Allergies, Author Interviews, BMJ, Immunotherapy, Pediatrics / 13.01.2023
Flinders Trial Tests Boiled Peanuts to Treat Peanut Allergic Children
MedicalResearch.com Interview with:
A/Prof Luke GrzeskowiakPhD | BPharm(Hons) | GCertClinEpid | AdvPracPharm | FSHP
Associate Professor (Practitioner Fellow)
Channel 7 Children’s Research Foundation Fellow in Medicines Use and Safety
College of Medicine & Public Health
Flinders University
Affiliate Research Fellow – South Australian Health & Medical Research Institute (SAHMRI)
Specialist Pharmacist – Flinders Women & Children, Flinders Medical Centre
Adjunct Research Fellow – Faculty of Pharmacy and Pharmaceutical Sciences, Monash University
Adjunct Research Fellow – Robinson Research Institute, The University of Adelaide
MedicalResearch.com: What is the background for this study?
Response: Peanut allergy affects 1-3% of children in Western countries, making it the most common food-related allergen. Only a small percentage (20%) of children grow out of their peanut allergy, with allergen avoidance and provision of rescue medications for the management of allergic reactions being the recognised mainstay of treatment for many years. However, avoidance of peanuts provides many challenges for children and their caregivers and requires children and caregivers to be hypervigilant regarding peanut ingestion, creating a significant burden. This burden can have a real impact on quality of life for children and their families.
In more recent years there has been emerging interest in what is referred to as oral immunotherapy as an active preventive treatment to reduce the risk of accidental peanut exposure. Oral immunotherapy involves exposing children to an extremely small dose of peanut, typically in the form of peanut flour, and then gradually increasing that dose over time to build tolerance. We have been looking at opportunities for making oral immunotherapy safer, which would then make it more suitable for more people. Our previous research showed that boiling peanuts alters its protein structure and allergic properties, meaning they were less likely to cause a severe allergic reaction, but were still able to improve tolerance to peanut allergens.
Dr. Wong[/caption]
Mitchell Wong, MD PhD
Professor of Medicine
Executive Vice Chair for Research Training
Department of Medicine
Executive Co-Director, Specialty Training and Advanced Research (STAR) Program
Director, UCLA CTSI KL2 Program
UCLA Division of General Internal Medicine and Health Services Research Los Angeles, CA 90024
MedicalResearch.com: What is the background for this study?
Response: It is estimated that social factors like poverty, education, and housing have a large impact on health. Yet, there are few interventions that exist to directly address those issues. Schools are a promising solution since society already invests heavily in education and schools are an everyday part of most children’s lives.
Dr. Robbins[/caption]
Rebecca Robbins, Ph.D.
Instructor in Medicine
Associate Scientist, Division of Sleep and Circadian Disorders
Investigator, Division of Sleep and Circadian Disorders
Departments of Medicine and Neurology
Brigham and Women's Hospital
MedicalResearch.com: What is the background for this study?
Response: Teens face myriad challenges to sleep, ranging from biological factors, including a preference for later bedtimes and increased need for sleep, to social factors, including social pressures and increased academic workloads, all limiting teenagers in their ability to keep a healthy sleep schedule.
In a nationally representative sample, we explored the prevalence of another potential barrier to sleep among teens, which are a set of beliefs that are held in the population, yet are actual counter to scientific principles regarding sleep and circadian rhythms.
Dr. Soriano[/caption]
Victoria Soriano PhD
Research Assistant/Officer, Population Allergy
University of Melbourne
MedicalResearch.com: What is the background for this study?
Response: Peanut allergy is one of the most common childhood food allergies, and children rarely grow out of it. The only proven way to prevent peanut allergy is to give infants age-appropriate peanut products in the first year of life.
We previously showed there was a dramatic increase in peanut introduction from 2007-11 to 2018-19, following changes to infant feeding guidelines. We wanted to know if earlier peanut introduction would reduce peanut allergy in the general population (in Melbourne, Australia).
Dr. Stingone[/caption]
Jeanette Stingone PhD
Assistant Professor, Epidemiology
Mailman School of Public Health
Columbia University
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Lead is a well-established neurotoxin, particularly when exposure occurs early in life and in childhood. Associations between elevated blood lead levels and lower scores on tests of neurodevelopment and cognition are seen consistently across studies, even when examining lower levels of exposure.
