Epidemiology of childhood peanut allergy

Dyer, Ashley; Rivkina, Victoria; Perumal, Dhivya; Smeltzer, Brandon M.; Smith, Bridget; Gupta, Ruchi S.

doi:10.2500/aap.2015.36.3819

Cited by 48 publications

(51 citation statements)

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“…Peanut allergy is particularly widespread in the younger population and affects almost ¼ of children with food allergy (FA) . Although PNA tends to develop in early life, it resolves in only 20% of children .…”

Section: Introductionmentioning

confidence: 99%

Peanut allergy diagnosis: Moving from basic to more elegant testing

Krogulska

Wood

2020

Pediatric Allergy Immunology

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Peanut allergy (PNA) is an IgE-mediated immune disorder, which merits particular attention due to its impact on the health and quality of life of millions of patients worldwide.Peanut allergy is particularly widespread in the younger population and affects almost ¼ of children with food allergy (FA). 1 Although PNA tends to develop in early life, it resolves in only 20% of children. 2 The overall prevalence of PNA is estimated as 0.4% in Europe and 0.6% in the United States. 3,4 The frequency of PNA by self-report is higher in the United States (1.2% to 8% of children) 5,6 than in Europe (from 0.5% to 2.5%). 3,7 Studies based on oral food challenge (OFC) have estimated the prevalence of PNA in Europe as 0.2%-1. 6%, 8,9 in Australia to be 3% at 12 months of age and 1.9% at 4 years. 10 On the basis of stringent criteria (peanut IgE > 14 kUA/L and prescribed epinephrine autoinjector), its prevalence among US school children was found to be 2%. 11Overall, the prevalence of PNA appears to be increasing, especially in developed countries. A large telephone-based survey found rates of PNA in US children rising from 0.6% in 1997 to 1.2% in 2002 and 2.1% in 2007. 2,5,6 Similar trends have been reported from the UK 8 ; however, studies from Canada 12 and a newer one from the UK suggest the prevalence has stabilized. 13 Peanut allergy also represents the most common cause of anaphylactic reactions in children, with its incidence increasing between five and sevenfold over the past 10 years. 14,15 It accounts for the majority of severe food-related allergic reactions and has the highest lifetime risk for both anaphylaxis and anaphylaxis mortalities. 16 Exposure to even trace amounts of peanut can induce a serious reaction, including anaphylactic shock.These facts result in significant effects on quality of life of patients and their families. In addition, the widespread distribution of peanuts (PN) in food products not only complicates their avoidance but also increases the risk of allergic reactions through accidental consumption. 2,16 Hence, an accurate diagnosis of PNA is vital. However, while the diagnosis is often obvious just based on the clinical history, in many cases it is far less clear given the imperfect nature of food allergy Abstract Peanut allergy (PNA) is an IgE-mediated immune disorder, which merits particular attention due to its impact on the health and quality of life of millions of patients worldwide. PNA tends to develop in early life and resolves in only 20% of peanutallergic children. It accounts for the majority of severe food-related allergic reactions.An accurate diagnosis of PNA is vital. In this review, we present the approach to the diagnosis of peanut allergy, starting from the history and proceeding to measures of overall sensitization and then to component-resolved diagnostics and oral food challenges as indicated. Additional testing in development includes basophil activation testing and determination of epitopes for peanut-allergic responses. Based on the literature, stepwise approaches and...

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Section: Introductionmentioning

confidence: 99%

Peanut allergy diagnosis: Moving from basic to more elegant testing

Krogulska

Wood

2020

Pediatric Allergy Immunology

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“…Peanut allergy is responsible for a large proportion of severe reactions to foods and, unlike milk and egg allergy, is typically life-long. 6, 7 While recent work suggests that early introduction of peanut can protect against development of peanut allergy, almost 10% of high-risk infants evaluated in the first year of life showed sensitization to peanut, rendering them ineligible for early peanut exposure. 8 Therefore, therapies for patients with established food allergies are clearly needed.…”

Section: Introductionmentioning

confidence: 99%

Omalizumab facilitates rapid oral desensitization for peanut allergy

MacGinnitie

Rachid

Gragg

et al. 2017

Journal of Allergy and Clinical Immunology

249

159

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Background Peanut oral immunotherapy (OIT) is a promising approach to peanut allergy but reactions are frequent and some patients cannot be desensitized. The anti-IgE medication omalizumab (Xolair) may allow more rapid peanut updosing and decrease reactions. Objective To evaluate if omalizumab facilitated rapid peanut desensitization in highly allergic patients. Methods Thirty-seven subjects were randomized to omalizumab (n=29) or placebo (n=8). After 12 weeks of treatment subjects underwent a rapid one-day desensitization of up to 250 mg of peanut protein, followed by weekly increases up to 2000 mg. Omalizumab was then discontinued and subjects continued on 2000 mg of peanut protein. They underwent an open challenge to 4000 mg peanut protein twelve weeks after stopping study drug. If tolerated, subjects continued on 4000 mg of peanut protein daily. Results The median peanut dose tolerated on the initial desensitization day was 250 mg for omalizumab versus 22.5 mg for placebo treated subject. Subsequently 23 of 29 (79%) subjects randomized to omalizumab tolerated 2000 mg peanut protein 6 weeks after stopping omalizumab versus 1 of 8 (12%) receiving placebo (p<0.01). Twenty-three subjects on omalizumab versus 1 on placebo passed the 4000 mg food challenge. Overall reaction rates were not significantly lower in omalizumab versus placebo treated subjects (OR=0.57 p=0.15), although omalizumab treated subjects were exposed to much higher doses of peanut. Conclusion Omalizumab allows subjects with peanut allergy to be rapidly desensitized over as little as 8 weeks of peanut OIT. In the majority of subjects, this desensitization is sustained after omalizumab is discontinued. Additional studies will help clarify which patients would benefit most from this approach.

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“…Approximately 0.6% of adults and 1e2% of children/infants in the U.S. are affected by peanut allergy (Dyer et al, 2015;Sicherer et al, 2010). Unfortunately there is no treatment currently available to cure peanut allergy and therefore, peanut-allergic patients must avoid consuming peanut.…”

Section: Introductionmentioning

confidence: 99%

Allergenicity attributes of different peanut market types

Koppelman

Jayasena

Luykx

et al. 2016

Food and Chemical Toxicology

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a b s t r a c tFour different market classes of peanut (Runner, Virginia Spanish, and Valencia) are commonly consumed in Western countries, but for some consumers peanuts are a main cause of food-induced anaphylaxis. Limited information is available on the comparative allergenicity of these distinct market classes. The aim of this study was to compare allergenicity attributes of different peanut cultivars.The protein content and protein profiles were highly comparable for all tested cultivars. All cultivar samples contained the major allergens Ara h 1, Ara h 2, Ara h 3 and Ara h 6, as assessed by SDS-PAGE and RP-HPLC, although some minor differences in major allergen content were found between samples. All samples were reactive in commercial ELISAs for detection and quantification of peanut protein. IgEbinding potency differed between samples with a maximum factor of 2, indicating a highly comparable allergenicity.Based on our observations, we conclude that peanuts from the main market types consumed in Western countries are highly comparable in their allergenicity attributes, indicating that safety considerations with regard to peanut allergy are not dependent on the peanut cultivar in question.

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Epidemiology of childhood peanut allergy

Cited by 48 publications

References 0 publications

Peanut allergy diagnosis: Moving from basic to more elegant testing

Peanut allergy diagnosis: Moving from basic to more elegant testing

Omalizumab facilitates rapid oral desensitization for peanut allergy

Allergenicity attributes of different peanut market types

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