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. 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. Chan[/caption]
Edmond S. Chan MD, FRCPC, FCSACI, FAAAAI
Head | Division of Allergy & Immunology | Department of Pediatrics, Faculty of Medicine
Clinical Professor, The University of British Columbia
Clinical Investigator, BC Children's Hospital Research Institute
BC Children's Hospital, Allergy Clinic
Vancouver, BC Canada
Treasurer, CSACI (Canadian Society of Allergy & Clinical Immunology)
MedicalResearch.com: What prompted you to look at the safety of peanut oral immunotherapy specifically in this patient population?
Response: Our previous research has investigated the overall safety of peanut oral immunotherapy (OIT) in preschool populations. However, we have not investigated the relationship between specific patient characteristics and the safety of OIT. Previous literature has shown that patient factors, such as age, gender, baseline sIgE levels, and atopic comorbidities have been shown to impact the safety of OIT for other food allergies and in older patients. However, no data exist on which factors predict safety of peanut OIT in preschool populations.