 360, 3704 HE Zeist, Netherlands.
authors.forename: A G
authors.initials: AG
authors.lastname: Kruizinga
authors.affiliation: Genclis, SAS, Vandoeuvre-les-Nancy, France.
authors.forename: B E
authors.initials: BE
authors.lastname: Bihain
authors.affiliation: Food Allergy Research and Resource Program, Department of Food Science and Technology, University of Nebraska-Lincoln, Lincoln, NE, USA.
authors.forename: S L
authors.initials: SL
authors.lastname: Taylor
authors.affiliation: EA 7299, Laboratory of Medical Hydrology and Climatology, Faculty of Medicine, Lorraine University, France; Internal Medicine, Clinical Immunology and Allergology, University Hospital, Nancy, France.
authors.forename: G
authors.initials: G
authors.lastname: Kanny
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000485:Allergens / Q000008:administration & dosage* / Q000633:toxicity; D052179:Antigens, Plant / Q000008:administration & dosage* / Q000633:toxicity; D002648:Child; D004306:Dose-Response Relationship, Immunologic; D004311:Double-Blind Method; D005260:Female; D005512:Food Hypersensitivity / Q000175:diagnosis / Q000209:etiology* / Q000276:immunology / Q000503:physiopathology; D005602:France; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008499:Medical Records; D018448:Models, Immunological; D010940:Plant Proteins / Q000008:administration & dosage* / Q000633:toxicity; D012189:Retrospective Studies; D012639:Seeds / Q000009:adverse effects*; D031685:Sesamum / Q000009:adverse effects*; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D000485:Allergens; D052179:Antigens, Plant; D010940:Plant Proteins
keywords: Allergy; Dose distribution; Modelling; Sesame; Threshold