Randomized Trial of Peanut Consumption in Infants at Risk for Peanut Allergy
Graham Roberts,Peter H. Sayre,Henry T. Bahnson,Suzana Radulovic,Alexandra F. Santos,Helen A. Brough,Deborah Phippard,Monica Basting,Mary Feeney,Victor Turcanu,Michelle L. Sever,Margarita Gomez Lorenzo,Marshall Plaut +12 more
TLDR
The early introduction of peanuts significantly decreased the frequency of the development of peanut allergy among children at high risk for this allergy and modulated immune responses to peanuts.Abstract:
Methods We randomly assigned 640 infants with severe eczema, egg allergy, or both to consume or avoid peanuts until 60 months of age. Participants, who were at least 4 months but younger than 11 months of age at randomization, were assigned to separate study cohorts on the basis of preexisting sensitivity to peanut extract, which was determined with the use of a skin-prick test — one consisting of participants with no measurable wheal after testing and the other consisting of those with a wheal measuring 1 to 4 mm in diameter. The primary outcome, which was assessed independently in each cohort, was the proportion of participants with peanut allergy at 60 months of age. Results Among the 530 infants in the intention-to-treat population who initially had negative results on the skin-prick test, the prevalence of peanut allergy at 60 months of age was 13.7% in the avoidance group and 1.9% in the consumption group (P<0.001). Among the 98 participants in the intention-to-treat population who initially had positive test results, the prevalence of peanut allergy was 35.3% in the avoidance group and 10.6% in the consumption group (P = 0.004). There was no significant between-group difference in the incidence of serious adverse events. Increases in levels of peanut-specific IgG4 antibody occurred predominantly in the consumption group; a greater percentage of participants in the avoidance group had elevated titers of peanut-specific IgE antibody. A larger wheal on the skin-prick test and a lower ratio of peanut-specific IgG4:IgE were associated with peanut allergy. Conclusions The early introduction of peanuts significantly decreased the frequency of the development of peanut allergy among children at high risk for this allergy and modulated immune responses to peanuts. (Funded by the National Institute of Allergy and Infectious Diseases and others; ClinicalTrials.gov number, NCT00329784.)read more
Citations
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Food allergy: A review and update on epidemiology, pathogenesis, diagnosis, prevention, and management.
TL;DR: This review provides general information to serve as a primer for those embarking on understanding food allergy and also details advances and updates in epidemiology, pathogenesis, diagnosis, and treatment that have occurred over the 4 years since the last comprehensive review.
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After asthma: redefining airways diseases
Ian D. Pavord,Richard Beasley,Alvar Agusti,Gary P. Anderson,Elisabeth H. Bel,Guy Brusselle,Guy Brusselle,Paul Cullinan,Adnan Custovic,Francine M. Ducharme,John V. Fahy,Urs Frey,Peter G. Gibson,Peter G. Gibson,Liam G Heaney,Patrick G. Holt,Marc Humbert,Marc Humbert,Clare M. Lloyd,Guy B. Marks,Fernando D. Martinez,Peter D. Sly,Erika von Mutius,Sally E. Wenzel,Heather J. Zar,Andrew Bush +25 more
TL;DR: The only way to make progress in the future is to be much more clear about the meaning of the labels used for asthma and to acknowledge the assumptions associated with them, which are believed to be the most important causes of the stagnation in key clinical outcomes observed in the past 10 years.
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Consensus-based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part I.
Andreas Wollenberg,Sébastien Barbarot,T. Bieber,Stéphanie Christen-Zaech,M. Deleuran,A. Fink-Wagner,U. Gieler,Giampiero Girolomoni,S. Lau,Antonella Muraro,Magdalena Czarnecka-Operacz,Torsten Schäfer,Peter Schmid-Grendelmeier,Dagmar Simon,Zsuzsanna Szalai,Jacek C Szepietowski,Alain Taieb,Antonio Torrelo,Thomas Werfel,J. Ring +19 more
TL;DR: This guideline was developed as a joint interdisciplinary European project, including physicians from all relevant disciplines as well as patients, and is a consensus‐based guideline, taking available evidence from other guidelines, systematic reviews and published studies into account.
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Randomized Trial of Introduction of Allergenic Foods in Breast-Fed Infants
Michael R. Perkin,Kirsty Logan,Anna Tseng,Bunmi Raji,Salma Ayis,Janet L. Peacock,Helen A. Brough,Tom Marrs,Suzana Radulovic,Joanna Craven,Carsten Flohr,Gideon Lack +11 more
TL;DR: The trial did not show the efficacy of early introduction of allergenic foods in an intention-to-treat analysis, and the consumption of 2 g per week of peanut or egg-white protein was associated with a significantly lower prevalence of these respective allergies than was less consumption.
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Complementary Feeding: A Position Paper by the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) Committee on Nutrition.
Mary Fewtrell,Jiri Bronsky,Cristina Campoy,Magnus Domellöf,Nicholas D. Embleton,Nataša Fidler Mis,Iva Hojsak,Jessie M. Hulst,Flavia Indrio,Alexandre Lapillonne,Christian Mølgaard,Christian Mølgaard +11 more
TL;DR: All infants should receive iron-rich CF including meat products and/or iron-fortified foods and no sugar or salt should be added to CF and fruit juices or sugar-sweetened beverages should be avoided.
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