3b:I[281230,["/_next/static/immutable/chunks/0l5c-zsrs2aic.js","/_next/static/immutable/chunks/3_n0rk2989-8h.js","/_next/static/immutable/chunks/3ofw495lt1gr1.js","/_next/static/immutable/chunks/3tofdpg99uc12.js","/_next/static/immutable/chunks/2rzojj6zgb9d9.js","/_next/static/immutable/chunks/42jxjvozn2thc.js","/_next/static/immutable/chunks/1jp6nkbajpbfs.js","/_next/static/immutable/chunks/3jn_lf7v27x-6.js","/_next/static/immutable/chunks/33qq2-hg37d0b.js","/_next/static/immutable/chunks/15isb0svrppbz.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/0asz50g5_lfq9.js","/_next/static/immutable/chunks/30ia-cxa0yoyc.js","/_next/static/immutable/chunks/3ghibkczd0agr.js","/_next/static/immutable/chunks/20mjl75wrar8n.js","/_next/static/immutable/chunks/3nxreg9fiyt2y.js","/_next/static/immutable/chunks/0c04lgvo3p78i.js","/_next/static/immutable/chunks/1u78gf_avpn77.js"],"PaperListPageClient"] 3e:I[70339,["/_next/static/immutable/chunks/355lxm8rh3fxr.js"],"IconMark"] 3c:T5d8,Sesame seed allergy is growing with reported fatalities. The diagnosis can be difficult with skin prick test (SPT) and specific IgE (sIgE) often showing discrepant results, and oral food challenges (OFC) have long waiting times and potentially severe reactions. We aimed to assess the accuracy of the basophil activation test (BAT) to diagnose sesame seed allergy. Children aged 6 months to 15 years, needing an OFC to sesame were included. All had OFC to sesame alongside SPT, sIgE to sesame and to Ses i 1, and BAT to sesame. Diagnostic performance was determined by ROC curve analyses, in comparison with OFC outcomes. Thirty children reacted to (32% sesame allergic, SA) and 65 tolerated (68% sesame sensitised tolerant, SST) sesame during OFC and 5 (5%) had an indeterminate OFC. SPT to sesame extract or tahini, Ses i 1-sIgE and BAT to sesame (but not sesame-sIgE) distinguished SA and SST. The area under the ROC curve for all ages/under 2 years was 0.852/0.901 for BAT, 0.820/0.877 for Ses i 1-sIgE, 0.823/0.864 for SPT to tahini and 0.614/0.716 for sesame-sIgE. BAT was the only test whose negative result accurately identified all tolerant children. Using 100% sensitivity and 100% specificity cut-offs, BAT required the lowest number of OFC. Using SPT and Ses i 1-IgE to reduce BAT did not change the number of OFC. BAT was the only test whose negative results allowed to safely advise on home introduction and required the lowest number of OFC to reach 100% diagnostic accuracy.3d:T861,ABSTRACT Background Sesame seed allergy is growing with reported fatalities. The diagnosis can be difficult with skin prick test (SPT) and specific IgE (sIgE) often showing discrepant results, and oral food challenges (OFC) have long waiting times and potentially severe reactions. We aimed to assess the accuracy of the basophil activation test (BAT) to diagnose sesame seed allergy. Methods Children aged 6 months to 15 years, needing an OFC to sesame were included. All had OFC to sesame alongside SPT, sIgE to sesame and to Ses i 1, and BAT to sesame. Diagnostic performance was determined by ROC curve analyses, in comparison with OFC outcomes. Results Thirty children reacted to (32% sesame allergic, SA) and 65 tolerated (68% sesame sensitised tolerant, SST) sesame during OFC and 5 (5%) had an indeterminate OFC. SPT to sesame extract or tahini, Ses i 1‐sIgE and BAT to sesame (but not sesame‐sIgE) distinguished SA and SST. The area under the ROC curve for all ages/under 2 years was 0.852/0.901 for BAT, 0.820/0.877 for Ses i 1‐sIgE, 0.823/0.864 for SPT to tahini and 0.614/0.716 for sesame‐sIgE. BAT was the only test whose negative result accurately identified all tolerant children. Using 100% sensitivity and 100% specificity cut‐offs, BAT required the lowest number of OFC. Using SPT and Ses i 1‐IgE to reduce BAT did not change the number of OFC. Conclusions BAT was the only test whose negative results allowed to safely advise on home introduction and required the lowest number of OFC to reach 100% diagnostic accuracy. 28:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Oral Food Challenge: Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Oral Food Challenge (modality). Clinician-written summaries and actionable practice insights. 