Adverse events associated with peanut oral immunotherapy in children–a systematic review and meta-analysis.
While peanut oral immunotherapy (POIT) represents a promising treatment for peanut allergies in children, safety concerns remain a common barrier to widespread adoption. We aimed to systematically assess available evidence to determine the risk and frequency of adverse events occurring during POIT, and examine study-level characteristics associated with their occurrence and severity. A systematic search of MEDLINE, EMBASE, and Web of Science was conducted through April 2019. Controlled and non-controlled studies evaluating POIT were eligible. Twenty-seven studies, involving 1488 subjects, were included. Adverse events to POIT were common and led to treatment discontinuation in 6.6% of children (95% CI 4.4-9.0; 27 studies, I2 = 48.7%). Adverse events requiring treatment with epinephrine occurred among 7.6% (4.5-11.4; 26 studies, I2 = 75.5%) of participants, at a rate of 2.0 per 10,000 doses (0.8-3.7; 15 studies, I2 = 64.4). Use of a rush treatment phase and targeting a higher maintenance dose were associated with a higher risk and frequency of epinephrine use, while using co-treatments in addition to POIT was associated with a lower risk of treatment discontinuation due to adverse events. While adverse events to POIT are common, this study provides promising explorative evidence that certain modifications to existing treatment protocols could significantly improve treatment outcomes.
Critical review on proteotypic peptide marker tracing for six allergenic ingredients in incurred foods by mass spectrometry.
Peptide marker identification is one of the most important steps in the development of a mass spectrometry (MS) based method for allergen detection, since the robustness and sensitivity of the overall analytical method will strictly depend on the reliability of the proteotypic peptides tracing for each allergen. The European legislation in place issues the mandatory labelling of fourteen allergenic ingredients whenever used in different food formulations. Among these, six allergenic ingredients, namely milk, egg, peanut, soybean, hazelnut and almond, can be prioritized in light of their higher occurrence in food recalls for undeclared presence with serious risk decision. In this work, we described the results of a comprehensive evaluation of the current literature on MS-based allergen detection aiming at collecting all available information about proteins and peptide markers validated in independent studies for the six allergenic ingredients of interest. The main features of the targeted proteins were commented reviewing all details available about known isoforms and sequence homology particularly in plant-derived allergens. Several critical aspects affecting peptide markers reliability were discussed and according to this evaluation a final short-list of candidate markers was compiled likely to be standardized and implemented in MS methods for allergen analysis.
Thermal processing of peanut impacts detection by current analytical techniques.
Recalls of spice containing products due to undeclared peanut have highlighted the importance of analytical methods in these foods. We examined the performance of peanut detection methods in cumin and garlic, focusing on quantitative ELISA. Although suitable for qualitative detection, accurate quantitation proved difficult. Roasting of peanut contaminants influenced ELISA results, with raw peanut over-detected (3.9-fold) and roasted peanut under-detected (3.5-fold). Further investigation demonstrated the importance of protein targets for ELISA. The kit which gave the least variable results was based on detection of 2S albumin proteins. Additionally, we show that these proteins are more efficiently extracted from roasted peanut. We conclude that current methods are largely suitable for the qualitative detection of peanut in cumin and garlic. Quantitation relies on assumptions as to the state of thermal processing of peanut. We suggest that analytical method providers address robust detection by target selection, including identifying targets by MS.
Peanut allergy diagnosis: moving from basic to more elegant testing.
Peanut allergy (PNA) is an IgE-mediated immune disorder which merits particular attention due to its impact on the health and quality of life of millions of patients worldwide. PNA tends to develop in early life and resolves in only 20% of peanut-allergic children. It accounts for the majority of severe food-related allergic reactions. An accurate diagnosis of PNA is vital. In this review we present the approach to the diagnosis of peanut allergy, starting from the history and proceeding to measures of overall sensitization and then to component-resolved diagnostics and oral food challenges as indicated. Additional testing in development include basophil activation testing and determination of epitopes for peanut allergic responses. Based on the literature stepwise approaches and predictive models for diagnosing PNA are also presented.
Food Allergy Prevention: More Than Peanut.
Given an apparent increase in food allergies worldwide, the focus on prevention strategies has intensified. Following the Learning Early About Peanut study, there is now a widespread acceptance that peanut should be introduced promptly into the diet of high-risk infants. However, most food allergies are caused by triggers other than peanut and additional prevention strategies are being evaluated. The appreciation of the role of an impaired skin barrier in the process of food sensitization and subsequent allergy has led to a spectrum of dermatologically orientated studies. Other prevention strategies address the role of the microbiome, dietary components, and other modifiable risk factors. With regard to early introduction of foods other than peanut, studies are heterogeneous in design and governmental and professional society response to the early introduction trials has varied, ranging from new guidelines confining advice specifically to peanut, to ones recommending prompt introduction of a broad spectrum of allergenic foods. Much remains to be determined with regard to the acceptability and uptake of the new guidelines and their impact on infant feeding behavior and food allergy outcomes. This review discusses the panoply of prevention approaches, their promise, and limitations.
