Commentary on Japanese Pediatric Guideline for Food Allergy 2016 Chapter 7 Oral Food Challenge Test

Abstract

 The topic of oral food challenge (OFC) has been addressed in Chapter 7 of the Japanese Pediatric Guideline of Food Allergy 2016.

 In addition to detailing the guidelines, Chapter 7 defines and highlights the purpose of OFC, risk assessment, and establishment of an OFC system based on evidence. As shown in the summary, there are 5 major changes. First, the definition of OFC was updated to “OFC is a test to diagnose food allergy in suspected cases and confirm the tolerance of certain foods previously determined to be allergens by ingesting them multiple times or in a single dose”. Second, the purpose of OFC was divided into two main aspects, namely, diagnosis and confirmation of tolerance. Third, risk assessment prior to OFC was also established. Fourth, the reproducibility of the OFC results and the target dose of OFC were examined. It is also recommended that stepwise OFCs be performed regularly to ensure safety during OFC. Finally, a system for implementing OFC safely was also discussed.

 We will explain these changes and the reasons underlying them in detail.