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TOFCs were positive in 65.2% (507/778); anaphylaxis occurred in 12.0% of positive OFCs (61/507, 7.8% overall) but was safely managed. Among 394 infants starting OIT, 97.5% (384/394) successfully initiated treatment below the TOFC-determined threshold.","limitations":"Retrospective chart review design limits data completeness and causal inference. The study population is infants with only grade 1–2 prior reactions, so findings may not generalize to those with more severe reactions. Skin prick test and Ara h 2 sIgE did not predict reaction threshold or severity, limiting the utility of biomarkers to avoid OFC.","practice_takeaway":"Routine OFC before peanut OIT — or before deciding on allergen avoidance — should be strongly considered in infants, as over one-third may be incorrectly labeled allergic. Sensitization markers (SPT, Ara h 2 sIgE) alone are insufficient to confirm allergy or determine OIT starting dose."}},{"doi":"10.1111/cea.70406","pmid":"42529903","title":"Hospital‐Based Food Challenges for the Diagnosis of Food Allergy—A\n BSACI\n Clinical Practice Statement","journal_title":"Clinical & Experimental Allergy","journal_issn":"0954-7894","published_at":"2026-07-30T00:00:00.000Z","url":"https://doi.org/10.1111/cea.70406","source_score":1,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-05T13:23:00.266Z","updated_at":"2026-08-05T13:23:00.266Z","tags":[{"paper_doi":"10.1111/cea.70406","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1111/cea.70406","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1111/cea.70406","tag_type":"condition","value":"Food Allergy","value_numeric":null},{"paper_doi":"10.1111/cea.70406","tag_type":"condition","value":"Food Hypersensitivity","value_numeric":null},{"paper_doi":"10.1111/cea.70406","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1111/cea.70406","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1111/cea.70406","tag_type":"modality","value":"Oral Food Challenge","value_numeric":null},{"paper_doi":"10.1111/cea.70406","tag_type":"study_design","value":"Clinical Practice Statement","value_numeric":null},{"paper_doi":"10.1111/cea.70406","tag_type":"warning","value":"No sample size is reported — this is a guideline/practice statement, not a clinical trial with enrolled patients.","value_numeric":null},{"paper_doi":"10.1111/cea.70406","tag_type":"warning","value":"Sex of patient population is not applicable given the guideline nature of this paper.","value_numeric":null},{"paper_doi":"10.1111/cea.70406","tag_type":"warning","value":"The impact_flag 'practice_changing' reflects the authoritative BSACI guideline status; actual practice impact will depend on local adoption.","value_numeric":null}],"summaries":{"what_studied":"This BSACI clinical practice statement evaluates the role of hospital-based food challenges (open and double-blind, placebo-controlled) in diagnosing and managing food allergy, covering indications, procedures, dosing protocols, safety requirements, and decision-making during challenges.","key_result":"Open food challenges are endorsed as a practical and effective diagnostic tool in daily clinical practice; outcomes either confirm safe food introduction/re-introduction or clarify which foods or forms (uncooked, cooked, baked, composite) require avoidance.","limitations":"This is a clinical practice statement rather than a systematic review or RCT, so recommendations are consensus- and expert opinion-based rather than derived from high-quality comparative trial data.","practice_takeaway":"Use open food challenges when history and allergy tests are discordant or allergy resolution is expected, ensuring challenges are age-appropriate in dose and food form, supervised by experienced staff, and conducted in a setting with emergency support and inpatient admission access."}},{"doi":"10.1111/pai.70402","pmid":"42473072","title":"Oral food challenges in\n FPIES\n : A narrative review and proposals for emergency and home‐based management of acute\n FPIES\n reaction","journal_title":"Pediatric Allergy and Immunology","journal_issn":"0905-6157","published_at":"2026-07-19T00:00:00.000Z","url":"https://doi.org/10.1111/pai.70402","source_score":1,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-23T13:33:24.408Z","updated_at":"2026-07-23T13:33:24.408Z","tags":[{"paper_doi":"10.1111/pai.70402","tag_type":"age_group","value":"pediatric","value_numeric":null},{"paper_doi":"10.1111/pai.70402","tag_type":"brand","value":"Isofundin","value_numeric":null},{"paper_doi":"10.1111/pai.70402","tag_type":"brand","value":"Plasmalyte","value_numeric":null},{"paper_doi":"10.1111/pai.70402","tag_type":"brand","value":"Ringer