Measuring water loss from the skin can predict anaphylaxis during food challenges

New research finds that measuring water loss through the skin during food challenges can predict anaphylaxis before symptoms appear, increasing patient comfort and safety. Now, the research group in Michigan hope to use skin patches to detect water loss and reduce the need for adrenaline during food challenges.

A food challenge is where patients are given increasing amounts of the food thought to cause their allergy under medical supervision, to confirm whether the food causes a reaction. Food challenges are highly accurate and are often necessary for diagnosing food allergies, but the patient may experience anaphylaxis symptoms and need to be given adrenaline. Using water loss to detect anaphylaxis before symptoms appear could make the experience more comfortable for patients, including children.

During anaphylaxis, the blood vessels dilate (widen) which increases heat and water loss from the surface of the skin (transepidermal water loss). The research group validated the use of transepidermal water loss for detecting anaphylaxis by comparing it with existing biochemical and clinical observation methods in 209 food challenges. They found that water loss correlated with biochemical markers of anaphylaxis and was detectable before clinical signs appeared.

Using a skin patch to detect water loss can be done without specialist equipment and is suitable for use in children, making it more practical than other methods.

The research group is currently recruiting participants aged six months to five years old for a pilot trial at the University of Michigan, Predicting Peanut Anaphylaxis and Reducing Epinephrine, to further study water loss to predict a serious reaction. They hope to pinpoint values that predict anaphylaxis to determine “stopping rules” for when to stop oral food challenges, reducing the need for adrenaline injections.

Read the full article in the Journal of Clinical Investigation.

*Amended on 14 November