The recent finding that early introduction of peanut can prevent ~70-90% of peanut allergy is a major step towards prevention of food allergy. However, because that finding was from a clinical trial in a very select population, there are several major questions that must be answered in order to implement these findings into clinical practice without causing more harm than good. These questions include who, if anyone, should be screened prior to early introduction for peanut allergy, how this screening should be done, and what quantity of peanut ingestion is needed to prevent peanut allergy. Our goal is to answer these critical questions so that the potential of these recent findings can be realized. To that end, we will enroll 400 infants at high- risk of peanut allergy. These infants will be given a peanut skin prick test, peanut food challenge and have blood drawn for measurement of peanut IgE, and then will be followed for assessment of peanut consumption and development of peanut allergy.
Aim 1 is to determine the rate of peanut reactivity in infancy among these high risk groups, Aim 2 is to characterize the performance of possible screening tests for peanut allergy in infancy, and Aim 3 is to characterize the peanut consumption patterns of these infants after screening and to determine the association with development of peanut allergy. Exploratory Aim 4 is to understand racial/ethnic disparities in risk of reactivity and diagnostic parameters of screening tests.

Public Health Relevance

This proposal is to enroll infants at high risk of peanut allergy in order to determine the risk of peanut allergy in various high risk groups, how screening tests for peanut allergy perform in these groups, and to characterize the relationship between dose of peanut and peanut prevention. These investigations will inform national guidelines and clinical practice about how to implement early peanut introduction.

Agency
National Institute of Health (NIH)
Institute
National Institute of Allergy and Infectious Diseases (NIAID)
Type
Research Project--Cooperative Agreements (U01)
Project #
5U01AI125290-04
Application #
9695910
Study Section
Infectious Diseases, Reproductive Health, Asthma and Pulmonary Conditions Study Section (IRAP)
Program Officer
Dong, Gang
Project Start
2016-06-27
Project End
2021-05-31
Budget Start
2019-06-01
Budget End
2020-05-31
Support Year
4
Fiscal Year
2019
Total Cost
Indirect Cost
Name
Johns Hopkins University
Department
Pediatrics
Type
Schools of Medicine
DUNS #
001910777
City
Baltimore
State
MD
Country
United States
Zip Code
21205