Document Detail


Household peanut consumption as a risk factor for the development of peanut allergy.
MedLine Citation:
PMID:  19203660     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Most children with peanut allergy (PA) react on first known oral exposure to peanut. Recent data suggest cutaneous exposure as a route of sensitization. OBJECTIVES: This study aimed to establish the relevant route of peanut exposure in the development of allergy. METHODS: Questionnaires were administered to children with PA and to high-risk controls (with egg allergy) and controls without allergy. Questionnaires were completed before subjects were aware of their PA status, avoiding recall bias. Questionnaires recorded maternal peanut consumption during pregnancy, breast-feeding, and the first year of life. Peanut consumption was determined among all household members, allowing quantification of environmental household exposure (household peanut). RESULTS: Median weekly household peanut in the 133 PA cases was significantly elevated (18.8 g) compared with 150 controls without allergy (6.9 g) and 160 high-risk controls (1.9 g). There were no differences in infant peanut consumption between groups. Differences in maternal peanut consumption during pregnancy (and lactation) were significant but become nonsignificant after adjusting for household peanut. A dose-response relationship was observed between environmental (nonoral) peanut exposure and the development of PA, which was strongest for peanut butter. Early oral exposure to peanut in infants with high environmental peanut exposure may have had a protective effect against the development of PA. CONCLUSIONS: High levels of environmental exposure to peanut during infancy appear to promote sensitization, whereas low levels may be protective in atopic children. No effect of maternal peanut consumption during pregnancy or lactation is observed, supporting the hypothesis that peanut sensitization occurs as a result of environmental exposure.
Authors:
Adam T Fox; Peter Sasieni; George du Toit; Huma Syed; Gideon Lack
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of allergy and clinical immunology     Volume:  123     ISSN:  1097-6825     ISO Abbreviation:  J. Allergy Clin. Immunol.     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-02-10     Completed Date:  2009-03-03     Revised Date:  2009-08-07    
Medline Journal Info:
Nlm Unique ID:  1275002     Medline TA:  J Allergy Clin Immunol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  417-23     Citation Subset:  AIM; IM    
Affiliation:
King's College London, the Medical Research Council and Asthma UK Centre in Allergic Mechanisms of Asthma, Division of Asthma, Allergy and Lung Biology, Guy's and St Thomas' National Health Service Foundation Trust, London, United Kingdom.
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MeSH Terms
Descriptor/Qualifier:
Arachis hypogaea / immunology*
Environmental Exposure
Family Characteristics
Great Britain / epidemiology
Humans
Peanut Hypersensitivity / epidemiology*,  immunology*
Questionnaires
Risk Factors
Comments/Corrections
Comment In:
J Allergy Clin Immunol. 2009 Feb;123(2):424-5   [PMID:  19203661 ]
J Allergy Clin Immunol. 2009 Aug;124(2):387; author reply 387-8   [PMID:  19477498 ]

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