Peanut Allergies

Almost one-third of peanut allergies, nearly all egg allergies resolve by age 6 years

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About three out of 10 peanut allergies and nine of 10 egg allergies resolved by age 6 years, although infants with early-onset severe eczema or multiple allergies were less likely to outgrow them, according to a longitudinal study.

These findings may inform the use of disease-modifying treatments such as oral immunotherapy or proactive treatment of eczema in early life, the researchers wrote in the study, which was published in The Journal of Allergy and Clinical Immunology.

29% of children with a peanut allergy and 89% of children with a raw egg allergy at age 1 year saw their allergy resolved by age 6 years.
Data were derived from Peters RL, et al. J Allergy Clin Immunol. 2022;doi:10.1016/j.jaci.2022.04.008.

“Prioritizing research of these and future interventions for infants less likely to naturally outgrow their allergy would yield the most benefit for health care resources and research funding,” Rachel L. Peters, PhD, associate professor, epidemiologist and team lead within the population allergy research group at Murdoch Children’s Research Institute, Royal Children’s Hospital, in Parkville, Victoria, Australia, said in a press release.

Rachel L. Peters

The researchers examined data from the HealthNuts population-based longitudinal study, which tracks the prevalence and natural history of allergic diseases among 5,276 children recruited at age 1 year from council-run immunizations in Melbourne, Australia, from 2007 to 2011.

Food allergy testing was performed during the 1-year visit, with follow-up oral food challenges or new testing for patients with new symptoms conducted at 2 (egg only), 4 and 6 years along with parental questionnaires.

Although 156 children had a peanut allergy at age 1 year, these allergies resolved in 29% (95% CI, 22-38) of children with definite allergy by age 6 years.

Compared with those children whose peanut allergy had resolved by age 6 years, persistent peanut allergy appeared more common among children who had early-onset severe eczema (adjusted OR = 3.23; 95% CI, 1.17-8.88), sensitization to at least one tree nut (aOR = 2.51; 95% CI, 1-6.35) and skin prick test results of 8 mm or larger (OR = 2.35; 95% CI, 1.08-5.12) at 1 year.

Among the 471 children with raw egg allergy at age 1 year, allergies resolved in 89% (95% CI, 85-92) of those with definite allergy by age 6 years.

Additionally, compared with children whose egg allergy had resolved, persistent egg allergy was more likely among children with an SPT result of 4 mm or larger (OR = 2.98; 95% CI, 1.35-6.36), peanut or sesame food sensitizations (aOR = 2.8; 95% CI, 1.11-7.03), early-onset severe eczema (aOR = 3.77; 95% CI, 1.35-10.52) and baked egg allergy (aOR = 7.41; 95% CI, 2.16-25.3) when aged 1 year.

During the time children were aged 1 to 6 years, new-onset peanut allergies developed in 0.7% (95% CI, 0.5-1.1), and new-onset raw egg allergies developed in 0.09% (95% CI, 0.03-0.3) of the children.

At age 6 years, peanut allergy — including definite, probable and possible outcomes — had an overall weighted prevalence of 3.1% (95% CI, 2.6-3.7), and egg allergy had an overall weighted prevalence of 1.2% (95% CI, 0.9-1.6).

Additionally, SPT responses at age 1 year appeared larger among children with persistent food allergy compared with those children whose allergies had resolved, although the researchers cautioned that these test results were poor predictors of predicting peanut allergy prognoses (area under the curve, 0.64; 95% CI, 0.54-0.74) and egg allergy prognoses (area under the curve, 0.68; 95% CI, 0.58-0.78) at age 6 years.

According to the researchers, this was the first study to monitor food allergy status through standardized questionnaires, SPTs and OFCs, and its results highlight how the onset of peanut allergy after age 1 year is a real and potentially increasing problem.

Further, the researchers wrote, challenges remain in predicting which patients will outgrow their allergies and when this tolerance will occur. Such information, they continued, would help clinical management, implementation of emerging therapies such as oral immunotherapy, and family counseling.

“Prioritizing research of these and future interventions for infants less likely to naturally outgrow their allergy would yield the most benefit for health care resources and research funding,” Peters said.

Reference:

Egg, Milk, And Peanut Allergies Can Be Prevented By Adding All 3 Foods To An Infant’s Diet Before Age 1

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Early introduction is the new standard for food allergy prevention.

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Food allergies are an everyday struggle for both the children who deal with them and their parents. Avoiding peanut products may not be all that difficult, but the same cannot be said for milk or eggs. Although there are treatment options available for childhood food allergies, many experts have moved toward preventing them alltogether — the standard for allergy prevention has recently shifted from delayed to early introduction of these foods.