While reducing exposure to lead is the primary intervention to prevent these adverse outcomes, there aren’t many interventions designed to support the neurodevelopment of children who have been exposed to lead. Some municipalities consider elevated blood lead levels as a criteria for inclusion in Early Intervention programs. Early Intervention programs are mandated under the Individuals with Disabilities Education Act and provide services for children younger than 3 years old with disabilities or developmental delays.
The objective of this study was to compare 3rd grade standardized test scores among children who had elevated blood lead levels early in life to see if children who had received Early Intervention services performed better on these tests than those who did not receive services. Using matching methods and an existing administrative data linkage of children who were born and attended public school in New York City, we observed that children exposed to lead who received Early Intervention services scored higher on standardized tests in both math and English Language arts than children exposed to lead who did not receive services. 
Dr. Fernandez-Mendoza[/caption]
Julio Fernandez-Mendoza, PhD, CBSM, DBSM
Associate Professor of Psychiatry & Behavioral Health
Sleep Research & Treatment Center
Director, Behavioral Sleep Medicine Program
Penn State Health Milton S. Hershey Medical Center
MedicalResearch.com: What is the background for this study? Is insomnia familial?
Response: Consistent research has shown that about 25% of school-age children have insomnia symptoms consisting of difficulties initiating or maintaining sleep. However, what has remained unknown is to what extent those insomnia symptoms persist all the way into adulthood, or whether they developmentally remit (go away with age) as the child grows into adolescence or young adulthood. This is the question that our study focused on.
Dr. Aris[/caption]
Izzuddin M Aris, PhD
Assistant Professor
Department of Population Medicine, Harvard Medical School
Division of Chronic Disease Research Across the Lifecourse
Harvard Pilgrim Health Care Institute
Boston, MA
MedicalResearch.com: What is the background for this study?
Response: Puberty is a key stage during child development. Previous research indicates that children in the United States are entering puberty at younger ages. These children may be in danger of developing certain diseases, such as type 2 diabetes, later in life. A better understanding of how early life factors affect puberty development is important for combating earlier puberty onset. .
Dr. Myran[/caption]
Daniel Myran, MD, MPH, CCFP, FRCPC
Family and Public Health and Preventive Medicine Physician
CIHR Fellow, Ottawa Hospital Research Institute
Department of Family Medicine Innovation Fellow
University of Ottawa
MedicalResearch.com: What is the background for this study?
Response: Canada legalized recreational, or non-medical, cannabis in October 2018. Canada took phased approach to legalization initially only allowing flower-based cannabis products and oils and after one year permitting the sale of commercial cannabis edibles (e.g. THC containing candies, baked goods, and drinks). In this study we took advantage of this phased roll out of legal cannabis to understand the impact of legalization on cannabis exposures or poisonings in children aged 0-9 years and the contribution of different types of cannabis products to these events.
Sean C. Rose, MD
Child Neurology
Nationwide Children’s Hospital
The Ohio State University, Columbus
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: There is conflicting evidence regarding the association between repetitive head impacts during youth contact sports and worse neurocognitive outcomes. Most research has been conducted in older adults, while the research in children is mostly limited to 1-2 sports seasons.
Dr. Cabana[/caption]
Michael Cabana, M.D., M.A., M.P.H
Professor of Pediatrics
Albert Einstein College of Medicine.
Physician-in-chief , Children's Hospital at Montefiore
Chair of the Department of Pediatrics
Albert Einstein College of Medicine
Member, U.S. Preventive Services Task Force
MedicalResearch.com: What is the background for this study and recommendation statement?
Response: Dental caries, also known as cavities or tooth decay, is the most common chronic disease in children in the United States and can develop in any child whose teeth have come in. Many young children under five years old do not visit a dentist, so the Task Force reviewed the latest evidence on how primary care clinicians can help prevent tooth decay in young children.
The Task Force’s research led to two important findings: all young children whose teeth have come in should have fluoride varnish applied by their clinician, and all children six months and older whose water supply doesn’t contain enough fluoride should receive fluoride supplements. Both approaches can help prevent cavities in kids.
The Task Force also determined that there is not enough evidence to recommend for or against screening for tooth decay in the primary care setting for children under five. This is consistent with the Task Force’s 2014 recommendation on dental caries.
