Food Allergy: Staying safe and looking ahead,
presented at the AAAAI Annual Meeting in San Diego, CA

SAN DIEGO-Parents of children with food allergies underutilize EpiPen when there is an emergency due to lack of empowerment, according to a study presented at the 2007 AAAAI Annual Meeting in San Diego, CA.

Jennifer S. Kim, Children's Memorial Hospital, Chicago, IL, and colleagues, surveyed parents of 240 children with a physician-diagnosed food allergy, an EpiPen prescribed, and living in a low-income zip code. Surveys were returned by 50% of subjects. Factors correlating with comfort included prior EpiPen administration and empowerment.

This study shows that parents of inner-city children with food allergies should be better prepared for an emergency. Increasing parental knowledge of proper EpiPen use may increase the comfort level among suburban parents. However, knowledge was not a significant contributing factor that increased comfort of EpiPen use among inner-city parents. In both urban and suburban parents, however, empowerment was a significant factor of comfort, showing that increasing empowerment in parents is an important way to increase comfort.

New research in desensitization of egg allergy
Children with egg allergy may be safely desensitized, or have a reduced sensitivity through oral desensitization therapy, according to a study presented at the 2007 AAAAI Annual Meeting in San Diego, CA.

Masayuki Akashi, National Center for Child Health and Development, Tokyo, Japan, and colleagues, aimed to investigate the efficacy and safety of oral desensitization therapy in children with egg allergy in Japan.

Thirteen children ages 4 to 8 years old, diagnosed with egg allergy were admitted to the study. Oral desensitization was performed with increasing dose of egg. Eleven of 13 children (85%) could eat 14g of egg during six month period. Two of the children tolerated 2g and 7g of egg after 6 months. This study shows that some children can be safely desensitized from egg allergy, and the others can have a reduced risk of critical allergic reaction with accidental ingestion of egg in all patients.

Predicting remission of peanut allergies in children
It is possible to predict remission of peanut allergies in children, according to a study conducted at Murdoch Children's Research Institute in Australia. Melbourne doctor, Katie J.Allen, MD, PhD will present findings of the research at the 2007 AAAAI Annual Meeting in San Diego, CA.

Dr. Allen and team identified patients with peanut sensitivity and followed them for up to 9 years to determine the clinical predictors of remission. By age 5 more than 21 % had experienced remission to peanut allergens.

Significantly, the patients who did not remit, when compared to those who remitted had a smaller peanut skin prick test wheal size at four years of age as well as a lower frequency of tree nut and sesame seed sensitization and asthma. According to Dr. Allen this shows that a fall in skin prick test wheal diameter can predict remission of peanut allergy.

Oral immunotherapy for peanut allergy in children is safe and effective
Peanut oral immunotherapy is safe and effective for decreasing the risk of a significant reaction with peanut ingestion, according to a study presented at the 2007 AAAAI Annual Meeting in San Diego, CA.

Scott David Nash, MD, Duke University Medical Center, Durham, NC, and colleagues, studied children with a clinical history of peanut allergy. These children went through three phases: a modified rush initial day of multiple doses; a build up phase of daily doses; and a daily maintenance phase of up to 18 months. An open food challenge to peanut flour was performed at the end of the study. Seven of the eight children that completed the study tolerated the maximum dose of peanut flour (7.8 g).

This study concludes that peanut oral immunotherapy is safe and effective for decreasing the risk of a significant reaction with peanut ingestion.

Children with food allergen sensitivity may have effects on lung function even after taking aeroallergen sensitization into account
Food allergen sensitization in children may affect lung function even after taking into account aeroallergen sensitization, according to a study presented at the 2007 AAAAI Annual Meeting in San Diego, CA.

Rajesh Kumar, MD, FAAAAI, Division of Allergy, Children's Memorial Hospital, Chicago, IL, and colleagues sought to determine whether food allergen sensitization in children is associated with lung function independently of aeroallergen sensitization. Researchers analyzed 919 children aged 10-17 years. Food allergen sensitization was determined by skin testing.

The study found that food allergen sensitization was associated with lower lung function in boys even after taking the effect of aeroallergen sensitization into account. However, the lower measures of lung function were not associated with airway obstruction. Along with the fact that the food allergen sensitized children had lower body mass index measurements, this finding may imply a developmental effect of food allergen sensitization on lung growth and development.

Early exposure to peanut is a risk factor for development of peanut allergy
Early exposure to low levels of peanut in human breast milk or in utero, may be a significant risk factor for the development of peanut allergy in infancy, according to a study presented at the 2007 AAAAI Annual Meeting in San Diego, CA.

Anne Des Roches, MD, Allergy Section, Hôspital Sainte-Justine, Montréal, PQ, Canada, and colleagues, analyzed the mothers of 403 infants between 1998 and 2005. The mothers underwent a detailed questionnaire about breastfeeding, maternal diet during pregnancy and breastfeeding, infant diet, environmental exposure to peanut and family atopic status.

Results of the questionnaires were then compared for age, sex, maternal age and maternal education level. Rate and duration of breastfeeding were similar in all groups, however the ingestion of peanut was clearly increased during breastfeeding and the pregnancy in the mothers. These results show that early exposure to low levels of peanut in breast milk or in utero, may be a significant factor for the development of peanut allergy in infancy.

Siblings of peanut allergic children, more likely to be allergic
Children with a peanut allergic sibling are more likely to be allergic to peanut, according to a study presented at the 2007 AAAAI Annual Meeting in San Diego, CA. Saiful Huq, University of Manitoba, Winnipeg, MB, Canada, and colleagues, studied 514 children, born in 1995 in Manitoba, Canada, who were given a questionnaire. The likelihood of peanut allergy in siblings was then determined based on parental report of allergist assessment and dispensed EpiPen.

They found that 32 (6.6%) of the children were peanut allergic. There was a total of 15 siblings with peanut allergy. Of these, 4 (8%) of the siblings had the index child with a peanut allergy and 11 (1.3%) with an index child not being peanut allergic. This concludes that children are more likely to be allergic to peanut if they have a peanut allergic sibling. Allergists should consider testing younger siblings before peanut is ingested.

These studies were presented at the 2007 Annual Meeting of the American Academy of Allergy, Asthma and Immunology (AAAAI). The AAAAI is the largest professional medical specialty organization in the United States representing allergists, asthma specialists, clinical immunologists, allied health professionals and others with special interest in the research and treatment of allergic disease.

Allergy/immunology specialists are pediatric or internal medicine physicians who have elected an additional two years of training to become specialized in the treatment of asthma, allergy and immunologic disease.

Established in 1943, the AAAAI has more than 6,000 members in the United States, Canada and 60 other countries. The AAAAI serves as an advocate for the public by providing educational information through its Web site www.aaaai.org, and its Physician Referral and Information Line at (800) 822-2762.

# # #