Researchers from McMaster University in Canada presented at the American Thoracic Society’s 2016 International Conference this past week. Their findings from the Canadian Healthy Infant Longitudinal Development Study show that children who eat egg, peanut, and cow’s milk products before the age of one are less likely to become allergic to these foods.

“There’s some literature that suggests there is a critical window of development in infancy, maybe between 4 to 6 months, whereby early introduction of foods could induce tolerance instead of sensitization,” lead investigator Maxwell Tran told Medical Daily. Tran called this study “the first to determine the effects of timing of food introduction to cow’s milk products, egg, and peanut, on food sensitization at age 1 in a general population-based cohort,” in astatement.

Tran and his colleagues gathered data on 1,421 children at the ages of 3, 6, 12, 18, and 24 months old to record how long parents exclusively breastfed the kids; the diversity of foods parents introduced them to; and when eggs, peanut products, and cow’s milk products were added to their diets. Each infant underwent skin prick testing to determine whether they had developed allergies to those foods by their first birthday.

The vast majority of parents introduced cow’s milk products, often via cow’s milk-based formula, to their children before the age of 1, and 48 percent did so between 0 and 6 months. On the other hand, most parents held off on introducing eggs. Six percent of parents introduced eggs between 0 and 6 months, 76 percent between 7 and 12 months, and 19 percent after 12 months.

Overall, introducing each food product before the age of 1 was associated with a lower risk for sensitization to the corresponding food allergen. Introducing eggs during that time led to a significant drop in the odds of becoming allergic to any of the three food allergens. While less food diversity was associated with a higher risk for all allergies, exclusive breastfeeding to 6 months was only linked to cow’s milk allergies.

“It’s possible that delayed food introduction and avoidance have led to an increase in food allergies over the years,” Tran added. “But more recently, there have been plenty of observational studies and a couple of randomized controlled trials that have showed protective effects of early food introduction for allergy prevention. The results of our study definitely support that and that’s why we’re now seeing these new recommendations around the world that suggest there’s no reason to delay the introduction of foods beyond 6 months, or even 4 to 6 months.”

In spite of the many proven benefits tied to breastfeeding, evidence has shown that it can lead to the development of certain food allergies. Food proteins found in human breast milk, especially mothers with a family history of allergies, can trigger the development of food allergies. Around six million children in the United States are living with a food allergy, which is equivalent to one out of every 13 kids.

Researchers from the National Institute of Allergy and Infectious Diseases conducted a similarstudy that compared the eating habits of children from Israel, who were given peanuts at an early age, and Jewish children living in the United Kingdom, who did not eat peanuts. Introducing peanuts early in life lowered Israeli children’s risk for developing an allergy to them by 81 percent.

Before any parents go sprinkling peanuts on top of all their children’s food, the American Academy of Allergy, Asthma and Immunology recommends they check with their doctor or allergist to make sure their child is not at a higher risk. Upon receiving approval, allergenic foods should only be introduced after complementary foods and only at home as opposed to a restaurant or daycare. Parents should also gradually increase the amount of allergenic food if no allergic reaction occurs. Lastly, parents should begin introducing one new food every three to five days.

Peanut Allergies Could Be History By 2020

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People of a certain age, say over 30, probably don’t remember peanut allergies being that big of a deal back in their schooling days. Now, peanut-free lunch tables and even peanut-free schools are the norm. No more peanut butter and jelly sandwiches in the name of the greater good.

According to one study from “Food Allergy Research & Education,” the rate of peanut allergies tripled in this country between 1997 and 2008. Childhood food allergies are a nightmare for millions of parents. 1 in 13 children have some sort of food allergy and the economic cost is estimated to be $25 billion a year.

Yes, there are ways of treating an allergic reaction but they’re not pleasant and often involve an emergency room. The CDC reported in 2008 that about 300,000 such visits occur annually for children under the age of 18. So what if you simply didn’t need to worry anymore?

Dr. Pierre-Henri Benhamou of DBV Technologies, a publically traded French biopharmaceutical company, thinks his team might have a better way of dealing with such allergies. Viaskin Peanut is a patch worn by those afflicted and changed daily. The patch works by slowly releasing small amounts of peanut protein onto the skin. The immune system, which normally rejects the protein in higher doses with deadly consequences, slowly builds a tolerance eventually becoming desensitized to it completely.

DBV recently completed the largest peanut allergy test in history throughout North America and Europe. The company says Viaskin Peanut “was shown to be effective at reducing the effect of peanut allergies and allows participants to significantly increase the quantity of peanut protein they can consume.”

Despite the results of those tests and being granted “fast track status” by the FDA, Dr. Benhamou doesn’t expect the drug to come to market until 2018.The success of Viaskin Peanut has led DVB to begin experimenting with dairy allergies as well.