Each half of a peanut kernel contains about 150 mg of peanut protein.
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Peanut allergies are food allergy. Accidental exposure to small amounts of peanut protein can provoke serious reactions. For children with these allergies, the killer can also be treated as long as it is at a lesser dose. The results of a clinical trial published today in the New England Journal of Medicine give excellent results for a careful desensitization program. Treatment does not improve allergy and contains significant risks, but it can help children to live without fear of triggering any peanut flavored in everything they eat.
The principle behind desensitization or allergen immunotherapy (AIT) is to allow the body to react less and less when exposed to an allergen, recognizing something that it sees as an invader. In 2015, the Journal of Allergy and Clinical Immunology elaborated the asına international consensus ted on treatment, and said that although the technique is undisputed for hay fever, its use in the treatment of food allergy will not be sufficiently understood.
Research on AIT for peanut allergies has not provided sufficient high-quality evidence to become an approved treatment. This is why the publication of this 3-step study is a big news: this is the last stage that drugs trials should go through before they can apply for licensing by the regulatory authorities, such as the FDA. However, this does not mean that science is not done and everyone can go home – there are more questions that need to be answered, and often more than one trial is needed before approval.
This study took place in 66 countries in 10 countries and recorded 551 patients with peanut allergy. Most of these patients – 496 years – were between 4 and 17 years of age. All of these participants were involved in a food screening that showed oat protein or flavored peanut protein in one day and other foods in a second day. The idea behind it was to make sure that the participant didn't know that they actually ate peanuts and not eat them, and the person who gave them food didn't know what they ate. Only people who reacted to hidden peanut protein were included in the study.
Subsequently, the participants were randomized: one-fourth of the placebo group was adjusted to receive a similar powder to the treatment but not to take any peanut protein and to receive three-quarters of the treatment. This treatment started as only 0.5 mg of peanut protein at the initial dose and was gradual output to 300 mg for 24 weeks – approximately the same as a single peanut. Then he came to the stage of care: 300 mg every day for 24 days.
When the treatment was over, the results were clear. In another food problem, the researchers tested how high the tolerance of the participants was. This started with a low dose of peanut protein and, if the participant did so, increased the dose in the next round. Only eight percent of the children in the placebo group did this in a 300 mg round compared to 77 percent in the treatment group.
In the next round of 600 mg, four percent of the children in the placebo group did this, while 67 percent of those in the treatment group did this. In the placebo group, 2.4% can tolerate 1,000 mg peanut protein compared to half of the treatment group. Among the 55 adults tested, differences in responses to the food challenge were not statistically significant.
Standing with Epipen
Exposing a very large group of children to foods that are extremely allergic, not lightly, without risks. The study had a high release rate of about 12 percent in the active group due to side effects, and all participants participating in the treatment showed that two-thirds were moderate or severe during the treatment. This is probably not entirely associated with the treatment itself, but higher than the placebo group, with less than half of which had a medium or heavy event during the trial.
During the final food problem, five percent of the children in the treatment group had a severe reaction and 25 percent had a moderate reaction. This was much lower than the ratio in the placebo group – 11 and 59 percent, respectively – but that the treatment and testing came with significant risks. In It's nothing to start at home, şey writes epidemiologist Michael Perkin.
A major weakness of the trial is that the maintenance period is cut in six months. Trials of long-term care are ongoing, but there is no evidence at this stage showing how long the treatment will be effective and even safe. If long-term care does not work, it will probably require a continuing discipline from patients in the rest of their lives. . The most important concern with immunotherapy is that the induced allergen tolerance is transient and that if regular consumption stops, it is lost. . "
Despite these warnings, there is no doubt that this is exciting and pleasant news for children with peanut allergies. Tüketim Most parents will regularly see the consumption of a few peanuts from their children as a very small price to maintain the threat of systemic anaphylaxis, P says Perkin.
New England Medical Journal, 2018. DOI: ().