peanut allergy

Peanut allergy treatment ‘a success’

Doctors say a potential treatment for peanut allergy has transformed the lives of children taking part in a large clinical trial.

The 85 children had to eat peanut protein every day – initially in small doses, but ramped up during the study.

The findings, published in the Lancet, suggest 84% of allergic children could eat the equivalent of five peanuts a day after six months.

Experts have warned that the therapy is not yet ready for widespread use.

Peanuts are the most common cause of fatal allergic reactions to food.

There is no treatment so the only option for patients is to avoid them completely, leading to a lifetime of checking every food label before a meal.

The trial, at Addenbrooke’s Hospital in Cambridge, tried to train the children’s immune systems to tolerate peanut protein.

Every day they were given a peanut protein powder – starting off on a dose equivalent to one 70th of a peanut.

The theory was that patients started at the extremely low dose, well below the threshold for an allergic response.

Once a fortnight the dose was increased while the children were in hospital, in case there was an reaction, and then they continued taking the higher dose at home.

The majority of patients learned to tolerate the peanut.

Lena Barden, 11, from Histon in Cambridgeshire, said: “It meant a trip to the hospital every two weeks.

“A year later I could eat five whole peanuts with no reaction at all.

“The trial has been an experience and adventure that has changed my life and I’ve had so much fun, but I still hate peanuts!”

‘Dramatic transformation’
One of the researchers, Dr Andrew Clark, told the BBC: “It really transformed their lives dramatically; this really comes across during the trial.

“It’s a potential treatment and the next step is to make it available to patients, but there will be significant costs in providing the treatment – in the specialist centres and staff and producing the peanut to a sufficiently high standard.”

Fellow researcher Dr Pamela Ewan added: “This large study is the first of its kind in the world to have had such a positive outcome, and is an important advance in peanut allergy research.”

But she said further studies would be needed and that people should not try this on their own as this “should only be done by medical professionals in specialist settings”.

The research has been broadly welcomed by other researchers in the field, but some concerns about how any therapy could be introduced have been raised.

Caution
Prof Gideon Lack, who is running a peanut allergy trial at the Evelina Children’s Hospital in London, told the BBC: “This is a really important research step in trying to improve our management of peanut allergy, but is not yet ready for use in clinical practice.

“We need a proper risk assessment needs to be done to ensure we will not make life more dangerous for these children.

He warned that 60% of people with a peanut allergy were also allergic to other nuts so a carefree lifestyle would rarely be an option.

Prof Barry Kay, from the department of allergy and clinical immunology at Imperial College London, said: “The real issues that still remain include how long the results will last, and whether the positive effects might lead affected individuals to have a false sense of security.

“Another issue to address is whether there will be long term side-effects of repeated peanut exposure even where full allergic reaction does not occur, such as inflammation of the oesophagus.

“So, this study shows encouraging results that add to the current literature, but more studies are needed to pin down these issues before the current advice to peanut allergy sufferers, which is to avoid eating peanuts, is changed.”

Maureen Jenkins, director of clinical services at Allergy UK, said: “The fantastic results of this study exceed expectation.

“Peanut allergy is a particularly frightening food allergy, causing constant anxiety of a reaction from peanut traces.

Source: BBC news

A girl dies in Ireland after pharmacy refuses to give her EpiPen

A teenage girl has died outside a pharmacy in Ireland after a staff member refused to give her family an EpiPen to inject her for a nut allergy because she didn’t have a prescription.

Emma Sloan, 14, was out for dinner in Dublin with her family when she accidentally ingested a sauce containing nuts that she mistook for curry, the Irish Herald reported.

The teenager suffered a severe allergic reaction but was not carrying an EpiPen, which delivers a shot of adrenaline that can reverse the effects of a severe, fast-acting reaction known as anaphylactic shock.

The family went to a nearby pharmacy and pleaded for an EpiPen but Emma’s mother, Caroline Sloan, said a male staff member refused to give them one without a prescription.

