Published Research Highlights of 2003

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Cashew allergy: observations of 42 children without associated peanut allergy 
Rance F, Bidat E, Bourrier T, Sabouraud D 
Hopital des Enfants, Allergologie, Toulouse Cedex, France 
Allergy 2003;58(12):1311-4 
Scientists analyzed clinical features and results of skin prick tests, IgE assays and food challenges of 42 children who had cashew allergy. The average age of the first allergic reaction was 2 years old. The allergy was diagnosed on average when the children were 2.7 years old. Scientists found that almost one-third of children are allergic to pistachios, a member of the same botanical family as cashews. 
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Effect of anti-IgE therapy (TNX-901) in patients with peanut allergy 
Leung DY, Sampson HA, Yunginger JW, Burks AW, Schneider LC, Wortel CH, Davis FM, Hyun JD, Shanahan WR 
National Jewish Medical and Research Center, Denver, CO 
New England Journal of Medicine 2003;348(11):986-93 
The goal of the study was to determine whether this therapy could increase tolerance of peanut. Eighty-four patients, ages 12 to 60, were recruited, and 81 finished the study. TNX-901 was administered to the study participants via injection in four doses every four weeks. They underwent another food challenge within two to four weeks after their last dose. At the end of the study, all patients on the drug showed a decrease in their IgE levels, and they remained that way eight weeks after the last dose, the last time these measurements were taken. 
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Prevalence of peanut allergy in primary-school children in Montreal, Canada 
Kagan RS, Joseph L, Dufresne C, Gray-Donald K, Turnbull E, Pierre YS, Clarke AE. 
Department of Pediatrics, McGill University Health Care Centre, Montreal, Quebec, Canada 
J Allergy Clin Immunol. 2003 Dec;112(6):1223-8. 
To determine the estimated prevalence of peanut allergy in Montreal, Canada, using history and confirmatory testing, investigators administered questionnaires to randomly-selected schools about peanut ingestion to children in kindergarten through grade 3. More than 4,000 children responded to the survey. Children who rarely or never eat peanuts, had a convincing history of peanut allergy, or whose history of peanut allergy was uncertain underwent skin prick testing. Investigators found the prevalence of peanut allergy to be 1.50% 
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Measurement of peptide-specific IgE as an additional tool in identifying patients with clinical reactivity to peanuts 
Beyer K, Ellman-Grunther L, Jarvinen KM, Wood RA, Hourihane J, Sampson HA 
Jaffe Institute for Food Allergy, The Mount Sinai School of Medicine, New York, NY 
J Allergy Clin Immunol 2003;112(1):202-7 
This study examined the effectiveness of a special blood test to better predict who may or may not actually react to peanut despite a positive standard allergy test. Researchers exposed the blood samples of 31children to the segments of peanut proteins and found that the samples from the patients who actually have reactions to peanut recognized certain segments in a different pattern compared to those with positive standard allergy tests but who tolerate eating peanut. 
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Monitoring peanut allergen in food products by measuring Ara h 1 
Pomes A, Helm RM, Bannon GA, Burks AW, Tsay A, Chapman MD 
Biotechnologies, Inc, Charlottesville, Va 
J Allergy Clin Immunol 2003;111(3):640-5 
The authors conducted an analysis of Ara H 1, a major peanut allergen, to detect peanut allergen in foods in order to reduce the risk of accidental exposure. Ara H 1 was measured in and extracted from 83 types of foods. The authors found that Ara h 1 levels in food products ranged from less than 0.1 microg/g to 500 microg/g, with peanut butter containing the highest amounts. The authors concluded that a new method (assay) of detecting the presence of Ara h 1 in food products had been created, and that this assay should be useful for monitoring peanut contamination in the food manufacturing and processing industry, and in developing thresholds for sensitization or allergic reaction in persons with peanut allergy. 
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Persistent protective effect of heat-killed Escherichia coli producing "engineered," recombinant peanut proteins in a murine model of peanut allergy 
Li XM, Srivastava K, Grishin A, Huang CK, Schofield B, Burks W, Sampson HA 
Department of Pediatrics, Mount Sinai School of Medicine, New York, NY 
J Allergy Clin Immunol 2003;112(1):159-67 
Peanut-allergic mice received a vaccine made with slightly altered (to modify their allergenicity) peanut proteins and heat-killed bacteria (E. coli) used to stimulate an "non-allergic" immune response to determine its usefulness in treating peanut allergy. Researchers administered one of three doses of the vaccine or a placebo in suppository (rectal) form, to groups of peanut-allergic mice. When the mice were later fed peanut, it was seen that they had reduced or no reactions, depending upon the dose they were treated with and length of treatment, compared to those who received placebo. 
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Relevance of casual contact with peanut butter in children with peanut allergy 
Simonte SJ, Ma S, Mofidi S, Sicherer SH 
Mount Sinai School of Medicine, New York, NY 
J Allergy Clin Immunol 2003;112(1):180-2 
This study observed children with severe peanut allergy while they were being exposed to peanut butter through touch and inhalation (smell). Thirty children participated in the study. Accidental casual contact was simulated by pressing a dab of peanut butter on the child's back for 1 minute, and by holding a dish containing 3 oz. of peanut butter 1 foot from the child's nose for 10 minutes. (The peanut butter was covered with a layer of gauze so it could not be identified, and the smell was disguised.) 
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The major peanut allergen, Ara h 2, functions as a trypsin inhibitor, and roasting enhances this function 
Maleki SJ, Viquez O, Jacks T, Dodo H, Champagne ET, Chung SY, Landry SJ 
United States Department of Agriculture-Agricultural Research Service-Southern Regional Research Center, New Orleans, LA 
J Allergy Clin Immunol 2003;112(1):190-5 
In a previous study, the researchers proved that heat changed the structure of peanut protein and increased its allergenic properties. This study examined whether roasting affected one of the major peanut allergens, Ara h 2, which is a protein that actually functions to inhibit digestive enzymes. Researchers found that roasting this peanut allergen actually increased its function as an anti-digestion enzyme. 
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The natural progression of peanut allergy: Resolution and the possibility of recurrence 
Fleischer DM, Conover-Walker MK, Christie L, Burks AW, Wood RA 
Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD 
J Allergy Clin Immunol 2003;112(1):183-9 
Researchers studied 80 children with peanut allergy by using food challenges to determine which children had outgrown their allergies. Children were selected for the challenges based on their IgE levels being low and favorable to have outgrown the allergy (5 units or less measured as units called "kU/L"). The research findings suggest that children with an IgE level of 2 or less have a higher chance of passing a food challenge. Researchers also learned that 97% of the children who passed their challenges had eaten peanut since then; however, 70% of them ate it only small amounts and infrequently. 
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The predictive value of a positive prick skin test to peanut in atopic, peanut-naive children 
Kagan R, Hayami D, Joseph L, St Pierre Y, Clarke AE. 
Division of Allergy/Clinical Immunology, Department of Pediatrics, Montreal Children's Hospital, McGill University, Montreal, Quebec 
Ann Allergy Asthma Immunol. 2003 Jun;90(6):640-5. 
Generally, children who have positive prick skin tests to peanut are told to avoid this food indefinitely, or until the diagnosis is confirmed with a food challenge. Scientists conducted a study and in a 7-year span, forty-seven patients who had positive prick skin tests to peanut but who did not previously ingest peanut were challenged with this food. Forty-nine percent of these tests were positive. 
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