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The natural history of peanut and tree nut allergy

Current Allergy and Asthma Reports volume 7, pages 175–181 (2007)Cite this article

Abstract

Peanut and tree nut allergies were once thought to be permanent. Recent studies have shown that about 20% and 10%, respectively, of young patients may outgrow peanut and tree nut allergies. For the majority of patients, however, the natural history is not favorable. In addition, approximately 8% of patients who outgrow peanut allergy may suffer a recurrence. The rising prevalence of these allergies, coupled with the knowledge that allergic reactions to these foods have the potential to be severe or fatal and that accidental exposures are common, makes developing effective treatments to alter the natural history of peanut and tree nut allergies even more crucial for those who will not outgrow them. At this time, avoidance of the offending foods and being prepared to treat a potential reaction after accidental ingestion is the only treatment, but many promising therapeutic interventions are being investigated.

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References and Recommended Reading

  1. Sicherer SH, Munoz-Furlong A, Sampson HA: Prevalence of peanut and tree nut allergy in the United States determined by means of a random digit dial telephone survey: a 5-year follow-up study. J Allergy Clin Immunol 2003, 112:1203–1207.

    Article  PubMed  Google Scholar 

  2. Emmett SE, Angus FJ, Fry JS, Lee PN: Perceived prevalence of peanut allergy in Great Britain and its association with other atopic conditions and with peanut allergy in other household members. Allergy 1999, 54:380–385.

    Article  PubMed  CAS  Google Scholar 

  3. Kanny G, Moneret-Vautrin DA, Flabbee J, et al.: Population study of food allergy in France. J Allergy Clin Immunol 2001, 108:133–140.

    Article  PubMed  CAS  Google Scholar 

  4. Grundy J, Matthews S, Bateman B, et al.: Rising prevalence of allergy to peanut in children: Data from 2 sequential cohorts. J Allergy Clin Immunol 2002, 110:784–789.

    Article  PubMed  Google Scholar 

  5. Joshi P, Mofidi S, Sicherer SH: Interpretation of commercial food ingredient labels by parents of food-allergic children. J Allergy Clin Immunol 2002, 109:1019–1021.

    Article  PubMed  Google Scholar 

  6. Vierk K, Falci K, Wolyniak C, Klontz KC: Recalls of foods containing undeclared allergens reported to the US Food and Drug Administration, fiscal year 1999. J Allergy Clin Immunol 2002, 109:1022–1026.

    Article  PubMed  Google Scholar 

  7. Altschul AS, Scherrer DL, Munoz-Furlong A, Sicherer SH: Manufacturing and labeling issues for commercial products: relevance to food allergy. J Allergy Clin Immunol 2001, 108:468.

    Article  PubMed  CAS  Google Scholar 

  8. Sicherer SH, Burks AW, Sampson HA: Clinical features of acute allergic reactions to peanut and tree nuts in children. Pediatrics 1998, 102:e6.

    Article  PubMed  CAS  Google Scholar 

  9. Bock SA, Munoz-Furlong A, Sampson HA: Fatalities due to anaphylactic reactions to foods. J Allergy Clin Immunol 2001, 107:191–193.

    Article  PubMed  CAS  Google Scholar 

  10. Bock SA, Atkins FM: The natural history of peanut allergy. J Allergy Clin Immunol 1989, 83:900–904.

    Article  PubMed  CAS  Google Scholar 

  11. Sicherer SH, Furlong TJ, Munoz-Furlong A, et al.: A voluntary registry for peanut and tree nut allergy: characteristics of the first 5149 registrants. J Allergy Clin Immunol 2001, 108:128–132.

    Article  PubMed  CAS  Google Scholar 

  12. Vander Leek TK, Liu AH, Stefanski K, et al.: The natural history of peanut allergy in young children and its association with serum peanut-specific IgE. J Pediatr 2000, 137:749–755.

    Article  PubMed  CAS  Google Scholar 

  13. Sampson HA, Mendelson L, Rosen JP: Fatal and near-fatal anaphylactic reactions to food in children and adolescents. N Engl J Med 1992, 327:380–384.

    PubMed  CAS  Google Scholar 

  14. Yu JW, Kagan R, Verreault N, et al.: Accidental ingestions in children with peanut allergy. J Allergy Clin Immunol 2006, 118:466–472.

