DOSE-DEPENDENT BIOMARKER CUT-OFFS PREDICTIVE OF ORAL FOOD CHALLENGE OUTCOMES

Introduction Improved biomarkers predictive of food challenge thresholds are needed. Methods A retrospective chart review was performed on IRB-approved clinical protocols where standardized screening oral food challenges (OFCs) to a cumulative dose of 500 mg protein were conducted to any of 11 potential food allergens. Dose-dependent receiver operating characteristic (ROC) curves for specific IgE (sIgE), sIgE/total IgE ratio (sIgEr), and skin prick test (SPT) were generated to determine optimal allergen-specific biomarker thresholds predictive of OFC outcome adjusting for cumulative tolerated dose (CTD). Results A total of 1274 OFCs completed by 427 participants were analyzed. The majority of food-specific SPT, sIgE, and sIgEr thresholds calculated from the CTD-dependent ROC curves were highly predictive of OFC outcome [area under the curves (AUCs) u003e 0.75]. Participants with values above the thresholds were more likely to have a positive challenge and react at lower doses compared to those with values below (p Conclusions These reported SPT, sIgE, and sIgEr threshold values appear highly predictive of challenge outcome and may serve as a substitute for food challenges in the appropriate setting.