Detection of allergic reactions during oral food challenge using noninvasive urinary prostaglandin D2 metabolites.

Abstract

Oral food challenge (OFC) is a gold standard diagnostic method for food allergy (FA).1 Positive or negative OFC results are judged by an experienced physician based on objective allergic signs without reference to accurate biomarkers. Although tingling or itching in the mouth, which commonly first appears before patients develop anaphylaxis, is included as one of the allergic symptoms elicited by an immunoglobulin E (IgE)-mediated FA2 . However, subtle symptoms do not fulfill the diagnostic criteria of an OFC-positive FA. The biggest issue for OFC is that the assessment is not based on the objective biomarker and that the judgment is uneven among physicians. Moreover, various cofactors influence the outcomes of OFC (e.g., dose, infection, and psychological factors).