What causes a child to have a peanut allergy
Some therapeutic modalities are currently under investigation and show considerable promise. These include monoclonal anti-IgE, oral peanut desensitization and immunotherapy, Chinese herbal formulas, probiotics, and heat-killed Listeria monocytogenes (HKL).
Probiotics are bacterial components that enhance the host’s intestinal microbial balance. Kalliomaki and colleagues conducted a prospective study dividing newborn infants into two groups receiving either the probiotic Lactobacillus rhamnosus strain GG (ATCC 53103) or placebo .
At 4 years of age, there was a significant decrease in the prevalence of atopic dermatitis (AD) in the Lactobacillus treatment group, suggesting a role for probiotics in the prevention of the development of AD. However, the number of children with allergic rhinitis and asthma did not differ between the two groups, although the concentration of exhaled nitric oxide, considered a marker of bronchial inflammation, was significantly greater in children receiving placebo than in those receiving Lactobacillus.
When added in vitro, probiotics resulted in enhanced production of IFN-γ, interleukin (IL)-10, and tumour necrosis factor α. However, oral istration of probiotics to children with food allergy, some of whom were allergic to peanut, is associated with a decrease in IgE production in vitro . This may support a role for probiotics in protecting against or ameliorating the allergy to peanut, although this is still experimental.
What Are the Signs & Symptoms of a Nut Allergy?
When someone with a peanut or tree nut allergy has something with nuts in it, the body releases chemicals love histamine (pronounced: HISS-tuh-meen).
This can cause symptoms such as:
- throat tightness
- trouble breathing
- dizziness or fainting
- itchy, watery, or swollen eyes
- a drop in blood pressure
- anxiety or a feeling something bad is happening
Reactions to foods, love peanuts and tree nuts, can be diverse.
It every depends on the person — and sometimes the same person can react differently at diverse times.
In the most serious cases, a nut or peanut allergy can cause anaphylaxis (say: an-uh-fuh-LAK-sis). Anaphylaxis is a sudden, life-threatening allergic reaction. A person’s blood pressure can drop, breathing tubes can narrow, and the tongue can swell.
People at risk for this helpful of a reaction own to be extremely careful and need a plan for handling emergencies, when they might need to use special medicine to stop these symptoms from getting worse.
HKL is a potent stimulator of the innate immune system.
Yeung and colleagues found that mice immunized with keyhole-limpet hemocyanin (KLH) mixed with HKL developed a reversion of the established immune responses dominated by the production of Th2 cytokines and high levels of KLH-specific IgE . Treatment with HKL induced a Th1-type response with high levels of IFN-γ and IgG2a and low KHL levels of IgE and IL-4. These results propose that use of HKL as an adjuvant during immunization can successfully bias the development of antigen-specific cytokine synthesis toward Th1 cytokine production even in the setting of an ongoing Th2-dominated response.
Frick and colleagues found KHL subcutaneous vaccination with peanut allergen and HKL increased the threshold for peanut allergen-induced skin reactions and symptoms in peanut-allergic dogs . Similar data own not yet been developed in humans, and the safety of this approach in human remains unclear.
In July 2016, Natasha Ednan-Laperouse collapsed on a flight from London to Nice, suffering a fatal allergic reaction to a baguette bought from Pret a Manger.
At an inquest, the court heard how Natasha, who was 15 and had multiple severe food allergies, had carefully checked the ingredients on the packet. Sesame seeds – which were in the bread dough, the family later found out – were not listed. “It was their fault,” her dad Nadim said in a statement. “I was stunned that a large food company love Pret could mislabel a sandwich and this could cause my daughter to die.”
This horrifying case highlights how careful people with allergies need to be, as do the food companies – not least because allergies own been growing in prevalence in the past few decades.
“Food allergy is on the rise and has been for some time,” says Holly Shaw, nurse adviser for Allergy UK, a charity that supports people with allergies.
Children are more likely to be affected – between 6 and 8% of children are thought to own food allergies, compared with less than 3% of adults – but numbers are growing in westernised countries, as well as places such as China.
“Certainly, as a charity, we’ve seen an increase in the number of calls we get, from adults and parents of children with suspected or confirmed allergy,” says Shaw. Certain types of allergy are more common in childhood, such as cow’s milk or egg allergy but, she says: “It is possible at any point in life to develop an allergy to something previously tolerated.”