Food Allergy: A Review.
Food allergy is an important public health problem that affects children and adults, and it has been increasing in prevalence in the last 2 to 3 decades. The symptoms can vary from mild to severe, and in extreme cases food allergy can lead to anaphylaxis, which is a life-threatening allergic reaction. Currently, there is no cure for food allergy. Management of food allergy includes allergen avoidance or emergency treatment. The eight most common food allergens are eggs, milk, peanuts, tree nuts, soy, wheat, crustacean shellfish, and fish, all of which are frequently consumed in the US. Thus, patients and their families must remain constantly vigilant, which can often be stressful. Moreover, nonallergic food reactions, such as food intolerance, are commonly mistaken as food allergies. This article highlights risk factors, natural history, diagnosis, and management of food allergy.
American Pistachio Growers 2020 Conference
The American Pistachio Growers Annual Conference is the largest gathering for pistachio growers and industry leaders, drawing attendees from across the United States. It’s three power-packed days of networking, education and community. This is where new products are shared, new relationships are forged and friendships are cultivated.
https://www.apgpower.org/apc20/
Sensory and Nutritional Properties of Peanut‐Based Beverages: A Promising Solution for Undernutrition in Malawi and Possibly Beyond.
Background: Undernutrition remains a challenge in countries like Malawi. To address this challenge, the search for effective nutrition interventions is on-going. In this study, sensory profiles of six peanut-based beverage prototypes were determined. Three of the prototypes had barley malt, and the other three had sorghum malt in their formulations. Nutrient profiles were determined using official standard analytical methods, and the results were compared to daily nutrient requirements to estimate nutritional value. Results: All the six prototypes were acceptable with mean overall liking scores ranging from 7.0 to 7.6. Prototypes containing sorghum malt were perceived as tasty, creamy, thick, and whitish, while those containing barley malt were perceived as sweet, watery, and brown. These terms, except whitish, had a significant impact (p < 0.05) on the overall liking mean score. The formulation incorporating sorghum malt (F-B) had a better nutrient profile than that containing barley malt (F-A) in terms protein, total dietary fiber, potassium, phosphorus, calcium, magnesium, iron, and zinc. A 237-mL (8 oz.) serving of the F-B was an excellent source (% DV ≥ 20) of high-quality protein, total dietary fiber, phosphorus, calcium, molybdenum, and manganese and also, a good source (10 ≤ % DV < 20) of potassium and magnesium. Conclusion: Based on consumer acceptability, both formulations can potentially increase peanut consumption in Malawi. Given its nutritional quality, the F-B may help in the management of undernutrition. Besides Malawi, the peanut-based beverage may also be valuable in other countries where undernutrition is also a challenge.
Discovery of Unexpected Sphingolipids in Almonds and Pistachios with an Innovative Use of Triple Quadrupole Tandem Mass Spectrometry.
The densely packed storage of valuable nutrients (carbohydrates, lipids, proteins, micronutrients) in the endosperm of nuts and seeds makes the study of their complex composition a topic of great importance. Ceramides in the total lipid extract of some ground almonds and pistachios were searched with a systematic innovative discovery precursor ion scan in a triple quadrupole tandem mass spectrometry, where iso-energetic collision activated dissociation was performed. Five descriptors were used to search components with different C18 long chain bases containing different structural motifs (d18:0, d18:1, d18:2, t18:0, t18:1). The presence of hexoside unit was screened with a specific neutral loss experiment under iso-energetic collision activated dissociation conditions. The discovery scans highlighted the presence of two specific hexosyl-ceramides with a modified sphingosine component (d18:2) and C16:0 or C16:0 hydroxy-fatty acids. The hexosyl-ceramide with the non-hydroxylated fatty acid seemed specific of pistachios and was undetected in almonds. The fast and comprehensive mass spectrometric method used here can be useful to screen lipid extracts of several more seeds of nutraceutical interest, searching for unusual and/or specific sphingosides with chemically decorated long chain bases.
Almond Shell-Derived, Biochar-Supported, Nano-Zero-Valent Iron Composite for Aqueous Hexavalent Chromium Removal: Performance and Mechanisms.
Nano-zero-valent iron biochar derived from almond shell (nZVI-ASBC) was used for hexavalent chromium (CR) removal. Experiments showed that pH was the main factor (p < 0.01) that affected the experimental results. At a dosage of 10 mg·L-1 and pH of 2-6, in the first 60 min, nZVI-ASBC exhibited a removal efficiency of 99.8%, which was approximately 20% higher than the removal yield at pH 7-11. Fourier transform infrared spectroscopy results indicated N-H was the main functional group that influenced the chemisorption process. The pseudo second-order dynamics and Langmuir isotherm models proved to be the most suitable. Thermodynamic studies showed that the reaction was exothermic and spontaneous at low temperatures (T < 317 K). Various interaction mechanisms, including adsorption and reduction, were adopted for the removal of Cr(VI) using the nZVI-ASBC composite. The findings showed that the BC-modified nZVI prepared with almond shell exerts a good effect and could be used for the removal of Cr(VI).