Analysis of Oral Food Challenge Outcomes in IgE-mediated Food Allergies to Almond in a Large Cohort.
BACKGROUND: While almond-specific IgE-mediated food allergies have traditionally been equated with other tree nut allergies, outcomes of oral food challenges to almond and the utility of clinical testing to predict IgE-mediated almond hypersensitivity is not well known. OBJECTIVE: To describe almond oral challenge outcomes and assess the predictive value of clinical testing. METHODS: 603 almond […]
First real-world safety analysis of preschool peanut oral immunotherapy.
BACKGROUND: In 2017, a clinical trial of 37 subjects demonstrated that preschool peanut oral immunotherapy (P-OIT) was safe, with predominantly mild symptoms reported and only 1 moderate reaction requiring epinephrine. OBJECTIVES: We sought to examine whether these findings would be applicable in a real-world setting. METHODS: As part of a Canada-wide quality improvement project, academic […]
Preventing peanut allergy: where are we now?
Peanut allergy affects 1% to 3% of the Western world, usually begins in early childhood, is rarely outgrown, and has no currently approved treatment. The identification and application of prevention strategies is therefore essential. In 2015, the Learning Early About Peanuts study findings found that early consumption of peanut protein was effective in preventing peanut allergy in […]
Managing Cross-Reactivity in Those with Peanut Allergy.
Peanut is an allergenic legume that can cross-react with other plant-based foods, notably other legumes and tree nuts. Peanut allergic individuals can be both co-sensitized as well as co-allergic to such items, requiring foresight when eliciting a clinical history of reaction, in the diagnostic evaluation of such allergies, and in the counseling of patients as to food […]
Long-term Outcome of Peanut Oral Immunotherapy Facilitated Initially by Omalizumab.
BACKGROUND: We successfully used omalizumab to faciliate peanut oral immunotherapy (OIT) in children with reactivity to ≤50mg peanut protein and with high peanut-IgE (median 229 kU/L). OBJECTIVE: We report on long-term OIT outcomes in these patients, including dosing changes, adverse events, peanut immunoglobulin changes and quality of life (QoL). METHODS: Patients were followed for up […]
Real World Experience With Peanut Oral Immunotherapy: Lessons Learned From 270 Patients.
BACKGROUND: Peanut allergy (PA) is a significant and increasing problem, interfering with psychological development and family life. The standard recommendation to avoid peanut products and have access to injectable epinephrine is often inadequate. Oral immunotherapy for PA has been formally studied. Clinical observations of allergen immunotherapy have repeatedly enhanced patient care. OBJECTIVE: The purpose of […]
Should Younger Siblings of Peanut Allergic Children Be Screened for Peanut Allergy?
The role of screening younger siblings of peanut allergic children with allergy testing before peanut introduction is controversial. Although certain guidelines note some value in screening this population, it is not a direct indication in the recent National Institute of Allergy and Infectious Diseases guideline. Some studies suggest that siblings of peanut allergic children are […]
Quantitative Assessment of the Safety Benefits Associated with Increasing Clinical Peanut Thresholds Through Immunotherapy.
BACKGROUND: Peanut immunotherapy studies are conducted with the aim to decrease the sensitivity of patients to peanut exposure with the outcome evaluated by testing the threshold for allergic response in a double-blind placebo-controlled food challenge. The clinical relevance of increasing this threshold is not well characterized. OBJECTIVE: We aimed to quantify the clinical benefit of […]
Association of Clinical Reactivity with Sensitization to Allergen Components in Multifood-Allergic Children.
BACKGROUND: Thirty percent of children with food allergies have multiple simultaneous allergies; however, the features of these multiple allergies are not well characterized serologically or clinically. OBJECTIVE: We comprehensively evaluated 60 multifood-allergic patients by measuring serum IgE to key allergen components, evaluating clinical histories and medication use, performing skin tests, and conducting double-blind, placebo-controlled food […]
Threshold Dose Distribution in Walnut Allergy.
BACKGROUND: In food allergy, eliciting doses (EDs) of foods on a population level can improve risk management and labeling strategies for the food industry and regulatory authorities. Previously, data available for walnut were unsuitable to determine EDs. OBJECTIVE: The objective of this study was to determine EDs for walnut allergic adults and to compare with […]