Stephen Till, professor of allergy at King’s College London and a consultant allergist at Guy’s and St Thomas’ hospital believe, says that an allergic reaction occurs when your immune system inappropriately recognises something foreign as a bug, and mounts an attack against it.
“You make antibodies which stick to your immune cells,” he says, “and when you get re-exposed at a later time to the allergen, those antibodies are already there and they trigger the immune cells to react.”
Allergies can own a huge impact on quality of life, and can, in rare cases such as that of Natasha Ednan-Laperouse, be fatal. There is no cure for a food allergy, although there has been recent promising work involving the use of probiotics and drug treatments. The first trial dedicated to treating adults with peanut allergy is just starting at Guy’s hospital.
“There is a lot of work going on in prevention to better understand the weaning process, and there’s a lot of buzz around desensitisation,” says Adam Fox, consultant paediatric allergist at Guy’s and St Thomas’ hospitals.
Desensitisation is conducted by exposing the patient to minuscule, controlled amounts of the allergen. It’s an ongoing treatment though, rather than a cure. “When they stop having it regularly, they’re allergic again, it doesn’t change the underlying process.”
What we do know is that we are more allergic than ever. “If you ponder in terms of decades, are we seeing more food allergy now than we were 20 or 30 years ago? I ponder we can confidently tell yes,” says Fox. “If you glance at the research from the 1990s and early 2000s there is beautiful excellent data that the quantity of peanut allergy trebled in a extremely short period.”
There has also been an increase in the number of people with severe reactions showing up in hospital emergency departments.
In 2015-16, 4,482 people in England were admitted to A&E for anaphylactic shock (although not every of these will own been below to food allergy). This number has been climbing each year and it’s the same across Europe, the US and Australia, says Fox.
Why is there this rise in allergies? The truth is, nobody knows. Fox doesn’t believe it is below to better diagnosis. And it won’t be below to one single thing.
There own been suggestions that it could be caused by reasons ranging from a lack of vitamin D to gut health and pollution. Weaning practices could also influence food allergy, he says. “If you introduce something much earlier into the diet, then you’re less likely to become allergic to it,” he says. A 2008 study found that the prevalence of peanut allergy in Jewish children in the UK, where the advice had been to avoid peanuts, was 10 times higher than that of children in Israel, where rates are low – there, babies are often given peanut snacks.
Should parents wean their babies earlier, and introduce foods such as peanuts?
Fox says it’s a “minefield”, but he advises sticking to the Department of Health and World Health Organization’s line that promotes exclusive breastfeeding for six months before introducing other foods, “and to not delay the introduction of allergenic foods such as peanut and egg beyond that, as this may increase the risk of allergy, particularly in kids with eczema”. (Fox says there is a direct relationship between a baby having eczema and the chances of them having a food allergy.)
The adults Till sees are those whose allergies started in childhood (people are more likely to grow out of milk or egg allergies, than peanut allergies, for instance) or those with allergy that started in adolescence or adulthood.
Again, it is not clear why you can tolerate something every your life and then develop an allergy to it. It could be to do with our changing diets in recent decades.
“The commonest new onset severe food allergy I see is to shellfish, and particularly prawns,” says Till. “It’s my own observation that the types of food we eat has changed fairly a lot in recent decades as a result of changes in the food industry and supply chain.” He says we are now eating foods such as tiger prawns that we probably didn’t eat so often in the past.
He has started to see people with an allergy to lupin flour, which comes from a legume in the same family as peanuts, which is more commonly used in continental Europe but has been increasingly used in the UK.
Sesame – thought to own been the cause of Natasha Ednan-Laperouse’s reaction – is another growing allergen, thanks to its inclusion in products that are now mainstream, such as hummus. One problem with sesame, says Till, is: “It often doesn’t show up extremely well in our tests, so it can be hard to gauge just how allergic someone is to it.”
Fox says it’s significant to stress that deaths from food allergy are still rare. “Food allergy is not the leading cause of death of people with food allergies – it’s still a extremely remote risk,” says Fox.
