Researchers at the Murdoch Childrens Research Institute and the University of Melbourne have been looking for a better way to diagnose peanut allergy. Currently, the best method is through an oral food challenge in a medical setting. This is the practice whereby someone with a suspected food allergy eats the food to see if there is a reaction. Not only is this a costly and lengthy process, it can also lead to an anaphylactic reaction.
This study found that measuring Ara h 2, which is the dominant peanut allergen detected in 90% to 100% of people with peanut allergy, appears to provide a higher diagnostic accuracy for peanut allergy. This two-step blood test would provide clearer results in a more cost-effective and convenient way. It would also reduce the number of oral food challenges and could minimize the over-diagnosis of peanut allergy.
Thursday, 29 March 2012
Tuesday, 27 March 2012
New Discovery May Help Food Allergic
 | |
| Research May Provide Clues to Food Allergy. |
Dr. Newberry's team placed a video in the gut of a mouse to observe what they thought would be dendritic cells sampling food particles and then seeking out antigens to neutralize or attack if the samples were found to be threatening. However, what they discovered was an escort, called goblet cells, whose job it is to bring the food sample to the dendritic cells. This discovery leads researchers to believe that goblet cells play a much more important role than previously thought. If these escort cells could be trained to bring food samples to the dendritic cells and introduce them in a friendly manner, perhaps the body wouldn't over-react to an innocent egg or peanut protein.These findings may help scientists introduce a drug therapy to tame an over-active immune system, like that found in people with food allergies or celiac disease.
Aaahhh...if we could only get our cells to play nice and cooperate...
Check out Christopher Wajnek's article Special Gut Cells May Help Tame Food Allergies for more information on Dr. Newberry's study.
Thursday, 22 March 2012
Food Allergy Blog Carnival for March 2012
Welcome to the latest edition of the Food Allergy Blog Carnival!
This carnival starts out with a humorous look at parenting a child with food allergies. Check out one mom's hilarious rendition of Hello Muddah- Food Allergy Version (yup, she's a singer too!). You may also want to take a look at a few of her other blog posts like, A Prayer to St. Patrick and Why Cupcakes Trump Children.
The Food Allergy Living Team brings us two posts, Helping Families Manage Food Allergies at School and Taking a Leap to Try New Foods.
This carnival starts out with a humorous look at parenting a child with food allergies. Check out one mom's hilarious rendition of Hello Muddah- Food Allergy Version (yup, she's a singer too!). You may also want to take a look at a few of her other blog posts like, A Prayer to St. Patrick and Why Cupcakes Trump Children.
The Food Allergy Living Team brings us two posts, Helping Families Manage Food Allergies at School and Taking a Leap to Try New Foods.
Stacy Molter offers her recipe for Food Allergy Friendly Chocolate Banana Parfait with Sugar Cookie Crumble. Yum!
Food Allergy Buzz wonders Does Heat Kill Allergens?
Suzanne Cullens brings us Ten Things You Might Not Know Have Peanuts.
That wraps up this edition. Thanks for visiting and have a great day!
Tuesday, 20 March 2012
Food Allergy Friendly Snacks
I mean how can Magherita Pizza Plentils be free of wheat? And, how can the Garlic and Parmesan Plentils or the Dill and Sour Cream Plentils be free of milk? I don't know how they did it, but these are really tasty chips! It gets better too...they are made with high protein lentils. For those of us avoiding several major allergens, finding sources of protein is a big deal. I love a snack chip that offers some benefits!
Plentils are available through online stores, including Enjoy Life's e-store, and will soon be available in grocery stores.
Thursday, 15 March 2012
Food Allergy Testing: Why are so Few Allergists Doing "The Gold Standard"?
of Allergy Notes makes some good observations about oral food challenges (OFC) in his article, "85% of Allergists perform Gold Standard Test for Diagnosis of Food Allergy". He points out that fewer than 6% of allergists perform more than 10 per month, citing time, insurance reimbursement and risk of adverse reactions as the reasons for conducting so few OFC's.
For several years food allergic patients have been told that OFC's are the most definitive method to test food allergies. More commonly however, skin prick tests and blood tests are used by allergists to determine food allergy. Our personal experience has shown that the results of these two common allergy tests may not provide definitive results. Skin tests on a person with eczema and/or sensitive skin is often of little value. Certain people react to nearly anything pricked into their skin and the blotchy red welts that result make it appear that the person is allergic to everything.
The next test for food allergies is blood work. I remember one visit to Children's Hospital with my then 2 1/2 year old. They told us to list any food we thought he might have an allergy to. We listed 30 foods we suspected.
The blood test results? Allergic to all.
Nonsense said our primary allergist as my child had been successfully eating many of these foods. We've had many inconclusive blood test results. Not only is blood work traumatizing to a child, but avoiding so many types of foods unnecessarily could lead to poor growth and nutrition.
