NEW YORK, July 11, (RTRS): Peanut allergy has proven to be a tough nut to crack. While there’s still no way to make peanuts completely safe for people who are allergic to them, an experimental therapy may make them less deadly, report researchers from Germany and the US.
While the research holds hope for the hundreds of thousands of American kids who are allergic to peanuts, there’s a lot more research to do before the therapy is ready for “prime time,” Dr Wayne Shreffler, an investigator on the study, told Reuters Health.
Unlike other food allergies — which might disappear as kids grow up or respond to doctor-supervised “challenges” allowing a child to build up a tolerance to the food — a peanut allergy usually lasts a lifetime, Shreffler and colleagues note in the Journal of Allergy and Clinical Immunology. And the severity of reactions may vary widely; one accidental exposure may lead to a minor rash, the next could be fatal.
The research team, from Berlin’s University Hospital Charite and Mount Sinai Medical Center in New York, wanted to know if a therapy could be developed that was safe to take by mouth and would reduce the threat of accidental peanut ingestion in peanut-allergic kids. “These patients were carefully selected to have an extremely low probability of growing out of their peanut allergy,” said Shreffler, who now practices at Massachusetts General Hospital in Boston. In the study, the first of its kind, tiny amounts of crushed peanuts were given by mouth to build up tolerance to peanut proteins. To limit the danger of a fatal reaction, the 23 children enrolled in the study were admitted to the hospital for the first week of therapy.
It took an average of 7 months of increasing doses for the kids to work up tolerance to one kernel’s worth of crushed peanut or 500 milligrams, more than is usually eaten in an “accidental ingestion,” the investigators say. After they reached 500 mg and were able to consume it daily without side effects for 8 weeks, they took two weeks off and then faced a new peanut food challenge.
Before this time, however, more than a third of the kids (35 percent) dropped out of the study, a rate “quite high compared to other studies,” the investigators note. Allergic reactions ranging from upset stomach to wheezing were common in all the children. Four, or 17 percent, dropped out because of a bad allergic reaction, a higher adverse reaction rate than some previous work. One patient quit during the hospital phase because of anxiety. Two, including the youngest participant, who couldn’t stomach the taste of the peanut/applesauce concoction, were dropped because they wouldn’t follow the trial rules.
Fourteen children made it to the end of the study. At the final food challenge, all but two of them were able to tolerate 1 gram of peanut compared to .19 gram at the beginning of the study, leading the investigators to conclude that “some patients” might benefit from this approach known as “oral immunotherapy.” “The glass is half full,” Shreffler said. The therapy was able to increase tolerance levels in “many more than would have had any change on their own,” he said while urging caution.
Whether the protection lasts longer than two weeks is not answered yet.
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Nutrition promoters: Advice from a trusted beautician carries a lot of weight.
In fact, a conversation about the importance of eating fruits and vegetables over a haircut or color could help a client take steps to eat better and trim unhealthy pounds, hints a small study conducted among African-American women.
African-American women generally consume fewer fruits and vegetables, get less exercise and drink smaller amounts of water than white women, all of which puts them at a higher risk for obesity and the diseases it can trigger, such as diabetes and heart disease. Community-based approaches have been recommended to address the problem. Beauty salons may be an ideal place to disseminate health information.
“The respect for cosmetologists within the African-American community allows for dialog to flow freely and for all within the salon to share their stories about personal life concerns, including health,” lead researcher Latasha Johnson, who was an undergraduate student at South Carolina State University, Orangeburg, at the time of the study, noted in an email to Reuters Health.
Johnson and her colleagues from South Carolina State and Florida State University, Tallahassee, identified two beauty salons in a rural African-American community of South Carolina. For 6 weeks, the beauty salon-based health intervention program called “Steps for a New You” was provided to select clients in one of the salons. The program includes scripted motivational sessions, informational packets and starter kits of sample items. The other salon carried on as usual.
The study team found that the women who received instruction and materials from a beautician increased their average fruit and vegetable intake from about 2 servings a day, based on a pre-program questionnaire, to 3 and a half a day at the end of the program. Health experts generally recommended at least 5 servings a day of fruits and vegetables.
As expected, clients at the other “control” salon saw no improvements in fruit and vegetable intake.
“I think the beauty salon is a very key venue to reach captive audiences of women,” Dr Antronette Yancey of the University of California, Los Angeles, who was not involved in the study, told Reuters Health. “They tend to serve a particular ethnic group and tailor their services to the needs of that group. This provides an opportunity to ethnically target materials.”
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Pricey drugs: Recommendations for expensive treatments made for a genetic disorder called alpha-1 antitrypsin deficiency should be withdrawn because the drugs have no benefit, scientists said recently. The disorder causes chronic lung disease and researchers who reviewed data from two trials on 140 patients with it found no evidence that alpha-1 antitrypsin medicines — made by various drugmakers including Talecris, Kamada, CSL and Baxter — do any good. Based on this evidence, the researchers said the treatment, which costs up to $150,000 a year in the United States, should not be recommended by doctors and advocacy groups.
“The drug has not shown any clinical benefit, is extremely costly and has important adverse effects,” said lead researcher Peter Gotzsche of the Nordic Cochrane Center at Rigshospitalet in Copenhagen, Denmark.
“In view of the lack of evidence and high cost of treatment, treating alpha-1 antitrypsin deficiency by replacement therapy cannot be recommended.”
According to the team, whose work was published in The Cochrane Library journal, recommendations by the American Thoracic Society and European Respiratory Society that promote alpha-1 antitrypsin replacement are “misguided”. “Both societies recommend augmentation therapy for patients with breathing problems related to alfa-1 antitrypsin deficiency. In our opinion, these recommendations are not reasonable,” said Gotzsche.
Alpha-1 antitrypsin deficiency affects less than one in 1,600 people. Those who inherit the disorder have low levels of the protein alpha-1 antitrypsin, also called alpha-1 proteinase inhibitor, which protects the tissue of the lungs from destruction by the body’s own white blood cells.
At a relatively young age, this can result in symptoms of emphysema, including shortness of breath and wheezing.
The aim of alpha-1 antitrypsin replacement therapy is to give the patient back the protective protein they are missing. This should limit damage to lungs and, ultimately, prevent early death. The protein is usually extracted from blood donated by healthy volunteers.