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Hugh A. Sampson - One of the best experts on this subject based on the ideXlab platform.
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ana o 3 an important cashew Nut anacardium occidentale l allergen of the 2s albumin family
The Journal of Allergy and Clinical Immunology, 2005Co-Authors: Jason M Robotham, Suzanne S. Teuber, Hugh A. Sampson, Shridhar K. Sathe, Fang Wang, Vanessa Seamon, K Beyer, Margaret Seavy, Kenneth H. RouxAbstract:Background Cashew Nut Allergy is the second most commonly reported tree Nut Allergy in the United States. We have previously cloned and characterized major cashew allergens belonging to the vicilin and legumin families of seed storage proteins. Objective Here we set out to describe a third major cashew allergen, a 2S albumin. Methods The recombinant cashew 2S albumin was amplified from a cDNA library by means of PCR, sequenced, and expressed in Escherichia coli . Immunoblotting was used to screen for reactivity with patients' sera, and inhibition immunoblotting was used to identify the corresponding native cashew Nut proteins. The mass of affinity-purified native allergen was determined by means of matrix-assisted laser desorption ionization–time of flight (MALDI-TOF) mass spectroscopy. Patients' sera were used to probe solid-phase 2S albumin peptides to identify linear epitopes. Results The cloned allergen, designated Ana o 3, was identified as 2S albumin. MALDI-TOF mass spectroscopy of native Ana o 3 yielded a molecular mass of 12,598 d. Immunoblot analysis showed 21 (81%) of 26 sera from patients with cashew Allergy were reactive. Three native Ana o 3 large-subunit isoforms with molecular weights ranging from approximately 6 to 10 kd were identified. Probing of overlapping synthetic Ana o 3 peptides with patients' sera identified 16 reactive peptides, 4 of which gave strong signals and one of which positionally overlaps linear epitopes in mustard and walNut allergenic 2S albumins. The overlapping cashew and walNut epitopes also share considerable homology. Conclusions We conclude that this 2S albumin protein is a major allergen in cashew Nut and demonstrates a possible basis for cross-reactivity with walNut 2S albumin.
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a voluntary registry for peaNut and tree Nut Allergy characteristics of the first 5149 registrants
The Journal of Allergy and Clinical Immunology, 2001Co-Authors: Scott H. Sicherer, Terence J. Furlong, Anne Munozfurlong, Wesley A Burks, Hugh A. SampsonAbstract:Background: A voluntary registry of individuals with peaNut and/or tree Nut Allergy was established in 1997 to learn more about these food allergies. Objective: The purpose of this study was to elucidate a variety of features of peaNut and tree Nut Allergy among the first 5149 registry participants. Methods: The registry was established through use of a structured questionnaire distributed to all members of the Food Allergy and Anaphylaxis Network and to patients by allergists. Parental surrogates completed the forms for children under the age of 18 years. Results: Registrants were primarily children (89% of registrants were younger than 18 years of age; the median age was 5 years), reflecting the membership of the Network. Isolated peaNut Allergy was reported by 3482 registrants (68%), isolated tree Nut Allergy by 464 (9%), and Allergy to both foods by 1203 (23%). Registrants were more likely to have been born in October, November, or December (odds ratio, 1.2; 95% CI, 1.18-1.23; P < .0001). The median age of reaction to peaNut was 14 months, and the median age of reaction to tree Nuts was 36 months; these represented the first known exposure for 74% and 68% of registrants, respectively. One half of the reactions involved more than 1 organ system, and more than 75% required treatment, frequently from medical personnel. Registrants with asthma were more likely than those without asthma to have severe reactions (33% vs 21%; P < .0001). In comparison with initial reactions, subsequent reactions due to accidental ingestion were more severe, more common outside the home, and more likely to be treated with epinephrine. Conclusions: Allergic reactions to peaNut and tree Nut are frequently severe, often occur on the first known exposure, and can become more severe over time. (J Allergy Clin Immunol 2001;108:128-32.)
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A voluntary registry for peaNut and tree Nut Allergy: characteristics of the first 5149 registrants.
Journal of Allergy and Clinical Immunology, 2001Co-Authors: Scott H. Sicherer, A. Wesley Burks, Terence J. Furlong, Anne Muñoz-furlong, Hugh A. SampsonAbstract:Abstract Background: A voluntary registry of individuals with peaNut and/or tree Nut Allergy was established in 1997 to learn more about these food allergies. Objective: The purpose of this study was to elucidate a variety of features of peaNut and tree Nut Allergy among the first 5149 registry participants. Methods: The registry was established through use of a structured questionnaire distributed to all members of the Food Allergy and Anaphylaxis Network and to patients by allergists. Parental surrogates completed the forms for children under the age of 18 years. Results: Registrants were primarily children (89% of registrants were younger than 18 years of age; the median age was 5 years), reflecting the membership of the Network. Isolated peaNut Allergy was reported by 3482 registrants (68%), isolated tree Nut Allergy by 464 (9%), and Allergy to both foods by 1203 (23%). Registrants were more likely to have been born in October, November, or December (odds ratio, 1.2; 95% CI, 1.18-1.23; P P Conclusions: Allergic reactions to peaNut and tree Nut are frequently severe, often occur on the first known exposure, and can become more severe over time. (J Allergy Clin Immunol 2001;108:128-32.)
