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Wiley InterScience | |||||||
  AllergyVolume 60 Issue 5, Pages 602 - 605 Published Online: 2 Feb 2005 Journal compilation © 2010 John Wiley & Sons A/S Published with the European Academy of Allergy and Clinical Immunology (EAACI)
Abstract | References | Full Text: HTML, PDF (Size: 108K) | Related Articles | Citation Tracking  Original article Double-blind placebo-controlled challenges for peanut allergy the efficiency of blinding procedures and the allergenic activity of peanut availability in the recipes Copyright 2005 Blackwell Munksgaard KEYWORDS double-blind placebo-controlled food challenge • fat • immunoglobulin E • peanut hypersensitivity • symptoms ABSTRACTBackground: A firm diagnosis of double-blind placebo-controlled food challenge (DBPCFC) would facilitate the diagnosis in patients with uncertain history of reaction. Guidelines are lacking for an upper provoking dose and how to hide high concentrations of peanuts. Aim: To develop and evaluate a double-blind recipe with minimum 10% of peanut. To compare the recipe with published recipes regarding blindness, taste, texture and immunoglobulin (Ig)E antibody binding to peanut. Methods: A recipe (I) with 10% of peanut was developed evaluated and used in DBPCFC. The challenges were followed by development of a concentrated recipe (II) (15% peanut, 25% fat). Recipe II was compared with the only published recipe (III) (11% peanut, 7% fat) regarding taste, texture and availability of peanut. Recipe IV (12% peanut, 10% fat) was developed using the same methods. The binding of IgE in the recipes was measured using an inhibition method. Results: During challenges, one patient reacted after 4 g, emphasizing the need for blinding recipes containing high doses of peanut. Evaluation between recipes II and III, only recipe II was regarded as blind by the taste panels. A tenfold lower availability of peanut protein in the recipe II was found at 50% of inhibition. Recipe IV had a better IgE binding that did not differ from the original peanut extract. Conclusion: The peanut taste and texture can be hidden in a challenge medium. The fat content was important for the availability of the allergenic protein in challenges. The availability of allergens must be taken into consideration when used for DBPCFC. Accepted for publication 20 May 2004 | 
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