Abstract：
BACKGROUND: To avoid complete elimination of hen eggs (HE) from diet, we introduced a very-low-dose (VLD) oral food challenge (OFC) in patients with severe HE allergy in 2019. Herein, we investigated the efficacy of VLD HE OFC for achieving the full dose OFC.
METHODS: Patients with an overt allergic reaction to LD (1/32 HE [≤100 mg]) or less, egg white (EW) protein within 6 months were included. In the VLD group, patients not achieving full-dose OFC (1/2 HE: 1600 mg EW protein) within 2 years were excluded. We retrospectively compared the rate of passing a full-dose OFC between patients who underwent a LD OFC before 2019 (LD group) and those who underwent a VLD OFC (1/100 HE: 32 mg EW protein) after 2019 (VLD group). The period for passing the full-dose OFC was evaluated using Kaplan-Meier survival analysis.
RESULTS: We enrolled 411 and 111 patients in the LD and VLD groups, respectively. The median age at OFC initiation was 2.2 [1.5-3.6] and 2.1 [1.4-3.2] years in the LD and VLD groups, respectively. EW- and ovomucoid-specific IgE levels were 38.3 (12.5-72.9) and 21.0 (8.3-46.2) kUA/L in the LD group and 49.8 [18.8-83.9] and 32.1 [15.6-67.8] kUA/L in the VLD group, respectively. Over 4 years, the LD and VLD groups passed the full-dose OFC at rates of 70 and 95%, respectively, with significant differences (log-rank test, P < 0.001).
CONCLUSIONS: VLD HE OFC may contribute to passing a full-dose OFC in patients with severe HE allergies.
METHODS: Patients with an overt allergic reaction to LD (1/32 HE [≤100 mg]) or less, egg white (EW) protein within 6 months were included. In the VLD group, patients not achieving full-dose OFC (1/2 HE: 1600 mg EW protein) within 2 years were excluded. We retrospectively compared the rate of passing a full-dose OFC between patients who underwent a LD OFC before 2019 (LD group) and those who underwent a VLD OFC (1/100 HE: 32 mg EW protein) after 2019 (VLD group). The period for passing the full-dose OFC was evaluated using Kaplan-Meier survival analysis.
RESULTS: We enrolled 411 and 111 patients in the LD and VLD groups, respectively. The median age at OFC initiation was 2.2 [1.5-3.6] and 2.1 [1.4-3.2] years in the LD and VLD groups, respectively. EW- and ovomucoid-specific IgE levels were 38.3 (12.5-72.9) and 21.0 (8.3-46.2) kUA/L in the LD group and 49.8 [18.8-83.9] and 32.1 [15.6-67.8] kUA/L in the VLD group, respectively. Over 4 years, the LD and VLD groups passed the full-dose OFC at rates of 70 and 95%, respectively, with significant differences (log-rank test, P < 0.001).
CONCLUSIONS: VLD HE OFC may contribute to passing a full-dose OFC in patients with severe HE allergies.
摘要：
背景：为了避免从饮食中完全消除鸡蛋（HE），我们在2019年对严重HE过敏患者进行了极低剂量（VLD）口服食物激发（OFC）。在这里，我们研究了VLDHEOFC实现全剂量OFC的疗效.
方法：对LD（1/32HE[≤100mg]）或以下有明显过敏反应的患者，包括6个月内的蛋清（EW）蛋白。在VLD组中，我们排除2年内未达到全剂量OFC(1/2HE:1600mgEW蛋白)的患者.我们回顾性比较了2019年之前接受LDOFC的患者（LD组）和2019年之后接受VLDOFC（1/100HE：32mgEW蛋白）的患者（VLD组）的全剂量OFC通过率。使用Kaplan-Meier生存分析评估通过全剂量OFC的时间。
结果：我们在LD和VLD组中招募了411和111名患者，分别。LD和VLD组开始OFC的中位年龄为2.2[1.5-3.6]和2.1[1.4-3.2]岁,分别。LD组的EW-和卵粘素特异性IgE水平分别为38.3（12.5-72.9）和21.0（8.3-46.2）kUA/L，VLD组的49.8[18.8-83.9]和32.1[15.6-67.8]kUA/L，分别。超过4年,LD和VLD组以70％和95％的比率通过了全剂量OFC，分别,具有显著差异(对数秩检验，P<0.001)。
结论：VLDHEOFC可能有助于严重HE过敏患者通过全剂量OFC。
方法：对LD（1/32HE[≤100mg]）或以下有明显过敏反应的患者，包括6个月内的蛋清（EW）蛋白。在VLD组中，我们排除2年内未达到全剂量OFC(1/2HE:1600mgEW蛋白)的患者.我们回顾性比较了2019年之前接受LDOFC的患者（LD组）和2019年之后接受VLDOFC（1/100HE：32mgEW蛋白）的患者（VLD组）的全剂量OFC通过率。使用Kaplan-Meier生存分析评估通过全剂量OFC的时间。
结果：我们在LD和VLD组中招募了411和111名患者，分别。LD和VLD组开始OFC的中位年龄为2.2[1.5-3.6]和2.1[1.4-3.2]岁,分别。LD组的EW-和卵粘素特异性IgE水平分别为38.3（12.5-72.9）和21.0（8.3-46.2）kUA/L，VLD组的49.8[18.8-83.9]和32.1[15.6-67.8]kUA/L，分别。超过4年,LD和VLD组以70％和95％的比率通过了全剂量OFC，分别,具有显著差异(对数秩检验，P<0.001)。
结论：VLDHEOFC可能有助于严重HE过敏患者通过全剂量OFC。
