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Ausgabe
Juni 2008
Erdnussallergie: Von
Allergien gegen Erdnüsse geht ein hohes Anaphylaxie-Risiko aus, da oft
nicht bekannt ist, dass Nahrungsmittel Erdnüsse enthalten. Die
Allergiker können diese Nahrungsmittel daher nicht meiden. Jetzt hat
Professor Wesley Burks,
Duke University Medical Center, NC, USA, im Fachblatt Lancet
darauf hingewiesen, dass wahrscheinlich innerhalb der nächsten fünf
Jahre eine Immuntherapie gegen Erdnussallergie entwickelt wird. (5)
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(sog. MEDLINE Abstract) finden Sie
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Quelle: The Lancet
IMMUNOTHERAPY FOR PEANUT ALLERGY SHOULD BE AVAILABLE IN
FIVE YEARS
Some form of immunotherapy is expected to be available for
peanut allergy within the next five years. But the reasons
for the increasing prevalence of this allergic reaction
remain unclear. The issues are discussed by Professor Wesley
Burks, Duke University Medical Center, NC, USA, in a Seminar
in this week’s edition of The Lancet.
Peanut allergy has become a major health concern worldwide,
especially in developed countries, and affects around 1% of
children under the age of five years. It is a disease
modulated by the immunoglobulin E part of the immune system—once
peanut protein is ingested, it crosslinks with these IgE
antibodies and causes release of inflammatory molecules such
as histamines. The mean age of diagnosis in children is 14
months, with symptoms occurring after the first known peanut
ingestion in 75% of those children eating peanuts for the
first time. Almost all initial reactions involve the skin,
approximately half involve the respiratory tract, and a
third the gastrointestinal tract.
Professor Burks says: “Because of the potentially severe
health consequences of peanut allergy, those suspected of
having had an allergic reaction to peanuts deserve a
thorough evaluation. All patients with peanut allergy should
be given an emergency management plan, as well as
epinephrine and antihistamines to have on hand at all times.
Patients and families should be taught to recognise early
allergic reactions to peanuts and how to implement
appropriate peanut-avoidance strategies. It is imperative
that severe, or potentially severe, reactions be treated
promptly with intramuscular epinephrine and oral
antihistamines. Patients who have had such a reaction should
be kept under observation in a hospital emergency department
or equivalent for up to four hours because of the possible
development of the late-phase allergic response.”
A study from the USA has shown that peanut allergy
prevalence in young children doubled from 0·4% in 1997 to
0·8% in 2002. There are many theories regarding the
increased prevalence of peanut allergy, none of them proven.
Among them is the hygiene hypothesis, which says that not
enough exposure to infectious agents in early childhood can
increase susceptibility to allergic disease. And researchers
have suggested that presence of peanuts in the mother’s diet
before birth could be risk factor for developing the allergy.
Among the approaches being looked at to reduce the impact of
this condition is development of transgenic plants to
produce hypoallergenic peanuts. However, as several peanut
proteins are involved in the allergic response, Professor
Burks says: “The process of altering enough of the peanut
allergens to make a modified peanut that is less likely to
cause an allergic reaction would probably render the new
peanut no longer a peanut.”
Future treatments are all focused around the attempt to curb
the immune response or induce tolerance by the immune system
in response to a specific food allergen. Possible approaches
include engineered peanut proteins used as immunotherapy and
specific oral tolerance induction, in which the food is
ingested in increasingly larger amounts on a regular basis.
Professor Burks concludes: “It is likely that in the next
five years there will be some type of immunotherapy
available for peanut allergenic individuals.”
Professor Wesley Burks,
Duke University Medical Center, NC, USA.
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