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The US PeaNut and Tree Nut Allergy Registry: characteristics of reactions in schools and day care.
The Journal of Pediatrics, 2001Co-Authors: Scott H. Sicherer, Jennifer Desimone, Terrence J. Furlong, Hugh A. SampsonAbstract:Abstract Objective: Severe food-allergic reactions occur in schools, but the features have not been described. Study design: Participants in the US PeaNut and Tree Nut Allergy Registry (PAR) who indicated that their child experienced an allergic reaction in school or day care were randomly selected for a telephone interview conducted with a structured questionnaire. Results: Of 4586 participants in the PAR, 750 (16%) indicated a reaction in school or day care, and 100 subjects or parental surrogates described 124 reactions to peaNut (115) or tree Nuts (9); 64% of the reactions occurred in day care or preschool, and the remainder in elementary school or higher grades. Reactions were reported from ingestion (60%), skin contact/possible ingestion (24%), and inhalation/possible skin contact or ingestion (16%). In the majority of reactions caused by inhalation, concomitant ingestion/skin contact could not be ruled out. Various foods caused reactions by ingestion, but peaNut butter craft projects were commonly responsible for the skin contact (44%) or inhalation (41%) reactions. For 90% of reactions, medications were given (86% antihistamines, 28% epinephrine). Epinephrine was given in school by teachers in 4 cases, nurses in 7, and parents or others in the remainder. Treatment delays were attributed to delayed recognition of reactions, calling parents, not following emergency plans, and an unsuccessful attempt to administer epinephrine. Conclusions: School personnel must be educated to recognize and treat food-allergic reactions. Awareness must be increased to avoid accidental exposures, including exposure from peaNut butter craft projects. (J Pediatr 2001;138:560-5)
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PeaNut and Tree Nut Allergy
Current opinion in pediatrics, 2000Co-Authors: Scott H. Sicherer, Hugh A. SampsonAbstract:Allergy to peaNut and tree Nuts is a major worldwide health concern. The prevalence of these allergies may be increasing, but the reasons for these increases remain unclear. This group of foods accoun
Vicki Mcwilliam - One of the best experts on this subject based on the ideXlab platform.
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the accuracy of diagnostic testing in determining tree Nut Allergy a systematic review
The Journal of Allergy and Clinical Immunology: In Practice, 2021Co-Authors: Tim Brettig, Jennifer J Koplin, Vicki Mcwilliam, Rachel L. Peters, Thanh Dang, Kirsten P. PerrettAbstract:Background Food Allergy is most accurately diagnosed by a formal oral food challenge (OFC); however, it is time and labor intensive, risks the individual to severe reaction, and access is often a limiting step in the diagnostic process. This is compounded for tree Nut Allergy diagnosis as several OFCs may be required to determine Allergy status to each individual tree Nut. Accurate diagnosis using minimally invasive diagnostic tests in predicting clinical tree Nut Allergy is important to correctly identify those with potentially life-threatening reactions and to efficiently and safely tailor Nut avoidance to only those Nuts deemed allergic to enable less restricted diets and increased food choices for food allergic individuals. Objective To conduct a systematic review on the diagnostic capacity of clinical tests (skin prick test, specific IgE, component-resolved diagnostics, and basophil activation test) to determine OFC-proven or clinical tree Nut Allergy. Methods We searched 4 electronic databases (OVID Medline, Embase, Cochrane library, and PubMed) until May 2020. Eligible studies were categorized by type of tree Nut and diagnostic test. Results A total of 27 studies assessed diagnostic accuracy to a specific tree Nut. Overall, the accuracy of diagnostic testing was only reasonable, with 95% positive predictive values established in a small number of tree Nuts. Cashew has best diagnostic accuracy, with the cashew component Ana o 3 being most predictive. At the other end of the spectrum, diagnostic testing of almond is poor and of limited clinical use. Conclusion The systematic review highlights the limitations of our current diagnostic tools for tree Nut Allergy and highlights further areas for research. The unidirectionality of cross-reactivity between cashew/pistachio and walNut/pecan is described and can aid diagnosis. Using diagnostic algorithms such as those demonstrated for walNut/pecan and cashew/pistachio Allergy, greater diagnostic accuracy and reduced number of OFCs may be achieved.