“But of course you don’t desire to be that one who is incredibly unlucky, so it causes grand anxiety. The genuine challenge of managing kids with food allergy is it’s really hard to predict which of the children are going to own the bad reactions, so everybody has to act as if they might be that one.”
en españolAlergia a los frutos secos y a los cacahuetes
Oh, nuts! They certain can cause you trouble if you’re allergic to them — and a growing number of kids are these days.
So what helpful of nuts are we talking about? Peanuts, for one, though they aren’t truly a nut.
They’re a legume (say: LEH-gyoom), love peas and lentils. A person also could be allergic to nuts that grow on trees, such as almonds, walnuts, pecans, cashews, hazelnuts, Brazil nuts, and pistachios.
When you ponder of allergies, you might picture lots of sneezing and runny noses. But unlike an allergy to spring flowers, a nut or peanut allergy can cause difficulty breathing and other extremely serious health problems. That’s why it’s very important for someone with a nut or peanut allergy to avoid eating nuts and peanuts, which can be tough because they’re in lots of foods.
Have an Emergency Plan
If you own a nut or peanut allergy, you and a parent should create a plan for how to handle a reaction, just in case.
That way your teachers, the school nurse, your basketball coach, your friends — everyone will know what a reaction looks love and how to respond.
To immediately treat anaphylaxis, doctors recommend that people with a nut or peanut allergy hold a shot of epinephrine (say: eh-puh-NEH-frin) with them. This helpful of epinephrine injection comes in an easy-to-carry container. You and your parent can work out whether you carry this or someone at school keeps it on hand for you. You’ll also need to identify a person who will give you the shot.
You might desire to own antihistamine medicine on hand too for mild reactions.
If anaphylaxis is happening, this medicine is never a substitute for epinephrine. After getting an epinephrine shot, you need to go to the hospital or other medical facility, where they will hold an eye on you for at least 4 hours and make certain the reaction is under control and does not come back.
What Happens With a Tree Nut or Peanut Allergy?
Your immune system normally fights infections. But when someone has a nut allergy, it overreacts to proteins in the nut. If the person eats something that contains the nut, the body thinks these proteins are harmful invaders and responds by working extremely hard to fight off the invader.
This causes an allergic reaction.
How Is a Tree Nut or Peanut Allergy Treated?
There is no special medicine for nut or peanut allergies and numerous people don’t outgrow them. The best treatment is to avoid the nut. That means not eating that nut, and also avoiding the nut when it’s mixed in foods. (Sometimes these foods don’t even taste nutty! Would you believe chili sometimes contains nuts to assist make it thicker?)
Staying safe means reading food labels and paying attention to what they tell about how the food was produced.
Some foods don’t contain nuts, but are made in factories that make other items that do contain nuts. The problem is the equipment can be used for both foods, causing "cross-contamination." That’s the same thing that happens in your own home if someone spreads peanut butter on a sandwich and dips that same knife into the jar of jelly.
After checking the ingredients list, glance on the label for phrases love these:
- "may contain tree nuts"
- "produced on shared equipment with tree nuts or peanuts"
People who are allergic to nuts also should avoid foods with these statements on the label.
Some of the highest-risk foods for people with peanut or tree nut allergy include:
- ice cream
- cookies and baked goods
- Asian and African foods
- sauces (nuts may be used to thicken dishes)
Talk to your allergist about how to stay safe in the school cafeteria. Also enquire about how you should handle other peanut encounters, love at restaurants or stadiums where people are opening peanut shells. People with nut allergies generally won’t own a reaction if they breathe in little particles.
That’s because the food generally has to be eaten to cause a reaction.
Allergic reactions are mediated by antigen-specific IgE bound to high-affinity receptors (FcεRI) on mast cells and basophils . TNX-901 is a humanized IgG1 monoclonal antibody against IgE that binds with high affinity to an epitope in the CH3 domain, masking a region responsible for binding to FcεRI. Leung and colleagues divided 84 patients with peanut allergy into four groups: a placebo arm and three athletic treatment groups receiving either 150, 300, or 450 mg of TNX-901 subcutaneously every 4 weeks for four doses .
Several weeks after completing the study, patients on the higher dose of anti-IgE therapy had a significant increase in the threshold of sensitivity to peanut by oral food challenge, from one peanut (178 mg) to almost nine peanuts (2,805 mg). Despite the short duration of the study, one would predict that indefinite istration of anti-IgE is needed to maintain a state of relative tolerance.
