New research from British Columbia confirms yet again that the earlier you start peanut immunotherapy the safer and more effective it is. This makes complete sense in the context of the new thinking about peanut allergy which emerged after Professor Gideon Lack’s LEAP trials eight years ago.
Dr Lack’s research had been prompted by a lecture tour he undertook on peanut allergy in Israel. Much to his surprise, his audience appeared baffled by his subject matter – peanut allergy was simply not an issue in Israel. How come not? An examination of early feeding practices in Israel, the UK and the USA suggested a possible answer. In Israel, a country where peanuts are widely consumed as a snack, a peanut mush is a common weaning food and babies as young as three months are fed peanut snacks. Thus peanuts are introduced through the digestive tract and tolerance induced at a very early age.
In the USA and the UK peanuts were assiduously avoided in infancy and toddlerhood and might be first encountered when a child was five or six or even older. While this might not be an issue for a child without an atopic background or history, for an atopic child this could present a risk. Especially if they also suffered from eczema and could have come into contact with peanut proteins through broken skin. In this case, the protein would have been introduced directly into the blood stream rather than through the digestive tract, sensitising the child’s immune system so that when it met it again as a food it was already primed to react.
This observation led to the LEAP study and a focus on immunotherapy as a way to recreate that tolerance in both children and adults. Many clinical trials later immunotherapy has been cleared as a safe treatment for children and pre school children. This latest trial confirms that this approach is not only safe but very successful. Moreover it can largely be implemented at home by parents supported by regular clinic visits making it very much cheaper and more convenient than earlier regimes which had to take place entirely in clinic.
With many thanks to Latitudes, the journal of the Association for Comprehensive Neuropathy, for alerting me to this research and for their helpful article on the study.
Red wine re-instated if you are old enough…..