Early Peanut Introduction: Translation to Clinical Practice

项目摘要：报告。 最近发现，早期种植花生可以预防约70%-90%的花生过敏。 朝着预防食物过敏迈出的重要一步。然而，因为这一发现来自临床 在非常精选的人群中进行试验，有几个主要问题必须得到回答 以便在不造成弊大于利的情况下将这些发现应用到临床实践中。 这些问题包括，在早期介绍之前，应该对谁进行筛查 花生过敏，应该如何进行这项筛查，以及花生摄入量是多少 需要预防花生过敏。我们的目标是回答这些关键问题，以便 这些最新发现的潜力是可以实现的。为此，我们将招收400名婴儿- 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 并抽血测定花生免疫球蛋白E，然后进行评估 花生的消费与花生过敏的发展。目标1是确定 在这些高危人群中，花生在婴儿期的反应性，目标2是表征 对婴儿期花生过敏进行可能的筛查试验，目标3是 筛查后描述这些婴儿的花生消费模式，并确定 花生过敏与发病的关系。探索性目标4是理解 反应风险和筛查试验的诊断参数方面的种族/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.