Transepidermal Water Loss Predicts Allergic Reaction Severity - EMJ

Transepidermal Water Loss Predicts Allergic Reaction Severity

1 Mins
Allergy & Immunology

SEVERITY of reaction amongst individuals with peanut allergies has been linked to transepidermal water loss (TEWL) according to new research presented at the American Academy of Allergy, Asthma & Immunology Annual Meeting. Lead study author, George Freigeh, University of Michigan, Ann Arbor, USA, commented: “Oral food challenges (OFC) remain the gold standard for diagnosing food allergies, despite concerns over inducing anaphylaxis. So, finding ways in which oral food challenges can become more accessible and more easily done is vital.” 

The study involved 234 patients participating in OFC at the University of Michigan’s food allergy clinics, whose TEWL was measured before taking part. The mean baseline TEWL for the entire cohort was 11.93 g/m2/hr. Means also included 11.63 g/m2/hr for females and 12.06 g/m2/hr for males, which was not a significant difference, according to the researchers. Additionally, means included 12.05 g/m2/hr for White patients, 9.8 g/m2/hr for Black patients, 11.92 g/m2/hr for Hispanic patients, and 11.52 g/m2/hr for Asian patients. 

The team found that there were inverse correlations between baseline TEWL and age (r: 0.138; P=0.03), and BMI (r: 0.168; P=0.01). Of the group, 38 patients experienced a clinically defined reaction during their OFC, with no significant correlations between baseline TEWL values and greater reaction severity. The study also included 20 patients who reacted during 49 OFC for peanut. A multiple logistic regression model including TEWL, peanut wheal, and total peanut IgE found a significant positive association between baseline TEWL and reaction status (odds ratio: 1.225; P=0.03). 

Freigeh commented that, though more data is needed, this initial study may show that TEWL has the potential to serve as one piece of the overall evaluation of a patient for food challenges, making them more accessible and safe.  

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