Help
Subscribe


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

 24 June 2017

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

fiogf49gjkf04

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

 23 June 2017 
Treatment for KRAS wild-type advanced colorectal cancer
 23 June 2017 
Epidemiology of Hep E
 23 June 2017 
Predictive model for clinical course of Crohn's disease
 22 June 2017 
Vonoprazan-based triple therapy on H. pylori eradication
 22 June 2017 
Adolescent transition in IBD
 22 June 2017 
Patient understanding of biologic therapy in IBD
 21 June 2017 
Hydrolyzed wheat flour improves immunogenicity in celiac disease
 21 June 2017 
Statins in chronic Hep C
 21 June 2017 
Racial disparities in colorectal cancer
 20 June 2017 
Therapies in chronic pancreatitis
 20 June 2017 
Genetic analyses for malignancy detection in biliary strictures
 20 June 2017 
Viral-associated esophagus cancers
 19 June 2017 
Global prevalence of IBS in adults
 19 June 2017 
Clinical improvement in mild acute pancreatitis
 19 June 2017 
Repeat biopsy and celiac disease outcomes 
 16 June 2017 
Exercise-induced GI syndrome—implications for intestinal disease
 16 June 2017 
HCV among reproductive-aged women and children in the USA
 16 June 2017 
Adverse events after outpatient colonoscopy
 15 June 2017 
Pioglitazone for NASH
 15 June 2017 
Urinary adverse events after rectal cancer treatment
 15 June 2017 
Treatment of eosinophilic esophagitis
 14 June 2017 
Genetics of familial colorectal cancer
 14 June 2017 
Abdominal ultrasound in blunt torso trauma
 14 June 2017 
Acute kidney injury in Hep C and sofosbuvir-based regimens
 13 June 2017 
Serrated polyps in the colon and rectum
 13 June 2017 
Colorectal cancer during pregnancy
 13 June 2017 
Biomarker for penetrating Crohn's
 12 June 2017 
Course of primary sclerosing cholangitis
 12 June 2017 
Quality of life in end-stage liver disease
 12 June 2017 
Clinical remission in patients with Crohn's disease
 09 June 2017 
Socioeconomic influences on H. pylori gastritis
 09 June 2017 
Celiac disease in Ireland
 09 June 2017 
Consultants do not follow up on GI tests they recommend
 08 June 2017 
Genetics and the gut microbiota and metabolic syndrome
 08 June 2017 
Antireflux surgery in extraesophageal reflux
 08 June 2017 
Breath testing in gastrointestinal disorders
 07 June 2017 
Multidisciplinary care and liver cancer
 07 June 2017 
Model for excluding NAFLD
 07 June 2017 
Hospital readmission in IBD
 06 June 2017 
Dietary patterns and colorectal cancer risk
 06 June 2017 
Direct-acting antiviral agents for HCV
 06 June 2017 
Medical therapies for stricturing Crohn’s
 05 June 2017 
Celiac disease prevalence in the USA
 05 June 2017 
Hospital-acquired conditions in Crohn’s disease
 05 June 2017 
Depression and IBD
 02 June 2017 
Menopausal hormone therapy and fecal incontinence
 02 June 2017 
Narcotic and corticosteroid prescriptions in IBD
 02 June 2017 
Treating anemia after gastrectomy
 01 June 2017 
Infliximab and cancer in pediatric IBD
 01 June 2017 
Health insurance policies in IBD
 01 June 2017 
Endoscopic quality improvement program for polyp detection
 31 May 2017 
Probiotics and Clostridium difficile infection
 31 May 2017 
Post-procedural adverse events after colonoscopy
 31 May 2017 
Clinical decision-making in severe alcoholic hepatitis
 30 May 2017 
Waist belts and reflux
 30 May 2017 
Colorectal cancer increases in developed and developing regions
 30 May 2017 
Antidepressants and bleeding in peptic ulcers
 26 May 2017 
Accreditation program for rectal cancer
 26 May 2017 
Risk of lower GI bleeds with aspirin
 26 May 2017 
Adverse events after outpatient colonoscopy in high-risk patients

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2017 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us