Researchers have discovered why children with asthma or multiple food allergies are more likely to react during oral food challenges (OFCs). This study highlights the importance of better screening to make these tests safer.
A recent study published in Nutrients looked at the allergy risks associated with OFCs, particularly focusing on common allergens like cow’s milk and hen’s eggs. They reviewed 205 OFCs in children, finding a failure rate of 32.2%—most reactions were mild.
Two key risk factors emerged: a diagnosis of asthma and multiple food allergies. Children with both asthma and a history of severe allergic reactions had an even higher chance of failing the OFCs. This emphasizes the need for careful patient selection to minimize risks during testing.
Diagnosing food allergies isn’t simple; it usually involves a detailed history and tests for specific antibodies. While these tests can suggest allergies, they aren’t always accurate. Thus, OFCs are often used as the gold standard. In these tests, children eat small amounts of potential allergens under medical supervision to see if they react.
Even though OFCs can sometimes cause severe reactions, they are crucial for determining if a child has outgrown an allergy. Research aims to identify which patients are more likely to react, helping doctors make safer choices for their patients.
The study reviewed children’s medical histories and found that cow’s milk and hen’s eggs were the most common allergens tested. Researchers used advanced statistical methods to analyze the data, looking for patterns that could indicate risk.
The findings showed that in a controlled environment, OFCs are generally safe. Most reactions were mild, with symptoms like hives and itching being most frequent. Severe reactions were rare and only occurred in a small number of cases. Again, asthma and multiple food allergies were significant factors that increased the likelihood of a reaction.
Moreover, researchers identified specific sIgE blood test thresholds that could help predict potential reactions during OFCs. For example, a level of 58.1 kU/L for baked milk was found to be particularly indicative without predicting long-term tolerance.
In summary, the study reaffirmed OFCs as a vital diagnostic tool for food allergies in children. With careful patient selection and proper supervision, serious reactions can often be avoided. A detailed medical history enhances safety and accuracy in these tests. Parents and clinicians should work together to ensure thorough evaluations before proceeding with OFCs.
This approach not only safeguards the child but also improves the overall effectiveness of allergy management strategies.
For more in-depth insights, you can read the full study here: Asthma and Multi-Food Allergy Are Risk Factors for Oral Food Challenge Failure.
References:
Klim, L., Michalik, M., Cichocka-Jarosz, E., & Jedynak-Wąsowicz, U. (2025). Nutrients, 17(17), 2769. DOI – 10.3390/nu17172769. Link to the study.
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Asthma, Food, Oral, Allergen, Allergy, Anaphylaxis, Children, Food Allergy, Nutrients, Research
