Prediction of short and long term food challenge outcome in children

At present, the double blind placebo controlled food challenge (DBPCFC)
represents the gold standard for the definitive diagnose of food allergy. The
DBPCFC is terminated and considered positive when objective symptoms occur.
However, there are several pitfalls in performing and interpreting food
challenges. Food challenges are expensive due to the time consuming procedure
and the need of trained staff. Moreover challenges can be dangerous by bearing
the risk of a severe allergic reaction. In children, the portion size and total
volume of the challenge food can be a problem. Furthermore, especially in young
children, symptoms during challenge can be difficult to interpret. Subjective
symptoms (abdominal complaints, oral allergy syndrome, change of behaviour) are
difficult to objectify and without extensive monitoring; less obvious objective
symptoms (as mild bronchoconstriction or change in blood pressure) are easily
missed. As a result false-negative tests do occur and negative challenges are
sometimes followed by an allergic reaction upon the reintroduction of the
allergen. With this study we aim to predict short term and long term food
challenge outcome with regular available patient data and objective clinical
and laboratory measurements before, during and after food challenge. Hereby we
tend to reduce the amount of food challenges by at least 50%.

The overall aim of this study is to find objective and sensitive markers to
predict short term and long term food challenge outcome.

Primary Objectives:
- Can we predict (severity of) short- and long-term food challenge outcome with
clinical and laboratory markers measured before food challenge in children with
suspected food allergy?

Secondary Objective:
- Can we identify objective clinical markers measured during food challenge, to
predict short term and long term food challenge outcome?
- What is the incidence and type of (accidental) allergic reactions during
follow up of positive and negative food challenges?
- Can we find predictors for reintroduction problems after negative food
challenge?

In this observational study we will use regular available clinical data and
food allergy diagnostics to predict (severity of) food challenge outcome (short
term and long term) in children with suspected food allergy for peanut.
Moreover we will measure in vivo clinical paramters during food challenge to
objectify food challenge outcome. For long term food challenge outcome we will
monitor subjects during 12 months after food challenge.

We will study children because it is important to diagnose food allergy at a
young age to prevent unnecessary restricted diets further in live. Moreover,
especially in children subjective reactions during challenge occur and subtle
reactions are difficult to objectivity. Therefore especially in children it is
important improve the diagnostics tools to detect food allergy and where
possible, reduce the amount of challenges.
There are no risks associated with participation to this study. There are no
individual patient benefits for the participation of this study. In the future,
the results of this study can lead to an improved diagnostic procedure in
patients with suspected food allergy and prevent children from challenge, more
over this study can lead to ore objective food challenge test outcomes.