Natural Course and Prognostic Factors of Immediate-Type Peanut Allergy in Children

Jung, Minyoung; Jeong, Hye-In; Kyung, Yechan; Kim, Su Kyung; Lee, Jun Hwa; Choi, Minhwan; Shim, Jung Yeon; Kim, Layun; Won, Hojeong; Kim, Kyunga; Kim, Jihyun; Ahn, Kangmo

doi:10.1159/000516811

Cited by 6 publications

(9 citation statements)

References 8 publications

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“…Peanut and tree nut allergies are more durable than egg and milk allergies. Depending on the study population, peanut allergy resolved in 14.8% to 29% by ages 6 through 10 years, and tree nut allergy resolved in 9% by a median age of 10 years (range, 5.8-15.7 years) …”

Section: Epidemiology Common Food Allergens and Natural Historymentioning

confidence: 99%

Management of Food Allergies and Food-Related Anaphylaxis

Iglesia,

Kwan,

Virkud

et al. 2024

JAMA

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ImportanceAn estimated 7.6% of children and 10.8% of adults have IgE-mediated food-protein allergies in the US. IgE-mediated food allergies may cause anaphylaxis and death. A delayed, IgE-mediated allergic response to the food-carbohydrate galactose-α-1,3-galactose (alpha-gal) in mammalian meat affects an estimated 96 000 to 450 000 individuals in the US and is currently a leading cause of food-related anaphylaxis in adults.ObservationsIn the US, 9 foods account for more than 90% of IgE-mediated food allergies—crustacean shellfish, dairy, peanut, tree nuts, fin fish, egg, wheat, soy, and sesame. Peanut is the leading food-related cause of fatal and near-fatal anaphylaxis in the US, followed by tree nuts and shellfish. The fatality rate from anaphylaxis due to food in the US is estimated to be 0.04 per million per year. Alpha-gal syndrome, which is associated with tick bites, is a rising cause of IgE-mediated food anaphylaxis. The seroprevalence of sensitization to alpha-gal ranges from 20% to 31% in the southeastern US. Self-injectable epinephrine is the first-line treatment for food-related anaphylaxis. The cornerstone of IgE-food allergy management is avoidance of the culprit food allergen. There are emerging immunotherapies to desensitize to one or more foods, with one current US Food and Drug Administration–approved oral immunotherapy product for treatment of peanut allergy.Conclusions and RelevanceIgE-mediated food allergies, including delayed IgE-mediated allergic responses to red meat in alpha-gal syndrome, are common in the US, and may cause anaphylaxis and rarely, death. IgE-mediated anaphylaxis to food requires prompt treatment with epinephrine injection. Both food-protein allergy and alpha-gal syndrome management require avoiding allergenic foods, whereas alpha-gal syndrome also requires avoiding tick bites.

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Section: Epidemiology Common Food Allergens and Natural Historymentioning

confidence: 99%

Management of Food Allergies and Food-Related Anaphylaxis

Iglesia,

Kwan,

Virkud

et al. 2024

JAMA

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“…Gupta et al found the prevalence of peanut allergy in early childhood, adolescence (14–17 years) and adulthood to be 2.6%, 2.1%, and 1.8%, respectively [ 2 •, 79 , 83 ]. Risk factors for peanut allergy persistence include diagnosis of atopic dermatitis at age one, sensitization to at least one tree nut/one other food/or dust mite, a low threshold for peanut reaction during an oral food challenge at age one [ 18 ••], peanut-specific IgE (sIgE) ≥ 1 kU/L at diagnosis [ 84 ], and anaphylaxis as initial reaction [ 85 ]. Having at least one Asian parent was a risk factor in both persisting egg and peanut allergy in the Australian HealthNuts study [ 11 ].…”

Section: Adolescencementioning

confidence: 99%

The Natural History and Risk Factors for the Development of Food Allergies in Children and Adults

Lee,

Trogen,

Brady

et al. 2024

Curr Allergy Asthma Rep

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Purpose of Review This narrative review explores food allergy prevalence and natural history stratified by life stages, especially in context of evolving knowledge over the last few decades. Recent Findings The prevalence of food allergy remains highest in early childhood with common food triggers being cow’s milk, soy, hen’s egg, wheat, peanut, tree nuts, sesame, fish, and shellfish. This correlates with certain risk factors especially pertinent in the postnatal period which appear to predispose an individual to developing a food allergy. Some allergies (such as milk and egg) were previously thought to be easily outgrown in early life; however, recent studies suggest increasing rates of persistence of these allergies into young adulthood; the reason behind this is unknown. Despite this, there is also evidence demonstrating that food allergies can be outgrown in adolescents and adults. Summary An understanding of the paradigm shifts in the natural history of food allergy allows clinicians to provide updated, age-appropriate, and tailored advice for patients on the management and prognosis of food allergy.

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“…As reported by the same research team, the rate of resolution of peanut allergy by the age of 4 years was reportedly 22% in 2015 [ 29 ]. A retrospective analysis conducted at 3 hospitals in Korea reported that the probabilities of peanut allergy resolution were 10.3% at age 6 years and 32.8% at age 10 years [ 39 ].…”

Section: Natural Course Of Specific Food Allergiesmentioning

confidence: 99%

“…29) A retrospec tive analysis conducted at 3 hospitals in Korea reported that the probabilities of peanut allergy resolution were 10.3% at age 6 years and 32.8% at age 10 years. 39) Tree nut allergy accounts for a considerable proportion of food allergies in children and frequently cause severe reactions, but the natural course of tree nut allergy compared to other major food allergies remains understudied. 40,41) A study published in 2005 that is still consistently cited when referring to the natural course of tree nuts reported a resolution rate of 8.9% among children with previous clinical reactivity and evidence of tree nut sensiti zation.…”

Section: Longitudinal Cohort Canadamentioning

confidence: 99%

Natural course of IgE-mediated food allergy in children

Jeong¹,

Lee²

2023

Clin Exp Pediatr

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The prevalence of food allergy and food-induced anaphylaxis in children is increasing worldwide. Cow’s milk, hen’s eggs, and wheat allergies in young children have a more favorable prognosis with a relatively early outgrow, while allergies to peanuts, tree nuts, and seafood are more likely to be persistent. Although our understanding of the mechanism underlying the resolution of food allergy is incomplete, the roles of dendritic cells, regulatory T cells, and regulatory B cells are important. Many past studies on the natural course of food allergy were retrospective analyses of specific study groups, but large-scale population-based prospective studies are now being published. This review summarizes recent studies of the natural course of cow’s milk, hen’s eggs, wheat, peanuts, tree nuts, soy, sesame, and seafood allergies. The potential factors affecting the natural course of food allergy include symptom severity on ingestion, age at diagnosis, allergic comorbidities, skin prick test reaction size or serum food-specific immunoglobulin (Ig) E levels, changes in sensitization degree, IgE epitope specificity, ratio of food-specific IgE to IgG4, food-specific IgA levels, component-resolved diagnostic profile, diet, gut microbiome, and interventions such as immunotherapy. Since food allergy places a significant burden on patients and their caregivers in daily life, clinicians should be able to provide relevant knowledge on the natural course of food allergy, appropriately evaluate its resolution, and offer therapeutic options whenever possible.

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Natural Course and Prognostic Factors of Immediate-Type Peanut Allergy in Children

Cited by 6 publications

References 8 publications

Management of Food Allergies and Food-Related Anaphylaxis

Management of Food Allergies and Food-Related Anaphylaxis

The Natural History and Risk Factors for the Development of Food Allergies in Children and Adults

Natural course of IgE-mediated food allergy in children

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