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논문 기본 정보

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학술저널
저자정보
Kim Hamin (Department of Pediatrics, Severance Hospital, Institute of Allergy, Institute for Innovation in Digital Healthcare, Yonsei University College of Medicine, Seoul, Korea.) Jeong Kyunguk (Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea.) Park Mireu (Department of Pediatrics, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.) Roh Yun Young (Department of Pediatrics, Severance Hospital, Institute of Allergy, Institute for Innovation in Digital Healthcare, Yonsei University College of Medicine, Seoul, Korea.) Jung Jae Hwa (Department of Pediatrics, Severance Hospital, Institute of Allergy, Institute for Innovation in Digital Healthcare, Yonsei University College of Medicine, Seoul, Korea.) Kim Soo Yeon (Department of Pediatrics, Severance Hospital, Institute of Allergy, Institute for Innovation in Digital Healthcare, Yonsei University College of Medicine, Seoul, Korea.) Kim Jong Deok (Department of Pediatrics, Severance Hospital, Institute of Allergy, Institute for Innovation in Digital Healthcare, Yonsei University College of Medicine, Seoul, Korea.) Kim Min Jung (Department of Pediatrics, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea.) Kim Yoon Hee (Department of Pediatrics, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.) Sohn Myung Hyun (Department of Pediatrics, Severance Hospital, Institute of Allergy, Institute for Innovation in Digital Healthcare, Yonsei University College of Medicine, Seoul, Korea.) Lee Sooyoung (Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea.) Kim Kyung Won (Department of Pediatrics, Severance Hospital, Institute of Allergy, Institute for Innovation in Digital Healthcare, Yonsei University College of Medicine, Seoul, Korea.)
저널정보
대한천식알레르기학회(구 대한알레르기학회) Allergy, Asthma & Immunology Research AAIR Vol.16 No.2
발행연도
2024.3
수록면
179 - 190 (12page)
DOI
10.4168/aair.2024.16.2.179

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Purpose: Despite the risk of anaphylaxis, oral food challenges (OFCs) are performed clinically for various indications, particularly to confirm tolerance development. This study aimed to assess OFCs by relevant indications and build an outcome prediction model to help determine when to perform OFCs in children who are likely to have developed immune tolerance. Methods: In total, 432 pediatric OFCs were retrospectively analyzed according to indications. Clinical characteristics, serum total immunoglobulin (Ig) E, blood eosinophils, and specific IgE and IgG4 levels for food allergens were noted and compared. Machine learning was utilized to select the most important variables in determining the passage of the OFCs, and prediction models were constructed using the selected variables. Results: OFCs were most commonly performed to confirm tolerance development (number, %; 267, 61.8%). The most common food allergens tested were egg (191, 44.2%) and milk (135, 31.3%). Children who passed the egg challenges for confirming tolerance acquisition had significantly lower egg white-specific IgE level (P = 0.008). Similarly, those who passed milk challenges had significantly lower cow’s milk-specific IgE (P = 0.002) and casein-specific IgE levels (P = 0.005). We developed a nomogram to predict the outcome of OFCs to determine the tolerance acquisition with the selected variables; lower food-specific IgE, higher total IgE, and younger age indicated a higher probability of passage. The area under the curve (95% confidence interval) was 0.623 (0.503–0.743) for egg and 0.734 (0.628–0.840) for milk. Conclusions: Serum total IgE and food-specific IgE combined with age showed trends toward passing OFCs for confirming tolerance development. The constructed model may be used by clinicians as a practical guide for minimizing the risks of OFCs and a timely reintroduction for children with food allergies.
#Food hypersensitivity #milk hypersensitivity #egg hypersensitivity #machine learning

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