What Will the Doctor Do?
If your doctor thinks you might own a nut or peanut allergy, he or she will probably send you to see a doctor who specializes in allergies. The (allergy specialist) will enquire you about past reactions and how endless it takes between eating the nut or peanut and getting the symptoms, such as hives.
The allergist may also enquire whether anyone else in your family has allergies or other allergy conditions, such as eczema or asthma.
Researchers aren’t certain why some people own food allergies and others don’t, but they sometimes run in families.
The allergist may also desire to do a skin test. This is a way of seeing how your body reacts to a extremely little quantity of the nut that is giving you trouble. The allergist will use a liquid extract of the nut that seems to be causing you symptoms.
During skin testing, a little scratch on your skin is made (it will be a quick pinch, but there are no needles!).
That’s how just a little of the liquid nut gets into your skin. If you get a reddish, itchy, raised spot, it shows that you may be allergic to that food or substance.
Skin tests are the best test for food allergies, but if more information is needed, the doctor may also order a blood test. At the lab, the blood will be mixed with some of the food or substance you may be allergic to and checked for antibodies.
It’s significant to remember that even though the doctor tests for food allergies by carefully exposing you to a extremely little quantity of the food, you should not attempt this at home! The only put for an allergy test is at the allergist’s office, where they are specially trained and could give you medicine correct away if you had a reaction.
What Else Should I Know?
If you discover out you own a nut or peanut allergy, don’t be bashful about it.
It’s significant to tell your friends, family, coaches, and teachers at school. The more people who know, the better off you are because they can assist you stay away from the nut that causes you problems.
Telling the server in a restaurant is also really significant because he or she can steer you away from dishes that contain nuts. Likewise, a coach or teacher would be capable to select snacks for the group that don’t contain nuts.
It’s grand to own people love your parents, who can assist you avoid nuts, but you’ll also desire to start learning how to avoid them on your own.
Peanut Allergy: Early Exposure Is Key to Prevention
Posted on by Dr.
Credit: Thinkstock (BananaStock, Kenishirotie)
With peanut allergy on the rise in the United States, you’ve probably heard parents strategizing about ways to hold their kids from developing this potentially dangerous condition. But is it actually possible to prevent peanut allergy, and, if so, how do you go about doing it?
There’s an entirely new strategy emerging now! A group representing 26 professional organizations, advocacy groups, and federal agencies, including the National Institutes of Health (NIH), has just issued new clinical guidelines aimed at preventing peanut allergy .
The guidelines propose that parents should introduce most babies to peanut-containing foods around the time they start eating other solid foods, typically 4 to 6 months of age. While early introduction is especially significant for kids at specific risk for developing allergies, it is also recommended that high-risk infants—those with a history of severe eczema and/or egg allergy—undergo a blood or skin-prick test before being given foods containing peanuts. The test results can assist to determine how, or even if, peanuts should be introduced in the youngsters’ diets.
This recommendation is turning older guidelines on their head.
In the past, pediatricians often advised parents to delay introducing peanuts and other common causes of food allergies into their kids’ diets. But in 2010, the thinking began shifting when a panel of food allergy experts concluded insufficient evidence existed to show that delaying the introduction of potentially problematic foods actually protected kids . Still, there wasn’t a strategy waiting to assist prevent peanut or other food allergies.
As highlighted in a previous blog entry, the breakthrough came in 2015 with evidence from the NIH-funded Learning Early about Peanut Allergy (LEAP) trial . That trial, involving hundreds of babies under a year ancient at high risk for developing peanut allergy, established that kids could be protected by regularly eating a favorite peanut butter-flavored Israeli snack called Bamba.
A follow-up study later showed those kids remained allergy-free even after avoiding peanuts for a year .
Under the new recommendations, published simultaneously in six journals including the Journal of Allergy and Clinical Immunology, every infants who don’t already test positive for a peanut allergy are encouraged to eat peanut-enriched foods soon after they’ve tried a few other solid foods. The guidelines are the first to offer specific recommendations for allergy prevention based on a child’s risk for peanut allergy:
- Infants at high risk for peanut allergy—based on severe eczema and/or egg allergy—are suggested to start consuming peanut-enriched foods between 4 to 6 months of age, but only after parents check with their health care providers.
