Oral Food Challenge Protocols in Food Protein-Induced Enterocolitis Syndrome: A Systematic Review
<h3>Background</h3><p dir="ltr">Oral food challenges (OFCs) are essential for the diagnosis and follow-up of acute food protein-induced <u>enterocolitis</u> syndrome (FPIES) because no diagnostic or prognostic biomarkers are available. However, the optimal OFC...
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| مؤلفون آخرون: | , , , , |
| منشور في: |
2025
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| _version_ | 1864513538635071488 |
|---|---|
| author | Tayseer Ibrahim (18589411) |
| author2 | Laura Argiz (22303411) Sonsoles Infante (22303414) Stefania Arasi (12115419) Ulugbek Nurmatov (125245) Marta Vazquez-Ortiz (9473788) |
| author2_role | author author author author author |
| author_facet | Tayseer Ibrahim (18589411) Laura Argiz (22303411) Sonsoles Infante (22303414) Stefania Arasi (12115419) Ulugbek Nurmatov (125245) Marta Vazquez-Ortiz (9473788) |
| author_role | author |
| dc.creator.none.fl_str_mv | Tayseer Ibrahim (18589411) Laura Argiz (22303411) Sonsoles Infante (22303414) Stefania Arasi (12115419) Ulugbek Nurmatov (125245) Marta Vazquez-Ortiz (9473788) |
| dc.date.none.fl_str_mv | 2025-04-08T03:00:00Z |
| dc.identifier.none.fl_str_mv | 10.1016/j.jaip.2024.12.033 |
| dc.relation.none.fl_str_mv | https://figshare.com/articles/journal_contribution/Oral_Food_Challenge_Protocols_in_Food_Protein-Induced_Enterocolitis_Syndrome_A_Systematic_Review/30197782 |
| dc.rights.none.fl_str_mv | CC BY 4.0 info:eu-repo/semantics/openAccess |
| dc.subject.none.fl_str_mv | Biomedical and clinical sciences Clinical sciences Immunology Paediatrics Food protein-induced enterocolitis syndrome Oral food challenge Food allergy Tolerance developmentnon–IgE-mediated food allergy Systematic review |
| dc.title.none.fl_str_mv | Oral Food Challenge Protocols in Food Protein-Induced Enterocolitis Syndrome: A Systematic Review |
| dc.type.none.fl_str_mv | Text Journal contribution info:eu-repo/semantics/publishedVersion text contribution to journal |
| description | <h3>Background</h3><p dir="ltr">Oral food challenges (OFCs) are essential for the diagnosis and follow-up of acute food protein-induced <u>enterocolitis</u> syndrome (FPIES) because no diagnostic or prognostic biomarkers are available. However, the optimal OFC procedure remains unclear. </p><h3>Objective</h3><p dir="ltr">This <u>systematic review</u> aimed to assess OFC procedures' design and clinical outcomes in patients with FPIES. </p><h3>Methods</h3><p dir="ltr">We searched 10 databases for studies published in English between 1978 and February 2024 involving children or adults undergoing OFC for FPIES. Critical appraisal followed Effective <u>Public Health</u> Practice Project parameters. </p><h3>Results</h3><p dir="ltr">In total, 52 studies met inclusion criteria, all observational studies. Of these, 35 were judged to have strong methodological quality. There was great heterogeneity in OFC procedures, particularly in cumulative dose, number, size, and timing between doses. Oral food challenge outcome reporting was often inadequate, especially regarding reaction symptoms and severity grading. In single-dose OFC protocols, most children reacted after at least 2 hours. Four small studies showed that a single dose of 25% of an age-appropriate portion was sufficient to trigger reactions in 80% to 100% of cases, and this was associated with less severe reactions. Owing to methodological heterogeneity and insufficient outcome reporting, further assessment of the OFC protocol characteristics associated with safer outcomes was not possible. </p><h3>Conclusions</h3><p dir="ltr">There is significant heterogeneity in <u>FPIES </u>OFC practices. Current recommendations for OFC procedures and outcome assessments have limitations and should be revisited, because this may affect <u>patient safety</u> and diagnostic accuracy. Future studies should focus on standardizing clinical outcomes and generating evidence to support safer, more accurate OFC protocols in FPIES.</p><h2>Other Information</h2><p dir="ltr">Published in: The Journal of Allergy and Clinical Immunology: In Practice<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1016/j.jaip.2024.12.033" target="_blank">https://dx.doi.org/10.1016/j.jaip.2024.12.033</a></p> |
| eu_rights_str_mv | openAccess |
| id | Manara2_3806fa0428d588b68c23b3f820db0041 |
| identifier_str_mv | 10.1016/j.jaip.2024.12.033 |
| network_acronym_str | Manara2 |
| network_name_str | Manara2 |
