Atopic dermatitis increases the effect of exposure to peanut antigen in dust on peanut sensitization and likely peanut allergy.

Abstract

BACKGROUND:

History and severity of atopic dermatitis (AD) are risk factors for peanut allergy. Recent evidence suggests that children can become sensitized to food allergens through an impaired skin barrier. Household peanut consumption, which correlates strongly with peanut protein levels in household dust, is a risk factor for peanut allergy.

OBJECTIVE:

We sought to assess whether environmental peanut exposure (EPE) is a risk for peanut sensitization and allergy and whether markers of an impaired skin barrier modify this risk.

METHODS:

Peanut protein in household dust (in micrograms per gram) was assessed in highly atopic children (age, 3-15 months) recruited to the Consortium of Food Allergy Research Observational Study. History and severity of AD, peanut sensitization, and likely allergy (peanut-specific IgE, ≥5 kUA/mL) were assessed at recruitment into the Consortium of Food Allergy Research study.

RESULTS:

There was an exposure-response relationship between peanut protein levels in household dust and peanut skin prick test (SPT) sensitization and likely allergy. In the final multivariate model an increase in 4 log2 EPE units increased the odds of peanut SPT sensitization (1.71-fold; 95% CI, 1.13- to 2.59-fold; P = .01) and likely peanut allergy (PA; 2.10-fold; 95% CI, 1.20- to 3.67-fold; P < .01). The effect of EPE on peanut SPT sensitization was augmented in children with a history of AD (OR, 1.97; 95% CI, 1.26-3.09; P < .01) and augmented even further in children with a history of severe AD (OR, 2.41; 95% CI, 1.30-4.47; P < .01); the effect of EPE on PA was also augmented in children with a history of AD (OR, 2.34; 95% CI, 1.31-4.18; P < .01).

CONCLUSION:

Exposure to peanut antigen in dust through an impaired skin barrier in atopically inflamed skin is a plausible route for peanut SPT sensitization and PA.

• Authors: Helen A Brough, Andrew H Liu, Scott Sicherer, Kerry Makinson, Abdel Douiri, Sara J Brown, Alick C Stephens, W H Irwin McLean, Victor Turcanu, Robert A Wood, Stacie M Jones, Wesley Burks, Peter Dawson, Donald Stablein, Hugh Sampson, Gideon Lack
• Journal: The Journal of allergy and clinical immunology (J Allergy Clin Immunol) Vol. 135 Issue 1 Pg. 164-70 (Jan 2015) ISSN: 1097-6825 [Electronic] United States
• PMID: 25457149 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

Chemical References

• Allergens
• Antigens, Plant
• Dust
• Plant Proteins

Topics

• Allergens (analysis, immunology)
• Antigens, Plant (analysis, immunology)
• Arachis (immunology)
• Dermatitis, Atopic (epidemiology, immunology)
• Dust (analysis, immunology)
• Environmental Exposure (adverse effects, analysis)
• Female
• Housing
• Humans
• Infant
• Male
• Odds Ratio
• Peanut Hypersensitivity (diagnosis, epidemiology, immunology)
• Plant Proteins (analysis, immunology)
• Skin Tests