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the accuracy of diagnostic testing in determining tree Nut Allergy a systematic review
The Journal of Allergy and Clinical Immunology: In Practice, 2021Co-Authors: Tim Brettig, Vicki Mcwilliam, Thanh D. Dang, Rachel L. Peters, Kirsten P. PerrettAbstract:ABSTRACT Background Food Allergy is most accurately diagnosed by a formal oral food challenge however it is time and labor intensive, risks the individual to severe reaction and access is often a limiting step in the diagnostic process. This is compounded for tree Nut Allergy diagnosis as several oral food challenges may be required to determine Allergy status to each individual tree Nut. Accurate diagnosis using minimally invasive diagnostic tests in predicting clinical tree Nut Allergy is important to correctly identify those with potentially life-threatening reactions, and to efficiently and safely tailor Nut avoidance to only those Nuts deemed allergic to enable less restricted diets and increased food choices for food allergic individuals. Objective To conduct a systematic review on the diagnostic capacity of clinical tests (Skin Prick Test (SPT), specific IgE, Component Resolved Diagnostics (CRD), Basophil Activation Test (BAT)) to determine oral food challenge proven or clinical tree Nut Allergy. Methods We searched four electronic databases (OVID Medline, Embase, Cochrane library and PubMed) until May 2020. Eligible studies were categorized by type of tree Nut, and diagnostic test. Results 27 studies assessed diagnostic accuracy to a specific tree Nut. Overall, the accuracy of diagnostic testing was only reasonable, with 95% positive predictive values established in a small number of tree Nuts. Cashew has best diagnostic accuracy, with the cashew component Ana o 3 being most predictive. At the other end of the spectrum, diagnostic testing of almond is poor and of limited clinical use. Conclusion The systematic review highlights the limitations of our current diagnostic tools for tree Nut Allergy and highlights further areas for research. The uni-directionality of cross-reactivity between cashew/pistachio and walNut/pecan is described and can aid diagnosis. Using diagnostic algorithms such as those demonstrated for walNut/pecan and cashew/pistachio Allergy may achieve greater diagnostic accuracy and reduced number of OFCs.
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Prevalence and Natural History of Tree Nut Allergy
Annals of Allergy Asthma & Immunology, 2020Co-Authors: Vicki Mcwilliam, Kirsten P. Perrett, Thanh D. Dang, Rachel L. PetersAbstract:Abstract Objective Tree Nuts are common causes of food-related allergic reactions and anaphylaxis. Resolution of tree Nut Allergy is thought to be low, yet studies of the natural history of tree Nut Allergy are limited. This review summarizes the available literature regarding tree Nut Allergy prevalence and natural history and discusses emerging diagnostic and prognostic developments that will inform clinical management of tree Nut Allergy. Data Sources A comprehensive literature search using PubMed was performed. Study Selections Peer-reviewed publications relating to tree Nut Allergy prevalence, resolution, and diagnosis were selected, and findings were summarized using a narrative approach. Results Tree Nut Allergy prevalence varies by age, region, and food Allergy definition, and ranges from less than 1% to approximately 3% worldwide. Reports on the natural history of tree Nut Allergy data are limited to retrospective clinical data or cross-sectional survey data of self-reported food Allergy, with reported resolution ranging from 9% to 14%. Component-resolved diagnostics and basophil activation testing offer the potential to improve the diagnostic accuracy and predicted prognosis of specific tree Nut Allergy, but studies are limited. Conclusion Tree Nut Allergy remains an understudied area of food Allergy research with limited region-specific studies based on robust food Allergy measures in population cohorts with longitudinal follow-up. This currently limits our understanding of tree Nut Allergy prognosis.
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Patterns of tree Nut sensitization and Allergy in the first 6 years of life in a population-based cohort
Journal of Allergy and Clinical Immunology, 2019Co-Authors: Vicki Mcwilliam, Jennifer J Koplin, Shyamali C Dharmage, Annelouise Ponsonby, Mimi L K Tang, Lyle C Gurrin, Kirsten P. Perrett, Rachel L. Peters, Katrina J. Allen, Terence DwyerAbstract:Background Longitudinal population-based data regarding tree Nut Allergy are limited. Objectives We sought to determine the population prevalence of tree Nut Allergy at age 6 years and explore the relationship between egg and peaNut Allergy at age 1 year and development of tree Nut Allergy at age 6 years. Methods A population-based sample of 5276 children was recruited at age 1 year and followed up at age 6 years. At age 1 year, allergies to egg and peaNut were determined by means of oral food challenge, and parents reported their child's history of reaction to tree Nuts. Challenge-confirmed tree Nut Allergy was assessed at age 6 years. Results At age 1 year, the prevalence of parent-reported tree Nut Allergy was 0.1% (95% CI, 0.04% to 0.2%). Only 18.5% of infants had consumed tree Nuts in the first year of life. At age 6 years, challenge-confirmed tree Nut Allergy prevalence was 3.3% (95% CI, 2.8% to 4.0%), with cashew the most common (2.7%; 95% CI, 2.2% to 3.3%). Of children with peaNut Allergy only at age 1 year, 27% (95% CI, 16.1% to 39.7%) had tree Nut Allergy at age 6 years compared with 14% (95% CI, 10.4% to 17.9%) of those with egg Allergy only and 37% (95% CI, 27.2% to 47.4%) of those with both peaNut and egg Allergy. Conclusions Tree Nut Allergy is uncommon in the first year of life, likely because of limited tree Nut consumption. At age 6 years, tree Nut Allergy prevalence is similar to peaNut Allergy prevalence. More than a third of children with both peaNut and egg Allergy in infancy have tree Nut Allergy at age 6 years. Understanding how to prevent tree Nut Allergy should be an urgent priority for future research.
