Peanut Allergy – New Developments

The vexing question about what to do about the alarming increase in peanut and other food allergies may have been finally answered.  The prevalence of peanut allergy tripled in the U.S. in the past decade while also rising in Africa and Asia.  It affects more than 1% of the U.S. population and is the leading cause of anaphylaxis and death from food allergy.  The American Academy of Pediatrics recommended in the year 2000, that parents refrain from feeding peanuts to children until 3 years of age hoping to reverse the trend.  However in 2008, after reviewing the published literature, the American Academy of Pediatrics retracted its recommendation, stating that there was insufficient evidence to call for early food avoidance.  Last month, (February of 2015), at the annual conference of the American Academy of Allergy, Asthma, and Immunology, the results of a landmark prospective, randomized controlled study addressing this issue were revealed and simultaneously published in the New England Journal of Medicine online.  The data strongly suggested that feeding peanut products regularly to infants with eczema, egg allergy, and a family history of food allergies from 6 months of age dramatically reduces the risk of peanut allergy, compared to children who avoided exposure to peanuts.  The differences in the two controlled groups were so stark that the guidelines are likely to be revised soon to promote early introduction of peanut products into the diets of at-risk children.

Prick skin testing with peanut extract and a blood test to measure antibodies to peanut protein are routinely employed in detecting allergic sensitivity to peanuts.  The recent availability of tests to measure antibodies to specific components of peanut proteins increased the predictability of adverse reactions on exposure to peanuts in sensitized children and adults.  These tests are also helping physicians to identify the appropriate patients and the clinical situations for in-office oral challenges with peanut products, which is the gold standard in the accurate diagnosis of peanut allergy.

In the past decade, a number of small, largely uncontrolled clinical trials have suggested that oral immunotherapy (giving children with peanut allergies increasing doses of peanut flour or peanut extract by mouth over time) can effectively desensitize many children with peanut allergy.  Although peanut oral immunotherapy shows promise, the evidence currently available on its effectiveness, risk benefit, and potential long-term consequences is insufficient to support its use in clinical practice.  Until more data is available, strict peanut avoidance is the current standard of care.

The board certified allergists/immunologists at Black & Kletz Allergy are can answer your questions and address your concerns regarding peanut allergies or any other type of allergy.  We have been serving the Washington, DC, Northern Virginia, Maryland metropolitan area for over 50 years and offer 3 convenient locations with parking.  Our office locations are in Washington, DC, McLean, VA (Tysons Corner, VA), and Manassas, VA.  Our Washington, DC and McLean, VA are accessible by the Metro.  Please call us at one of our locations to schedule an appointment or you can Request an Appointment online on our website and we will respond within 24 hours by the next business day.