    Article  PubMed  Google Scholar 

  15. Shreffler WG, Beyer K, Chu TT, et al.: Microarray immunoassay: association of clinical history, in vitro IgE function, and heterogeneity of allergenic peanut epitopes. J Allergy Clin Immunol 2004, 113:776–782.

    Article  PubMed  CAS  Google Scholar 

  16. Sicherer SH, Munoz-Furlong A, Burks AW, Sampson HA: Prevalence of peanut and tree nut allergy in the US determined by a random digit dial telephone survey. J Allergy Clin Immunol 1999, 103:559–562.

    Article  PubMed  CAS  Google Scholar 

  17. Emmett SE, Angus FJ, Fry JS, Lee PN: Perceived prevalence of peanut allergy in Great Britain and its association with other atopic conditions and with peanut allergy in other household members. Allergy 1999, 54:380–385.

    Article  PubMed  CAS  Google Scholar 

  18. Tariq SM, Stevens M, Matthews S, et al.: Cohort study of peanut and tree nut sensitisation by age of 4 years. BMJ 1996, 313:514–517.

    PubMed  CAS  Google Scholar 

  19. Spergel JM, Beausoleil JL, Pawlowski NA: Resolution of peanut allergy. Ann Allergy Asthma Immunol 2000, 85:473–476.

    PubMed  CAS  Google Scholar 

  20. Rangaraj S, Ramanathan V, Tuthill DP, et al.: General paediatricians and the case of resolving peanut allergy. Pediatr Allergy Immunol 2004, 15:449–453.

    Article  PubMed  Google Scholar 

  21. Hourihane JO, Roberts SA, Warner JO: Resolution of peanut allergy: case-control study. BMJ 1998, 316:1271–1275.

    PubMed  CAS  Google Scholar 

  22. Skolnick HS, Conover-Walker MK, Barnes C, et al.: The natural history of peanut allergy. J Allergy Clin Immunol 2001, 107:367–374.

    Article  PubMed  CAS  Google Scholar 

  23. Fleischer DM, Conover-Walker MK, Christie L, et al.: The natural progression of peanut allergy: resolution and the possibility of recurrence. J Allergy Clin Immunol 2003, 112:183–189.

    Article  PubMed  Google Scholar 

  24. Busse PJ, Nowak-Wegrzyn AH, Noone SA, et al.: Recurrent peanut allergy [letter]. N Engl J Med 2002, 347:1535–1536.

    Article  PubMed  Google Scholar 

  25. Kerr PE, Pong AH: Peanut resensitization after negative skin tests and negative oral challenge [abstract]. J Allergy Clin Immunol 2004, 113:S151.

    Article  Google Scholar 

  26. Factor JM, Mendelson LM, Rosen JP: Recurrence of peanut allergy cannot be predicted by continued avoidance or serum specific IgE [abstract]. J Allergy Clin Immunol 2003, 111:S275.

    Article  Google Scholar 

  27. Fleischer DM, Conover-Walker MK, Christie L, et al.: Peanut allergy: recurrence and its management. J Allergy Clin Immunol 2004, 114:1195–1201.

    Article  PubMed  CAS  Google Scholar 

  28. Fleischer DM, Conover-Walker MK, Matsui EC, Wood RA: The natural history of tree nut allergy. J Allergy Clin Immunol 2005, 116:1087–1093.

    Article  PubMed  CAS  Google Scholar 

  29. Ewan PW: Clinical study of peanut and tree nut allergy in 62 consecutive patients: new features and associations. BMJ 1996, 312:1074–1078.

    PubMed  CAS  Google Scholar 

  30. Ewan PW, Clark AT: Long-term prospective observational study of patients with peanut and nut allergy after participation in a management plan. Lancet 2001, 357:111–115.

    Article  PubMed  CAS  Google Scholar 

  31. Ewan PW, Clark AT: Efficacy of a management plan based on severity assessment in longitudinal and case-controlled studies of 747 children with nut allergy: proposal for good practice. Clin Exp Allergy 2005, 35:751–756.

    Article  PubMed  CAS  Google Scholar 

  32. Hourihane JO: Peanut allergy—current status and future. Clin Exp Allergy 1997, 27:1240–1246.

    Article  PubMed  CAS  Google Scholar 

  33. Clark AT, Ewan PW: The development and progression of allergy to multiple nuts at different ages. Pediatr Allergy Immunol 2005, 16:507–511.

    Article  PubMed  Google Scholar 

  34. Clark AT, Ewan PW: Interpretation of tests for nut allergy in one thousand patients, in relation to allergy or tolerance. Clin Exp Allergy 2003, 33:1041–1045.

