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Di Stasio L, Tranquet O, Picariello G, Ferranti P, Morisset M, Denery-Papini S, Mamone G. Comparative analysis of eliciting capacity of raw and roasted peanuts: the role of gastrointestinal digestion. Food Res Int 2020; 127:108758. [DOI: 10.1016/j.foodres.2019.108758] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 10/09/2019] [Accepted: 10/14/2019] [Indexed: 01/06/2023]
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Scott LA, Jones BI, Berni TR, Berni ER, De Vries J, Currie CJ. Evaluation of the epidemiology of peanut allergy in the United Kingdom. Expert Rev Clin Immunol 2019; 15:1333-1339. [PMID: 31774311 DOI: 10.1080/1744666x.2020.1693264] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Aims: To describe the epidemiology of peanut allergy (PA) in the UK over the last three decades.Methods: PA patients were identified from the Clinical Practice Research Datalink between 1987 and 2015. Incidence and prevalence of PA were compared between 2000 and 2015. Prevalence and relative risk (RR) of atopic comorbidities, anaphylaxis, adrenaline prescriptions versus matched controls were calculated.Results: Point prevalence of PA in the entire population and those <18 years increased from 31 to 202 and 116 to 635 per 100,000, respectively, between 2000 and 2015. Incidence increased from 8.6 to 18.2 per 100,000. Incidence in 2015 was 105 cases per 100,000 aged 0-4 years versus 13.4 per 100,000 aged 5+ years. Anaphylactic events affected 1.2% of the cases and 0.007% of the controls. The rate of adrenaline prescriptions was 5,910 per 100,000 person-years for PA patients. RRs for asthma, eczema and allergic rhinitis in PA patients versus controls were 4.5 (95% CI 4.2-4.8), 3.2 (3.1-3.4) and 2.6 (2.4-3.0), respectively.Conclusions: The prevalence and incidence of PA increased markedly over the study period. PA was associated with atopic conditions and anaphylaxis. PA patients had increased adrenaline prescriptions.
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Affiliation(s)
| | | | | | | | - Jane De Vries
- Independent consultant to Aimmune Therapeutics Inc., London, UK
| | - Craig J Currie
- Global Epidemiology, Pharmatelligence, Cardiff, UK.,The Institute of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK
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Elegbede CF, Papadopoulos A, Just J, Moneret-Vautrin DA, Deschildre A, Crépet A. Gender, prick test size and rAra h 2 sIgE level may predict the eliciting dose in patients with peanut allergy: Evidence from the Mirabel survey. Clin Exp Allergy 2019; 49:677-689. [PMID: 30689235 DOI: 10.1111/cea.13348] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 11/30/2018] [Accepted: 12/02/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Peanut allergy management is based on active avoidance and access to emergency treatment including self-injectable adrenaline. Knowing the dose at which a patient is likely to react is crucial for risk assessment and could significantly improve management by integrating a personalized approach. OBJECTIVE To develop a threshold dose distribution curve model from routinely collected data. METHODS The MIRABEL survey is an observational study of 785 patients with peanut allergy/sensitization conducted in France, Belgium and Luxemburg. The current analysis included the 238 participants for whom medical and oral food challenge data were available. Several statistical models (Kaplan-Meier, Cox model, Weibull and Lognormal with predictive factors, basic Weibull and Lognormal) were compared to select the best model and predictive factor combination associated with the threshold doses. Inferences were made with a Bayesian approach. RESULTS Patients were mainly children (mean age: 9 years [IQR: 6-11]; 87% < 16 years) and males (62%). Median Ara h2 s IgE was of 8kUA/L [IQR: 1-55] and median skin prick test size of 10 mm [IQR: 7-13]. OFC was positive in 204 patients (86%). The median threshold dose was of 67 mg of peanut protein [IQR: 16-244]. The dose at which 1% of the patients are likely to react with objective symptoms was 0.26 [0.03; 2.24] mg of peanut protein. Gender, size of the skin prick test (SPT) and Ara h 2 specific IgE level had a significant impact on the threshold dose distribution curve. The Cox model was the most effective to predict threshold doses with this combination of factors. Girls react to lower doses than boys with a beta coefficient associated to the risk and a 95% credible interval of 0.44 [0.04; 0.77]. The higher the size of the SPT and the Ara h 2 specific IgE level are, the higher the risk of reacting to a small amount of peanut, with beta coefficients associated to the risk and 95% credible intervals of 0.05 [0.02; 0.08] and 0.01 [0.01; 0.02], respectively. CONCLUSION AND CLINICAL RELEVANCE According to the model, routinely collected data could be used to estimate the threshold dose. The consequences could be the identification of high-risk patients who are susceptible to react to small amounts of peanut and a personalized management of peanut allergy integrating the risk of allergic reaction. Limitations of this study are that assessors of OFC outcome were aware of SPT and Arah2 results, and a further validation study is required to confirm the predictive value of these parameters.
