Peanut Allergy: Changes in Dogma and Past, Present, and Future Directions
Insights
Early introduction of peanuts may prevent peanut allergy in infants, contrary to previous advice. High-risk infants should see a specialist promptly for evaluation and potential new therapies.
Area of Science:
- Pediatric Allergy and Immunology
- Clinical Pediatrics
Background:
- Rising prevalence of peanut allergy in children.
- Life-threatening risks associated with accidental peanut exposure.
- Outdated recommendations suggested delaying peanut introduction.
Purpose of the Study:
- To review current evidence on peanut allergy prevention.
- To discuss the shift towards early peanut introduction.
- To highlight the need for specialist evaluation in high-risk infants.
Main Methods:
- Review of recent studies on early infant feeding practices.
- Analysis of evidence supporting early peanut introduction for allergy prevention.
- Discussion of current and emerging treatment modalities.
Main Results:
- Recent evidence supports early peanut introduction for peanut allergy prevention.
- Delayed introduction is no longer recommended based on new findings.
- Strict allergen avoidance remains the primary treatment.
Conclusions:
- Early peanut introduction is a key strategy for preventing peanut allergy.
- Prompt specialist evaluation is crucial for high-risk infants.
- Novel immunotherapies (oral, sublingual, epicutaneous) are under development.
Abstract:
The prevalence of food allergy in the pediatric population, specifically to peanuts, has been rising. Accidental exposure to peanuts in a person who is allergic may have life-threatening consequences. Previous recommendations regarding peanut allergy included a delay in introduction of peanut to infants. However, more recent studies have provided sufficient contrary evidence supporting early introduction of peanuts for prevention of peanut allergy. Therefore, prompt evaluation by a specialist should be considered in infants at high risk of developing peanut allergy. Current treatment is strict avoidance of the allergen; however, future therapies are being sought, including oral immunotherapy, sublingual immunotherapy, and epicutaneous immunotherapy. [Pediatr Ann. 2018;47(7):e300-e304.].
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