Lactate","value_numeric":null},{"paper_doi":"10.1111/pai.70402","tag_type":"brand","value":"Zophren","value_numeric":null},{"paper_doi":"10.1111/pai.70402","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1111/pai.70402","tag_type":"condition","value":"Food Protein-Induced Enterocolitis Syndrome","value_numeric":null},{"paper_doi":"10.1111/pai.70402","tag_type":"generic","value":"methylprednisolone","value_numeric":null},{"paper_doi":"10.1111/pai.70402","tag_type":"generic","value":"ondansetron","value_numeric":null},{"paper_doi":"10.1111/pai.70402","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1111/pai.70402","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1111/pai.70402","tag_type":"modality","value":"Antiemetic","value_numeric":null},{"paper_doi":"10.1111/pai.70402","tag_type":"modality","value":"Corticosteroid","value_numeric":null},{"paper_doi":"10.1111/pai.70402","tag_type":"modality","value":"Intravenous Fluid Resuscitation","value_numeric":null},{"paper_doi":"10.1111/pai.70402","tag_type":"modality","value":"Oral Food Challenge","value_numeric":null},{"paper_doi":"10.1111/pai.70402","tag_type":"modality","value":"Oral Rehydration Therapy","value_numeric":null},{"paper_doi":"10.1111/pai.70402","tag_type":"sample_size","value":"n=31","value_numeric":31},{"paper_doi":"10.1111/pai.70402","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1111/pai.70402","tag_type":"warning","value":"Ondansetron dosing and indications described are partly off-label per French/FDA approvals (approved from 6 months for chemotherapy-related nausea; off-label use for FPIES is increasingly accepted but lacks RCT support.","value_numeric":null},{"paper_doi":"10.1111/pai.70402","tag_type":"warning","value":"The proposed OFC and emergency protocols are expert consensus from a French working group and have not yet been validated in a prospective trial; the French national registry (NCT05528900) is ongoing.","value_numeric":null},{"paper_doi":"10.1111/pai.70402","tag_type":"warning","value":"The sample_size tag reflects the number of studies included in the systematic search, not a patient-level N; individual study cohorts ranged from 4 to 267 OFCs.","value_numeric":null},{"paper_doi":"10.1111/pai.70402","tag_type":"warning","value":"The study design is a narrative review with a PRISMA-inspired (not full PRISMA) search methodology, which may introduce selection bias.","value_numeric":null}],"summaries":{"what_studied":"This narrative review (2017–2025, 31 studies) by the French FPIES working group evaluated oral food challenge (OFC) protocols and acute reaction management in children with Food Protein-Induced Enterocolitis Syndrome (FPIES), then proposed a standardized national protocol covering OFC dosing, hospital emergency care, and home emergency kits.","key_result":"A single dose of 25% of an age-appropriate serving size is sufficient to trigger a reaction in most cases (usually within 2–3 h). Split-dose one-day protocols carry significantly higher risk of severe reactions than multi-day protocols (e.g., one-day OFC: 30% severe vs. two-day OFC: 5% severe; OR=10.5, 95% CI 1.28–87.1). The proposed protocol uses 25% in hospital (day 1), then 50% and 100% at home on separate days. For acute reactions: oral/sublingual ondansetron for mild-to-moderate cases; IV isotonic fluid bolus 10 mL/kg over 5–20 min for moderate-to-severe; IV methylprednisolone 1 mg/kg for severe cases. Adrenaline is not indicated unless IgE-mediated features are present.","limitations":"Evidence base is predominantly retrospective studies with small sample sizes and heterogeneous protocols; no randomized controlled trials exist comparing OFC protocols or parenteral vs. oral/sublingual ondansetron. The proposed protocol is not yet validated prospectively (ongoing French registry NCT05528900).","practice_takeaway":"For supervised FPIES OFC, use a single 25% age-appropriate serving in hospital followed by home escalation (50%, then 100%)—this reduces severe reactions compared to multi-dose same-day protocols. Send families home with an emergency kit containing oral rehydration solution and weight-based oral ondansetron (2 mg for 8–15 kg, 4 mg for 15–30 kg, 8 mg for >30 kg); adrenaline is not needed in classic FPIES."