Tree nut whole extract sensitization is common in young adults, but it is usually asymptomatic, according to a study published in Clinical and Experimental Allergy. Researchers examined the prevalence of reported symptoms and allergic sensitization to tree nuts at age 24 in the BAMSE population-based cohort study and examined early life factors associated with tree nut allergy. Data were available for 54% of the 4,089 BAMSE study participants. The prevalence of tree nut sensitization was estimated at 21.2%, and the prevalence rates of tree nut allergy symptoms and combined sensitization and symptoms were 9.8% and 7.9%, respectively. Of the sensitized individuals, 63% were asymptomatic and only 16% were storage protein sensitized. Egg allergy, eczema, and asthma at preschool age were associated with future development of tree nut symptoms and storage protein sensitization (adjusted ORs, 8.50, 2.53, and 5.59, respectively). Tree nut allergy at age 24 was associated with current eczema and markers of current asthma severity. For all tree nuts evaluated, sensitization to storage proteins was more strongly associated with symptoms than sensitization to whole extract. “Our study reveals that most extract-based tree nut-sensitized individuals do not have tree nut allergy and hence extract-based testing for tree nuts without a specific clinical suspicion should not be performed,” the lead author of the study said in a statement.

Early Moisturizer Use Does Not Reduce Overall Incidence of AD in Infants

The early use of moisturizers in at risk infants does not reduce the incidence of moderate to-severe atopic dermatitis (AD) and overall incidence of AD in infancy, according to a study published in The Australasian Journal of Dermatology. Investigators sought to compare the incidence of moderate or severe AD and total incidence of AD in a cohort of at-risk infants treated with moisturizers from the first 2 weeks of life with a similar group without moisturizers. They performed a single-center, prospective, parallel group, randomized study in infants with at least two first-degree relatives with atopy. A total of 200 participants was recruited, with 100 in each arm. Participants were randomized into either a treatment group with moisturizers or a control group without moisturizers and assessed at 2, 6, and 12 months for AD; if present, the severity was assessed using SCORAD index. The study team also compared the overall incidence of AD, trans-epidermal water loss (TEWL), stratum corneum (SC) hydration, pH, and incidence of food and environmental sensitization and allergies between both groups. Genotyping for loss-of-function mutations in the FLG gene was also conducted. The study team found no significant difference in incidence of moderate or severe AD nor in total incidence of AD at 12 months between the treatment and control groups. There was a lower mean SCORAD in the treatment group than in the control group, but no significant difference in TEWL, SC hydration, and skin pH. In addition, no significant side effects were reported