| oai_identifier_str | oai:figshare.com:article/30197782 |
| publishDate | 2025 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| rights_invalid_str_mv | CC BY 4.0 |
| spelling | Oral Food Challenge Protocols in Food Protein-Induced Enterocolitis Syndrome: A Systematic ReviewTayseer Ibrahim (18589411)Laura Argiz (22303411)Sonsoles Infante (22303414)Stefania Arasi (12115419)Ulugbek Nurmatov (125245)Marta Vazquez-Ortiz (9473788)Biomedical and clinical sciencesClinical sciencesImmunologyPaediatricsFood protein-induced enterocolitis syndromeOral food challengeFood allergyTolerance developmentnon–IgE-mediated food allergySystematic review<h3>Background</h3><p dir="ltr">Oral food challenges (OFCs) are essential for the diagnosis and follow-up of acute food protein-induced <u>enterocolitis</u> syndrome (FPIES) because no diagnostic or prognostic biomarkers are available. However, the optimal OFC procedure remains unclear. </p><h3>Objective</h3><p dir="ltr">This <u>systematic review</u> aimed to assess OFC procedures' design and clinical outcomes in patients with FPIES. </p><h3>Methods</h3><p dir="ltr">We searched 10 databases for studies published in English between 1978 and February 2024 involving children or adults undergoing OFC for FPIES. Critical appraisal followed Effective <u>Public Health</u> Practice Project parameters. </p><h3>Results</h3><p dir="ltr">In total, 52 studies met inclusion criteria, all observational studies. Of these, 35 were judged to have strong methodological quality. There was great heterogeneity in OFC procedures, particularly in cumulative dose, number, size, and timing between doses. Oral food challenge outcome reporting was often inadequate, especially regarding reaction symptoms and severity grading. In single-dose OFC protocols, most children reacted after at least 2 hours. Four small studies showed that a single dose of 25% of an age-appropriate portion was sufficient to trigger reactions in 80% to 100% of cases, and this was associated with less severe reactions. Owing to methodological heterogeneity and insufficient outcome reporting, further assessment of the OFC protocol characteristics associated with safer outcomes was not possible. </p><h3>Conclusions</h3><p dir="ltr">There is significant heterogeneity in <u>FPIES </u>OFC practices. Current recommendations for OFC procedures and outcome assessments have limitations and should be revisited, because this may affect <u>patient safety</u> and diagnostic accuracy. Future studies should focus on standardizing clinical outcomes and generating evidence to support safer, more accurate OFC protocols in FPIES.</p><h2>Other Information</h2><p dir="ltr">Published in: The Journal of Allergy and Clinical Immunology: In Practice<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1016/j.jaip.2024.12.033" target="_blank">https://dx.doi.org/10.1016/j.jaip.2024.12.033</a></p>2025-04-08T03:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1016/j.jaip.2024.12.033https://figshare.com/articles/journal_contribution/Oral_Food_Challenge_Protocols_in_Food_Protein-Induced_Enterocolitis_Syndrome_A_Systematic_Review/30197782CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/301977822025-04-08T03:00:00Z |
| spellingShingle | Oral Food Challenge Protocols in Food Protein-Induced Enterocolitis Syndrome: A Systematic Review Tayseer Ibrahim (18589411) Biomedical and clinical sciences Clinical sciences Immunology Paediatrics Food protein-induced enterocolitis syndrome Oral food challenge Food allergy Tolerance developmentnon–IgE-mediated food allergy Systematic review |
| status_str | publishedVersion |
| title | Oral Food Challenge Protocols in Food Protein-Induced Enterocolitis Syndrome: A Systematic Review |
| title_full | Oral Food Challenge Protocols in Food Protein-Induced Enterocolitis Syndrome: A Systematic Review |
| title_fullStr | Oral Food Challenge Protocols in Food Protein-Induced Enterocolitis Syndrome: A Systematic Review |
| title_full_unstemmed | Oral Food Challenge Protocols in Food Protein-Induced Enterocolitis Syndrome: A Systematic Review |
| title_short | Oral Food Challenge Protocols in Food Protein-Induced Enterocolitis Syndrome: A Systematic Review |
| title_sort | Oral Food Challenge Protocols in Food Protein-Induced Enterocolitis Syndrome: A Systematic Review |
| topic | Biomedical and clinical sciences Clinical sciences Immunology Paediatrics Food protein-induced enterocolitis syndrome Oral food challenge Food allergy Tolerance developmentnon–IgE-mediated food allergy Systematic review |