}},{"doi":"10.1016/j.anai.2026.06.031","pmid":"42362149","title":"Assessment of Sesame Seed Tolerance in Sesame Allergic Children","journal_title":"Annals of Allergy, Asthma & Immunology","journal_issn":"1081-1206","published_at":"2026-06-26T00:00:00.000Z","url":"https://doi.org/10.1016/j.anai.2026.06.031","source_score":7,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-11T13:32:57.796Z","updated_at":"2026-07-11T13:32:57.796Z","tags":[{"paper_doi":"10.1016/j.anai.2026.06.031","tag_type":"age_group","value":"pediatric","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.06.031","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.06.031","tag_type":"condition","value":"Sesame Allergy","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.06.031","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.06.031","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.06.031","tag_type":"modality","value":"Oral Food Challenge","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.06.031","tag_type":"sample_size","value":"n=27","value_numeric":27},{"paper_doi":"10.1016/j.anai.2026.06.031","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.06.031","tag_type":"study_design","value":"Retrospective Chart Review","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.06.031","tag_type":"warning","value":"Sex distribution across the 27 participants is not explicitly reported in the abstract; 'mixed' sex tag is assumed based on typical pediatric allergy cohorts.","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.06.031","tag_type":"warning","value":"The paper is published in June 2026 but lists a DOI with '2026.06.031', which appears consistent with an advance or current publication; no preprint ambiguity was noted.","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.06.031","tag_type":"warning","value":"The 'practice_changing' impact flag is applied cautiously—while findings are clinically meaningful, the small sample (n=27) and retrospective design mean results should be interpreted with care until confirmed in larger prospective studies.","value_numeric":null}],"summaries":{"what_studied":"Retrospective chart review evaluating whether sesame-allergic children (with IgE-mediated allergy and prior reactions to concentrated sesame products) could tolerate intact sesame seeds during supervised oral food challenges (OFCs), using a standardized stepwise protocol up to 1–3 teaspoons cumulative dose.","key_result":"85% of children (23/27) passed OFCs to intact sesame seeds without clinically significant symptoms; 15% (4/27) had objective allergic reactions requiring treatment at 50–500 mg of sesame protein. OFCs occurred a median of 2 years after the most recent sesame reaction.","limitations":"Small sample size (n=27) limits generalizability. Retrospective design introduces selection bias—only patients who underwent OFCs were included. No control group or long-term follow-up data on sustained tolerance.","practice_takeaway":"Many sesame-allergic children who reacted to concentrated sesame products may tolerate intact sesame seeds—supervised OFCs can help identify these children and guide individualized dietary counseling. Reserve OFCs for a supervised clinical setting, as 15% still had reactions requiring treatment."}},{"doi":"10.1111/all.70368","pmid":"42052864","title":"IgE\n Antibody Function and Mast Cell Activation to Egg in Children Undergoing Baked and Loosely Cooked Egg Challenges","journal_title":"Allergy","journal_issn":"0105-4538","published_at":"2026-04-29T00:00:00.000Z","url":"https://doi.org/10.1111/all.70368","source_score":7,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-11T13:21:04.680Z","updated_at":"2026-05-11T13:21:04.680Z","tags":[{"paper_doi":"10.1111/all.70368","tag_type":"age_group","value":"child","value_numeric":null},{"paper_doi":"10.1111/all.70368","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1111/all.70368","tag_type":"condition","value":"Egg Allergy","value_numeric":null},{"paper_doi":"10.1111/all.70368","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1111/all.70368","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1111/all.70368","tag_type":"modality","value":"Basophil Activation Test","value_numeric":null},{"paper_doi":"10.1111/all.70368","tag_type":"modality","value":"Mast Cell Activation Test","value_numeric":null},{"paper_doi":"10.1111/all.70368","tag_type":"modality","value":"Oral Food Challenge","value_numeric":null},{"paper_doi":"10.1111/all.70368","tag_type":"sample_size","value":"n=133","value_numeric":133},{"paper_doi":"10.1111/all.70368","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1111/all.70368","tag_type":"study_design","value":"Diagnostic Accuracy Study","value_numeric":null},{"paper_doi":"10.1111/all.70368","tag_type":"warning","value":"Raw egg allergy was explicitly excluded — findings apply only to baked and loosely cooked egg