No abstract available.
Peanut Hypersensitivity

Peanut allergy is common and potentially severe. This hypersensitivity reaction starts early in childhood and continues throughout life. Dietary elimination of peanuts is mandatory when atopic dermatitis is accompanied with peanut allergy. We experienced a case of a 9-year-old female atopic dermatitis patient showing positive CAP RAST and oral food challenge test with peanuts. Her skin lesions were cleared after dietary elimination of peanuts.
Arachis ; Child ; Dermatitis, Atopic* ; Female ; Humans ; Hypersensitivity ; Peanut Hypersensitivity* ; Skin

PURPOSE: To evaluate the anti-allergic effects of intragastric treatment with various strains of lactobacillus, we undertook this study in the murine model of peanut allergy. METHODS: Ten groups of mice were sensitized and boosted with 1 mg/dose of crude peanut intragastricly at day 1, 2, 3, 7 and 21. Also, each groups of mice was treated with various strains of lactobacillus or PBS starting on the 1st day of sensitization, for 3 weeks daily. During the experiment, peanut specific serum IgE, IgG1, IgG2a were measured at weekly intervals, and compared at week four which is one week after the end of lactobacillus treatment. RESULTS: By treatment with various strains of lactobacillus, peanut specific IgE levels were decreased in all treated groups of mice compared to sham-treated mice. And at least six of the 10 groups of mice treated with various strains of L. casei or L. acidophilus showed remarkable down-regulatory effects on the production of peanut specific IgE antibodies, while the regulatory effects on specific IgG1, and IgG2a antibodies were variable. Especially, L. casei IBS041 showed harmonized regulatory effect on the productions of peanut specific IgE, IgG1 and IgG2a. CONCLUSION: We selected and partly confirmed several strains of lactobacillus which showed anti-allergic effects in the production of antigen specific IgE in the murine model of peanut allergy.
Animals ; Antibodies ; Immunoglobulin E ; Immunoglobulin G ; Lactobacillus* ; Mice ; Peanut Hypersensitivity*

Food allergies continue to increase exponentially and therapies that can modify the natural course of disease is a recent top priority of the research. IgE-mediated food allergy represents both a promising and an intriguing disease of application for allergen specific immunotherapy. In particular, oral immunotherapy (OIT) may offer a novel effective therapeutic modality for persistent and severe forms of food allergies. In such patients, avoidance of the causative foods only may be insufficient because of the risk of unplanned exposure to causative foods. In patients with cow's milk, hen's egg, and peanut allergies, several recently published studies, including meta-analysis, confirmed the overall benefit of OIT. However, the definitive evidence of efficacy and safety with long-term therapeutic or disease-modifying effects is limited. In current protocols, entry indications, and initial-escalating-maintenance doses, the form of antigens, durations, and follow-up periods await to be standardized. Most of the clinical trials of OIT demonstrate effective desensitization, but the ability for inducing long-term tolerance remains to be improved, and the ratio of risks versus benefits of OIT should be considered in detail. The ultimate goal is extending OIT to primary care practice, but at this time, OIT remains within the purview of allergy specialists in terms of associated risk-benefit ratios, related safety, and long-term tolerance induction.
Food Hypersensitivity* ; Humans ; Hypersensitivity ; Immunotherapy* ; Milk ; Ovum ; Peanut Hypersensitivity ; Primary Health Care ; Specialization

