Background

Early introduction of dietary peanut in high-risk infants with severe eczema, egg allergy, or both prevented peanut allergy at 5 years of age in the Learning Early About Peanut Allergy (LEAP) study. The protective effect persisted after 12 months of avoiding peanuts in the 12-month extension of the LEAP study (LEAP-On). It is unclear whether this benefit is allergen and allergic disease specific.

Objective

We sought to assess the effect of early introduction of peanut on the development of allergic disease, food sensitization, and aeroallergen sensitization.

Methods

Asthma, eczema, and rhinoconjunctivitis were diagnosed based on clinical assessment. Reported allergic reactions and consumption of tree nuts and sesame were recorded by questionnaire. Sensitization to food allergens and aeroallergens was determined by means of skin prick testing and specific IgE measurement.

Results

A high and increasing burden of food allergen and aeroallergen sensitization and allergic disease was noted across study time points; 76% of LEAP participants had at least 1 allergic disease at 60 months of age. There were no differences in allergic disease between LEAP groups. There were small differences in sensitization and reported allergic reactions for select tree nuts, with levels being higher in the LEAP consumption group. Significant resolution of eczema and sensitization to egg and milk occurred in LEAP participants and was not affected by peanut consumption.

Conclusion

Early consumption of peanut in infants at high risk of peanut allergy is allergen specific and does not prevent the development of other allergic disease, sensitization to other food allergens and aeroallergens, or reported allergic reactions to tree nuts and sesame. Furthermore, peanut consumption does not hasten the resolution of eczema or egg allergy.

中文翻译：

---

早期花生过敏研究队列中早期食用花生的过敏原特异性及其对过敏性疾病发展的影响

背景

在早期了解花生过敏 (LEAP) 研究中，在患有严重湿疹、鸡蛋过敏或两者兼有的高危婴儿中早期引入膳食花生可预防 5 岁时的花生过敏。在 LEAP 研究 (LEAP-On) 的 12 个月延长期内，避免食用花生 12 个月后，保护作用仍然存在。目前尚不清楚这种益处是否是过敏原和过敏性疾病特异性的。

客观的

我们试图评估早期引入花生对过敏性疾病、食物致敏和气源性过敏原致敏的影响。

方法

根据临床评估诊断哮喘、湿疹和鼻结膜炎。通过问卷记录报告的过敏反应和食用坚果和芝麻。通过皮肤点刺试验和特异性 IgE 测量确定对食物过敏原和气源性过敏原的敏感性。

结果

研究发现，食物过敏原、气源性过敏原致敏和过敏性疾病的负担越来越重；76% 的 LEAP 参与者在 60 个月大时至少患有 1 种过敏性疾病。LEAP 组之间的过敏性疾病没有差异。某些树坚果的致敏性和报告的过敏反应存在微小差异，LEAP 食用组的水平更高。LEAP 参与者的湿疹和对鸡蛋和牛奶的敏感性显着缓解，并且不受花生消费的影响。

结论

花生过敏高风险婴儿早期食用花生是过敏原特异性的，不会预防其他过敏性疾病的发展、对其他食物过敏原和气源性过敏原的敏感性，或对坚果和芝麻的过敏反应。此外，食用花生不会加速湿疹或鸡蛋过敏的消退。