10/6/03 Threshold reactivity to milk, egg, peanut and sesame in allergic individualsSummaryA concern for individuals considered to be allergic to certain foods is the amount of the suspect food which will elicit a clinical reaction. This is of practical importance because many food-induced allergic reactions occur when the offending food is present in small amounts as a "contaminant" in prepared foods. Morisset et al of the Univ. Hospital in Nancy, France carried out graded dose blinded food challenges in individuals with strong IgE sensitivity (based on skin test and/or in vitro tests) to four suspect foods (egg, peanut, milk and sesame). Hemodynamic and respiratory symptoms were more common with reactions to peanut and sesame challenge (particularly sesame). The lowest reactive threshold doses were 2 mg for egg, 5 mg for peanut, 0.1 ml of milk, and 30 mg for sesame seed. When peanut oil was used for challenge 10 of 29 individuals reacted; 5 of 6 sesame- sensitive subjects reacted to sesame oil. Reference Clin Exp Allergy 2003;33:1046-51 Editor’s Comments These findings highlight the fact that 1) allergic reactions tend to be more severe with peanut and sesame challenges than with egg and milk challenges; 2) the minimal amount of foods such as egg which may elicit allergic reactions are within the range that can be found as "hidden ingredients" in prepared foods; 3) peanut and sesame oils may elicit reactions in allergic individuals. This latter finding was not surprising with regard to sesame oil. The situation with peanut oil is more complex since the amount of peanut allergen present in such oils depends on the method used to obtain the oil. Peanut oil is still used extensively as cooking oil in some locations within the USA.
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