Yanagida Noriyuki, Imai Takanori, Sato Sakura, Ebisawa Motohiro
Department of Pediatrics, Sagamihara National Hospital, Kanagawa, Japan.
Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Kanagawa, Japan.
PLoS One. 2015 Dec 1;10(12):e0143717. doi: 10.1371/journal.pone.0143717. eCollection 2015.
The use of oral food challenges (OFCs) in clinics is limited because they are complicated and associated with anaphylactic symptoms. To increase their use, it is necessary to develop novel, effective, and safe methods. However, the effectiveness of different OFCs has not been compared.
To investigate the effect of ingestion methods on wheat allergy symptoms and treatment during OFCs.
Without changing the total challenge dose, we changed the administration method from a 5-installment dose titration every 15 min (15-min interval method) to 3 installments every 30 min (30-min interval method). We retrospectively reviewed and compared the results of 65 positive 15-min interval wheat challenge tests conducted between July 2005 and February 2008 and 87 positive 30-min interval tests conducted between March 2008 and December 2009.
A history of immediate symptoms was more common for the 30-min interval method; however, no difference between methods was observed in other background parameters. Switching from the 15-min to the 30-min interval method did not increase symptoms or require treatment. The rate of cardiovascular symptoms (p = 0.032), and adrenaline use (p = 0.017) was significantly lower with the 30-min interval method. The results did not change after adjusting for the effects of immediate symptom history in multivariate analysis.
This study suggests that the 30-min interval method reduces the risk of adverse events, compared to the 15-min interval method.
口服食物激发试验（OFCs）在临床中的应用有限，因为其操作复杂且与过敏症状相关。为了增加其应用，有必要开发新颖、有效且安全的方法。然而，不同口服食物激发试验的有效性尚未得到比较。
研究摄入方法对口服食物激发试验期间小麦过敏症状及治疗的影响。
在不改变总激发剂量的情况下，我们将给药方法从每15分钟分5次剂量滴定（15分钟间隔法）改为每30分钟分3次给药（30分钟间隔法）。我们回顾性分析并比较了2005年7月至2008年2月期间进行的65次阳性15分钟间隔小麦激发试验和2008年3月至2009年12月期间进行的87次阳性30分钟间隔试验的结果。
30分钟间隔法出现速发症状的病史更为常见；然而，在其他背景参数方面未观察到两种方法之间存在差异。从15分钟间隔法改为30分钟间隔法并未增加症状或需要治疗。30分钟间隔法的心血管症状发生率（p = 0.032）和肾上腺素使用量（p = 0.017）显著更低。在多变量分析中对速发症状病史的影响进行校正后，结果未发生变化。
本研究表明，与15分钟间隔法相比，30分钟间隔法可降低不良事件的风险。