We've now done about a dozen oral food challenges in the allergist's office now. They are very time consuming- taking between 3-4 hours typically. This makes it difficult to do during the school year (and who wants to give up a school holiday to sit in the allergist's office to eat something that may cause an allergic reaction?). There are three types of OFC's: open, single-blind and double blind. In the open challenge, everyone knows the suspected food is being given. This is the only type of challenge we've done. A single blind means the patient doesn't know if they are ingesting the offending food or a placebo, and in the double blind, the patient and the medical staff are unaware if it is the suspected food or a placebo. We have observed a huge psychological factor in these open challenges in which the person may think there is tongue tingling or thickness in the throat because they know the food may cause a reaction. We have also found over the years, OFC's have become more and more expensive to us as insurance companies have decreased reimbursement.
So, even OFC's still may not give the definite results we seek. Some of our challenges may have been halted prematurely by the allergist who was concerned about possible reactions. Sometimes we leave the OFC still not knowing for sure if there was a reaction. For now, though, it's the best test we've got and it does provide some clues that may be helpful to the food allergic person and their family.
In light of this, I hope to see more training of allergists and better reimbursement from insurance companies. Until we come up with something better, let's use OFC's to help those with food allergies determine what foods need to be avoided and what foods they need not fear.
Check out Oral Food Challenge Practices among Allergists in the United States from The Journal of Allergy and Immunology for more information.
For several years food allergic patients have been told that OFC's are the most definitive method to test food allergies. More commonly however, skin prick tests and blood tests are used by allergists to determine food allergy. Our personal experience has shown that the results of these two common allergy tests may not provide definitive results. Skin tests on a person with eczema and/or sensitive skin is often of little value. Certain people react to nearly anything pricked into their skin and the blotchy red welts that result make it appear that the person is allergic to everything.
The next test for food allergies is blood work. I remember one visit to Children's Hospital with my then 2 1/2 year old. They told us to list any food we thought he might have an allergy to. We listed 30 foods we suspected.
The blood test results? Allergic to all.
Nonsense said our primary allergist as my child had been successfully eating many of these foods. We've had many inconclusive blood test results. Not only is blood work traumatizing to a child, but avoiding so many types of foods unnecessarily could lead to poor growth and nutrition.
We've now done about a dozen oral food challenges in the allergist's office now. They are very time consuming- taking between 3-4 hours typically. This makes it difficult to do during the school year (and who wants to give up a school holiday to sit in the allergist's office to eat something that may cause an allergic reaction?). There are three types of OFC's: open, single-blind and double blind. In the open challenge, everyone knows the suspected food is being given. This is the only type of challenge we've done. A single blind means the patient doesn't know if they are ingesting the offending food or a placebo, and in the double blind, the patient and the medical staff are unaware if it is the suspected food or a placebo. We have observed a huge psychological factor in these open challenges in which the person may think there is tongue tingling or thickness in the throat because they know the food may cause a reaction. We have also found over the years, OFC's have become more and more expensive to us as insurance companies have decreased reimbursement.
So, even OFC's still may not give the definite results we seek. Some of our challenges may have been halted prematurely by the allergist who was concerned about possible reactions. Sometimes we leave the OFC still not knowing for sure if there was a reaction. For now, though, it's the best test we've got and it does provide some clues that may be helpful to the food allergic person and their family.
In light of this, I hope to see more training of allergists and better reimbursement from insurance companies. Until we come up with something better, let's use OFC's to help those with food allergies determine what foods need to be avoided and what foods they need not fear.
Check out Oral Food Challenge Practices among Allergists in the United States from The Journal of Allergy and Immunology for more information.
Tuesday, 13 March 2012
Making EpiPens Publicly Available for Allergic Reactions
I recently learned that our school district now has stock Epipens in all buildings. The rationale for this was in the event of a sheltering-in situation, additional emergency medications for food and insect allergic reactions may need to be available. I am unclear what happens when these medications expire. Where is the funding for extra Epipens going to come from, and who is keeping track of expiration dates?
Our school buildings already have defibrillators. "A Dangerous Allergy to Change", by Gillian Tett in FT magazine talks about the Good Samaritan Law leading to installation of defibrillators and questions why Epipens are not treated in the same manner.
The Virginia senate has sent an Epipen bill to the governor for signature following the death of an elementary student allergic to peanuts. Are we heading to nationwide availability of stock epinephrine in our schools, parks and other public places? It certainly makes sense from a health perspective, but I understand the concerns when it comes to cost and tracking of expired meds.
Does your school stock epinephrine? Would you be more apt to travel to places, say Disney, if you knew there was epinephrine readily available in the event of an anaphylactic emergency?
Our school buildings already have defibrillators. "A Dangerous Allergy to Change", by Gillian Tett in FT magazine talks about the Good Samaritan Law leading to installation of defibrillators and questions why Epipens are not treated in the same manner.
The Virginia senate has sent an Epipen bill to the governor for signature following the death of an elementary student allergic to peanuts. Are we heading to nationwide availability of stock epinephrine in our schools, parks and other public places? It certainly makes sense from a health perspective, but I understand the concerns when it comes to cost and tracking of expired meds.
