oral food challenge (OFC) data to better understand clinical reactivity to a range of seeds beyond
sesame—an allergen now recognized as a major contributor to
food allergy–related reactions.
The analysis included 392 oral food challenges in 361 children, most of whom were boys and predominantly White. These challenges, performed between 2005 and 2024, covered eight seeds commonly associated with allergic responses: sesame, sunflower, mustard, flaxseed, poppy, caraway, chia, and annatto. Each OFC followed a stepwise, unblinded approach, with doses given every 20 minutes to reach an age-appropriate cumulative protein intake. Several children underwent testing for more than one seed, and a few required repeated challenges for the same seed.
According to the authors, the study’s findings indicate that elevated SPT wheal sizes and higher sIgE levels may serve as useful predictors of clinical reactivity to sesame and sunflower. “Sunflower and sesame SPTs correlated with OFC outcomes and may be reliable indicators of clinical reactivity,” the researchers noted, emphasizing their potential role in refining allergy evaluation strategies.
"However, the study’s retrospective design and the exclusion of individuals who never underwent food challenges limit its ability to estimate true seed allergy prevalence in the general pediatric population. Despite these constraints, the work contributes valuable evidence toward understanding how children respond to seed allergens and the diagnostic tools that may help guide safe dietary decisions," they concluded.
Buckey TM, Navard-Keck A, Atalla J, Samandi L, Ram G, Spergel JM, Kennedy KL. Seed Allergy Evaluation and Outcomes in a Pediatric Food Challenge Center. J Allergy Clin Immunol Pract. 2025 Oct 22:S2213-2198(25)00960-2. doi: 10.1016/j.jaip.2025.10.009. Epub ahead of print. PMID: 41135849.
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