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Nut Allergy prevalence and differences between asian born children and australian born children of asian descent a state wide survey of children at primary school entry in victoria australia
Clinical & Experimental Allergy, 2016Co-Authors: Mary Panjari, Jennifer J Koplin, Shyamali C Dharmage, Lyle C Gurrin, Vicki Mcwilliam, Rachel L. Peters, Susan M Sawyer, Jana EckertAbstract:Background Asian infants born in Australia are 3 times more likely to develop Nut Allergy than non-Asian infants and rates of challenge-proven food Allergy in infants have been found to be unexpectedly high in metropolitan Melbourne. To further investigate risk factors for Nut Allergy we assessed the whole of State prevalence distribution of parent-reported Nut Allergy in 5 year old children entering school. Methods Using the 2010 School Entrant Health Questionnaire administered to all 5 year old children in Victoria, Australia, we assessed the prevalence of parent-reported Nut Allergy (tree Nut and peaNut) and whether this was altered by region of residence, socioeconomic status, country of birth or history of migration. Prevalence was calculated as observed proportion with 95% confidence intervals (CI). Risk factors were evaluated using multivariable logistic regression and adjusted for appropriate confounders. Results Parent-reported Nut Allergy prevalence was 3.1% (95%CI 2.9-3.2) amongst a cohort of nearly 60,000 children. It was more common amongst children of mothers with higher education and socioeconomic index and less prevalent amongst children in regional Victoria than in Melbourne. While children born in Australia to Asian-born mothers (aOR 2.67 95%CI 2.28, 3.27) were more likely to have Nut Allergy than non-Asian children, children born in Asia who subsequently migrated to Australia were at decreased risk of Nut Allergy (aOR 0.1 95%CI 0.03, 0.31). Conclusion Migration from Asia after the early infant period appears protective for the development of Nut Allergy. Additionally, rural regions have lower rates of Nut Allergy than urban areas. This article is protected by copyright. All rights reserved.
Venu Gangur - One of the best experts on this subject based on the ideXlab platform.
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cardiac mmcp 4 mast cell expansion and elevation of il 6 and ccr1 3 and cxcr2 signaling chemokines in an adjuvant free mouse model of tree Nut Allergy
Immunobiology, 2015Co-Authors: Babu Gonipeta, Sitaram Parvataneni, Eun Jung Kim, Radhakrishna Para, Ines Srkalovic, Tina Ortiz, Venu GangurAbstract:Abstract Background Nut Allergy is a growing and potentially fatal public health problem. We have previously reported a novel mouse model of near-fatal hazelNut (HN) Allergy that involves transdermal sensitization followed by oral elicitation of allergic reactions. Here we studied the cardiac mast cell and cardiac tissue responses during oral Nut induced allergic reaction in this mouse model. Methods Groups of mice were sensitized with HN and specific and total IgE were measured by ELISA. Oral allergic reaction was quantified by rectal thermometry and plasma mouse mast cell protease (mMCP)-1 by ELISA. Cardiovascular functions were determined by a non-invasive tail cuff method. Mucosal mast cells (MMC) and intestinal connective tissue MC (CTMC) were studied by immunohistochemistry (IHC) for mMCP-1 and mMCP-4 protein expression respectively. Cardiac MC were studied by toluidine blue (TB) as well as by the above IHC methods. Cytokines and chemokines in the tissues were quantified by a multiplex protein array method. Results Oral allergen challenge (OAC) of transdermal sensitized mice results in hypothermia, hypotension, tachycardia and rapid elevation of circulating mMCP-1. The IHC analysis of small intestine found significant expansion of mMCP-1+ MMCs and mMCP-4+ CTMCs. The TB analysis of cardiac tissues showed degranulation of majority of cardiac MCs. The IHC analysis of cardiac tissues showed very little mMCP-1 expression, but marked mMCP-4 expression. Furthermore, repeated OAC resulted in significant expansion of mMCP-4+ cardiac MCs in both the pericardium and the myocardium. Protein array analysis revealed significant elevation of cardiac IL-6 and CCR1/3 and CXCR2 signaling chemokines upon oral elicitation compared to sensitization alone. Conclusion These results demonstrate that: (i) besides the intestine, cardiac mast cells and the cardiac tissue respond during oral Nut induced allergic reaction; and (ii) repeated oral elicitation of reaction is associated with cardiac mMCP-4+ mast cell expansion and elevation of cardiac IL-6, and CCR1/3 and CXCR2 signaling chemokines.
