Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 04 December 2016

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Development of peanut allergy and protection against peanut ingestion

Separate research teams in this week's New England Journal of Medicine address the development of peanut allergy, and the use of anti-IgE therapy to protect against unintended peanut ingestion.

News image

The prevalence of peanut allergy appears to have increased in recent decades.

However, apart from a family history of peanut allergy and the presence of atopy, there are no known risk factors.

In this study, researchers from England used data from a geographically defined cohort of 13,971 preschool children to identify those with a history of peanut allergy. The team also assessed a subgroup that reacted to a double-blind peanut challenge.

The team prospectively collected data on the whole cohort. They then collected information by interview from the parents of children with peanut reactions, and of children from 2 groups of controls.

The controls were randomly selected from the cohort, and from children whose mothers had a history of eczema and who had had eczema themselves in their first 6 months.

Development of peanut allergy was associated with the use of skin preparations containing peanut oil.
New England Journal of Medicine

Overall, 49 children had a history of peanut allergy. This was confirmed by peanut challenge in 23 of 36 children tested.

The research team found no evidence of prenatal sensitization from the maternal diet. They also determined that peanut-specific IgE was not detectable in the cord blood.

They found that peanut allergy was independently associated with intake of soy milk or soy formula (OR 2.6), rash over joints and skin creases (OR 2.6), and oozing, crusted rash (OR 5.2).

In addition, analysis of interview data showed that the use of skin preparations containing peanut oil was an independent factor in the development of peanut allergy (OR 6.8).

Dr Gideon Lack's team concluded, "Sensitization to peanut protein may occur in children through the application of peanut oil to inflamed skin".

"The association with soy protein could arise from cross-sensitization through common epitopes."

"Confirmation of these risk factors in future studies could lead to new strategies to prevent sensitization in infants who are at risk for subsequent peanut allergy."

In the same publication, a further article looks at the effect of anti-IgE therapy in patients with peanut allergy. Peanut-induced anaphylaxis is an IgE-mediated condition that is estimated to affect 1.5 million people. It causes between 50 and 100 deaths per year in the United States.

TNX-901 is a humanized IgG1 monoclonal antibody against IgE. It recognizes and masks an epitope in the CH3 region of IgE responsible for binding to the high-affinity Fcepsilon receptor on mast cells and basophils.

In this study, researchers from the United States conducted a double-blind, randomized, dose-ranging trial in 84 patients with a history of hypersensitivity to peanut.

The team confirmed hypersensitivity in all patients. They then established the threshold dose of encapsulated peanut flour using a double-blind, placebo-controlled oral food challenge.

The researchers randomly assigned patients to receive either TNX-901 (150, 300, or 450 mg) or placebo subcutaneously every 4 weeks for 4 doses.

The patients then underwent a final oral food challenge within 2 to 4 weeks after the fourth dose.

The research team determined a mean baseline threshold of sensitivity of 178 to 436 mg of peanut flour in the various groups.

They found that mean increases in the oral-food-challenge threshold were 710 mg in the placebo group, 913 mg in the 150 mg TNX-901 group, 1650 mg in the 300 mg TNX-901 group, and 2627 mg in the 450 mg TNX-901 group.

The team found that TNX-901 was well tolerated.

Dr Donald Leung's team concluded, "A 450-mg dose of TNX-901…increased the threshold of sensitivity to peanut on oral food challenge from a level equal to approximately half a peanut (178 mg) to one equal to almost 9 peanuts (2805 mg)".

This is "An effect that should translate into protection against most unintended ingestions of peanuts".

New Engl J Med 2003; 348: 977-85, 986-93
17 March 2003

Go to top of page Email this page Email this page to a colleague

 02 December 2016 
Occurrence and severity of alcoholic hepatitis
 02 December 2016 
Hep E in acute liver failure
 02 December 2016 
Food antigen in active eosinophilic esophagitis
 01 December 2016 
Iron deficiency in anemic ulcerative colitis patients
 01 December 2016 
Prognostic factors after paracetamol-induced liver failure
 01 December 2016 
Factors that influence colorectal cancer screening findings
 30 November 2016 
Certolizumab pegol in Crohn's disease
 30 November 2016 
Genetic risk of Crohn's in chronic granulomatous disease
 30 November 2016 
Rifaximin in diarrhea-predominant IBS
 29 November 2016 
Assessing liver steatosis
 29 November 2016 
Treating Zenker's diverticulum
 29 November 2016 
Colorectal cancer surveillance in ulcerative colitis
 28 November 2016 
Complications in celiac disease
 28 November 2016 
Monitoring IBD with mobile technology
 28 November 2016 
Reducing warfarin-related upper GI bleeds
 25 November 2016 
Metal vs plastic stents for pancreatic cancer surgery
 25 November 2016 
Yoga and IBS therapy 
 25 November 2016 
Colorectal cancer screening issues
 24 November 2016 
Partner burden in celiac disease
 24 November 2016 
Fusobacterium nucleatum for colorectal cancer prognosis
 24 November 2016 
PPIS and gastric cancer risk
 23 November 2016 
Diagnosing autoimmune pancreatitis
 23 November 2016 
Readmissions in cirrhosis
 23 November 2016 
Quality assurance standards for colonoscopy
 22 November 2016 
Fatigue in IBD
 22 November 2016 
PPIs and C. diff in ICU 
 22 November 2016 
Bile acid diarrhea in function bowel disorder with diarrhea
 21 November 2016 
Financial incentives and colorectal cancer screening
 21 November 2016 
Pain after endoscopic resection of gastric tumors
 21 November 2016 
Antivirals and chemotherapy in Hep C patients with cancer
 18 November 2016 
Ustekinumab in Crohn’s disease
 18 November 2016 
Colorectal cancer risk and self-reported family history
 18 November 2016 
Antivirals and chemotherapy in Hep C patients with cancer
 17 November 2016 
Liver-related specialty care in patients with Hep C
 17 November 2016 
Risk of overweight in infants
 17 November 2016 
Moderate alcohol consumption and NAFLD
 16 November 2016 
PPI therapy in liver disease
 16 November 2016 
Education in Gastroenterology fellowship
 16 November 2016 
Paternal preconceptional use of anti-TNF-α agents
 15 November 2016 
Novel treatment of NASH 
 15 November 2016 
Physician perspectives on Hep C management
 15 November 2016 
Contraceptives and ulcerative colitis
 14 November 2016 
Cardiovascular risk in NAFLD 
 14 November 2016 
Vit D and NAFLD
 14 November 2016 
Malignancy risk in IBD 
 11 November 2016 
Treatment of Hep C along with opioid agonist therapy
 11 November 2016 
Diabetes and liver cancer risk in Hep C cirrhosis
 11 November 2016 
Biomarker of cirrhosis progression
 10 November 2016 
Testosterone levels and cirrhosis outcomes in men
 10 November 2016 
Improving bowel quality before colonoscopy
 10 November 2016 
Fecal microbiota transplantation and CDI episodes
 09 November 2016 
Minimizing costs of esophagogastroduodenoscopy and colonoscopy
 09 November 2016 
Risk of TB in IBD patients receiving therapy
 09 November 2016 
Liver transplant wait-list and mortality in infants
 08 November 2016 
NSAIDS and risk of Barrett’s
 08 November 2016 
Ferritin levels and NAFLD mortality
 08 November 2016 
Alarms in the diagnosis of colorectal cancer
 07 November 2016 
BMI and fibrosis regression during Hep B
 07 November 2016 
Prognosis and biliary tract malignancies
 07 November 2016 
Post-colonoscopy colorectal cancer

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2016 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us