NDLI: Identifying infants at high risk of peanut allergy: the Learning Early About Peanut Allergy (LEAP) screening study.

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Identifying infants at high risk of peanut allergy: the Learning Early About Peanut Allergy (LEAP) screening study.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Du Toit, George Roberts, Graham Sayre, Peter H. Plaut, Marshall Bahnson, Henry T. Mitchell, Herman Radulovic, Suzana Chan, Susan Fox, Adam Turcanu, Victor Lack, Gideon
Description	Country affiliation: United kingdom Author Affiliation: Du Toit G ( King's College London, King's Health Partners, MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, and Department of Paediatric Allergy, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.)
Abstract	BACKGROUND: Peanut allergy (PA) is rare in countries in which peanuts are introduced early into infants' diets. Learning Early About Peanut Allergy (LEAP) is an interventional study aiming to assess whether PA can be prevented by oral tolerance induction. OBJECTIVE: We sought to characterize a population screened for the risk of PA. METHODS: Subjects screened for the LEAP interventional trial comprise the LEAP screening study cohort. Infants were aged 4 to 10 months and passed a prescreening questionnaire. RESULTS: This analysis includes 834 infants (mean age, 7.8 months). They were split into the following: group I, patients with mild eczema and no egg allergy (n = 118); group II, patients with severe eczema, egg allergy, or both but 0-mm peanut skin prick test (SPT) wheal responses (n = 542); group III, patients with severe eczema, egg allergy, or both and 1- to 4-mm peanut wheal responses (n = 98); and group IV, patients with greater than 4-mm peanut wheal responses (n = 76). Unexpectedly, many (17%) in group II had peanut-specific IgE sensitization (≥ 0.35 kU/L); 56% of group III were similarly sensitized. In contrast, none of the patients in group I and 91% of those in group IV had peanut-specific IgE sensitization. Sensitization on skin testing to peanut (SPT response of 1-4 mm vs 0 mm) was associated with egg allergy and severe eczema (odds ratio [OR], 2.31 [95% CI, 1.39-3.86] and 2.47 [95% CI, 1.14-5.34], respectively). Similar associations were observed with specific IgE sensitization. Black race was associated with a significantly higher risk of peanut-specific IgE sensitization (OR, 5.30 [95% CI, 2.85-9.86]). Paradoxically, for a given specific IgE level, black race was protective against cutaneous sensitization (OR, 0.15 [95% CI, 0.04-0.61]). CONCLUSION: Egg allergy, severe eczema, or both appear to be useful criteria for identifying high-risk infants with an intermediate level of peanut sensitization for entry into a PA prevention study. The relationship between specific IgE level and SPT sensitization needs to be considered within the context of race.
File Format	HTM / HTML
ISSN	00916749
e-ISSN	10976825
Journal	Journal of Allergy and Clinical Immunology
Issue Number	1
Volume Number	131
Language	English
Publisher	Elsevier
Publisher Date	2013-01-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Immunology Peanut Hypersensitivity Epidemiology Allergens Immunology Arachis Hypogaea Eczema Complications Immunoglobulin E Infant Diagnosis Prognosis Skin Tests Research Support, N.i.h., Extramural Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Immunology and Allergy Immunology

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