Ran across this while reviewing the FARRP site information:
http://www.tno.nl/downloads/food_allergy_in_children.pdf
CM, thought you would like it especially.
That's a great find, Boo. You're right, I do like it.
One thing that I wonder about though, is that it is
known that apple and hazelnut (and peach, if memory serves) allergies are different (evidently) in geographically diverse populations across Europe-- one thing which is not yet clear (as far as I know) is whether or not those differences are
genetically based or if they are dictated by
regional exposure to pollens.This tickled my memory because while I know many hazelnut allergic persons, I don't know
anyone with the kind of sensitivity that this study suggests is reasonably normative in that population. Ergo, I wonder if the people I know have "the other" kind of hazelnut allergy-- the one which is more common in another region of Europe, I mean. South of the the Alps/Pyrenees, food allergies seem to be different in some fundamental ways. This is also seen (somewhat) on an East-West boundary line in the middle Mediterranean, as well-- but is that because of exposure? Cultural food preferences? Not really clear what all of that means. It's been
assumed that it's based solely on exposure... but if that were true, then rice allergy ought to dominate Asia, and wheat allergy ought to dominate southern Europe. But clearly that isn't the whole story.
The vast majority of studies like this one are from extreme Northern Europe (pretty much all of the studies large enough to have statistics associated are from Norway, Sweden, and Holland). So just what does that mean when translating those threshold determinations to a more genetically (and geographically) diverse population such as that in North America?
I'll also add that they probably didn't include C.I. data for a
good reason in that one-- like the other study, the numbers are small enough that those confidence intervals are probably huge unless they systematically excluded those with very high and very low thresholds. Such people already probably
self-select out of such studies to start with.
How many people with apparent reactivity like my DD's to peanut (or Boo's to milk) would consent to a DBPC challenge for the allergen? Not many. Of that population of people, I'm guessing that number would be less than 5%.
Similarly, why would someone with a tolerance like that achieved with desensitization go through one? Again-- they wouldn't. (Mostly.)