{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T21:43:48Z","timestamp":1784324628419,"version":"3.55.0"},"reference-count":24,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T00:00:00Z","timestamp":1766016000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T00:00:00Z","timestamp":1766016000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009360","name":"King's College London","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009360","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Allergy"],"published-print":{"date-parts":[[2026,4]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Cow's milk allergy is the most common food allergy worldwide and the top cause of food anaphylaxis fatalities. Identifying patients at higher risk of severe symptoms as well as patients with a lower threshold of reactivity would improve their management. We aimed to assess the utility of putative biomarkers to identify these high\u2010risk patients.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n The severity of allergic reactions to baked milk (\n BM<\/jats:styled-content>\n ) and to fresh milk (\n FM<\/jats:styled-content>\n ) during oral food challenges (\n OFC<\/jats:styled-content>\n ) was assessed prospectively during the\n BAT2<\/jats:styled-content>\n study (\n NCT03309488<\/jats:styled-content>\n ), according to the Practall guidelines. Demographic, clinical and immunological parameters were compared between severe\/non\u2010severe and higher\/lower threshold reactors to\n BM<\/jats:styled-content>\n or\n FM<\/jats:styled-content>\n . Receiver Operating Characteristic curve analyses were performed to measure the accuracy of biomarkers with discriminative ability.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Seventy\u2010one children reacted to cow's milk: 22 (15%) to\n BM<\/jats:styled-content>\n and 49 (43%) to\n FM<\/jats:styled-content>\n . Seven (32%) and 12 (24%) reactors had severe symptoms during\n OFC<\/jats:styled-content>\n to\n BM<\/jats:styled-content>\n and\n FM<\/jats:styled-content>\n , respectively. The median cumulative dose of milk protein tolerated was 0.44\u2009g for\n BM<\/jats:styled-content>\n and 0.143\u2009g for\n FM<\/jats:styled-content>\n . The basophil activation test (\n BAT<\/jats:styled-content>\n ) was the only biomarker that could distinguish severity and threshold groups.\n BAT<\/jats:styled-content>\n optimal cut\u2010offs had 71% sensitivity and 100% specificity to identify severe reactors to\n BM<\/jats:styled-content>\n and 96% sensitivity and 41% specificity to identify children reacting to 0.143\u2009g or less of\n FM<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n BAT was the only biomarker for severity and threshold of allergic reactions to BM and FM, respectively. Once applied to clinical practice, BAT can help risk\u2010stratify cow's milk allergic patients and improve their management.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/all.70175","type":"journal-article","created":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T11:13:21Z","timestamp":1766056401000},"page":"1193-1204","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Basophil Activation Test as Biomarker of Severity and Threshold of Allergic Reactions to Cow's Milk During Oral Food Challenges"],"prefix":"10.1111","volume":"81","author":[{"given":"Holly","family":"Boyd","sequence":"first","affiliation":[{"name":"Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine King's College London London UK"},{"name":"Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences King's College London London 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