The impact of government advice to pregnant mothers regarding peanut avoidance on the prevalence of peanut allergy in United Kingdom children at school entry

Hourihane, J.O.; Aiken, Rachel; Briggs, Roger; Gudgeon, L.A.; Grimshaw, Kate; DunnGalvin, Audrey; Roberts, S. P.

doi:10.1016/j.jaci.2006.12.670

Cited by 193 publications

(158 citation statements)

References 9 publications

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“…For example, allergies to the peanut tripled in incidence between 1997 and 2008 in the USA and the UK (Hourihane et al 2007;. However, in the cohort studies carried out this increasing rate not appear to be real, showing similar data of prevalence over time (Ben-Shoshan et al 2009;Venter et al 2010).…”

Section: Introductionmentioning

confidence: 98%

Food Allergy and the Oral Immunotherapy Approach

Cabrera

Urra

2014

Arch. Immunol. Ther. Exp.

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Food allergy represents an increasing health problem, with children being the most affected population. The symptoms can appear within minutes or hours of ingesting the offending food, producing skin manifestations, respiratory, gastrointestinal and anaphylactic reactions in the severe forms. Food allergy is established by the loss of tolerance to food proteins, and is characterized by an altered balance of regulatory T (Treg) cells and the shift to Th2 type cytokines in the intestinal lamina propria. We have described the contribution of different factors in establishing oral tolerance, such as the antigenic exposition route, the gut microenvironment, and the timing of the food introduction. Apart from avoiding the food, immunotherapy is the only intervention which produces oral desensitization to food proteins. Among the underlying immunological mechanisms of oral immunotherapy (OIT) are the changes in humoral immunity (a decrease of allergen-specific IgE and an increase of allergen-specific IgG4) and cellular changes such as the increased number of FoxP3 ? Treg cells. At present, the experiences of OIT with various foods are offering promising results. OIT appears to be safe producing low adverse reactions, and effective in inducing desensitization in most subjects with food allergy.

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Section: Introductionmentioning

confidence: 98%

Food Allergy and the Oral Immunotherapy Approach

Cabrera

Urra

2014

Arch. Immunol. Ther. Exp.

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“…One other cross-sectional study made reference to maternal peanut consumption and peanut sensitisation in infants (2) . The authors reported that there was no statistically significant difference in whether mothers changed their peanut consumption (reduced or avoided, i.e.…”

Section: Question 1: Mother's Diet During Pregnancy and Lactationmentioning

confidence: 99%

“…Two cross-sectional studies were relevant to research question 4 (Table 3) (2,19) . One study utilised a birth cohort (658 children) from the Isle of Wight (19) ; subjects were initially recruited whilst mothers were pregnant.…”

Section: Question 2: Childhood Dietmentioning

confidence: 99%

“…The other cross-sectional study (2) involved 1072 mother and child pairs. The children were aged 4-5 years, born after the COT recommendations were first issued, and living in Southampton or Manchester.…”

Section: Question 2: Childhood Dietmentioning

confidence: 99%

“…Because IgE-mediated allergic reactions require prior exposure and immunological sensitisation to the allergen, this suggests that sensitisation has already been acquired, either in utero, or by unrecognised oral exposure or non-oral (cutaneous or respiratory) routes. As many as one in fiftyfive children in the UK may currently show evidence of an allergic reaction to peanuts (2) ; indeed, peanut allergy is the most common cause of severe allergic reaction to foods, causing 30 % of all cases of anaphylaxis outside hospital (3) . Data from the Isle of Wight UK Birth Cohort Study suggest a threefold rise in the prevalence of peanut sensitisation and allergy in children born between 1989-90 and 1994 -6 (4,5) .…”

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confidence: 99%

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Peanut sensitisation and allergy: influence of early life exposure to peanuts

et al. 2010

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The aim of the present systematic review was to evaluate the influence of early life exposure (maternal and childhood) to peanuts and the subsequent development of sensitisation or allergy to peanuts during childhood. Studies were identified using electronic databases and bibliography searches. Studies that assessed the impact of non-avoidance compared with avoidance or reduced quantities of peanuts or peanut products on either sensitisation or allergy to peanuts, or both outcomes, were eligible. Six human studies were identified: two randomised controlled trials, two casecontrol studies and two cross-sectional studies. In addition, published animal and mechanistic studies, relevant to the question of whether early life exposure to peanuts affects the subsequent development of peanut sensitisation, were reviewed narratively. Overall, the evidence reviewed was heterogeneous, and was limited in quality, for example, through lack of adjustment for potentially confounding factors. The nature of the evidence has therefore hindered the development of definitive conclusions. The systematic review of human studies and narrative expert-led reviews of animal studies do not provide clear evidence to suggest that either maternal exposure, or early or delayed introduction of peanuts in the diets of children, has an impact upon subsequent development of sensitisation or allergy to peanuts. Results from some animal studies (and limited evidence from human subjects) suggest that the dose of peanuts is an important mediator of peanut sensitisation and tolerance; low doses tend to lead to sensitisation and higher doses tend to lead to tolerance.Peanut allergy: Diet: Prenatal exposure: Childhood exposure Onset of peanut allergy typically occurs in childhood, with 70-100 % (1) of peanut-allergic children being reported to react upon their first known dietary exposure to peanuts. Because IgE-mediated allergic reactions require prior exposure and immunological sensitisation to the allergen, this suggests that sensitisation has already been acquired, either in utero, or by unrecognised oral exposure or non-oral (cutaneous or respiratory) routes. As many as one in fiftyfive children in the UK may currently show evidence of an allergic reaction to peanuts (2) ; indeed, peanut allergy is the most common cause of severe allergic reaction to foods, causing 30 % of all cases of anaphylaxis outside hospital (3) . Data from the Isle of Wight UK Birth Cohort Study suggest a threefold rise in the prevalence of peanut sensitisation and allergy in children born between 1989-90 and 1994 -6 (4,5) . Recent data from children born in 2001 -2 show no further increases in the prevalence of peanut sensitisation and allergy (6) .In 1998 the UK Government issued precautionary advice to mothers whose children have a family history of allergic diseases, that they may wish to avoid peanut consumption during pregnancy and breast-feeding and avoid giving the child peanuts and peanut products until the child is 3 years of age (7) . The precautionary advice was...

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