PURPOSE: The purpose of this study was to establish the diagnostic decision point (DDP) of peanut specific IgE (sIgE) for predicting the outcome of oral food challenge (OFC). We also evaluated the usefulness of sIgE to peanut components (Ara h 1, 2, 3, 8, and 9) in diagnosing peanut allergy. METHODS: Korean children aged over 12 months with a suspected peanut allergy were enrolled. Diagnosis of peanut allergy was confirmed by an open OFC or through the convincing history of anaphylaxis. Cutoff levels of sIgE to peanut and peanut components were determined by analyzing receiver operating characteristic curves. RESULTS: Forty-eight children (22 boys and 26 girls) with a suspected peanut allergy were enrolled. The previously established DDP for peanut-sIgE antibodies (14 kU/L) showed a sensitivity of 22.7%, specificity of 100%, positive predictive value (PPV) of 100%, and negative predictive value of 60.4% in our study population. The median levels of peanut-sIgE (5.4 kU/L vs 1.1 kU/L, P<0.001) and Ara h 2-sIgE (0.8 kU/L vs 0 kU/L, P<0.001) were significantly higher in the peanut allergy group than in the peanut tolerance group. The peanut-sIgE concentration indicating a PPV of 100% was 10.3 kU/L. The Ara h 2-sIgE level of 4.0 kU/L had a PPV of 100%. CONCLUSIONS: Our results showed that the cutoff levels for peanut (10.3 kU/L) and Ara h 2 (4.0 kU/L) established in this study is useful for the diagnosis of peanut allergy in Korean children.
Anaphylaxis ; Antibodies ; Child* ; Diagnosis ; Food Hypersensitivity ; Humans ; Immunoglobulin E* ; Peanut Hypersensitivity* ; ROC Curve ; Sensitivity and Specificity

Recently, the peanut allergy has been of great concern because its prevalence and life-threatening events are increasing in North America and Europe. Peanut is the most common food to cause fatal and near-fatal food allergy. The threshold of clinical reactivity can be very low. Approximately 50% of young children with egg allergy develop oral tolerance to egg by age 5 years, while about 80% of young children will react to peanuts after this age. Current treatment is strict avoidance of all peanut products and timely treatment of accidental ingestions with antihistamines and self-injectable epinephrine. Several factors of processing and cooking methods of peanut can explain the differences of the rate of peanut allergy among the countries. However, it is expected that the prevalence of peanut allergy will increase in Korea because westernized dietary pattern are getting popular. This review focuses on current understandings of peanut allergy including immunologic characteristics of peanut, diagnosis, recommendation, and recent researches for new treatment of peanut allergy.
Arachis ; Child ; Cooking ; Diagnosis ; Egg Hypersensitivity ; Epinephrine ; Europe ; Food Hypersensitivity ; Histamine Antagonists ; Humans ; Korea ; North America ; Ovum ; Peanut Hypersensitivity* ; Prevalence

Recently, the peanut allergy has been of great concern because its prevalence and life-threatening events are increasing in North America and Europe. Peanut is the most common food to cause fatal and near-fatal food allergy. The threshold of clinical reactivity can be very low. Approximately 50% of young children with egg allergy develop oral tolerance to egg by age 5 years, while about 80% of young children will react to peanuts after this age. Current treatment is strict avoidance of all peanut products and timely treatment of accidental ingestions with antihistamines and self-injectable epinephrine. Several factors of processing and cooking methods of peanut can explain the differences of the rate of peanut allergy among the countries. However, it is expected that the prevalence of peanut allergy will increase in Korea because westernized dietary pattern are getting popular. This review focuses on current understandings of peanut allergy including immunologic characteristics of peanut, diagnosis, recommendation, and recent researches for new treatment of peanut allergy.
Arachis ; Child ; Cooking ; Diagnosis ; Egg Hypersensitivity ; Epinephrine ; Europe ; Food Hypersensitivity ; Histamine Antagonists ; Humans ; Korea ; North America ; Ovum ; Peanut Hypersensitivity* ; Prevalence

