Help
Subscribe


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

 28 May 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

 27 May 2016 
Hepatocellular carcinoma in chronic Hep B patients
 27 May 2016 
Obstructive sleep apnea and NASH
 27 May 2016 
Risk stratification in acute upper GI bleeding
 26 May 2016 
Education booklet for colonoscopy bowel preparation
 26 May 2016 
Uncomplicated diverticulitis in outpatients
 26 May 2016 
Direct-acting antivirals in Hep C cirrhosis
 25 May 2016 
Preventing NSAID-associated GI toxicity
 25 May 2016 
Recurrence of Barrett’s after successful endoscopic therapy
 25 May 2016 
PPIs and NSAID-induced small bowel injury
 24 May 2016 
Fecal inflammatory markers in Crohn's
 24 May 2016 
Depression and IBD recurrence
 24 May 2016 
New therapies for NASH
 23 May 2016 
Risk factors for peptic ulcer bleeding outcomes
 23 May 2016 
Liver transplantation for hepatocellular carcinoma
 23 May 2016 
Cancer after colectomy in IBD
 20 May 2016 
Biomarker for colorectal cancer diagnosis
 20 May 2016 
Prognostic score for hepatic venous outflow obstruction
 20 May 2016 
Treatment for uncomplicated acute diverticulitis
 19 May 2016 
Probiotics and H. pylori eradication
 19 May 2016 
Impaired skeletal health in atrophic gastritis
 19 May 2016 
Predicting outcome in ulcerative colitis
 18 May 2016 
Erectile dysfunction in IBD
 18 May 2016 
Acute GERD and esophageal histologic changes
 18 May 2016 
Surgical fundoplication for GERD 
 17 May 2016 
Mucosal dysbiosis in Crohn's disease
 17 May 2016 
Vitamin D level and clinical status in IBD 
 17 May 2016 
Inpatient costs for IBD and acute pancreatitis
 16 May 2016 
Outcomes of postcolonoscopy colorectal cancers
 16 May 2016 
Therapy for Crohn's in a Medicaid population
 16 May 2016 
C. difficile in ulcerative colitis patients
 13 May 2016 
Parkinson's disease and IBD
 13 May 2016 
Non-traditional heart disease risk factors in NAFLD
 13 May 2016 
Inactivated oral cholera vaccine
 12 May 2016 
Gestational diabetes mellitus and NAFLD
 12 May 2016 
Impact of Crohn's in the USA
 12 May 2016 
Ozanimod induction and ulcerative colitis
 11 May 2016 
Anti-TNF discontinuation in IBD
 11 May 2016 
Age and disease presentation with Crohn's disease
 11 May 2016 
Prognosis after colorectal cancer resection
 10 May 2016 
Gluten-free diet in patients with IBS-diarrhea
 10 May 2016 
Noninvasive test for IBD
 10 May 2016 
Digital health for gastroenterology
 09 May 2016 
Diarrheal infections in adults
 09 May 2016 
Quality improvement initiative and readmission for cirrhosis
 09 May 2016 
Coffee or tea and the risk of Barrett's
 06 May 2016 
Recurrent pancreatitis after acute pancreatitis
 06 May 2016 
Risk factors in peptic ulcer bleeding
 06 May 2016 
Managing acute lower GI bleeding
 05 May 2016 
Chemoradiotherapy vs chemotherapy for pancreatic cancer
 05 May 2016 
Genetics in early-early-onset IBD
 05 May 2016 
Reductions in quality of screening colonoscopies
 04 May 2016 
Anti-TNF therapy for IBD
 04 May 2016 
Bismuth and H. pylori eradication
 04 May 2016 
Chromoendoscopy vs colonoscopy for dysplasia in colitis
 03 May 2016 
Vedolizumab for IBD
 03 May 2016 
Surgery vs medical therapy for GERD
 03 May 2016 
PPIs and gut microbiota
 02 May 2016 
Genetic variant that increase NAFLD risk
 02 May 2016 
Resection of colorectal polyps
 02 May 2016 
Mycophenolate mofetil as first-line treatment of autoimmune hepatitis

Blackwell Publishing


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