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identification of t and b cell subsets that expand in the central and peripheral lymphoid organs during the establishment of Nut Allergy in an adjuvant free mouse model
International Scholarly Research Notices, 2013Co-Authors: Babu Gonipeta, David M Duriancik, Eun Jung Kim, Elizabeth M Gardner, Venu GangurAbstract:Nut allergies are potentially fatal and rarely outgrown for reasons that are not well understood. Phenotype of T- and B-cell subsets that expand during the early stages of Nut Allergy is largely unknown. Here we studied this problem using a novel mouse model of Nut Allergy. Mice were rendered hazelNut allergic by a transdermal sensitization/oral elicitation protocol. Using flow cytometry, the T- and B-cell phenotype in the bone marrow (BM), spleen, and the mesenteric lymph node (MLN) of allergic and control mice was analyzed. Nut allergic mice exhibited an expansion of CD4+ CD62L- T cells in BM and spleen; a similar trend was noted in the MLN. There was expansion of CD80+ B cells in BM and spleen and MLN and CD62L- cells in BM and spleen. Interestingly, among CD80+ B cells, significant proportion was CD73- particularly in the MLN. These data demonstrate that during the early establishment of hazelNut Allergy there is (i) expansion of CD4+CD62L- T-cell subsets in both the BM and the periphery, (ii) expansion of CD80+ and CD62L- B-cell subsets in BM and the periphery, and (iii) a significant downregulation of CD73 on a subset of B cells in MLN.
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Development of an adjuvant-free cashew Nut Allergy mouse model.
International archives of allergy and immunology, 2009Co-Authors: Sitaram Parvataneni, Babu Gonipeta, Robert J. Tempelman, Venu GangurAbstract:Background: Cashew Nut Allergy is an emerging food Allergy with a high risk of systemic anaphylaxis. Currently, an adjuvant-free animal model to study cashew Nut Allergy is not avai
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An Adjuvant-Free Mouse Model of Tree Nut Allergy Using HazelNut as a Model Tree Nut
International Archives of Allergy and Immunology, 2007Co-Authors: Neil P. Birmingham, Sitaram Parvataneni, Hanem Hassan, Jack R. Harkema, Sridhar Samineni, Lalitha Navuluri, Caleb Kelly, Venu GangurAbstract:Background: Tree Nut Allergy, a major group of food Allergy, is often linked to fatal or near-fatal systemic anaphylaxis. Currently, an adjuvant-free mouse model to study tree Nut h
Scott H. Sicherer - One of the best experts on this subject based on the ideXlab platform.
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Current perspectives on tree Nut Allergy: a review.
Journal of asthma and allergy, 2018Co-Authors: Tamar Weinberger, Scott H. SichererAbstract:Tree Nut (TN) Allergy is common and often severe. It has become an important health concern as availability and consumption have increased. Prevalence varies by age and geographic region and appears to have increased in children. Accidental ingestion of TNs is common. Unfortunately, there is a lower likelihood of resolution of TN Allergy, roughly 10%. TN-specific skin tests and serum immunoglobulin E levels can help aid in the diagnosis of TN Allergy, but a careful medical history is important because a positive test in isolation is not typically diagnostic. Component-resolved diagnostic tests are being increasingly utilized and may improve accuracy. Management consists of strict avoidance of the causal Nut(s) and prompt treatment of symptoms upon accidental exposure. A specific consideration with regard to the management of TN Allergy is the decision to avoid all TNs or only the TNs to which a patient is clinically allergic. There are currently no data on the primary or secondary prevention of TN Allergy. Treatment strategies are being evaluated.
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PeaNut and tree Nut Allergy.
Chemical immunology and allergy, 2015Co-Authors: Amanda L. Cox, Scott H. SichererAbstract:Allergy to peaNut and tree Nuts is a major worldwide health concern. The prevalence of these allergies may be increasing, but the reasons for these increases remain unclear. This group of foods accounts for a large proportion of severe and fatal food-allergic reactions. These allergies present most often during childhood but can occur at any age. Resolution is possible but uncommon, and frequent lifetime reactions caused by accidental ingestion are a serious problem. The major allergens of peaNut and most tree Nuts have been identified, allowing for insights into patient diagnoses, clinical outcomes, and potential future immunotherapies.
