TY - JOUR
T1 - Preventing Peanut Allergy
T2 - Where Are We Now?
AU - Fisher, Helen R.
AU - Keet, Corinne A.
AU - Lack, Gideon
AU - du Toit, George
N1 - Funding Information:
H. R. Fisher was funded/supported by the National Institute for Health Research (NIHR) Biomedical Research Centre based at Guy's and St Thomas’ National Health Service (NHS) Foundation Trust and King's College London and/or the NIHR Clinical Research Facility. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, or the Department of Health.Conflicts of interest: H. R. Fisher acts as a consultant for Aimmune therapeutics. C. A. Keet receives grant support from the National Institutes of Health; is on the Board of the American Board of Allergy and Immunology; and receives royalties from Up-To-Date. G. Lack reported receiving research support from the National Institute of Allergy and Infectious Diseases, Food Allergy Research and Education, MRC and Asthma UK Centre, UK Department of Health through National Institute for Health Research Biomedical Research Centre based at Guy's & St Thomas’ National Health Service Foundation Trust and King's College London, National Peanut Board, Food Standards Agency, and Action Medical Research; and has stock/stock options with DBV Technologies. G. Du Toit has received research support from the National Institute of Allergy and Infectious Diseases (supporting Learning Early About Peanuts Trio Trial, covering part salary), Food Allergy Research & Education (FARE) Grant (support of EAT-On Trial), MRC and Asthma UK Centre Contribution to King's College London Division of Asthma, Allergy & Lung Biology (of which Pediatric Allergy Research is a part), Aimmune (commercial trials, CI in UK for peanut desensitization trials, Scientific Advisory Board) and DBV (commercial trial PI, UK Scientific advisor).Disclosure of Relevant Financial Relationships with Commercial Interests: H. R. Fisher acts as a consultant for Aimmune therapeutics. C. A. Keet receives grant support from the National Institutes of Health; is on the Board of the American Board of Allergy and Immunology; and receives royalties from Up-To-Date. G. Lack reported receiving research support from the National Institute of Allergy and Infectious Diseases, Food Allergy Research and Education, MRC and Asthma UK Centre, UK Department of Health through National Institute for Health Research Biomedical Research Centre based at Guy's & St Thomas’ National Health Service Foundation Trust and King's College London, National Peanut Board, Food Standards Agency, and Action Medical Research; and has stock/stock options with DBV Technologies. G. Du Toit has received research support from the National Institute of Allergy and Infectious Diseases (supporting Learning Early About Peanuts Trio Trial, covering part salary), Food Allergy Research & Education (FARE) Grant (support of EAT-On Trial), MRC and Asthma UK Centre Contribution to King's College London Division of Asthma, Allergy & Lung Biology (of which Pediatric Allergy Research is a part), Aimmune (commercial trials, CI in UK for peanut desensitization trials, Scientific Advisory Board) and DBV (commercial trial PI, UK Scientific advisor). M. Schatz declares no relevant conflicts of interest.
Funding Information:
Conflicts of interest: H. R. Fisher acts as a consultant for Aimmune therapeutics. C. A. Keet receives grant support from the National Institutes of Health ; is on the Board of the American Board of Allergy and Immunology; and receives royalties from Up-To-Date. G. Lack reported receiving research support from the National Institute of Allergy and Infectious Diseases , Food Allergy Research and Education , MRC and Asthma UK Centre, UK Department of Health through National Institute for Health Research Biomedical Research Centre based at Guy's & St Thomas' National Health Service Foundation Trust and King's College London, National Peanut Board, Food Standards Agency, and Action Medical Research; and has stock/stock options with DBV Technologies. G. Du Toit has received research support from the National Institute of Allergy and Infectious Diseases (supporting Learning Early About Peanuts Trio Trial, covering part salary), Food Allergy Research & Education (FARE) Grant (support of EAT-On Trial), MRC and Asthma UK Centre Contribution to King's College London Division of Asthma, Allergy & Lung Biology (of which Pediatric Allergy Research is a part), Aimmune (commercial trials, CI in UK for peanut desensitization trials, Scientific Advisory Board) and DBV (commercial trial PI, UK Scientific advisor).