    Article  PubMed  CAS  Google Scholar 

  35. Sampson HA: Utility of food-specific IgE concentrations in predicting symptomatic food allergy. J Allergy Clin Immunol 2001, 107:891–896.

    Article  PubMed  CAS  Google Scholar 

  36. Hourihane JO, Dean TP, Warner JO: Peanut allergy in relation to heredity, maternal diet, and other atopic diseases: results of a questionnaire survey, skin prick testing, and food challenges. BMJ 1996, 313:518–521.

    PubMed  CAS  Google Scholar 

  37. de Leon MP, Drew AC, Glaspole IN, et al.: Functional analysis of cross-reactive immunoglobulin E antibodies: peanut-specific immunoglobulin E sensitizes basophils to tree nut allergens. Clin Exp Allergy 2005, 35:1056–1064.

    Article  PubMed  CAS  Google Scholar 

  38. de Leon MP, Drew AC, Glaspole IN, et al.: IgE cross-reactivity between the major peanut allergen Ara h 2 and tree nut allergens. Mol Immunol 2007, 44:463–471.

    Article  PubMed  CAS  Google Scholar 

  39. Kulig M, Bergmann R, Klettke U, et al.: Natural course of sensitization to food and inhalant allergens during the first 6 years of life. J Allergy Clin Immunol 1999, 103:1173–1179.

    Article  PubMed  CAS  Google Scholar 

  40. Sigurs N, Hattevig G, Kjellman B, et al.: Appearance of atopic disease in relation to serum IgE antibodies in children followed up from birth for 4 to 15 years. J Allergy Clin Immunol 1994, 94:757–763.

    Article  PubMed  CAS  Google Scholar 

  41. Oppenheimer JJ, Nelson HS, Bock SA, et al.: Treatment of peanut allergy with rush immunotherapy. J Allergy Clin Immunol 1992, 90:256–262.

    Article  PubMed  CAS  Google Scholar 

  42. Nelson HS, Lahr J, Rule R, et al.: Treatment of anaphylactic sensitivity to peanuts by immunotherapy with injections of aqueous peanut extract. J Allergy Clin Immunol 1997, 99:744–751.

    Article  PubMed  CAS  Google Scholar 

  43. Srivastava KD, Kattan JD, Zou ZM, et al.: The Chinese herbal medicine formula FAHF-2 completely blocks anaphylactic reactions in a murine model of peanut allergy. J Allergy Clin Immunol 2005, 115:171–178.

    Article  PubMed  Google Scholar 

  44. Li XM: Beyond allergen avoidance: update on developing therapies for peanut allergy. Curr Opin Allergy Clin Immunol 2005, 5:287–292.

    Article  PubMed  Google Scholar 

  45. Pons L, Palmer K, Burks W: Towards immunotherapy for peanut allergy. Curr Opin Allergy Clin Immunol 2005, 5:558–562.

    PubMed  CAS  Google Scholar 

  46. Frick OL, Teuber SS, Buchanan BB, et al.: Allergen immunotherapy with heat-killed Listeria monocytogenes alleviates peanut and food-induced anaphylaxis in dogs. Allergy 2005, 60:243–250.

    Article  PubMed  CAS  Google Scholar 

  47. Leung DYM, Sampson HA, Yunginger JW, et al.: Effect of anti-IgE therapy in patients with peanut allergy. N Engl J Med 2003, 348:986–993.

    Article  PubMed  CAS  Google Scholar 

  48. Mansfield L: Successful oral desensitization for systemic peanut allergy. Ann Allergy Asthma Immunol 2006, 97:266–267.

    Article  PubMed  Google Scholar 

  49. Enrique E, Pineda F, Malek T, et al.: Sublingual immunotherapy for hazelnut food allergy: a randomized, double-blind, placebo-controlled study with a standardized hazelnut extract. J Allergy Clin Immunol 2005, 116:1073–1079.

    Article  PubMed  CAS  Google Scholar 

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  1. National Jewish Medical and Research Center, 1400 Jackson Street, J321, Denver, CO, 80206, USA

    David M. Fleischer MD

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  1. David M. Fleischer MD
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Correspondence to David M. Fleischer MD.

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Fleischer, D.M. The natural history of peanut and tree nut allergy. Curr Allergy Asthma Rep 7, 175–181 (2007). https://doi.org/10.1007/s11882-007-0018-y

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