Pseudoallergen-Free and Low-Histamine Diet in Adolescents With Chronic Spontaneous Urticaria (PAF-LH-CSU)
Clinical Response to a Histamine- and Pseudoallergen-Restricted Diet in Patients With Chronic Urticaria
The goal of this clinical trial is to learn whether a histamine- and pseudoallergen-restricted diet can help reduce symptoms in people with chronic urticaria. It will also learn whether this diet changes the need for urticaria medication.
The main questions it aims to answer are:
Does the diet lower urticaria activity, including hives and itching?
Does the diet improve disease control and quality of life?
Does the diet change the need for urticaria medication?
Which clinical or laboratory factors may affect response to the diet?
There is no comparison group. Researchers will compare participants' symptoms before and after the diet.
Participants will:
Follow a structured histamine- and pseudoallergen-restricted diet
Continue their usual urticaria treatment as recommended by their doctor
Record or report their urticaria symptoms during follow-up
Visit the clinic for assessment of symptoms, disease control, quality of life, medication use, and laboratory findings.
調査の概要
状態
状態
条件
条件
介入・治療
介入・治療
詳細な説明
Chronic spontaneous urticaria in children is a heterogeneous condition characterized by recurrent wheals, angioedema, or both for more than six weeks without a consistent external trigger. Although second-generation H1-antihistamines are the mainstay of treatment, disease activity may persist in some children despite standard care.
Dietary factors, including histamine-rich foods, histamine-releasing foods, and pseudoallergens such as selected additives, preservatives, colorants, and naturally occurring food components, have been proposed as potential aggravating factors in a subset of patients. However, the clinical value of dietary restriction in pediatric chronic spontaneous urticaria remains uncertain, and better evidence is needed to determine whether a time-limited dietary approach provides additional benefit.
This randomized controlled study will evaluate a structured low-histamine and pseudoallergen-free diet as an adjunct to standard guideline-based care in children with chronic spontaneous urticaria. The comparator group will receive standard care with general age-appropriate healthy eating advice, without specific restriction of histamine-rich or pseudoallergen-containing foods during the primary comparison period.
All participants will continue to receive standard clinical care according to current urticaria management principles. Antihistamine treatment will be permitted according to clinical need. The study will also explore whether baseline clinical and laboratory characteristics, including autologous serum skin test status and routine inflammatory markers, are associated with response to the dietary intervention.
Because this is a pediatric dietary study, the dietary intervention will be standardized, time-limited, and implemented with parental guidance. Unnecessary prolonged dietary restriction will be avoided.
研究の種類
研究の種類
入学 (推定)
入学
段階
段階
- 適用できない
連絡先と場所
研究場所
-
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Fatih
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Istanbul、Fatih、トルコ(Türkiye)、34100
- Istanbul University, Istanbul Faculty of Medicine, Department of Pediatric Allergy and Immunology
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参加基準
適格基準
適格基準
就学可能な年齢
- 子
- 大人
健康ボランティアの受け入れ
説明
IInclusion Criteria:
Children aged 1 to 18 years Diagnosis of chronic spontaneous urticaria Disease duration of at least 6 weeks Presence of active urticaria symptoms at enrollment Ability of the child and/or parent/caregiver to complete symptom and diet follow-up forms Ability and willingness of the family to follow the assigned dietary recommendation Written informed consent from parent or legal guardian Assent from the child when applicable
Exclusion Criteria:
Pure chronic inducible urticaria Urticaria secondary to an identified trigger IgE-mediated food allergy requiring a specific elimination diet Active infection or parasitic disease Oral corticosteroid use within the previous 4 weeks Current or recent biological treatment for chronic urticaria Coeliac disease Inflammatory bowel disease Known systemic mast cell disease Severe chronic systemic disease affecting diet, growth, or follow-up Significant malnutrition or a medical condition requiring a special diet Pregnancy or lactation in postmenarchal adolescents Inability or unwillingness of the child or family to adhere to the assigned dietary recommendation Incomplete follow-up data
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:ダブル
アーム数
武器と介入
参加者グループ / アーム参加者グループ / アーム |
介入・治療介入・治療 |
|---|---|
|
実験的:Low-histamine and pseudoallergen-free diet group
Children with chronic spontaneous urticaria assigned to this arm will receive a structured low-histamine and pseudoallergen-free diet in addition to standard guideline-based clinical care.
|
Participants assigned to the intervention group will receive a structured low-histamine and pseudoallergen-free diet for 4 weeks in addition to standard guideline-based clinical care.
The diet will restrict histamine-rich foods, foods considered to promote histamine release, and foods containing common pseudoallergen sources such as selected additives, preservatives, colorants, and naturally occurring pseudoallergen-rich foods.
Antihistamine treatment will be permitted according to clinical need.
|
|
アクティブコンパレータ:General dietary advice control group
Children with chronic spontaneous urticaria assigned to this arm will receive standard guideline-based clinical care with general age-appropriate healthy eating advice, without specific restriction of histamine-rich or pseudoallergen-containing foods during the primary comparison period.
|
Participants assigned to the control group will receive standard guideline-based clinical care together with general age-appropriate healthy eating advice.
No specific restriction of histamine-rich foods, histamine-releasing foods, or pseudoallergen-containing foods will be recommended during the primary 4-week comparison period.
Antihistamine treatment will be permitted according to clinical need.
|
この研究は何を測定していますか?
