A rise in transepidermal water loss predicts food anaphylaxis before symptom onset

摘要: MethodsWe recruited participants from the University of Michigan Food Allergy clinics undergoing clinical OFCs. TEWL was measured at baseline and throughout OFCs. TEWL was interrogated on the volar forearm and was either spot measured using a TM Hex tewameter or measured continuously via a VT310 tewameter (Courage+ Khazaka gmbh). Allergists unaware of TEWL results conducted all OFCs and adjudicated clinical outcomes. Participants who consented gave blood before and after OFCs for biomarker analyses.ResultsSpot measured TEWL rose significantly during food anaphylaxis but did not in non-reacting OFCs (mean+ 2.93 vs-1.00 g/m 2/h, p< 0.0001, n= 76). TEWL increases occurred on average 45 minutes before clinical anaphylaxis diagnosis. Biochemical evidence of anaphylaxis was confirmed via a rise in tryptase (mean+ 1.13 vs.-0.20 ng/mL, p< 0.01) during anaphylaxis vs. non-reacting …