Severe Reactions to a Soy Containing Beverage in Peanut Allergic Individuals Not Avoiding Soy

Rationale: Three peanut-allergic individuals experienced severe reactions to a nationally distributed high-protein beverage in the same month. The major protein sources in the beverage were soy-based ingredients and cows’ milk. These individuals did not avoid soy in their diet and previously consumed various soy products without adverse reactions. Peanut contamination of the beverage was not detected by specific ELISA, so attention shifted to the soy ingredients. The research objective was to elucidate differences between the soy milk and soy protein isolate used in the beverage and other forms of soy safely consumed by these individuals. Methods: Specific IgE levels from the three sera were determined by ImmunoCAP® and ImmunoCAP® ISAC. The soy components of the high-protein beverage and 16 forms of soy representing the range of soy ingredients used in foods were screened by SDS-PAGE and immunoblotting. Results: CAP scores ranged from high to very high (peanut: 93.1–441; soy: 10.3–26.1). All sera recognized multiple proteins in many soy products and ingredients. ISAC profiles indicated these individuals were not sensitized to birch pollen or Glym4, which separates them from previously published soy milk reaction profiles. A possible unique protein at 28–30kD in the beverage’s soy milk ingredient was recognized by IgE-binding when compared to other soy products. Conclusions: These individuals were able to consume many soy products even though their sera had high levels of specific soy IgE to multiple soy proteins. Individuals with very high specific IgE scores to peanut may need to avoid certain types of soy milk

Threshold Dose for Shrimp: A Risk Characterization Based on Objective Reactions in Clinical Studies

A DBPCFC [double-blind, placebo-controlled food challenge] of shrimp-allergic adults was conducted to obtain individual threshold doses. Results of this study and published research were combined and a population threshold for shrimp was determined from dose-distribution modeling. The shrimp-allergic population seems to have a higher threshold compared to other populations for other food allergens. Additional shrimp challenges should be done to confirm these initial results

Sesame eliciting and safe doses in a large sesame allergic population

Background: Sesame is a significant food allergen causing severe and even fatal reactions. Given its increasing prevalence in western diet, sesame is listed as an allergenic food requiring labeling in the United States and EU. However, data on the population reaction doses to sesame are limited. Methods: All sesame oral food challenges (OFCs), performed either for diagnosis or for threshold identification before the beginning of sesame oral immunotherapy (OIT) between November 2011 and July 2021 in Shamir medical center were analyzed for reaction threshold distribution. Safe-dose challenges with 90–120 min intervals were also analyzed. Results: Two hundred and fifty patients underwent 338 positive OFCs, and additional 158 safe-dose OFCs were performed. The discrete and cumulative protein amounts estimated to elicit an objective reaction in 1% (ED01) of the entire cohort (n = 250) were 0.8 mg (range 0.3–6.3) and 0.7 mg (range 0.1–7.1), respectively, and those for 5% of the population (ED05) were 3.4 mg (range 1.2–20.6) and 4.5 mg (range 1.2–28.8), respectively. Safe-dose OFCs showed similar values of ED01 (0.8, 0.4–7.5 mg) and ED05 (3.4, 1.2–22.9 mg). While doses of ≤1 mg sesame protein elicited oral pruritus in 11.6% of the patients, no objective reaction was documented to this amount in any of the challenges, including safe-dose OFCs. Conclusions: This study provides data on sesame reaction threshold distribution in the largest population of allergic patients studied, with no right or left censored data, and with validation using a safe-dose OFC. It further supports the current methods for ED determination as appropriate for establishing safety precautions for the food industry

Updated full range of Eliciting Dose values for Cow’s milk for use in food allergen risk assessment

Access to Eliciting Doses (ED) for allergens enables advanced food allergen risk assessment. Previously, the full ED range for 14 allergenic foods, including milk, and recommendations for their use were provided (Houben et al., 2020). Additional food challenge studies with cow’s milk-allergic patients added 247 data points to the original dataset. Using the Stacked Model Averaging statistical method for interval-censored data on the 697 individual NOAELs and LOAELs for milk generated an updated full ED distribution. The ED01 and ED05, the doses at which 1% and 5% of the milk-allergic population would be predicted to experience any objective allergic reaction, were 0.3 and 3.2 mg milk protein for the discrete and 0.4 mg and 4.3 mg milk protein for the cumulative dose distribution, respectively. These values are slightly higher but remain within the 95% confidence interval of previously published EDs. We recommend using the updated EDs for future characterization of risks of exposure of milk-allergic individuals to milk protein. This paper contributes to the discussion on the Reference Dose for milk in the recent Ad hoc Joint FAO/WHO Expert Consultation on Risk Assessment of Food Allergens. It will also benefit harmonization of food allergen risk assessment and risk management globally

A sampling study of blood pressure levels in White and Negro residents of Nassau, Bahamas

Results of a study of blood pressure levels in Negro and white residents of Nassau, Bahamas, have been presented. Persons for study were selected by means of probability sample design. The purpose of the study was to describe as accurately as possible the differing patterns of blood pressure with regard to race, age, and sex. The site was selected because of the opportunity to study the two races in a somewhat different environment and perhaps mode of life than previously reported by others. Also, the water supply of the area is known to be high in salt.The following facts were disclosed: 1. 1. A definite racial difference is seen. The pattern of progression of blood pressure with age is almost linear in the Negro. The white race, however, shows a flattening or "plateau" effect from the time adult ages are reached until middle life, when mean blood pressure again tends to rise. This is seen in the means of both systolic and diastolic pressure, but most noticeably in regard to the systolic.2. 2. Sex differences are shown. Women of both races have lower mean systolic pressures during the reproductive years than men of their race. Negro men have slightly but consistently higher mean diastolic pressures than women almost throughout life.3. 3. Comparison with population studies elsewhere leads to the conclusion that Bahamian Negroes resemble Negroes elsewhere in the Western Hemisphere and Bahamian white persons resemble white people in other geographic locations in regard to blood pressure. A particularly provocative comparison is that of Bahamian Negroes with Negroes in St. Kitts (Leeward Islands),8 since blood pressure patterns appear similar, despite high salt intake in the Bahamas and low salt intake in St. Kitts.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/32390/1/0000465.pd

Managing Big Sagebrush in a Changing Climate

This publication identifies areas where big sagebrush populations are most and least vulnerable to climate change and demonstrates where continued investment in sagebrush conservation and restoration could have the most impact

Experiencing History: A Roundtable Discussion of Architecture, Theatre, and Culture of England

This presentation features a roundtable discussion among students who traveled to England during Spring Break, March 5-11, 2022. This presentation seeks to share primary and secondary research about England’s architecture and theatre, as well as additional insights about England’s culture and history gained through first-hand experiences of traveling within the city of London and to Stonehenge and Bath