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a voluntary registry for peaNut and tree Nut Allergy characteristics of the first 5149 registrants
The Journal of Allergy and Clinical Immunology, 2001Co-Authors: Scott H. Sicherer, Terence J. Furlong, Anne Munozfurlong, Wesley A Burks, Hugh A. SampsonAbstract:Background: A voluntary registry of individuals with peaNut and/or tree Nut Allergy was established in 1997 to learn more about these food allergies. Objective: The purpose of this study was to elucidate a variety of features of peaNut and tree Nut Allergy among the first 5149 registry participants. Methods: The registry was established through use of a structured questionnaire distributed to all members of the Food Allergy and Anaphylaxis Network and to patients by allergists. Parental surrogates completed the forms for children under the age of 18 years. Results: Registrants were primarily children (89% of registrants were younger than 18 years of age; the median age was 5 years), reflecting the membership of the Network. Isolated peaNut Allergy was reported by 3482 registrants (68%), isolated tree Nut Allergy by 464 (9%), and Allergy to both foods by 1203 (23%). Registrants were more likely to have been born in October, November, or December (odds ratio, 1.2; 95% CI, 1.18-1.23; P < .0001). The median age of reaction to peaNut was 14 months, and the median age of reaction to tree Nuts was 36 months; these represented the first known exposure for 74% and 68% of registrants, respectively. One half of the reactions involved more than 1 organ system, and more than 75% required treatment, frequently from medical personnel. Registrants with asthma were more likely than those without asthma to have severe reactions (33% vs 21%; P < .0001). In comparison with initial reactions, subsequent reactions due to accidental ingestion were more severe, more common outside the home, and more likely to be treated with epinephrine. Conclusions: Allergic reactions to peaNut and tree Nut are frequently severe, often occur on the first known exposure, and can become more severe over time. (J Allergy Clin Immunol 2001;108:128-32.)
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A voluntary registry for peaNut and tree Nut Allergy: characteristics of the first 5149 registrants.
Journal of Allergy and Clinical Immunology, 2001Co-Authors: Scott H. Sicherer, A. Wesley Burks, Terence J. Furlong, Anne Muñoz-furlong, Hugh A. SampsonAbstract:Abstract Background: A voluntary registry of individuals with peaNut and/or tree Nut Allergy was established in 1997 to learn more about these food allergies. Objective: The purpose of this study was to elucidate a variety of features of peaNut and tree Nut Allergy among the first 5149 registry participants. Methods: The registry was established through use of a structured questionnaire distributed to all members of the Food Allergy and Anaphylaxis Network and to patients by allergists. Parental surrogates completed the forms for children under the age of 18 years. Results: Registrants were primarily children (89% of registrants were younger than 18 years of age; the median age was 5 years), reflecting the membership of the Network. Isolated peaNut Allergy was reported by 3482 registrants (68%), isolated tree Nut Allergy by 464 (9%), and Allergy to both foods by 1203 (23%). Registrants were more likely to have been born in October, November, or December (odds ratio, 1.2; 95% CI, 1.18-1.23; P P Conclusions: Allergic reactions to peaNut and tree Nut are frequently severe, often occur on the first known exposure, and can become more severe over time. (J Allergy Clin Immunol 2001;108:128-32.)
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The US PeaNut and Tree Nut Allergy Registry: characteristics of reactions in schools and day care.
The Journal of Pediatrics, 2001Co-Authors: Scott H. Sicherer, Jennifer Desimone, Terrence J. Furlong, Hugh A. SampsonAbstract:Abstract Objective: Severe food-allergic reactions occur in schools, but the features have not been described. Study design: Participants in the US PeaNut and Tree Nut Allergy Registry (PAR) who indicated that their child experienced an allergic reaction in school or day care were randomly selected for a telephone interview conducted with a structured questionnaire. Results: Of 4586 participants in the PAR, 750 (16%) indicated a reaction in school or day care, and 100 subjects or parental surrogates described 124 reactions to peaNut (115) or tree Nuts (9); 64% of the reactions occurred in day care or preschool, and the remainder in elementary school or higher grades. Reactions were reported from ingestion (60%), skin contact/possible ingestion (24%), and inhalation/possible skin contact or ingestion (16%). In the majority of reactions caused by inhalation, concomitant ingestion/skin contact could not be ruled out. Various foods caused reactions by ingestion, but peaNut butter craft projects were commonly responsible for the skin contact (44%) or inhalation (41%) reactions. For 90% of reactions, medications were given (86% antihistamines, 28% epinephrine). Epinephrine was given in school by teachers in 4 cases, nurses in 7, and parents or others in the remainder. Treatment delays were attributed to delayed recognition of reactions, calling parents, not following emergency plans, and an unsuccessful attempt to administer epinephrine. Conclusions: School personnel must be educated to recognize and treat food-allergic reactions. Awareness must be increased to avoid accidental exposures, including exposure from peaNut butter craft projects. (J Pediatr 2001;138:560-5)
Rachel L. Peters - One of the best experts on this subject based on the ideXlab platform.
