New Research Shows Peanut Allergy May Be Prevented Early in Life

[Macabre]

Groundbreaking results of the first randomized clinical trial to prevent food allergy in a large group of high-risk infants were presented today at the annual scientific meeting of the American Academy of Allergy, Asthma & Immunology (AAAAI) in Houston. Published in the prestigious New England Journal of Medicine, researchers led by Gideon Lack, M.D., of Kings College London, found that sustained consumption of a peanut-containing snack by babies at high risk for developing peanut allergy prevented them from developing peanut allergy. Peanut consumption achieved an 86 percent reduction in peanut allergy at age 5 among children who had negative skin prick tests to peanut at study entry, and a 70 percent reduction in peanut allergy among those who were sensitized to peanut (positive skin prick test) at the beginning of the study.

The Learning Early About Peanut Allergy (LEAP) study was funded by Food Allergy Research & Education (FARE) and the National Institute of Allergy and Infectious Diseases (NIAID), part of the NIH. It was designed and conducted by the Immune Tolerance Network, a collaborative network of clinical researchers sponsored by NIAID. Read more about these critically important findings in our press release, and stay tuned to our blog for additional research updates from the AAAAI meeting.

[GoingNuts]

Hmmmm.  Does regular exposure through breast milk count?

[SilverLining]

Hmmmm.  Does regular exposure through breast milk count?

I would say no. I think sometimes the protein goes through the milk, but not always.

[Macabre]

I don't know how else DS would have gotten sensitized to peanut. He reacted upon first exposure. And he wasn't even eating it.

[LinksEtc]

I'm not going to do my usual "Tweeted by" thing b/c everybody is talking about this ...

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"Preventing Peanut Allergy through Early Consumption — Ready for Prime Time?"
Rebecca S. Gruchalla, M.D., Ph.D., and Hugh A. Sampson, M.D.
February 23, 2015
http://www.nejm.org/doi/full/10.1056/NEJMe1500186#.VOueOkbpw4E.twitter

More than 500 infants at high risk for peanut allergy were randomly assigned to receive peanut products (consumption group) or to avoid them (avoidance group). Approximately 10% of children, in whom a wheal measuring more than 4 mm developed after they received a peanut-specific skin-prick test, were excluded from the study because of concerns that they would have severe reactions. At 5 years of age, the children were given a peanut challenge to determine the prevalence of peanut allergy. The results are striking — overall, the prevalence of peanut allergy in the peanut-avoidance group was 17.2% as compared with 3.2% in the consumption group.

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http://www.leapstudy.co.uk/about-leap


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"Early Introduction of Peanut Protects Against Allergy, LEAP Study Finds"
http://allergicliving.com/2015/02/23/early-introduction-of-peanut-protects-against-allergy-leap-study-finds/

Feeding peanut to young infants with heightened allergy risk reduces the odds that a peanut allergy will develop by a remarkable 70 to 80 percent, according to findings in the landmark LEAP study, which were revealed at the AAAAI conference in Houston on Feb. 23.

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Landmark study presented at AAAAI Annual Meeting paves way for food allergy prevention
LEAP study hints at new food allergy guidelines
http://www.aaaai.org/about-the-aaaai/newsroom/news-releases/leap-study-food-allergy.aspx

"We believe the results from this trial are so compelling, and the problem of the increasing prevalence of peanut allergy so alarming that new guidelines should be forthcoming very soon," Hugh A. Sampson, MD, FAAAAI, noted in an accompanying editorial. Sampson is a past-president of AAAAI and current Director of the Jaffe Food Allergy Institute with the Icahn School of Medicine at Mount Sinai.

[hedgehog]

DS definitely reacted to breast milk.  And I was consuming peanuts on a regular basis.  When DD wanted PBJ fir lunch, it was just so easy to make two and have one myself for lunch.

[GoingNuts]

I'd say DS was reacting to PB in my breast milk as well - and he had an obvious reaction the first time he tried to eat PB.  He didn't even eat it; he just grabbed a sandwich, put it up to his mouth and before he could take a bite he had massive clown lips.  He was about 17 months old at that time.

[eragon]

http://www.bbc.co.uk/news/health-31550816

Dr Lack was my sons first allergy doctor .

[Mezzo]

So what would make a baby be identified as high-risk? If there was any family history of allergies of any kind? Wouldn't that be every baby in the US?

[Mezzo]

It says their high-risk definition was babies who themselves had eczema or egg allergy. That would be none of my kids. So under that protocol my DD wouldn't be selected to try to prevent it.

It will be interesting to see what actual guidelines come out of this. I know they got dramatic results, but can they really generalize this for use at this point?

[becca]

Well, my  economist friend posted about this on FB.  I commented, and she replied the obvious, but still good news, "Nothing works for everyone. But exposure works for more."  So, as a guideline the research was good, but there are alway outliers.

What I hate is how the media runs with this stuff, as if it is a one size fits all "cure."   

My comment in her thread was about breastfeeding, and my child being sensitized then.   

[Macabre]

Lol.

@iknowtiffany: A new study shows 99% of people will read #LEAP headlines and nothing further. #AAAAI15

[devnull]

Why do I bother to read the exclusion criteria when I know it will just make me frustrated?

[LinksEtc]

Tweeted by @AllergyKidsDoc

#LEAP results exciting but you should NOT do at home - every single participant screened with both skin test AND oral challenge #AAAAI15

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Tweeted by @iknowtiffany

Side effects of #LEAP include: blaming moms for allergies & a sudden increase in mother-in-laws giving babies peanut butter.

[devnull]

A group of kids who could eat peanut were fed peanut and continue to eat peanut.  While I understand the excitement over the results from treatment versus control on a publication standpoint the transfer to real life validity isn't overwhelming when one considers the first wave of peanut allergic kids did not under the conventional thought of the early to mid 2000s from allergy to avoid if high risk.

Meaning if ignorance of high risk avoidance existed then how did such a significant population of sensitized individuals come into being?  And what about the other 7 of the top 8?

Why do I bother.  How quickly allergists forget the blame we shouldered for NOT waiting to introduce.