IgE sensitisation predicts threshold but not anaphylaxis during oral
food challenges to cow's milk
Predicting reaction threshold and severity are important to improve the
management of food allergy, however the determinants of, and
relationship between, these parameters are significant knowledge gaps.
Identifying robust predictors could enable the reliable
risk-stratification of food-allergic individuals. In this series of
young people with CM-allergy undergoing DBPCFC – the largest reported
in the literature – we did identify any baseline marker which predicted
the occurrence of anaphylaxis at challenge, consistent with existing
data. 1 There is one report of IgE-sensitisation being
predictive of severity in CM-allergy, 5 however the
authors included non-reactive patients in their analysis which
significantly skewed the analyses, resulting in misleading conclusions.
6 IgE-sensitisation in our cohort, particularly to
casein, was predictive of LOAEL. Including an assessment of casein IgE
may therefore be of clinical utility when evaluating patients with
CM-allergy in the clinical setting.