Objective eliciting doses of peanut-allergic adults and children can be combined for risk assessment purposes

RJB Klemans, WM Blom, FC van Erp, LJN Masthoff, CM Rubingh, CK van der Ent, CAFM Bruijnzeel-Koomen, GF Houben, Suzanne Pasmans, Y Meijer, AC (André) Knulst

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BackgroundTo improve food labelling strategies, information regarding eliciting doses (EDs) and the effect of patient characteristics on these EDs is necessary. ObjectiveTo establish EDs for objective and subjective symptoms and analyse the effect of sensitization levels and other patient characteristics on threshold distribution curves (TDCs). MethodsThreshold data from 100 adults and 262 children with a positive food challenge were analysed with interval-censoring survival analysis (ICSA) and fitted to a TDC from which EDs could be extracted. Possible influencing factors were analysed as covariates by ICSA. A hazard ratio (HR) was calculated in case of a significant effect. ResultsTDCs for both objective and subjective symptoms were significantly different between adults and children (P<0.001). Objective ED05 values, however, were comparable (2.86mg peanut protein in adults and 6.38mg in children). Higher levels of sIgE to Ara h 2 and peanut extract were associated with a larger proportion of patient groups reacting to a dose increase with objective symptoms (adults and children) or subjective symptoms (adults, in children a trend). Age had a similar effect in children (HR 1.05 for objective symptoms and 1.09 for subjective symptoms). Gender had no effect on TDCs. Conclusion and Clinical RelevanceSubjective and objective TDCs were different between adults and children, but objective ED05 values were comparable, meaning that threshold data from children and adults can be combined for elaboration of reference doses for risk assessment. Higher sIgE levels to Ara h 2 and peanut extract were associated with a larger proportion of both patient groups to react to a certain dose increase.
Original languageUndefined/Unknown
Pages (from-to)1237-1244
Number of pages8
JournalClinical & Experimental Allergy
Issue number7
Publication statusPublished - 2015

Research programs

  • EMC MM-03-61-05-A

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