Food Allergy, Peanut Allergy, Tree Nut Allergy
Conditions
Keywords
Peanut allergy, Tree Nut allergy, Precautionary allergen labeling, May contain traces, Allergen threshold
Brief summary
This protocol will help better define whether patients with peanut and/or tree nut food allergy can tolerate traces in products with precautionary allergen labelling.
Detailed description
Visit 1 (V1): During this visit at the Pediatric Research Platform at the Children's Hospital, subjects will undergo an open food challenge to 3 processed foods labeled with may contain traces by following safety and accuracy guidelines for food challenges (7). The following foods (similar for all patients) will be given in one dose in the size of a regular serving: * cookies, max 30 g; * chocolate, max 30 g; * breakfast cereals, max 50 g. Each meal will be administered with a 1 hour observation period in between and at the end. If the patient does not react to any of the foods or has only oral itching (mild symptoms), he/she will be instructed to stop the ban on may contain foods and eat them regularly. If the patient has more than mild symptoms, the study will be stopped and the patient will be banned from eating foods with traces. The study subjects with a negative challenge and instructed to eat foods with the may contain label will be provided emergency medications and instruction on when and how to use them according to current guidelines (8). An age appropriate quality of life questionnaire will be filled out by the parents/patient during the visit. For the following 3 months after may contain food challenges, the patients will be invited to eat on a regular basis any foods labeled as may contain tree nuts and/or peanuts and record the consumption on a diary. Such foods will only be eaten in presence of a family member instructed for the measures to be taken in case of a reaction. They will record any history of reaction and contact the study team. The brand name of the food, and if available the batch will be recorded. The participants will store the study food and its packaging safely in a box and bring it along at V2 for allergen content analysis. If a reaction occurs, the food will be analyzed for allergen content by immunoaffinity capillary elecrophoresis-matrix assisted laser desorption/ionization mass spectrometry, as well as a simplified version of this technique, the immunomagnetic separation -matrix-assisted laser desorption/ionization mass spectrometry. Visit 2 (V2): During this visit, the parents/patients will report on the brand, the frequency and the amount of may contain foods eaten since V1. The quality of life questionnaire will be filled out again by the parents/patient.
Interventions
OTHEROral food challenge to foods with traces
Subjects will undergo an open food challenge to 3 processed foods labeled with may contain traces. The following foods (similar for all patients) will be given in one dose in the size of a regular serving: * cookies, max 30 g; * chocolate, max 30 g; * breakfast cereals, max 50 g. Each meal will be administered with a 1 hour observation period in between and at the end.
Sponsors
University Hospital, Geneva
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
2 Years to 18 Years
Healthy volunteers
Yes
Inclusion criteria
* Children aged 2-18 years at time of inclusion * Tree nut or peanut allergy documented by: * Positive skin prick tests (SPTs) to peanut and/or tree nuts * Positive specific IgE (sIgE) to peanut and/or tree nuts ( ≥0.35 kU/L) * A recent (\< 1 year) positive food challenge, reacting to the dose of 30 mg of proteins or below. * Parent/Legal guardian has been informed about the study and has signed Informed Consent Form
Exclusion criteria
* History of a moderate or severe reaction during a food challenge with a dose of 30 mg of proteins or less. * Expected non-adherence to the study protocol. * Severe or uncontrolled asthma.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Result of the food challenges with foods labelled with may contain traces (tolerated or reacted). | At study entry | Result of the food challenges with foods labelled with may contain traces (tolerated or reacted). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Tolerance to foods labelled with may contain traces eaten normally during a 3 months follow-up. | During 3 months follow-up | Tolerance to foods labelled with may contain traces eaten normally during a 3 months follow-up (reactions / no reactions to these foods). |
| Frequency of reactions to foods labelled with may contain traces eaten normally during a 3 months follow-up. | During 3 months follow-up | Frequency of reactions to foods labelled with may contain traces eaten normally during a 3 months follow-up (number of reactions). |
| Severity of reactions to foods labelled with may contain traces eaten normally during a 3 months follow-up. | During 3 months follow-up | Severity of reactions to foods labelled with may contain traces eaten normally during a 3 months follow-up (severity of reactions by reaction type). |
| Changes of quality of life after 3 months without restriction of foods labelled with may contain traces, compared to baseline when restricting. | At entry and after 3 months | Changes of quality of life measured with the age-appropriate Food allergy quality of life questionnaire (0-12 years \[parents\], 7-12 years \[patients\], or 13-17 years \[patients\]. Results (on a continuous numerical ranking from 1 to 6 for each item) after 3 months without restriction of foods labelled with may contain traces, are compared to baseline when restricting. |
Countries
Switzerland
Outcome results
None listed