Peanut Tolerance With Maintenance OIT

Researchers conducted a peanut oral immunotherapy (OIT) treatment protocol to determine the long-term therapeutic efficacy among patients who have difficulty reaching a 3,000-mg target maintenance dose of peanut protein (PP). Patients aged 6 to 19 had starting doses of 12.5 mg PP and reached maintenance doses of 1,200 mg.. The study consisted of an in-hospital initial induction-desensitization phase, in which a maximal individualized tolerated dose was determined and then consumed daily at home. Doses were gradually increased monthly for 5 months. Among participants, 91% appeared to achieve desensitization following long-term treatment with maintenance doses ranging from 600-1,500 mg.

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Protecting Against Red Meat Allergy

Previous research has shown that meats containing the antigen galactose-α-1,3-galactose (α-Gal) play a large role in red meat allergy (RMA). Since the molecular structure of α-Gal is similar to that of the B antigen, researchers hypothesized that patients who harbor the B antigen are less likely to undergo allergic sensitization to α-Gal and develop RMA. To test this, they employed a cohort of RMA patients and controls, all with known blood types, and compared expected and observed frequencies of blood types O, A, B, and AB in the two groups. Among those with RMA, the observed frequency of the B antigen (types B or AB) was markedly lower than expected (4.35% vs 20.3%,). Patients expressing the B antigen were less likely than those without the B antigen (blood types O or A) to produce α-Gal-specific immunoglobulin E (IgE) or beef-specific IgE and were 5-times less likely to have been diagnosed with RMA.

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 Preventing Childhood Asthma Exacerbations

Data on the safety and efficacy of increasing inhaled glucocorticoids at early signs of asthma exacerbation are limited in children. Researchers examined children aged 5 to 11 with mild-to-moderate asthma and at least one asthma exacerbation treated with systemic glucocorticoids in the previous year. Participants were randomized to continue the same dose (low-dose group) or a quintupled dose (high-dose group) for 7 days at the early signs of loss of asthma control. The rate of severe asthma exacerbations treated with systemic glucocorticoids did not differ significantly between groups, nor didtime to first exacerbation, treatment failure rate, symptom scores, or albuterol use during yellow-zone episodes.

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Long-Term Results from Peanut Allergy Trials

Researchers examined a group of children and teens to determine lifestyle changes after oral (OIT), oral+ omalizumab (O+OIT) and epicutaneous (EPIT) immunotherapies. Among those in the O+OIT group, 89% consumed at least 300 mg of peanuts, compared with 56% and 53% in the OIT and EPIT groups, respectively. Complete peanut avoidance occurred in 11% O+OIT patients, compared with 20% of EPIT and 22% of OIT patients. Dosing frequency varied from once per month to daily. Participants showed a high rate of anaphylaxis requiring epinephrine if they kept with the peanut challenge at home.

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Food Allergy & Pediatric Asthma Control

To study the effect of food allergy (FA) and type of food allergen on asthma related healthcare utilization in young children, researchers examined children aged12 and younger with immunoglobulin E-mediated food allergy, and matched controls. Asthma-related emergency room (ER) visit and hospitalization rates were similar between asthmatic children with and without FA. Peanuts, tree nuts, eggs, milk, and fish/shellfish were not associated with increased asthma-related ER visits or hospitalization.

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Asthma in Siblings and Risk for Childhood Asthma

To determine if having an older sibling with asthma increases one’s risk for asthma, high-risk newborns were enrolled in a study. Rates of asthma at ages 6 to 13 years were 19% to 23%, 27% to 31%, 36% to40%, and 40% to49% for children with a family history of no asthma, parental asthma, sibling asthma, or both parental and sibling asthma, respectively. Asthma in older siblings was associated with increased odds of asthma at ages 6, 8, 11, and 13 years. Parental asthma was not associated with a significant increase in risk.