Background: The eliciting dose (ED) for a peanut allergic reaction in 5% of the peanut allergic population, the\r\nED05, is 1.5 mg of peanut protein. This ED05 was derived from oral food challenges (OFC) that use graded,\r\nincremental doses administered at fixed time intervals. Individual patientsââ?¬â?¢ threshold doses were used to generate\r\npopulation dose-distribution curves using probability distributions from which the ED05 was then determined. It is\r\nimportant to clinically validate that this dose is predictive of the allergenic response in a further unselected group\r\nof peanut-allergic individuals.\r\nMethods/Aims: This is a multi-centre study involving three national level referral and teaching centres.\r\n(Cork University Hospital, Ireland, Royal Childrenââ?¬â?¢s Hospital Melbourne, Australia and Massachusetts General Hospital,\r\nBoston, U.S.A.) The study is now in process and will continue to run until all centres have recruited 125 participates\r\nin each respective centre.\r\nA total of 375 participants, aged 1ââ?¬â??18 years will be recruited during routine Allergy appointments in the centres.\r\nThe aim is to assess the precision of the predicted ED05 using a single dose (6 mg peanut = 1.5 mg of peanut\r\nprotein) in the form of a cookie. Validated Food Allergy related Quality of Life Questionnaires-(FAQLQ) will be\r\nself-administered prior to OFC and 1 month after challenge to assess the impact of a single dose OFC on FAQL.\r\nSerological and cell based in vitro studies will be performed.\r\nConclusion: The validation of the ED05 threshold for allergic reactions in peanut allergic subjects has potential\r\nvalue for public health measures. The single dose OFC, based upon the statistical dose-distribution analysis of past\r\nchallenge trials, promises an efficient approach to identify the most highly sensitive patients within any given\r\nfood-allergic population
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