“He told me I couldn’t get it without a prescription. He told me to bring her to an A&E,” she told the newspaper.
Mrs Sloan said she tried to take Emma to Temple Street Hospital, but her daughter collapsed and died on the way.
“She died on the footpath. A doctor was passing and tried to help and put her into the recovery position. Ambulance and fire brigade men worked on her. But she was gone,” Mrs Sloan told the Herald.

“My daughter died on a street corner with a crowd around her. “I’m so angry I was not given the EpiPen to inject her. I was told to bring Emma to an A&E department. Emma was allergic to nuts and was very careful. How could a peanut kill my child?
“I want to appeal to parents of children with nut allergies to make sure their child always carries an EpiPen with them.”

Regulations prohibit the dispensing of EpiPen injections without a prescription, the Irish Herald reported.
Mrs Sloan said she had gone to an all-you-can-eat Chinese buffet with Emma and her two other daughters on Wednesday evening for a family meal.

While Emma was usually extremely careful about what she ate, on this occasion she overlooked a sign that warned a sauce contained nuts, Mrs Sloan said.

“Emma has always been very careful and would check the ingredients of every chocolate bar and other foods to be sure they didn’t contain nuts,” she told the newspaper.

“She had a satay sauce. She thought it was curry sauce because it looked like curry sauce and smelled like curry. I’m not blaming the restaurant because there was a sign reading ‘nuts contained’ but it wasn’t noticed. After a while, Emma began to say, ‘I can’t breathe, I can’t breathe’.”

Police and the pharmacy regulatory body, the Pharmaceutical Society of Ireland, have launched an investigation into the girl’s death.

Source: The Sydney Morning Herald

Eating nuts during pregnancy may lower child’s chance of peanut allergy

Pregnant peanut lovers can celebrate, perhaps with a PB&J snack: A study out Monday shows an association between pregnant women who ate the most peanuts and tree nuts and children with a decreased risk of allergy.

Women had been advised to avoid peanuts and tree nuts, as well as other highly allergic foods, during pregnancy and until the child turned 3, as a way to try to reduce the chances of an allergy. But those recommendations were rescinded after researchers found that the effort didn’t work.

In the current study — from Boston Children’s Hospital and published Monday in the Journal of the American Medical Assn. Pediatrics – found that women who ate nuts more than five times a month had the lowest incidence of allergic children.

“By linking maternal peanut consumption to reduced allergy risk, we are providing new data to support the hypothesis that early allergen exposure increases tolerance and reduces risk of childhood food allergy,” Dr. Michael Young, lead author of the study, said in a statement.

Current guidelines recommend that mothers should not restrict their diets during pregnancy, but this recommendation remains a widely debated topic among food allergy experts,” Dr. Ruchi Gupta wrote in an opinion piece accompanying the study. Further research is needed, Gupta wrote, to determine why one in 13 U.S. children has a food allergy of some kind.

Despite recommendations to avoid allergens, more children were found to be allergic to nuts and other foods, with the rate tripling from 1997 to 2007. Peanut allergies affect 1% to 3% of people in most Western countries. In the U.S., it’s at 4%, the study said. The reasons are not known.

“No one can say for sure if the avoidance recommendation for peanuts was related to the rising number of peanut allergies seen in the late 1990s and early 2000s, but one thing is certain: It did not stop the increase,” Young said.

The researchers looked at data from 8,205 children, whose parents were part of the Nurses Study, a long-term health study. They found 140 cases of peanut or tree nut allergy among the children born between Jan. 1, 1990, and Dec. 31, 1994.

Animal studies have shown a protective effect of maternal exposure to allergens in foods. The human data, Young said, are not strong enough to conclude a cause and effect relationship. He said more research is needed.

Tree nuts are walnuts, almonds, pistachios, cashews, pecans, hazelnuts, macadamia nuts and Brazil nuts. Peanuts, Gupta noted, are a good source of protein, and they provide folic acid, which has the potential to prevent neural tube defects.

Of course, the researchers said, women who are themselves allergic should not eat peanuts or tree nuts.
Source: La times