A better way to diagnose walnut and pecan allergy

Oral food challenges to diagnose food allergies are expensive, time-consuming and put the patient at risk of suffering an allergic reaction. Researchers have previously developed an algorithm that may reduce the number of oral food challenges required for diagnosis by almost 80 per cent when used in patients with suspected walnut and pecan allergy.

The algorithm uses a combination of a skin prick test, a basophil activation test (BAT), and information about a patients’ co-allergy status. It was originally tested in the 2017 NUT CRACKER study , and has now been validated in a new cohort of 120 patients with a suspected history of tree nut allergy, plus 63 patients who originally participated in NUT CRACKER.

Food allergy clinical trials are an important component of research into better diagnosis, prevention and care. When recruiting patients for clinical trials, participant inclusion criteria is often based on positive oral food challenge results. An oral food challenge may not be acceptable to all study participants, particularly those who are acutely sensitive, yet excluding participants on this basis may generate a study bias.

In the recent validation of the walnut and pecan allergy algorithm, researchers found it decreased the need for oral food challenges by 78.8 per cent, with 2.5 per cent false positives and no false negatives.

Reference: Goldberg MR, et al. 2020. Journal of Allergy and Clinical Immunology: In Practice. DOI:10.1016/j.jaip.2020.09.041.