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Affiliation(s)
- Chabi Fabrice Elegbede
- French Agency for Food, Environmental and Occupational Health Safety (ANSES), Risk Assessment Department (DER), Methology and Studies Unit, Maisons-Alfort, France.,French National Institute for Agricultural Research (INRA), Paris Institute of Technology for Life, Food and Environmental Sciences (AgroParisTech), UMR Economie Publique INRA-AgroParisTech, Thiverval-Grignon, France
| | - Alexandra Papadopoulos
- French Agency for Food, Environmental and Occupational Health Safety (ANSES), Risk Assessment Department (DER), Methology and Studies Unit, Maisons-Alfort, France
| | - Jocelyne Just
- Asthma and Allergy Center, Hôpital d'Enfants Armand-Trousseau, Paris, France.,INSERM, UMR_S 1136, Sorbonne Universités, UPMC Univ Paris 06, Paris, France.,Institut Pierre Louis d'Epidémiologie et de Santé Publique, Equipe EPAR, Paris, France
| | - Denise Anne Moneret-Vautrin
- Allergy Department, Centre Hospitalier E Durckheim, Epinal, France.,Allergyvigilance Network, Vandoeuvre les Nancy, France.,Lorraine University, Nancy, France
| | - Antoine Deschildre
- Pediatric Pulmonology and Allergy Department, CHU Lille, Hôpital Jeanne de Flandre, Lille, France
| | - Amélie Crépet
- French Agency for Food, Environmental and Occupational Health Safety (ANSES), Risk Assessment Department (DER), Methology and Studies Unit, Maisons-Alfort, France
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Juesas C, Aguilar C, Vieths S. New routes of allergen immunotherapy. Allergol Immunopathol (Madr) 2017; 45 Suppl 1:39-40. [PMID: 29129404 DOI: 10.1016/j.aller.2017.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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De S Rebouças J, Irache JM, Camacho AI, Gastaminza G, Sanz ML, Ferrer M, Gamazo C. Immunogenicity of peanut proteins containing poly(anhydride) nanoparticles. Clin Vaccine Immunol 2014; 21:1106-12. [PMID: 24899075 DOI: 10.1128/CVI.00359-14] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
In the last decade, peanut allergy has increased substantially. Significant differences in the prevalence among different countries are attributed to the type of thermal processing. In spite of the high prevalence and the severe reaction induced by peanuts, there is no immunotherapy available. The aim of this work was to evaluate the potential application of poly(anhydride) nanoparticles (NPs) as immunoadjuvants for peanut oral immunotherapy. NPs loaded with raw or roasted peanut proteins were prepared by a solvent displacement method and dried by either lyophilization or spray-drying. After physicochemical characterization, their adjuvant capacity was evaluated after oral immunization of C57BL/6 mice. All nanoparticle formulations induced a balanced T(H)1 and T(H)2 antibody response, accompanied by low specific IgE induction. In addition, oral immunization with spray-dried NPs loaded with peanut proteins was associated with a significant decrease in splenic T(H)2 cytokines (interleukin 4 [IL-4], IL-5, and IL-6) and enhancement of both T(H)1 (gamma interferon [IFN-γ]) and regulatory (IL-10) cytokines. In conclusion, oral immunization with poly(anhydride) NPs, particularly spray-dried formulations, led to a pro-T(H)1 immune response.