Infants already showing signs of peanut sensitivity in blood and/or skin-prick tests should attempt peanuts for the first time under the supervision of their doctor or allergist. In some cases, test results indicating a strong reaction to peanut protein might lead a specialist to recommend that a specific kid avoid peanuts.
- Infants with mild to moderate eczema should incorporate peanut-containing foods into their diets by about 6 months of age. It’s generally OK for them to own those first bites of peanut at home and without prior testing.
- Infants without eczema or any other food allergy aren’t likely to develop an allergy to peanuts.
To be on the safe side, it’s still a excellent thought for them to start eating peanuts from an early age.
Once peanut-containing foods own been consumed safely, regular exposure is key to allergy prevention. The guidelines recommend that infants—and particularly those at the greatest risk of allergies—eat about 2 grams of peanut protein (the quantity in 2 teaspoons of peanut butter) 3 times a week.
Of course, it’s never a excellent thought to give infants whole peanuts, which are a choking hazard.
Infants should instead get their peanuts in prepared peanut-containing foods or by stirring peanut powder into other familiar foods. They might also attempt peanut butter spread on bread or crackers.
In recent years, peanut allergy in the U.S. has almost quadrupled, making it the leading cause of death due to severe, food-related allergic reactions. The hope is that, with widespread implementation of these new guidelines, numerous new cases of peanut allergy can now be prevented.
 Addendum guidelines for the prevention of peanut allergy in the United States: Report of the National Institute of Allergy and Infectious Diseases-sponsored expert panel.
Togias A, Cooper SF, Acebal ML, et al. Pediatr Dermatol. 2017 Jan;34(1):e1-e21.
 Guidelines for the diagnosis and management of food allergy in the United States: report of the NIAID-sponsored expert panel. NIAID-Sponsored Expert Panel., Boyce JA, Assa’ad A, Burks AW, Jones SM, Sampson HA, Wood RA, Plaut M, Cooper SF, Fenton MJ, Arshad SH, Bahna SL, Beck LA, Byrd-Bredbenner C, Camargo CA Jr, Eichenfield L, Furuta GT, Hanifin JM, Jones C, Kraft M, Levy BD, Lieberman P, Luccioli S, McCall KM, Schneider LC, Simon RA, Simons FE, Teach SJ, Yawn BP, Schwaninger JM.
J Allergy Clin Immunol. 2010 Dec;126(6 Suppl):S1-58.
 Randomized Trial of Peanut Consumption in Infants at Risk for Peanut Allergy. Du Toit G, Roberts G, Sayre PH, Bahnson HT, Radulovic S, Santos AF, Brough HA, Phippard D, Basting M, Feeney M, Turcanu V, Sever ML, Gomez Lorenzo M, Plaut M, Lack G; the LEAP Study Team. N Engl J Med. 2015 Feb 23.
 Effect of Avoidance on Peanut Allergy after Early Peanut Consumption. Du Toit G, Sayre PH, Roberts G, Sever ML, Lawson K, Bahnson HT, Brough HA, Santos AF, Harris KM, Radulovic S, Basting M, Turcanu V, Plaut M, Lack G; Immune Tolerance Network LEAP-On Study Team..N Engl J Med. 2016 Apr 14;374(15):1435-43.
Guidelines for Clinicians and Patients for Diagnosis and Management of Food Allergy in the United States (National Institute of Allergy and Infectious Diseases/NIH)
Food Allergy (National Institute of Allergy and Infectious Diseases/NIH)
Learning Early about Peanut Allergy (LEAP) Study
NIH Support: National Institute of Allergy and Infectious Diseases
Chinese Herbal Formula
A herbal formula called Food Allergy Herbal Formula (FAHF)-1 was previously reported to block systemic anaphylactic in mice sensitized to peanut protein.
It does so by reducing mast cell degranulation and histamine release, peanut-specific serum IgE level, and Th2 cytokine secretion . A subsequent report used a refined herbal formula, FAHF-2, produced after exclusion of two herbs from the original formula. Peanut-sensitized mice pretreated with FAHF-2 for 7 weeks had no signs of anaphylaxis following peanut challenge 1, 3, and 5 weeks posttherapy. It was concluded that FAHF-2 treatment protected against athletic anaphylaxis in peanut-allergic mice .
