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Cost-Effectiveness of Oral Immunotherapy Treatments vs No Treatment for Peanut Allergy in Children

The first peanut oral immunotherapy (OIT) for children was approved by the US Food and Drug Administration (FDA) in 2020. While clinical efficacy is established, evidence on cost-effectiveness-whether the benefits outweigh the costs and adverse effects-remains limited. A variant of OIT, known as probiotic and peanut OIT (PPOIT), has shown similar efficacy in trials.

Food Allergy

Food allergies have become more common in our community, with up to one in ten young children now affected. Reactions can range from mild hives to life threatening anaphylaxis and breathing difficulties. The most common food allergies are to egg, peanut, tree nuts, cow’s milk, fish, shellfish, sesame, wheat and soy.

Colostrum as a Protective Factor Against Peanut Allergy: Evidence From a Birth Cohort

Food allergy affects families' quality of life, can be lifelong and life-threatening, urging the identification of early modifiable risk factors. Formula feeding in the first days of life may increase the risk of cow's milk allergy, a risk often attributed to cow's milk allergens exposure. Early formula feeding also reduces the colostrum intake, the first 3 days' milk, which is rich in bioactive compounds critical for immune and gut health. This study investigates whether partial colostrum feeding increases the risk of food allergy beyond cow's milk.

Making a SmartStart for peanut introduction to support food allergy prevention guidelines for infants

Food allergy affects up to 10% of Australian infants. It was hypothesized that if parents follow the Australasian Society of Clinical Immunology and Allergy guidelines, Australian food allergy rates may stabilize or decline.

Feasibility and safety of introducing cashew nut spread in infant diets-A randomized trial

To reduce peanut allergy prevalence, infant feeding guidelines now recommend introducing peanuts in an age-appropriate form (such as peanut butter) as part of complementary feeding. However, due to a lack of randomized trial evidence, most infant feeding and food allergy prevention guidelines do not include tree nuts. The aims of this trial were to determine safety and feasibility of dosage consumption recommendations for infant cashew nut spread introduction.

Immuno-epigenomic analysis identifies attenuated interferon responses in naïve CD4 T cells of adolescents with peanut and multi-food allergy

IgE-mediated food allergies have been linked to suboptimal naïve CD4 T (nCD4T) cell activation in infancy, underlined by epigenetic and transcriptomic variation. Similar attenuated nCD4T cell activation in adolescents with food allergy have also been reported, but these are yet to be linked to specific epigenetic or transcriptional changes.

Probiotic peanut oral immunotherapy versus oral immunotherapy and placebo in children with peanut allergy in Australia (PPOIT-003): a multicentre, randomised, phase 2b trial

Oral immunotherapy is effective at inducing desensitisation to allergens and induces sustained unresponsiveness (ie, clinical remission) in a subset of patients, but causes frequent reactions. We aimed to investigate whether addition of a probiotic adjuvant improved the efficacy or safety of peanut oral immunotherapy.

Identifying gene network patterns and associated cellular immune responses in children with or without nut allergy

Although evidence suggests that the immune system plays a key role in the pathophysiology of nut allergy, the precise immunological mechanisms of nut allergy have not been systematically investigated. The aim of the present study was to identify gene network patterns and associated cellular immune responses in children with or without nut allergy.

Dysfunctional gut microbiome networks in childhood ige‐mediated food allergy

The development of food allergy has been reported to be related with the changes in the gut microbiome, however the specific microbe associated with the pathogenesis of food allergy remains elusive. This study aimed to comprehensively characterize the gut microbiome and identify individual or group gut microbes relating to food-allergy using 16S rRNA gene sequencing with network analysis.

Study protocol of a multicentre, randomised, controlled trial evaluating the effectiveness of probiotic and peanut oral immunotherapy

Peanut allergy is the the most common cause of life-threatening food-induced anaphylaxis. There is currently no effective long-term treatment. There is a pressing need for definitive treatments that improve the quality of life and prevent fatalities. Allergen oral immunotherapy (OIT) is a promising approach, which is effective at inducing desensitisation; however, OIT has a limited ability to induce sustained unresponsiveness (SU).