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The key events dose-response framework: A foundation for examining variability in elicitation thresholds for food allergens

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Author: Taylor, S.L. · Gendel, S.M. · Houben, G.F. · Julien, E.
Type:article
Date:2009
Institution: TNO Kwaliteit van Leven
Source:Critical Reviews in Food Science and Nutrition, 8, 49, 729-739
Identifier: 241720
doi: doi:10.1080/10408390903098707
Keywords: Safety Nutrition · Food and Chemical Risk Analysis · Food allergy · Key Events Dose-Response Framework · Low dose dose-response · Minimal eliciting dose · Thresholds

Abstract

Food allergies are caused by immunological reactions in individuals sensitized to normal protein components of foods. For any given sensitized individual, the severity of a reaction is generally assumed to be proportional to the dose of allergenic protein. There is substantial clinical evidence that threshold doses exist for the elicitation of an allergic reaction; however, the threshold (i.e., lowest dose that elicits a reaction) varies substantially across the sensitized population. Current approaches to protecting sensitized individuals from exposure to food allergens are highly qualitative (i.e., they rely on food avoidance). The Key Events Dose-Response Framework is an analytical approach for refining understanding of the biological basis of the dose-response. Application of this approach to food allergy provides a foundation for a more rigorous quantitative understanding of variability in allergic response. This study reviews the allergic disease process and the current approaches to identifying thresholds for food allergens. The pathway of key biological events occurring between food intake and allergic response is considered, along with factors that may determine the nature and severity of response to food allergens. Data needs, as well as implications for identifying thresholds, and for characterizing variability in thresholds, are also discussed. Copyright © Taylor and Francis Group, LLC.