title: Oral Food Challenges: The Design must Reflect the Clinical Question.
abstract: Oral food challenges are the gold-standard diagnostic investigation for diagnosing food allergy. They allow a subject to consume an age-appropriate portion of allergenic food under surveillance to assess whether a reproducible immune-mediated adverse response is demonstrated. The specific design of food challenge must closely reflect the anticipated management step being considered. In clinical practice, food challenges are most commonly used to investigate the subject's status of allergy or tolerance to a food. However, other characteristics of food allergy are increasingly being investigated through recent studies. In particular, studies investigating food allergy prevention strategies, the impact of oral immunotherapy on subjects' threshold for allergic reactions and also their potential acquisition of long-term tolerance each utilize differing designs of oral food challenges to investigate their specific hypothesis. We examine how oral food challenges may be designed to assess specific characteristics of the food allergic response.
authors.affiliation: Department of Paediatric Allergy, Division of Asthma, Allergy and Lung Biology, King's College London and Guy's and St Thomas' National Health Service Foundation Trust, Westminster Bridge Road, London, SE1 7EH, UK, mary.feeney@kcl.ac.uk.
authors.forename: Mary
authors.initials: M
authors.lastname: Feeney
authors.forename: Tom
authors.initials: T
authors.lastname: Marrs
authors.forename: Gideon
authors.initials: G
authors.lastname: Lack
authors.forename: George
authors.initials: G
authors.lastname: Du Toit
mesh_terms: D000367:Age Factors; D000485:Allergens / Q000276:immunology; D000818:Animals; D002986:Clinical Trials as Topic; D005512:Food Hypersensitivity / Q000276:immunology* / Q000628:therapy; D006801:Humans; D007108:Immune Tolerance / Q000276:immunology
chemical_list: D000485:Allergens