However, this herbal formula has not yet been studied in humans for safety and efficacy.
Immunotherapy and DNA Immunization
Oppenheimer and colleagues conducted a trial of rush injection immunotherapy for the treatment of anaphylactic sensitivity to peanut . Patients in the treatment group were capable to tolerate increased amounts of peanut in food challenges after treatment. Unfortunately, there was a high rate of adverse systemic reactions, including a case of fatal anaphylaxis, associated with the treatment group compared with the group receiving placebo.
Another approach makes use of deoxyribonucleic acid (DNA) immunization.
DNA immunization employs the subcutaneous injection of a plasmid DNA vector encoding a specific allergenic protein. After uptake and processing by antigen-presenting cells, it is presented to T cells in the context of the major histocompatibility complicated. This approach is thought to induce a Th1 phenotypic response with upregulation of interferon (IFN)-γ, an increase in IgG2a, and suppression of allergen-specific IgE production . This approach has thus far been used in murine models and has yet to be applied to human subjects.
Posted In: Health, Science
Tags: allergy, Bamba, kid health, eczema, egg allergy, food allergy, infants, LEAP, Learning Early about Peanut Allergy, nih dir, peanut, peanut allergies, peanut allergy, peanuts, pediatrics
Exclusive breastfeeding or first baby formula is recommended for around the first 6 months of life.
If your baby has a cow’s milk allergy and is not being breastfed, talk to your GP about what helpful of formula to give your baby.
Pregnant or breastfeeding women don’t need to avoid foods that can trigger allergic reactions (including peanuts), unless you’re allergic to them.
If your baby already has an allergy such as a diagnosed food allergy or eczema, or if you own a family history of food allergies, eczema, asthma or hay-fever, you may need to be particularly careful when introducing foods, so talk to your GP or health visitor first.
How will I know if my kid has a food allergy?
An allergic reaction can consist of 1 or more of the following:
- itchy skin or rash
- a cough
- itchy throat and tongue
- diarrhoea or vomiting
- runny or blocked nose
- swollen lips and throat
- wheezing and shortness of breath
- sore, red and itchy eyes
In a few cases, foods can cause a severe allergic reaction (anaphylaxis) that can be life-threatening.
Get medical advice if you ponder your kid is having an allergic reaction to a specific food.
Don’t be tempted to experiment by cutting out a major food, such as milk, because this could lead to your kid not getting the nutrients they need. Talk to your health visitor or GP, who may refer you to a registered dietitian.
Introducing foods that could trigger allergy
When you start introducing solid foods to your baby from around 6 months ancient, introduce the foods that can trigger allergic reactions one at a time and in extremely little amounts so that you can spot any reaction.
These foods are:
- seeds (serve them crushed or ground)
- eggs (eggs without a red lion stamp should not be eaten raw or lightly cooked)
- nuts and peanuts (serve them crushed or ground)
- cows’ milk
- shellfish (don’t serve raw or lightly cooked)
- foods that contain gluten, including wheat, barley and rye
See more about foods to avoid giving babies and young children.
These foods can be introduced from around 6 months as part of your baby’s diet, just love any other foods.
Once introduced and if tolerated, these foods should become part of your baby’s usual diet to minimise the risk of allergy.
Evidence has shown that delaying the introduction of peanut and hen’s eggs beyond 6 to 12 months may increase the risk of developing an allergy to these foods.
Lots of children outgrow their allergies to milk or eggs, but a peanut allergy is generally lifelong.
If your kid has a food allergy, read food labels carefully.
Avoid foods if you are not certain whether they contain the food your kid is allergic to.
Food additives and children
Food contains additives for numerous reasons, such as to preserve it, to help make it safe to eat for longer, and to give colour or texture.
All food additives go through strict safety testing before they can be used. Food labelling must clearly show additives in the list of ingredients, including their name or «E» number and their function, such as «colour» or «preservative».
A few people own adverse reactions to some food additives, love sulphites, but reactions to ordinary foods, such as milk or soya, are much more common.
Read more about food colours and hyperactivity.
Sheet final reviewed: 24 July 2018
Next review due: 24 July 2021