PRODUCTS

　This product corresponds to the “moderate” loading test of the medical guideline.

　Contains 750 mg of egg protein (Kjeldahl method).

　Equivalent to approximately 6 g of boiled egg (whole egg) boiled for 15 minutes, 4 g of hard-boiled egg white, or 1/8 of a whole egg.

　Includes egg yolk and egg white ingredients.

　This product corresponds to the “small amount” loading test in the medical guideline.

　Contains 100mg of milk protein (Kjeldahl method).

　Equivalent to 3ml of milk.

　Because it is made from skimmed milk powder, its antigenicity may be slightly lower than that of 3ml of raw cow’s milk.

　We conducted a food oral load test using the same powder as Tamakona 250 and Tamakona 750 at 4 hospitals and 3 clinics in Japan. The subjects were 252 patients with a history of egg allergy, median age 1.7 years (median, interquartile range 1.2-4.6 years), total IgE 172IU/mL (53-611), egg white specific IgE 14.3 kUA/L (4.3-33.8), obomucoid specific IgE 7.5 kUA/L (1.6-24.5). (24.5) .

　Of the 252 patients, 200 (79.3%) had negative (asymptomatic) food oral load tests with this powder. Of the 52 positive subjects, 13 (25%) had mild severity as defined by anaphylaxis guidelines, 38 (73%) had moderate severity, and 1 (2%) had severe severity. Onset of symptoms ranged from 61 minutes (25 to 102), peak from 80 minutes (20 to 138), and resolution from 120 minutes (84 to 180). Oral antihistamines were administered in 34 patients (65%), oral steroids in 15 patients (29%), and inhaled beta2-stimulants in 5 patients (10%), with no severe cases requiring intramuscular adrenaline injection.

　Of the 154 patients, 148 (96%) had negative (asymptomatic) food oral load tests with this powder. Of the 16 positive cases, 4 (25%) were mild in severity as defined by anaphylaxis guidelines, 12 (75%) were moderate, and 0 (0%) were severe. Onset of symptoms ranged from 48 minutes (28-90), peak from 65 minutes (49-100), and resolution from 133 minutes (86-153). Oral antihistamines were administered in 13 patients (81%), oral steroids in 6 patients (38%), beta2-stimulant inhalation in 4 patients (25%), and no severe cases required intramuscular adrenaline injection.

　References : Yanagida N, Sato S, Takahashi K, et.al.：J Allergy Clin Immunol Pract. 2019 Feb；7（2）：716-718.(Open Access)

　Results of a stepwise loading test in infants who had not eaten chicken eggs and who were sensitized to egg white-specific IgE were reported. Eighty-seven subjects included in the analysis were suspected of having eczema or other food allergies, so specific IgE antibody titers associated with chicken eggs were measured. The subjects were 9.9 months of age (median, same below), with a total IgE level of 101 IU/mL, egg white-specific IgE level of 18.0 kUA/L, and obomucoid-specific IgE level of 0.99 kUA/L. A small loading test with a powder equivalent to Tamakona 250 was performed, and 12 (14%) were positive and Adrenaline intramuscular injection was required for 1 patient (1.1%). A moderate-dose challenge test with a powder equivalent to Tamakona 750® was performed on 75 patients who tested negative, and 9 (12%) tested positive. A stepwise loading test on unfed and IgE-sensitized children was found to be relatively safe, with many children escaping complete elimination.

　References : Mitomori et al. Threshold and safe ingestion dose among infants sensitized to hen’s egg

　conducted on children with a history of triggering symptoms or sensitization, resulted in 53 of 563 (9.4%) and 20 of 103 (19%) positives, respectively (Yanagida et al. Timing of onset of allergic symptoms…). Similar to the above study, the triggering symptoms started to appear about 60 minutes (median) after the chicken egg powder was loaded. On the other hand, the triggering symptoms of cow’s milk powder started to appear about 30 minutes (median) after loading. It was confirmed that the test can be safely administered to children with or suspected of having chicken egg or cow’s milk allergy.

　References : Yanagida et al. Timing of onset of allergic symptoms following low-dose milk and egg challenges

　In a clinical study in which 276 subjects (median age 1.2 years, total IgE 104 IU/mL, egg white-specific IgE 14.7 kUA/L, obomucoid-specific IgE 5.3 kUA/L) were instructed to consume egg yolk splice at home with a negative tolerance test, 6 subjects (2.1%) ) only had minor triggering symptoms; 5 of the 6 patients were able to continue the egg yolk binder thereafter, and 1 patient had mild respiratory symptoms, resulting in complete elimination of the egg yolk binder. Based on the above, it is considered that egg yolk bridges can be safely consumed if the Tamakona 250® loading test is negative.

　References : Yanagida et al. Safe egg yolk consumption after a negative result for low-dose egg oral food challenge

　Study subjects Babies who had itchy eczema or atopic dermatitis from within a few months of birth and whose eczema was cured by 6 months of age with appropriate skin care and topical steroids
Egg intake method: A very small amount of heated whole egg powder for research purposes (about 0.2 g of egg, equivalent to 25 tamakona) is taken once a day from 6 months of age, and from 9 months of age, the amount is increased about 5 times (equivalent to half of 250 tamakona). Safety was confirmed by a loading test at the beginning and when increasing the amount of food. As a comparison, the same number of babies were asked to eat the powder without chicken eggs.
Results: Comparing the number of children who showed allergic reactions to the equivalent of about half a cooked whole egg at the age of 1 year, the percentage of children who showed allergic reactions was lower in the group that ate the powder (intervention group).
*In response to the publication of this study, in 2017, the Japanese Society of Pediatric Allergy issued a “Recommendation on the Prevention of the Development of Egg Allergy” and recommended that, in order to prevent the onset of egg allergy, the consumption of eggs in weaning food should not be delayed, but rather that a small amount should be started as early as possible. This information can be found on the Society’s website.
Modified from Natsume O, Kabashima S, et.al.Lancet. 2017 Jan 21;389(10066):276-286より改変