Peanut Hypersensitivity Clinical Trial
Official title:
Molecular Analysis of Immuno-Regulatory Genes Expressed by Mononuclear Cells From Peanut Skin Test Positive Individuals With and Without a History of Peanut Ingestion
The purpose of this study is to develop a tool to better predict clinical allergy to peanut, so that those who are skin test positive but non allergic will not have to unnecessarily avoid peanut, and those with true allergy can be diagnosed, possibly without oral ingestion challenge, and treated appropriately
Peanut allergy occurs in about 1% of the population. Allergic reactions to peanuts and tree
nuts account for the majority of fatal and near fatal food allergic reactions. Currently the
only available treatment is complete avoidance of peanut. Despite avoidance, the majority of
peanut allergic people will accidentally ingest peanut. Accurate diagnosis is critical, yet
often problematic. Current diagnostic methods such as skin and blood tests cannot predict
definitively who is allergic and can result in patients being falsely labeled. One such
group is children who have never been exposed to peanut as a means of preventing allergy,
yet have positive skin tests. The only means of definitively diagnosing this group is with
an oral peanut challenge, a potentially risky procedure. Previous studies have demonstrated
differences in certain genes and growth factors between peanut allergic and non-allergic
individuals. The proposed study has 2 phases. The first phase, almost completed, examines
expression of genes and growth factors in defined groups of peanut allergic and non-allergic
individuals which should help distinguish between these groups. Peripheral blood mononuclear
cells from each patient will be cultured and analyzed for a variety of growth factors and
other immune molecules, including mRNA, thought to be important in allergy.
The second phase of this study will involve feeding peanut to individuals with positive skin
tests, who have never been peanut exposed. Their blood will be examined before and after the
challenge using information from Part 1, and results will be correlated with their ability
to tolerate peanut on feeding. This study should enable us to better predict who is truly
peanut allergic.
There are four groups of patients in this study. Group 1 consists of individuals who are
allergic to peanut. This group of individuals will have a positive skin test to peanut and a
previous allergi reaction to peanut. Group 2 consists of indivduals who have a positive skin
test to peanut but who are able to ingest peanuts without problems. Group 3 consists of
individuals who have a positive skin test to peanut but who have no known ingestion of
peanut and who have avoided peanut lifelong for whatever reason (e.g. a strong family
history of peanut allergy). Lastly, group 4 consists of control subjects who are negative to
the peanut skin test and are able to tolerate peanut without problems.
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Observational Model: Defined Population, Primary Purpose: Screening, Time Perspective: Cross-Sectional
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