tolerance phenotypes.","value_numeric":null},{"paper_doi":"10.1111/all.70368","tag_type":"warning","value":"Sex breakdown of the 133 participants is not explicitly reported in the abstract; 'mixed' sex tag is inferred from a pediatric cohort context.","value_numeric":null},{"paper_doi":"10.1111/all.70368","tag_type":"warning","value":"Study design is a sub-group analysis of the BAT2 cohort; may not be fully representative of broader pediatric egg allergy populations.","value_numeric":null}],"summaries":{"what_studied":"This study evaluated the diagnostic performance of the mast cell activation test (MAT) for egg allergy in 133 children from the BAT2 egg study, grouped by oral food challenge outcomes to baked egg (BE) and loosely cooked egg (LCE), and examined how IgE characteristics (levels, specific activity, avidity, diversity) and IgG4/IgE ratios modulate mast cell response.","key_result":"MAT achieved an AUC of 0.749 for baked egg allergy and 0.704 for LCE allergy; sensitivity/specificity at optimal cut-off was 52%/89% for BE and 70%/66% for LCE, with overall diagnostic accuracy of 68% for both — lower than other tests. MAT outperformed sIgE alone only when sIgE ≥ 1 KU/L, and IgG4/IgE ratios were inversely correlated with MAT response.","limitations":"- Raw egg allergy was not assessed, limiting generalizability to the full spectrum of egg allergy.\n- MAT's diagnostic accuracy (68%) was lower than other available tests, reducing its standalone clinical utility.\n- Study is a sub-group analysis of an existing cohort (BAT2), which may introduce selection bias.","practice_takeaway":"MAT adds value over sIgE alone only when egg-specific IgE is ≥ 1 KU/L, so it should not replace standard diagnostics but can serve as a functional tool to probe IgE activity and IgG4 interference in egg-allergic children. Clinicians should note MAT's high specificity (89%) but low sensitivity (52%) for baked egg allergy when interpreting results."}},{"doi":"10.1111/all.70349","pmid":"42037009","title":"Optimising the Diagnosis of Sesame Seed Allergy With the Basophil Activation Test","journal_title":"Allergy","journal_issn":"0105-4538","published_at":"2026-04-27T00:00:00.000Z","url":"https://doi.org/10.1111/all.70349","source_score":7,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-05-01","doi":"10.1111/all.70349","days":"14","issn":"0105-4538","rank":"8","field":"Clinical Medicine","score":"7","category":"Allergy","categories":["Allergy"],"_categories":["Allergy"]},"pubmed":{"doi":"10.1111/all.70349","title":"Optimising the Diagnosis of Sesame Seed Allergy With the Basophil Activation Test.","journal":"Allergy","methods":"","results":"Thirty children reacted to (32% sesame allergic, SA) and 65 tolerated (68% sesame sensitised tolerant, SST) sesame during OFC and 5 (5%) had an indeterminate OFC. SPT to sesame extract or tahini, Ses i 1-sIgE and BAT to sesame (but not sesame-sIgE) distinguished SA and SST. The area under the ROC curve for all ages/under 2 years was 0.852/0.901 for BAT, 0.820/0.877 for Ses i 1-sIgE, 0.823/0.864 for SPT to tahini and 0.614/0.716 for sesame-sIgE. BAT was the only test whose negative result accurately identified all tolerant children. Using 100% sensitivity and 100% specificity cut-offs, BAT required the lowest number of OFC. Using SPT and Ses i 1-IgE to reduce BAT did not change the number of OFC.","abstract":"$3c","keywords":["anaphylaxis","basophil activation test","food allergy","oral food challenge","sesame"],"pubmed_id":"42037009","conclusions":"","publication_date":"2026-04-27T00:00:00"},"crossref":{"DOI":"10.1111/all.70349","URL":"https://doi.org/10.1111/all.70349","ISSN":["0105-4538","1398-9995"],"link":[{"URL":"https://onlinelibrary.wiley.com/doi/pdf/10.1111/all.70349","content-type":"application/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https://onlinelibrary.wiley.com/doi/full-xml/10.1111/all.70349","content-type":"application/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https://onlinelibrary.wiley.com/doi/pdf/10.1111/all.70349","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":null,"score":1,"title":["Optimising the Diagnosis of Sesame Seed 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BAT should be considered the preferred first-line confirmatory test in children with suspected sesame allergy, especially those under 2 years.","what_studied":"The diagnostic accuracy of the basophil activation test (BAT) vs. skin prick test (SPT), sesame-specific IgE (sIgE), and Ses i 1-sIgE for sesame seed