title: Debates in allergy medicine: baked egg and milk do not accelerate tolerance to egg and milk.
abstract: There is emerging evidence that children with egg and cow's milk allergy who can tolerate these allergens cooked in baked goods are more likely to develop tolerance. As a result a hypothesis has arisen that exposure to egg and milk in baked goods may hasten tolerance development; however, it is unclear whether children who develop tolerance do so because they have ingested low levels of egg or milk in baked products. An alternative explanation for the improved prognosis in those who can tolerate food allergens in the baked form is that tolerance to egg and milk in baked goods is simply an indicator of a phenotype that is less likely to be persistent. We discuss the role that the baked egg or milk allergy phenotype plays on predicting tolerance development and suggest that it is the phenotype of the disease rather than exposure to altered allergens that is the strongest predictor of tolerance development.
authors.affiliation: Centre of Food and Allergy Research, Murdoch Childrens Research Institute, Melbourne, Australia ; Department of Paediatrics, University of Melbourne, Parkville, Australia.
authors.forename: Thanh D
authors.initials: TD
authors.lastname: Dang
authors.affiliation: Centre of Food and Allergy Research, Murdoch Childrens Research Institute, Melbourne, Australia ; Department of Paediatrics, University of Melbourne, Parkville, Australia.
authors.forename: Rachel L
authors.initials: RL
authors.lastname: Peters
authors.affiliation: Centre of Food and Allergy Research, Murdoch Childrens Research Institute, Melbourne, Australia ; Department of Allergy and Clinical Immunology, The Royal Children's Hospital, Melbourne, Australia ; Department of Gastroenterology and Clinical Nutrition, The Royal Children's Hospital, Melbourne, Australia ; Department of Paediatrics, University of Melbourne, Parkville, Australia ; Institute of Inflammation and Repair, University of Manchester, Manchester, UK ; Murdoch Childrens Research Institute, The Royal Children's Hospital, Parkville, Australia.
authors.forename: Katrina J
authors.initials: KJ
authors.lastname: Allen
keywords: Baked; Component resolved diagnostics; Egg allergy; Food allergy; IgE; Immunotherapy; Milk allergy; Tolerance
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