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Kroghsbo S, Rigby NM, Johnson PE, Adel-Patient K, Bøgh KL, Salt LJ, Mills ENC, Madsen CB. Assessment of the sensitizing potential of processed peanut proteins in Brown Norway rats: roasting does not enhance allergenicity. PLoS One 2014; 9:e96475. [PMID: 24805813 PMCID: PMC4013017 DOI: 10.1371/journal.pone.0096475] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Accepted: 04/08/2014] [Indexed: 11/29/2022] Open
Abstract
Background IgE-binding of process-modified foods or proteins is the most common method for examination of how food processing affects allergenicity of food allergens. How processing affects sensitization capacity is generally studied by administration of purified food proteins or food extracts and not allergens present in their natural food matrix. Objectives The aim was to investigate if thermal processing increases sensitization potential of whole peanuts via the oral route. In parallel, the effect of heating on sensitization potential of the major peanut allergen Ara h 1 was assessed via the intraperitoneal route. Methods Sensitization potential of processed peanut products and Ara h 1 was examined in Brown Norway (BN) rats by oral administration of blanched or oil-roasted peanuts or peanut butter or by intraperitoneal immunization of purified native (N-), heated (H-) or heat glycated (G-)Ara h 1. Levels of specific IgG and IgE were determined by ELISA and IgE functionality was examined by rat basophilic leukemia (RBL) cell assay. Results In rats dosed orally, roasted peanuts induced significant higher levels of specific IgE to NAra h 1 and 2 than blanched peanuts or peanut butter but with the lowest level of RBL degranulation. However, extract from roasted peanuts was found to be a superior elicitor of RBL degranulation. Process-modified Ara h 1 had similar sensitizing capacity as NAra h 1 but specific IgE reacted more readily with process-modified Ara h 1 than with native. Conclusions Peanut products induce functional specific IgE when dosed orally to BN rats. Roasted peanuts do not have a higher sensitizing capacity than blanched peanuts. In spite of this, extract from roasted peanuts is a superior elicitor of RBL cell degranulation irrespectively of the peanut product used for sensitization. The results also suggest that new epitopes are formed or disclosed by heating Ara h 1 without glucose.
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Affiliation(s)
- Stine Kroghsbo
- National Food Institute, Technical University of Denmark, Søborg, Denmark
| | - Neil M. Rigby
- Institute of Food Research, Norwich Research Park, Colney, Norwich, United Kingdom
| | - Philip E. Johnson
- Institute of Food Research, Norwich Research Park, Colney, Norwich, United Kingdom
| | | | - Katrine L. Bøgh
- National Food Institute, Technical University of Denmark, Søborg, Denmark
| | - Louise J. Salt
- Institute of Food Research, Norwich Research Park, Colney, Norwich, United Kingdom
| | - E. N. Clare Mills
- Institute of Food Research, Norwich Research Park, Colney, Norwich, United Kingdom
| | - Charlotte B. Madsen
- National Food Institute, Technical University of Denmark, Søborg, Denmark
- * E-mail:
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Kotz D, Simpson CR, Sheikh A. Incidence, prevalence, and trends of general practitioner-recorded diagnosis of peanut allergy in England, 2001 to 2005. J Allergy Clin Immunol 2011; 127:623-30.e1. [PMID: 21236479 DOI: 10.1016/j.jaci.2010.11.021] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2010] [Revised: 09/20/2010] [Accepted: 11/05/2010] [Indexed: 11/25/2022]
Abstract
BACKGROUND Previous descriptions of the epidemiology of peanut allergy have mainly been derived from small cross-sectional studies. OBJECTIVE To interrogate a large national research database to provide estimates for the incidence, prevalence, and trends of general practitioner (GP)-recorded diagnosis of peanut allergy in the English population. METHODS Version 10 of the QRESEARCH database was used with data from 2,958,366 patients who were registered with 422 United Kingdom general practices in the years 2001 to 2005. The primary outcome was a recording of clinician-diagnosed peanut allergy. RESULTS The age-sex standardized incidence rate of peanut allergy in 2005 was 0.08 per 1000 person-years (95% CI, 0.07-0.08), and the prevalence rate was 0.51 per 1000 patients (95% CI, 0.49-0.54). This translated into an estimated 4000 incident cases (95% CI, 3500-4600) and 25,700 prevalent cases (95% CI, 24,400-27,100) of GP-recorded diagnosis of peanut allergy in England in 2005. During the study period, the incidence rate of peanut allergy remained fairly stable, whereas the prevalence rate doubled. In those under 18 years of age, the crude lifetime prevalence rate was higher in males than females. A significant inverse relationship between prevalence and socioeconomic status was found. CONCLUSION These data on GP-recorded diagnosis of peanut allergy from a large general practice database suggest a much lower prevalence in peanut allergy than has hitherto been found. This difference may in part be explained by underrecording of peanut allergy in general practice. Further research is needed to assess the true frequency of peanut allergy in the population and whether there has been a true increase in recent years.
