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Peanut allergens associated with provoking clinical symptoms

Project Code: T07015

31/10/2002

Allergy and Inflammation Sciences, University of Southampton.
Warner, J ; Hourihane, J

This study has achieved Objectives 1 and 2 and has already had a significant impact in the communities of academic and clinical allergy.

The fundamental issues identified in this study are as follows:

1. There appears to be factors operative in reactions in the community which render retrospective evaluation of their severity unreliable compared to the prospective evaluation of a low-dose, double-blind, placebo-controlled food challenge, where most extrinsic factors are controlled or eliminated.

2. There appears to be little correlation between the challenge scores and the scores retrospectively applied to community reactions. This underlines the difficulty of using double-blind placebo controlled food challenges for anything other than a diagnostic purpose. Their use for prognostic assessment of future risk remains to be further refined.

3. The direct effect of asthma on a low-dose DBPCFC is difficult to assess due to safety considerations.

4. A history of asthma appears to affect indirectly the outcome of a low-dose challenge in stable subjects. Non-asthmatics show a stronger association between peanut-specific IgE levels and challenge score.

5. The matrix of a food challenge vehicle and, by extension, of complex foods in community reactions, is a key factor in determining the outcome of the reaction elicited.

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