Study under review: Effect of Avoidance on Peanut Allergy after Early Peanut Consumption
Despite an increase in the number of women avoiding peanuts and other common allergy triggers during pregnancy and breastfeeding, the prevalence of peanut allergies actually increased since 1997. About 4.4 million people in the U.S. now have allergies to peanuts, and peanut allergies remain one of the deadliest food allergies.
Figure 1 shows the general mechanism for peanuts causing allergy. There are multiple potential allergenic proteins in the peanut, all denoted by ‘ara h’ (a shortened version of the scientific name for the peanut, Arachis hypogea). Ara h1-h3 are linked to more severe anaphylaxis reactions, especially Ara h2. These reactions include swelling of the face and mouth, decreased blood pressure, difficulty breathing, and cardiac arrest. Development of allergies to other Ara h proteins results in less severe symptoms, like hives, gastrointestinal distress, and an itchy mouth.
Adapted from: Burks, W. J Clin Invest. 2003 Apr 1.If you didn’t read it already, go check out “Going nuts over peanut exposure” in Study Deep Dives #7 (May 2015) - the summary discussed the results of the five-year Learning Early About Peanut Allergy (LEAP) trial. In short: infants at risk for developing peanut allergies who avoided peanut consumption were five times as likely to actually develop the allergy, compared to infants who consumed a peanut product at least three times per week. The infants who avoided peanuts also had higher levels of antigen markers that are characteristic of allergy development (IgE) and lower levels of antigen markers that are characteristic of immune tolerance (IgG4).
As noted in the previous Study Deep Dives, a planned follow-up study would continue to evaluate members of both groups of trial participants through an additional year of peanut avoidance. When the researchers conducted the original trial, they didn’t know if the four-year early exposure would turn off the allergy development, or if it had simply suppressed it during that trial period. They wanted to determine whether continuous lifelong exposure to peanuts would be required in order to maintain tolerance, or if the early exposure effects might persist - this would be important for parents to know whether they needed to continue to be vigilant about monitoring their child’s exposure or not. This study, Persistence to Oral Tolerance to Peanut (LEAP-On) reports the data of that additional follow-up year.
Peanut allergies are one of the most common causes of allergy-related deaths, predominantly due to allergies to the peanut protein Ara h2. After conducting a previous trial that evaluated peanut consumption versus peanut avoidance in the development of peanut allergies in at risk children, the researchers continued to follow participants through an additional 12-month period of peanut avoidance to determine if the effects persisted.
Other Articles in Issue #18 (April 2016)
HDL: When good cholesterol breaks bad
LDL is commonly referred to as “bad”, whereas HDL is “good”. Like many other labels, these are oversimplified, especially as HDL-raising drugs have failed. This study explores why that might be.
Interview: Aaron Blaisdell, PhD
Dr. Blaisdell heads up a cognition research lab at UCLA, and is a central figure in the movement to research links between ancestral health and modern health.
High-carb, high satiety?
A common refrain is that carbs make you gain weight, and are too easy to overconsume. Luckily, this line of thinking can be tested in a randomized trial
Does omega status depend on your genes?
Genetic data could end up rewriting some aspects of nutrition literature. This study looked at people from different locales around the world, to see if they metabolize certain fats differently depending on their genes
Does this gluten make me look fat?
Links between gluten and weight gain haven’t been seen so much in observational evidence, but that doesn’t mean they don’t exist. This animal study is one of the first to look at a potential mechanism
Interview: Paul Jaminet, PhD
Dr. Jaminet is the CEO of a promising biotech targeting solid tumors. Here, he explains the science and business behind an innovative potential therapy that targets cancer from a new angle
Add fuel to the fire … or take it away?
Competitive endurance athletes manipulate their carb intake in various ways, and those aren’t always based on evidence. A new carb-cycling strategy may help to shave off precious seconds.
Don’t drink and drive, unless it’s grape juice
Red wine may get all the attention, but grapes (and grape juice) have benefits of their own. This randomized trial tested daily grape juice intake, not just for typical cognitive tests, but also for driving performance
ALA: Alliterative (anti)Longevity Aid?
ALA is used for a variety of purposes, such as for blood sugar control and potential longevity benefits. But this new evidence plants a seed of warning for those taking ALA over long periods of time.