Beta-blocker therapy beneficial for peanut allergy
patients with heart disease
from the Journal of Allergy & Clinical Immunology

MILWAUKEE - New research shows that beta-blocker therapy should still improve the survival rate in patients who suffer from peanut allergies and have heart disease, according a study featured in the May 2004 Journal of Allergy & Clinical Immunology (JACI). The JACI is the peer-reviewed scientific journal of the American Academy of Allergy, Asthma & Immunology (AAAAI).

In heart disease patients, treatment with beta-blockers lowers the risk of subsequent heart attacks. For peanut allergy sufferers, epinephrine is the recommended treatment for severe allergic reactions. However, epinephrine may be ineffective in those patients taking beta-blockers for their heart disease.

John A. Tenbrook, Jr., MD, and colleagues from Tufts-New England Medical center in Boston and National Jewish Medical and Research Center in Denver, used a computer simulation to capture the risks of death from heart disease and from anaphylaxis for a population of 10,000 patients with heart disease and peanut allergy. They found that for peanut allergic patients who are post heart attack or who have had congestive heart failure, the heart disease benefit of beta-blockers outweighs the increased likelihood of dying from anaphylaxis.

As the prevalence of peanut allergy increases in the United States, more patients may be faced with the choice of discontinuing their beta-blocker therapy. However, findings from the JACI study provide a framework to aid clinicians and patients in the decision making process.

Common household cleaning agents successful in eliminating peanut allergen
Peanut allergen is relatively easily cleaned from hands and tabletops with common household cleaning agents and does not appear to be widely distributed in schools, according to a study featured in the May 2004 Journal of Allergy and Clinical Immunology (JACI).

Tamara T. Perry, MD, and colleagues from Johns Hopkins School of Medicine examined several factors: peanut allergen on surfaces in schools, the presence of residual peanut protein after using cleaning products, and airborne peanut protein when people were eating several forms of peanut.

Researchers found that there is a relatively low risk of exposure to peanut allergen when tables contaminated with small quantities of peanut butter are carefully cleaned with most common household cleaning products or water. Common household cleaning agents, except dishwashing liquid, easily removed peanut allergen from tabletops. Also, large amounts of peanut butter were removed from hands using liquid soap, bar soap or commercial wipes. However, researchers noted that plain water and antibacterial hand sanitizer did leave detectable peanut allergen on the hands. These cleaning methods are less than ideal and may result in contamination of other objects.

The study's findings provide a better understanding of the extent and likelihood of potential exposure to peanut allergen in various settings. Researchers conclude that there is relatively low risk of exposure to significant concentrations of the major peanut allergen when surfaces and hands are cleaned with common household cleaning agents and that school cafeteria tables and desks are not likely to be source of significant exposure for more peanut allergic patients.

The AAAAI represents allergists, asthma specialists, clinical immunologists, allied health professionals and others with a special interest in the research and treatment of allergic disease. Established in 1943, the AAAAI has more than 6,500 members in the United States, Canada and 60 other countries. The AAAAI serves as an advocate to the public by providing educational information and a physician referral directory through its Web site at www.aaaai.org.

# # #

EDITOR'S NOTE: These studies were published in the peer-reviewed, scientific journal of the American Academy of Allergy, Asthma and Immunology, but do not necessarily reflect the policies or the opinions of the AAAAI. To receive a copy of the above studies, please contact John Gardner (jgardner@aaaai.org) at (414) 272-6071. The theme of the May JACI focuses on food allergy, and features several additional articles that highlight new research into the treatment and understanding of food allergies. Visit the JACI Highlights feature on the AAAAI Web site, www.aaaai.org, for access to summaries of articles featured in the May JACI.