Researchers sought to understand that individual dietary advice and vulnerability to food allergens required eliciting doses (EDs) for a study. The Eliciting Dose 01 (ED01) for milk and egg was 0.2 mg total protein, calculated from allergic subjects undergoing Oral Food Challenges (OFCs) populations. The respective Eliciting Dose 05 (ED05) for milk and egg were 2.4 mg and 2.3 mg, respectively. Investigators sought to validate the EDs of that subpopulation of milk and egg-allergic children because approximately 70% of those allergic to such foods may tolerate them when baked. Between January 2018 and December 2020, study group assessed consecutive OFC for fresh milk and egg in a population of baked food-tolerant children. About 87 (30.2%) of the 288 children included in the study (median age 56 – IQR 36-92.5 months, 67.1% male) had positive OFC results, 38 with milk and 49 with egg. Milk had the most conservative ED01 of 0.3 mg total protein (IQR 0.03-2.9), and egg had the most conservative ED01 of 14.4 mg total protein (IQR 3.6-56.9). The ED05 for milk was 4.2 (IQR 0.9-19.6) mg, and the ED05 for the egg was 87.7 (IQR 43-179) mg. These thresholds were 1.5 (milk ED01), 1.75 (milk ED05), 72 (egg ED01), and 38.35 (egg ED05), times higher than the current ones. Children allergic to milk and egg but tolerant to baked proteins had higher reactivity thresholds than the general population of milk and egg-allergic children. This distinction should be considered in both individual and population risk stratification. Milk caused reactions in baked milk-tolerant children at lower doses than eggs in egg-tolerant children. It could be related to the relative safety of egg versus milk in the determinism of fatal anaphylactic reactions in children.
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