allergy was assessed in children aged 6 months to 15 years who required an oral food challenge (OFC), using OFC outcome as the reference standard.","key_result":"BAT achieved the highest AUC (0.852 overall; 0.901 in under-2s) and was the only test whose negative result correctly identified all sesame-tolerant children, requiring the fewest OFCs for 100% diagnostic accuracy. Sesame-sIgE performed poorly (AUC 0.614 overall; 0.716 under-2s). Of 100 children, 30 (32%) were sesame allergic and 65 (68%) were sensitised but tolerant on OFC.","limitations":"Single-centre study with a relatively small sample (n=100, only 30 allergic); 5% had indeterminate OFC outcomes, which were excluded from analysis. The population was pre-selected (all needed OFC), limiting generalisability to unselected or community populations."}},{"doi":"10.1016/j.anai.2026.04.020","pmid":"42025947","title":"Racial Differences in Food Allergy Diagnostics: Utilization and Outcomes at a Single Center","journal_title":"Annals of Allergy, Asthma & Immunology","journal_issn":"1081-1206","published_at":"2026-04-21T00:00:00.000Z","url":"https://doi.org/10.1016/j.anai.2026.04.020","source_score":7,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-09T13:22:17.273Z","updated_at":"2026-05-09T13:22:17.273Z","tags":[{"paper_doi":"10.1016/j.anai.2026.04.020","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.04.020","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.04.020","tag_type":"condition","value":"Food Allergy","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.04.020","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.04.020","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.04.020","tag_type":"modality","value":"Oral Food Challenge","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.04.020","tag_type":"modality","value":"Skin Prick Testing","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.04.020","tag_type":"modality","value":"Specific IgE Testing","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.04.020","tag_type":"sample_size","value":"n=6251","value_numeric":6251},{"paper_doi":"10.1016/j.anai.2026.04.020","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.04.020","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.04.020","tag_type":"warning","value":"Confounders such as atopic comorbidities, insurance status, and referral patterns were not clearly accounted for in the abstract, potentially influencing OFC utilization rates.","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.04.020","tag_type":"warning","value":"Single-center study — findings may not generalize to other practice settings or geographic regions.","value_numeric":null},{"paper_doi":"10.1016/j.anai.2026.04.020","tag_type":"warning","value":"The paper does not describe how race was classified (self-reported vs. assigned), which may affect interpretation of racial comparisons.","value_numeric":null}],"summaries":{"what_studied":"Retrospective single-center study of 6,251 patients evaluated for food allergy, comparing diagnostic test utilization (OFC, sIgE, SPT) and outcomes between Black and White patients to assess whether testing bias contributes to racial differences in food allergy prevalence.","key_result":"Black patients had higher mean sIgE for tree nuts (12.0 vs 8.4 ng/mL, p<0.001) and all allergens combined (14.8 vs 13.8 ng/mL, p<0.001), yet underwent OFCs less often (2.2% vs 4.8%, p<0.001) — despite a higher OFC pass rate (90.6% vs 85.7%, p=0.02). No significant SPT wheal or flare differences were found.","limitations":"Single-center retrospective design limits generalizability. Reasons why clinicians ordered fewer OFCs in Black patients were not directly measured (confounding by sIgE levels or other factors not fully controlled). Racial categorization was not described in detail, raising questions about classification accuracy.","practice_takeaway":"Black patients may be underreferred for OFCs despite higher OFC pass rates, suggesting possible overdiagnosis of food allergy in this group. Clinicians should consider whether standard sIgE thresholds for OFC referral are equitable across racial groups and not rely on sIgE levels alone to withhold challenge testing."