主要な結果の測定
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Change in weekly urticaria activity score
時間枠:Baseline to week 4
|
Change in weekly urticaria activity score (UAS7) from baseline to week 4 will be compared between the low-histamine and pseudoallergen-free diet group and the general healthy eating advice control group.
|
Baseline to week 4
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Change in urticaria control test score
時間枠:Baseline to week 4
|
Change in urticaria control test (UCT) score from baseline to week 4 will be compared between the low-histamine and pseudoallergen-free diet group and the general healthy eating advice control group.
|
Baseline to week 4
|
二次結果の測定
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Change in dermatology quality-of-life score
時間枠:Baseline to week 4
|
Change in age-appropriate dermatology quality-of-life score from baseline to week 4 will be compared between the low-histamine and pseudoallergen-free diet group and the general healthy eating advice control group.
|
Baseline to week 4
|
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Change in antihistamine requirement
時間枠:Baseline to week 4
|
Change in antihistamine requirement from baseline to week 4 will be compared between the two study groups.
Antihistamine use will be assessed according to the need for standard-dose or increased-dose second-generation H1-antihistamine treatment.
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Baseline to week 4
|
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Proportion of participants achieving clinical response
時間枠:Baseline to week 4
|
The proportion of participants achieving clinical response at week 4 will be compared between the two study groups.
Clinical response will be defined as at least a 50% reduction in weekly urticaria activity score from baseline to week 4.
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Baseline to week 4
|
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Dietary adherence
時間枠:Basaline to week 4.
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Adherence to the assigned dietary recommendation will be assessed during the 4-week intervention period using a dietary adherence checklist or dietary diary.
|
Basaline to week 4.
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協力者と研究者
出版物と役立つリンク
一般刊行物
- Zuberbier T, Abdul Latiff AH, Abuzakouk M, Aquilina S, Asero R, Baker D, Ballmer-Weber B, Bangert C, Ben-Shoshan M, Bernstein JA, Bindslev-Jensen C, Brockow K, Brzoza Z, Chong Neto HJ, Church MK, Criado PR, Danilycheva IV, Dressler C, Ensina LF, Fonacier L, Gaskins M, Gaspar K, Gelincik A, Gimenez-Arnau A, Godse K, Goncalo M, Grattan C, Grosber M, Hamelmann E, Hebert J, Hide M, Kaplan A, Kapp A, Kessel A, Kocaturk E, Kulthanan K, Larenas-Linnemann D, Lauerma A, Leslie TA, Magerl M, Makris M, Meshkova RY, Metz M, Micallef D, Mortz CG, Nast A, Oude-Elberink H, Pawankar R, Pigatto PD, Ratti Sisa H, Rojo Gutierrez MI, Saini SS, Schmid-Grendelmeier P, Sekerel BE, Siebenhaar F, Siiskonen H, Soria A, Staubach-Renz P, Stingeni L, Sussman G, Szegedi A, Thomsen SF, Vadasz Z, Vestergaard C, Wedi B, Zhao Z, Maurer M. The international EAACI/GA(2)LEN/EuroGuiDerm/APAAACI guideline for the definition, classification, diagnosis, and management of urticaria. Allergy. 2022 Mar;77(3):734-766. doi: 10.1111/all.15090. Epub 2021 Oct 20.
- Weller K, Groffik A, Church MK, Hawro T, Krause K, Metz M, Martus P, Casale TB, Staubach P, Maurer M. Development and validation of the Urticaria Control Test: a patient-reported outcome instrument for assessing urticaria control. J Allergy Clin Immunol. 2014 May;133(5):1365-72, 1372.e1-6. doi: 10.1016/j.jaci.2013.12.1076. Epub 2014 Feb 9.
- Mlynek A, Zalewska-Janowska A, Martus P, Staubach P, Zuberbier T, Maurer M. How to assess disease activity in patients with chronic urticaria? Allergy. 2008 Jun;63(6):777-80. doi: 10.1111/j.1398-9995.2008.01726.x.
- Magerl M, Pisarevskaja D, Scheufele R, Zuberbier T, Maurer M. Effects of a pseudoallergen-free diet on chronic spontaneous urticaria: a prospective trial. Allergy. 2010 Jan;65(1):78-83. doi: 10.1111/j.1398-9995.2009.02130.x. Epub 2009 Oct 1.
- Kapat A, Murmu R, Mandal S, Biswas K, Sarma N, Bala AK. Effect of Dietary Intervention in Paediatric Patients with Chronic Spontaneous Urticaria: Open Labelled Randomised Controlled Trial. Maedica (Bucur). 2025 Jun;20(2):275-282. doi: 10.26574/maedica.2025.20.2.275.
研究記録日
主要日程の研究
研究開始 (実際)
研究開始
一次修了 (推定)
一次修了
研究の完了 (推定)
研究の完了
試験登録日
最初に提出
最初に提出
QC基準を満たした最初の提出物
QC基準を満たした最初の提出物
最初の投稿 (実際)
最初の投稿
学習記録の更新
投稿された最後の更新 (実際)
投稿された最後の更新
QC基準を満たした最後の更新が送信されました
QC基準を満たした最後の更新が送信されました
最終確認日
最終確認日
詳しくは
本研究に関する用語
その他の研究ID番号
その他の研究ID番号
- ASST-PAF-LH-CSU-2025-3729877
- 2025-3729877 (その他の識別子:Istanbul University, Istanbul Faculty of Medicine Clinical Research Ethics Committee)
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
IPD プランの説明
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
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