Journal
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY
Volume 132, Issue 3, Pages 630-638Publisher
MOSBY-ELSEVIER
DOI: 10.1016/j.jaci.2013.02.034
Keywords
Peanut; sensitization; allergy; environment; dust; ELISA; biological activity; basophil activation test
Categories
Funding
- National Institute for Health Research (NIHR) Biomedical Research Centre at Guy's & St Thomas' NHS Foundation Trust
- King's College London
- Medical Research Council [G0902018]
- Department of Health through the NIHR comprehensive Biomedical Research Centre award
- King's College Hospital NHS Foundation Trust
- Medical Research Council
- Gulbenkian Programme for Advanced Medical Education
- European Academy of Allergy and Clinical Immunology
- Portuguese Society of Allergy and Clinical Immunology
- Anaphylaxis Campaign
- National Peanut Board
- Sodilac
- Novartis
- Nestle Nutrition
- GlaxoSmithKline
- Serono Symposia International Foundation
- MRC [G0902018] Funding Source: UKRI
- Asthma UK [MRC-AsthmaUKCentre] Funding Source: researchfish
- Medical Research Council [G1000758, G0902018, G1000758B] Funding Source: researchfish
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Background: Peanut allergy is an important public health concern. To understand the pathogenesis of peanut allergy, we need to determine the route by which children become sensitized. A dose-response between household peanut consumption (HPC; used as an indirect marker of environmental peanut exposure) and the development of peanut allergy has been observed; however, environmental peanut exposure was not directly quantified. Objective: We sought to explore the relationship between reported HPC and peanut protein levels in an infant's home environment and to determine the biological activity of environmental peanut. Methods: Peanut protein was quantified in wipe and dust samples collected from 45 homes with infants by using a polyclonal peanut ELISA. Environmental peanut protein levels were compared with peanut consumption assessed by using a validated peanut food frequency questionnaire and other clinical and household factors. Biological activity of peanut protein in dust was assessed with a basophil activation assay. Results: There was a positive correlation between peanut protein levels in the infant's bed, crib rail, and play area and reported HPC over 1 and 6 months. On multivariate regression analysis, HPC was the most important variable associated with peanut protein levels in the infant's bed sheet and play area. Dust samples containing high peanut protein levels induced dose-dependent activation of basophils in children with peanut allergy. Conclusions: We have shown that an infant's environmental exposure to peanut is most likely to be due to HPC. Peanut protein in dust is biologically active and should be assessed as a route of possible early peanut sensitization in infants.
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