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Affiliation(s)
- Daniel Kotz
- Department of General Practice, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Center, Maastricht, The Netherlands
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Stutius LM, Sheehan WJ, Rangsithienchai P, Bharmanee A, Scott JE, Young MC, Dioun AF, Schneider LC, Phipatanakul W. Characterizing the relationship between sesame, coconut, and nut allergy in children. Pediatr Allergy Immunol 2010; 21:1114-8. [PMID: 21073539 PMCID: PMC2987573 DOI: 10.1111/j.1399-3038.2010.00997.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Sesame and coconut are emerging food allergens in the United States. We sought to examine whether children allergic to peanuts and tree nuts are at increased risk of having an allergy to sesame or coconut. We performed a retrospective chart review of children who underwent skin prick testing (SPT) to sesame and coconut and identified 191 children who underwent SPT to sesame and 40 to coconut. Sensitization to sesame was more likely in children with positive SPT to peanuts (odds ratio [OR] = 6.7, 95% confidence interval [CI] [2.7-16.8], p < 0.001) and tree nuts (OR = 10.5, 95% CI [4.0-27.7], p < 0.001). Children with histories of both peanut and tree nut reaction were more likely to have a history of sesame reaction (OR = 10.2, 95% CI [2.7-38.7], p < 0.001). Children with sensitization or allergy to peanuts or tree nuts were not more likely to be sensitized or allergic to coconut. In conclusion, children with peanut or tree nut sensitization were more likely to be sensitized to sesame but not coconut. Children with clinical histories of both peanut and tree nut allergy were more likely to be allergic to sesame.
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Abstract
PURPOSE OF REVIEW To highlight recent advances in management of peanut allergy. RECENT FINDINGS Peanut allergy presents during early childhood. The prevalence of peanut allergy in children in developed countries appears to be increasing. Several factors, such as peanut-specific or environmental, are hypothesized as contributing to increased prevalence. However, there is no consensus on this matter. Component-related diagnostic tests are being explored to characterize clinical sensitivity. Currently, the primary treatment includes avoidance of peanut and immediate treatment of anaphylaxis. Recent peanut oral immunotherapy (OIT) trials achieved successful desensitization to peanuts in study participants, which may benefit many patients. Newer prospective studies are exploring effects of early high-dose peanut protein introduction versus avoidance in high-risk infants and development of peanut tolerance [Learning Early About Peanut Allergy (LEAP) study]. Several other immunotherapeutic approaches are being investigated in animal models. SUMMARY There is no cure for peanut allergy. Peanut oral immunotherapy offers a potential treatment for desensitization.
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Affiliation(s)
- Milind Pansare
- Division of Allergy/Immunology, Wayne State University, and Pediatric Residency Program, The Carman and Ann Adams Department of Pediatrics, Children's Hospital of Michigan, Detroit, Michigan 48201, USA.
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Abstract
BACKGROUND Peanut allergy is relatively common among children in developed countries and may have severe outcomes, including anaphylaxis. However, few data about peanut allergy in developing countries are available. Meanwhile, formulated foods with peanuts as a major ingredient are being promoted to prevent and control malnutrition in developing countries. OBJECTIVE The objectives of the paper are to review the existing epidemiologic data about peanut allergy, to determine whether the prevalence of peanut allergy is lower in developing countries, and to explore the possible reasons for onset of peanut allergy. METHODS Publications relevant to peanut allergy were searched via Pubmed, and prevalence and etiological factors of peanut allergy were reviewed. RESULTS Data about peanut allergy were scarce in most developing countries. The existing data support the conclusion that peanut allergy is not as common in developing countries as in developed countries and may not be a major concern for programs promoting formulated food containing peanuts for control of malnutrition. However, plans for treatment of individuals with peanut allergy could be incorporated into these formulated food supplementation programs. A few risk factors (late introduction of peanuts to children, peanut processing technology, non-oral peanut exposure, and maternal peanut exposure during pregnancy and lactation) have been hypothesized to be associated with peanut allergy. However, more conclusive data are needed to verify or disprove these hypotheses. CONCLUSIONS Peanut allergy is not as common in developing countries as in developed countries and may not be a major concern for programs promoting formulated food containing peanuts for control of malnutrition. However, more research about prevalence of peanut allergy is warranted in developing countries.
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Affiliation(s)
- Zhenyu Yang
- Global Alliance for Improved Nutrition (GAIN), Geneva, Switzerland.
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