PURPOSE: Clinical features of peanut allergy can range from localized to systemic reactions. Because peanut and birch pollen have cross-reactivity, peanut can lead to localized allergic reaction in Fagales pollen-sensitized oral allergy syndrome (OAS) patients without peanut sensitization per se. The purpose of this study was to discriminate true peanut food allergy from cross-reactive hypersensitivity in birch-sensitized peanut allergy. METHODS: Birch-sensitized (n=81) and peanut anaphylaxis patients (n=12) were enrolled. Peanut-related allergic reactions and sensitization profiles were examined. Specific IgE to Fagales tree pollens (birch, oak), peanut, and their component allergens (Bet v 1, Bet v 2, Ara h 1, Ara h 2, Ara h 3, Ara h 8, and Ara h 9) were evaluated. Based on these specific IgEs and clinical features, the patients were classified into 4 groups: group 1 (Fagales pollen allergy without OAS), group 2 (Fagales pollen allergy with OAS), group 3 (OAS with peanut anaphylaxis), and group 4 (peanut anaphylaxis). RESULTS: After peanut consumption, one-third of OAS patients experienced oral symptoms not associated with peanut sensitization. Ara h 1 or Ara h 2 was positive in peanut anaphylaxis patients, whereas Ara h 8 was positive in OAS patients. There were 4 patients with both peanut anaphylaxis and OAS (group 3). Both Ara h 2 and Ara h 8 were positive in these patients. Foods associated with OAS in Korea showed unique patterns compared to Westernized countries. CONCLUSIONS: Ara h 2 and Ara h 8 may be important component allergens for discriminating peanut allergy.
Allergens* ; Anaphylaxis ; Arachis* ; Betula ; Food Hypersensitivity ; Humans ; Hypersensitivity ; Immunoglobulin E ; Korea* ; Peanut Hypersensitivity* ; Pollen ; Rhinitis, Allergic, Seasonal ; Trees

BACKGROUND: In peanut and tree nut allergic children a history of anaphylaxis is associated with subsequent severe reactions. OBJECTIVE: We aimed to prospectively rechallenge peanut and tree nut allergic children with a history of mild/moderate reactions to assess their allergy over time. METHODS: In this cohort study peanut and tree nut allergic children with a history of mild/moderate reactions during a controlled oral challenge were invited to have a follow-up oral challenge to the same food at least 1 year later. RESULTS: Twenty-six children participated in the study. The mean time interval between the first and second challenge for all participants was 35.5 months. Peanut or tree nut allergy resolved in 38.5% of participants. Those with persistent peanut or tree nut allergy showed a decrease in their reaction threshold and/or increased severity in 81% of cases. There were no demographic features or skin test results that were predictive of changes in severity over time. CONCLUSION: Peanut and tree nut allergic children with a history of mild/moderate reactions who remained allergic demonstrated a high rate of more severe reactions and/or reduced thresholds upon rechallenge over a year later, however, the rate of resolution of allergy in this group may be higher than previously reported.
Anaphylaxis ; Arachis ; Child ; Cohort Studies ; Follow-Up Studies ; Humans ; Hypersensitivity ; Nut Hypersensitivity ; Nuts ; Peanut Hypersensitivity ; Prospective Studies ; Skin Tests ; Trees

PURPOSE: Peanut allergy is a major cause of fatal food-induced anaphylaxis. Cooking methods can affect the allergic properties of peanut proteins. The aim of this study was to determine the allergenicity of peanut according to cooking methods. METHODS: Eight kinds of peanut were included in the study: raw peanut, boiled peanut, roasted peanut (10 min, 20 min and 30 min), peanut butter, fried peanut and vinegarish peanut. The proteins were extracted with PBS and analyzed using the SDS-PAGE IgE immunoblot assay with pooled sera from 8 patients with atopic dermatitis. These patients had peanut- specific IgE levels greater than 15 kU/L, which were measured by the CAP-FEIA. RESULTS: The SDS-PAGE IgE immunoblot assay revealed more intense protein bands of Ara h 2 in roasted peanut and peanut butter than in raw, boiled, fried and vinegarish peanut. The protein band of Ara h 1 was not undetected in fried and vinegarish peanut. Ara h 3 had a stable band pattern in all samples, but there was the most prominent band at 37-40 kDa in vinegarish peanut. The IgE immunoblot assay revealed that 10 min roasted peanut had more IgE binding to Ara h 2, and there was no IgE binding to Ara h 1 in fried and vinegarish peanut. In vinegarish peanut, there was almost no IgE binding to it. CONCLUSION: The results of this study suggest that the roasted peanut may increase the allergenicity of Ara h 2 as compared to Ara h 1. Fried and vinegarish peanut may reduce the allergenicity of peanut.
Anaphylaxis ; Butter ; Cooking ; Dermatitis, Atopic ; Electrophoresis, Polyacrylamide Gel ; Humans ; Immunoglobulin E ; Peanut Hypersensitivity ; Proteins