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the accuracy of diagnostic testing in determining tree Nut Allergy a systematic review
The Journal of Allergy and Clinical Immunology: In Practice, 2021Co-Authors: Tim Brettig, Jennifer J Koplin, Vicki Mcwilliam, Rachel L. Peters, Thanh Dang, Kirsten P. PerrettAbstract:Background Food Allergy is most accurately diagnosed by a formal oral food challenge (OFC); however, it is time and labor intensive, risks the individual to severe reaction, and access is often a limiting step in the diagnostic process. This is compounded for tree Nut Allergy diagnosis as several OFCs may be required to determine Allergy status to each individual tree Nut. Accurate diagnosis using minimally invasive diagnostic tests in predicting clinical tree Nut Allergy is important to correctly identify those with potentially life-threatening reactions and to efficiently and safely tailor Nut avoidance to only those Nuts deemed allergic to enable less restricted diets and increased food choices for food allergic individuals. Objective To conduct a systematic review on the diagnostic capacity of clinical tests (skin prick test, specific IgE, component-resolved diagnostics, and basophil activation test) to determine OFC-proven or clinical tree Nut Allergy. Methods We searched 4 electronic databases (OVID Medline, Embase, Cochrane library, and PubMed) until May 2020. Eligible studies were categorized by type of tree Nut and diagnostic test. Results A total of 27 studies assessed diagnostic accuracy to a specific tree Nut. Overall, the accuracy of diagnostic testing was only reasonable, with 95% positive predictive values established in a small number of tree Nuts. Cashew has best diagnostic accuracy, with the cashew component Ana o 3 being most predictive. At the other end of the spectrum, diagnostic testing of almond is poor and of limited clinical use. Conclusion The systematic review highlights the limitations of our current diagnostic tools for tree Nut Allergy and highlights further areas for research. The unidirectionality of cross-reactivity between cashew/pistachio and walNut/pecan is described and can aid diagnosis. Using diagnostic algorithms such as those demonstrated for walNut/pecan and cashew/pistachio Allergy, greater diagnostic accuracy and reduced number of OFCs may be achieved.
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the accuracy of diagnostic testing in determining tree Nut Allergy a systematic review
The Journal of Allergy and Clinical Immunology: In Practice, 2021Co-Authors: Tim Brettig, Vicki Mcwilliam, Thanh D. Dang, Rachel L. Peters, Kirsten P. PerrettAbstract:ABSTRACT Background Food Allergy is most accurately diagnosed by a formal oral food challenge however it is time and labor intensive, risks the individual to severe reaction and access is often a limiting step in the diagnostic process. This is compounded for tree Nut Allergy diagnosis as several oral food challenges may be required to determine Allergy status to each individual tree Nut. Accurate diagnosis using minimally invasive diagnostic tests in predicting clinical tree Nut Allergy is important to correctly identify those with potentially life-threatening reactions, and to efficiently and safely tailor Nut avoidance to only those Nuts deemed allergic to enable less restricted diets and increased food choices for food allergic individuals. Objective To conduct a systematic review on the diagnostic capacity of clinical tests (Skin Prick Test (SPT), specific IgE, Component Resolved Diagnostics (CRD), Basophil Activation Test (BAT)) to determine oral food challenge proven or clinical tree Nut Allergy. Methods We searched four electronic databases (OVID Medline, Embase, Cochrane library and PubMed) until May 2020. Eligible studies were categorized by type of tree Nut, and diagnostic test. Results 27 studies assessed diagnostic accuracy to a specific tree Nut. Overall, the accuracy of diagnostic testing was only reasonable, with 95% positive predictive values established in a small number of tree Nuts. Cashew has best diagnostic accuracy, with the cashew component Ana o 3 being most predictive. At the other end of the spectrum, diagnostic testing of almond is poor and of limited clinical use. Conclusion The systematic review highlights the limitations of our current diagnostic tools for tree Nut Allergy and highlights further areas for research. The uni-directionality of cross-reactivity between cashew/pistachio and walNut/pecan is described and can aid diagnosis. Using diagnostic algorithms such as those demonstrated for walNut/pecan and cashew/pistachio Allergy may achieve greater diagnostic accuracy and reduced number of OFCs.
