Evidence map›Paper›PMID 29331070›Full record

ReviewAllergy2018

How does dose impact on the severity of food-induced allergic reactions, and can this improve risk assessment for allergenic foods?: Report from an ILSI Europe Food Allergy Task Force Expert Group and Workshop.

A E J Dubois, P J Turner, J Hourihane, B Ballmer-Weber, K Beyer, C-H Chan, M H Gowland, S O'Hagan, L Regent, B Remington and 3 more

Abstract readReview
In one paragraph

Review in Allergy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Review
  5. Food allergens in immune systems.Food science and biotechnology · 2025
    Review
  6. Anaphylaxis: Definition and criteria.Journal of food allergy · 2024
    Article
  7. Who Needs Epinephrine? Anaphylaxis, Autoinjectors, and Parachutes.The journal of allergy and clinical immunology. In practice · 2023
    Review
  8. Article
  9. Article
  10. Article
  11. Article
  12. Updated population minimal eliciting dose distributions for use in risk assessment of 14 priority food allergens.Food and chemical toxicology : an international journal published for the British Industrial Biological Research Association · 2020
    Review
  13. Review
  14. Review
  15. Review
  16. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

A E J DuboisUniversity Medical Centre Groningen, Groningen, The Netherlands.ORCID 0000-0001-7909-0296
P J TurnerImperial College London, London, UK.ORCID 0000-0001-9862-5161
J HourihaneUniversity College Cork, Cork, Ireland.
B Ballmer-WeberUniversity Hospital Zürich, Zürich, Switzerland.
K BeyerCharité Universitätsmedizin Berlin, Berlin, Germany.
C-H ChanFood Standards Agency, London, UK.
M H GowlandAllergy Action, St Albans, UK.
S O'HaganPepsiCo International, Leicester, UK.
L RegentAnaphylaxis Campaign, Farnborough, UK.
B RemingtonThe Netherlands Organisation for Applied Scientific Research (TNO), Zeist, The Netherlands.
S SchnadtGerman Allergy and Asthma Association (DAAB), Mönchengladbach, DE.
T StrohekerNestlé, Lausanne, Switzerland.
R W R CrevelUnilever, Bedford, UK.

Funding

Medical Research Council MR/K010468/1
6 · The paper itself

Abstract

Quantitative risk assessment (QRA) for food allergens has made considerable progress in recent years, yet acceptability of its outcomes remains stymied because of the limited extent to which it has been possible to incorporate severity as a variable. Reaction severity, particularly following accidental exposure, depends on multiple factors, related to the allergen, the host and any treatments, which might be administered. Some of these factors are plausibly still unknown. Quantitative risk assessment shows that limiting exposure through control of dose reduces the rates of reactions in allergic populations, but its impact on the relative frequency of severe reactions at different doses is unclear. Food challenge studies suggest that the relationship between dose of allergenic food and reaction severity is complex even under relatively controlled conditions. Because of these complexities, epidemiological studies provide very limited insight into this aspect of the dose-response relationship. Emerging data from single-dose challenges suggest that graded food challenges may overestimate the rate of severe reactions. It may be necessary to generate new data (such as those from single-dose challenges) to reliably identify the effect of dose on severity for use in QRA. Success will reduce uncertainty in the susceptible population and improve consumer choice.

Indexed as

AllergensCross ReactionsEuropeFoodFood HypersensitivityHumansImmunizationRisk AssessmentRisk FactorsSeverity of Illness IndexAllergensallergenic foodseliciting doseprecautionary allergen labellingrisk assessmentseverity

Identifiers

PMID29331070
PMCPMC6032860

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.