}},{"doi":"10.1016/j.jaip.2026.04.009","pmid":"42019722","title":"Prevalence and clinical picture of wheat allergy in children: two observational studies in Germany","journal_title":"The Journal of Allergy and Clinical Immunology: In Practice","journal_issn":"2213-2198","published_at":"2026-04-20T00:00:00.000Z","url":"https://doi.org/10.1016/j.jaip.2026.04.009","source_score":7,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-07T22:49:56.913Z","updated_at":"2026-05-07T22:49:56.913Z","tags":[{"paper_doi":"10.1016/j.jaip.2026.04.009","tag_type":"age_group","value":"child","value_numeric":null},{"paper_doi":"10.1016/j.jaip.2026.04.009","tag_type":"age_group","value":"infant","value_numeric":null},{"paper_doi":"10.1016/j.jaip.2026.04.009","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1016/j.jaip.2026.04.009","tag_type":"condition","value":"Food Allergy","value_numeric":null},{"paper_doi":"10.1016/j.jaip.2026.04.009","tag_type":"condition","value":"Wheat Allergy","value_numeric":null},{"paper_doi":"10.1016/j.jaip.2026.04.009","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.jaip.2026.04.009","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1016/j.jaip.2026.04.009","tag_type":"modality","value":"Allergen-Specific IgE Testing","value_numeric":null},{"paper_doi":"10.1016/j.jaip.2026.04.009","tag_type":"modality","value":"Oral Food Challenge","value_numeric":null},{"paper_doi":"10.1016/j.jaip.2026.04.009","tag_type":"sample_size","value":"n=1,381 (cohort); n=334 (cross-sectional)","value_numeric":1381},{"paper_doi":"10.1016/j.jaip.2026.04.009","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.jaip.2026.04.009","tag_type":"study_design","value":"Observational Study (Birth Cohort + Cross-Sectional)","value_numeric":null},{"paper_doi":"10.1016/j.jaip.2026.04.009","tag_type":"warning","value":"The cross-sectional OFC cohort was recruited from specialist hospital centers, which may not reflect the general population — prevalence and severity data from this arm should not be generalized broadly.","value_numeric":null},{"paper_doi":"10.1016/j.jaip.2026.04.009","tag_type":"warning","value":"The 'impact_flag' of practice_changing is applied cautiously: the finding that wheat-specific IgE is not diagnostically useful is a clinically meaningful message, but the study is observational and limited in sample size for the cohort arm.","value_numeric":null},{"paper_doi":"10.1016/j.jaip.2026.04.009","tag_type":"warning","value":"The study design is labeled as two separate observational studies with different populations; the combined sample size tag reflects the larger birth cohort (n=1,381), but the OFC cross-sectional arm had n=334. Clinicians should interpret each result in its respective study context.","value_numeric":null}],"summaries":{"what_studied":"Two observational studies examined pediatric wheat allergy in Germany: (1) a population-based birth cohort (EuroPrevall, Berlin, n=1,381) tracking prevalence to age 2 years, and (2) a cross-sectional study across 5 German hospitals (n=334, median age 15 months) characterizing allergic reactions via oral food challenges (OFCs) and monitoring tolerance development in 50 rechallenged children.","key_result":"Wheat allergy prevalence was low at 0.2% (3/1,381) in the birth cohort. In the OFC study, 41% (137/334) reacted, with no child reacting to less than 32 mg of wheat protein. Wheat-specific IgE did not predict reactivity, severity, or threshold. Among 50 followed children, 46% (23/50) developed tolerance by a median age of 37 months.","limitations":"Birth cohort prevalence is based on a small number of confirmed cases (n=3), limiting precision. The cross-sectional OFC study was conducted at specialist centers, which may overrepresent sensitized or high-risk children. Follow-up data are available for only 50 of the 137 children who reacted.","practice_takeaway":"Wheat-specific IgE should not be used alone to confirm wheat allergy or predict reaction severity in children — OFC remains the diagnostic standard. Clinicians can counsel families that nearly half of wheat-allergic infants may outgrow their allergy by around 3 years of age."}}],"initialOffset":8,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"modality","value":"Oral Food Challenge"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Modalities","href":"/hub/tag/modality"},{"name":"Oral Food Challenge"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"modality","hub_tag_value":"Oral Food Challenge"}}}]] 2b:null 2f:[["$","title","0",{"children":"Oral Food Challenge: Research & Clinical Takeaways | ReachRx"}],["$","meta","1",{"name":"description","content":"Explore peer-reviewed papers on Oral Food Challenge (modality). Clinician-written summaries and actionable practice insights. 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