Funding Information:
H. R. Fisher was funded/supported by the National Institute for Health Research (NIHR) Biomedical Research Centre based at Guy's and St Thomas’ National Health Service (NHS) Foundation Trust and King's College London and/or the NIHR Clinical Research Facility. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, or the Department of Health.Conflicts of interest: H. R. Fisher acts as a consultant for Aimmune therapeutics. C. A. Keet receives grant support from the National Institutes of Health; is on the Board of the American Board of Allergy and Immunology; and receives royalties from Up-To-Date. G. Lack reported receiving research support from the National Institute of Allergy and Infectious Diseases, Food Allergy Research and Education, MRC and Asthma UK Centre, UK Department of Health through National Institute for Health Research Biomedical Research Centre based at Guy's & St Thomas’ National Health Service Foundation Trust and King's College London, National Peanut Board, Food Standards Agency, and Action Medical Research; and has stock/stock options with DBV Technologies. G. Du Toit has received research support from the National Institute of Allergy and Infectious Diseases (supporting Learning Early About Peanuts Trio Trial, covering part salary), Food Allergy Research & Education (FARE) Grant (support of EAT-On Trial), MRC and Asthma UK Centre Contribution to King's College London Division of Asthma, Allergy & Lung Biology (of which Pediatric Allergy Research is a part), Aimmune (commercial trials, CI in UK for peanut desensitization trials, Scientific Advisory Board) and DBV (commercial trial PI, UK Scientific advisor).
Publisher Copyright:
© 2018 American Academy of Allergy, Asthma & Immunology
PY - 2019/2
Y1 - 2019/2
N2 - Peanut allergy affects 1% to 3% of the Western world, usually begins in early childhood, is rarely outgrown, and has no currently approved treatment. The identification and application of prevention strategies is therefore essential. In 2015, the Learning Early About Peanuts study findings found that early consumption of peanut protein was effective in preventing peanut allergy in high-risk children as compared with peanut avoidance. These findings resulted in changes to allergy prevention guidelines and policy across the world. There are country-specific variations to guidelines, but, within these variations, feeding peanut to children in infancy is a common theme. There are numerous logistical challenges surrounding the implementation of contemporary guidelines at a population level. In the United States, guidelines advise according to risk level with prescreening recommended for high-risk children (mod/severe eczema, egg allergy). Even though high-risk children represent the minority of the childhood population, there are still significant challenges associated with identifying and screening such infants. The need for conducting allergy testing before first giving peanut protein to high-risk infants is debated; although adopting this approach promotes safety, it is financially and logistically challenging. Clinical trials that explore the real-life application of these guidelines are needed as is an assessment of guidelines (Australia, for example) that do not adopt the approach of screening.
AB - Peanut allergy affects 1% to 3% of the Western world, usually begins in early childhood, is rarely outgrown, and has no currently approved treatment. The identification and application of prevention strategies is therefore essential. In 2015, the Learning Early About Peanuts study findings found that early consumption of peanut protein was effective in preventing peanut allergy in high-risk children as compared with peanut avoidance. These findings resulted in changes to allergy prevention guidelines and policy across the world. There are country-specific variations to guidelines, but, within these variations, feeding peanut to children in infancy is a common theme. There are numerous logistical challenges surrounding the implementation of contemporary guidelines at a population level. In the United States, guidelines advise according to risk level with prescreening recommended for high-risk children (mod/severe eczema, egg allergy). Even though high-risk children represent the minority of the childhood population, there are still significant challenges associated with identifying and screening such infants. The need for conducting allergy testing before first giving peanut protein to high-risk infants is debated; although adopting this approach promotes safety, it is financially and logistically challenging. Clinical trials that explore the real-life application of these guidelines are needed as is an assessment of guidelines (Australia, for example) that do not adopt the approach of screening.
KW - Allergy prevention
KW - Children
KW - Food allergy
KW - Peanut allergy
UR - http://www.scopus.com/inward/record.url?scp=85058544286&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85058544286&partnerID=8YFLogxK
U2 - 10.1016/j.jaip.2018.11.005
DO - 10.1016/j.jaip.2018.11.005
M3 - Review article
C2 - 30717867
AN - SCOPUS:85058544286
SN - 2213-2198
VL - 7
SP - 367
EP - 373
JO - Journal of Allergy and Clinical Immunology: In Practice
JF - Journal of Allergy and Clinical Immunology: In Practice
IS - 2
ER -