Does your school stock epinephrine? Would you be more apt to travel to places, say Disney, if you knew there was epinephrine readily available in the event of an anaphylactic emergency?
Friday, 9 March 2012
Food Allergy Carnival Countdown
Are you familiar with blog carnivals? They are designed for bloggers to share specific posts with each other and to the world wide web at large. Food allergy has their own blog carnival supported by Food Allergy Buzz. I'll be hosting the March edition which comes out March 22, 2012. What do you need to do to participate in the carnival? Select one or two of your best recent blog posts and submit them here. Then, on March 22, come back to Food Allergy Assistant and read through all the great entries. If you want to get a feel for what is submitted to the carnival, check out the February edition hosted by Peanut Free Mama.
Hope to see your work in the next food allergy carnival!
UPDATE: Blog Carnival seems to be experiencing technical difficulties. For now, email title and link directly to me at foodallergyassistant@gmail.com. Submissions accepted until 11 pm Weds. March 21.
Hope to see your work in the next food allergy carnival!
UPDATE: Blog Carnival seems to be experiencing technical difficulties. For now, email title and link directly to me at foodallergyassistant@gmail.com. Submissions accepted until 11 pm Weds. March 21.
Thursday, 8 March 2012
Safe Treatment for Food Allergy
While avoidance has long been the recommended treatment for food allergy, several presentations at the annual meeting of the AAAAI this week offer hope for better options. One Step Closer to Treatment for Food Allergy outlines two potential treatments, oral immunotherapy and sublingual immunotherapy. Sublingual refers to the allergen being held under the tongue until it dissolves, while oral means actually swallowing the allergen.
Research with children who have milk allergy provided some clues to those who may benefit from either, or both, of these treatments. While the sample sizes are small, positive results have been obtained and resulted in tolerance for milk protein. For more information, check with your allergist about immunotherapy for food allergies.This is not something that should be done at home as it requires medical supervision.
Progress appears to be slow and steady...
For more information about presentations at the AAAAI annual meeting, see abstracts from the presenters.
Research with children who have milk allergy provided some clues to those who may benefit from either, or both, of these treatments. While the sample sizes are small, positive results have been obtained and resulted in tolerance for milk protein. For more information, check with your allergist about immunotherapy for food allergies.This is not something that should be done at home as it requires medical supervision.
Progress appears to be slow and steady...
For more information about presentations at the AAAAI annual meeting, see abstracts from the presenters.
Tuesday, 6 March 2012
International Food Allergy Meeting Offers New Research and Knowledge
The 2012 American Academy of Allergy, Asthma and Immunology annual meeting is wrapping up in Orlando Florida. The conference, scheduled from March 2-6 this year, brings together more than 6,500 allergists, immunologists, related physicians, other health professionals and industry representatives to discuss new research and other developments in allergy, asthma and immunologic diseases. Over the coming days and weeks, I'll be reporting on some of the food allergy information coming out of the conference. In the meantime, if you want to see what's happening, check out MedPage's Facebook page for live streaming of the meeting or follow #aaaai on Twitter for updates. Allergy Notes supplies a very helpful list of specific allergists using Twitter to provide updates during the conference. Follow any of them for the latest info.
Here's a copy of the final conference schedule. Yes, it's 170 pages, but look at this small sampling of food allergy presentations:
Here's a copy of the final conference schedule. Yes, it's 170 pages, but look at this small sampling of food allergy presentations:
- Oral Immunotherapy for Food Allergens by Dr. Wesley Burks
- Challenges of Managing Multiple Food Allergies, Dr. Julie Wang and Dr. Michael C. Young
- Food-Dependent Exercise-Induced Anaphylaxis with Dr. Anna M. Feldweg and Dr. Kirsi M. Jarvinen-Seppo
- Common Dilemmas in Caring for Children with FoodAllergies- Teri Holbrook, CRNP and Kim E. Mudd, RN MSN CCRP
- Food Allergy I–Diagnosis and Treatment
- Food Allergy Related Issues/Immune Skin Disease
- Dissecting Mechanisms of Oral Tolerance in Food Allergy moderated by Dr. Wayne G. Shreffler
- Induction of Tolerance with Baked Milk: Potential Mechanisms with Dr. Jennifer S. Kim
- Don’t Cross Me! Guiding Patients with Food Allergy Regarding Cross Contact, Ingredient Allergenicity and Precautionary Labeling, moderated by Dr. Stephen L. Taylor, and G. Lynn Christie, MS RD
Friday, 2 March 2012
Food Allergy Resources for Schools
I just sent these links to the school nurse director in our school district:
The above was accompanied by a short note acknowledging my awareness that the district was re-evaluating its food allergy policy in the coming months and my offer to assist during this process. I also pointed out that the first two resources offer free online courses for schools.
Feel free to copy the above information and send it to your school. The ideas of staff training and epinephrine availability for any student or staff member should be universal at any school. Help spread the word!
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