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Prevalence and Natural History of Tree Nut Allergy
Annals of Allergy Asthma & Immunology, 2020Co-Authors: Vicki Mcwilliam, Kirsten P. Perrett, Thanh D. Dang, Rachel L. PetersAbstract:Abstract Objective Tree Nuts are common causes of food-related allergic reactions and anaphylaxis. Resolution of tree Nut Allergy is thought to be low, yet studies of the natural history of tree Nut Allergy are limited. This review summarizes the available literature regarding tree Nut Allergy prevalence and natural history and discusses emerging diagnostic and prognostic developments that will inform clinical management of tree Nut Allergy. Data Sources A comprehensive literature search using PubMed was performed. Study Selections Peer-reviewed publications relating to tree Nut Allergy prevalence, resolution, and diagnosis were selected, and findings were summarized using a narrative approach. Results Tree Nut Allergy prevalence varies by age, region, and food Allergy definition, and ranges from less than 1% to approximately 3% worldwide. Reports on the natural history of tree Nut Allergy data are limited to retrospective clinical data or cross-sectional survey data of self-reported food Allergy, with reported resolution ranging from 9% to 14%. Component-resolved diagnostics and basophil activation testing offer the potential to improve the diagnostic accuracy and predicted prognosis of specific tree Nut Allergy, but studies are limited. Conclusion Tree Nut Allergy remains an understudied area of food Allergy research with limited region-specific studies based on robust food Allergy measures in population cohorts with longitudinal follow-up. This currently limits our understanding of tree Nut Allergy prognosis.
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Patterns of tree Nut sensitization and Allergy in the first 6 years of life in a population-based cohort
Journal of Allergy and Clinical Immunology, 2019Co-Authors: Vicki Mcwilliam, Jennifer J Koplin, Shyamali C Dharmage, Annelouise Ponsonby, Mimi L K Tang, Lyle C Gurrin, Kirsten P. Perrett, Rachel L. Peters, Katrina J. Allen, Terence DwyerAbstract:Background Longitudinal population-based data regarding tree Nut Allergy are limited. Objectives We sought to determine the population prevalence of tree Nut Allergy at age 6 years and explore the relationship between egg and peaNut Allergy at age 1 year and development of tree Nut Allergy at age 6 years. Methods A population-based sample of 5276 children was recruited at age 1 year and followed up at age 6 years. At age 1 year, allergies to egg and peaNut were determined by means of oral food challenge, and parents reported their child's history of reaction to tree Nuts. Challenge-confirmed tree Nut Allergy was assessed at age 6 years. Results At age 1 year, the prevalence of parent-reported tree Nut Allergy was 0.1% (95% CI, 0.04% to 0.2%). Only 18.5% of infants had consumed tree Nuts in the first year of life. At age 6 years, challenge-confirmed tree Nut Allergy prevalence was 3.3% (95% CI, 2.8% to 4.0%), with cashew the most common (2.7%; 95% CI, 2.2% to 3.3%). Of children with peaNut Allergy only at age 1 year, 27% (95% CI, 16.1% to 39.7%) had tree Nut Allergy at age 6 years compared with 14% (95% CI, 10.4% to 17.9%) of those with egg Allergy only and 37% (95% CI, 27.2% to 47.4%) of those with both peaNut and egg Allergy. Conclusions Tree Nut Allergy is uncommon in the first year of life, likely because of limited tree Nut consumption. At age 6 years, tree Nut Allergy prevalence is similar to peaNut Allergy prevalence. More than a third of children with both peaNut and egg Allergy in infancy have tree Nut Allergy at age 6 years. Understanding how to prevent tree Nut Allergy should be an urgent priority for future research.
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Nut Allergy prevalence and differences between asian born children and australian born children of asian descent a state wide survey of children at primary school entry in victoria australia
Clinical & Experimental Allergy, 2016Co-Authors: Mary Panjari, Jennifer J Koplin, Shyamali C Dharmage, Lyle C Gurrin, Vicki Mcwilliam, Rachel L. Peters, Susan M Sawyer, Jana EckertAbstract:Background Asian infants born in Australia are 3 times more likely to develop Nut Allergy than non-Asian infants and rates of challenge-proven food Allergy in infants have been found to be unexpectedly high in metropolitan Melbourne. To further investigate risk factors for Nut Allergy we assessed the whole of State prevalence distribution of parent-reported Nut Allergy in 5 year old children entering school. Methods Using the 2010 School Entrant Health Questionnaire administered to all 5 year old children in Victoria, Australia, we assessed the prevalence of parent-reported Nut Allergy (tree Nut and peaNut) and whether this was altered by region of residence, socioeconomic status, country of birth or history of migration. Prevalence was calculated as observed proportion with 95% confidence intervals (CI). Risk factors were evaluated using multivariable logistic regression and adjusted for appropriate confounders. Results Parent-reported Nut Allergy prevalence was 3.1% (95%CI 2.9-3.2) amongst a cohort of nearly 60,000 children. It was more common amongst children of mothers with higher education and socioeconomic index and less prevalent amongst children in regional Victoria than in Melbourne. While children born in Australia to Asian-born mothers (aOR 2.67 95%CI 2.28, 3.27) were more likely to have Nut Allergy than non-Asian children, children born in Asia who subsequently migrated to Australia were at decreased risk of Nut Allergy (aOR 0.1 95%CI 0.03, 0.31). Conclusion Migration from Asia after the early infant period appears protective for the development of Nut Allergy. Additionally, rural regions have lower rates of Nut Allergy than urban areas. This article is protected by copyright. All rights reserved.
