Early Peanut Introduction: Translation to Clinical Practice

项目摘要： 最近发现，早期引进花生可以预防70-90%的花生过敏，这是一个重要的研究领域。 向预防食物过敏迈出了重要一步。然而，由于这一发现是来自临床研究， 在一个非常选定的人群中进行试验，有几个主要问题必须回答， 以便将这些发现应用到临床实践中，而不会造成弊大于利。 这些问题包括谁，如果有的话，应该在早期引入之前进行筛查。 花生过敏，这种筛查应该如何进行，以及花生摄入量是多少 防止花生过敏我们的目标是回答这些关键问题， 这些最新发现的潜力可以实现。为此，我们将招募400名高- 花生过敏的风险。这些婴儿将接受花生皮肤点刺试验、花生食物挑战 并抽血检测花生IgE，然后进行随访评估 花生消费和花生过敏的发展。目标1是确定 在这些高危人群中，婴儿期的花生反应性，目的2是表征 在婴儿期进行可能的花生过敏筛查试验，目标3是 在筛查后描述这些婴儿的花生消费模式，并确定 与花生过敏症的关系。探索目标4是了解 反应性风险和筛查试验诊断参数的种族/民族差异。

Project Summary:   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.