Personalized management for unmet needs with food allergy.

Abstract

Patients with food allergies are at risk of experiencing accidental allergic symptoms in real life. Low thresholds may be a risk factor for accidental allergic reactions. Therefore, the evaluation of this threshold is required for the management of food allergies. We have suggested a management approach to identify the threshold dose and the consumable dose, considering patient age and the severity of food allergies. A younger age is a risk factor for accidental allergic reactions, and school-age children are likely to have a lower quality of life (QOL) than younger children. Additionally, patients with a low threshold may have difficulty in acquiring tolerance. We performed a stepwise oral food challenge (OFC) to evaluate the threshold and consumable doses for patients with food allergies. Performing a low-dose OFC for the first step would identify the dose that could be consumed at home safely and avoid the complete elimination of allergic foods. Identifying the threshold dose would be effective in managing the risk of accidental ingestion. For patients who react to low-dose OFC, low-dose oral immunotherapy (OIT) would be expected to prevent the experience of allergic reactions by accidental ingestion and consume medium doses safely. For food allergy patients and their caregivers, identifying the consumable dose would help manage the diet and eliminate their anxiety. Low-dose OFC and low-dose OIT are effective and well tolerated, which would improve their QOL. Considering the severity of food allergy and age, determining a safe threshold with no reactions would meet the unmet needs of patients with food allergy.