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Peanuts

How one study changed what we know about peanut allergy

An estimated one in 50 children in the UK has a peanut allergy. Consuming a small amount could lead to a minor reaction, such as itching and swelling, but can also lead to anaphylaxis and even death. Peanut allergy is a major cause of anaphylaxis in children. Despite its commonality – there was a 72% rise in hospital admissions for children caused by anaphylaxis in England between 2013 and 2019 - there is no cure.

Research from King’s, led by Professor Gideon Lack and Professor Alexandra Santos from the Faculty of Life Sciences & Medicine, has made ground-breaking in-roads to our understanding of food allergy. Their work has changed the global understanding of peanut allergy and informed work on other food allergies, such as eggs, milk, shellfish and tree nuts.

The LEAP study, led by Professor Lack, showed for the first time that early consumption of peanuts during infancy led to protection from peanut allergy. The common understanding at the time was in fact the opposite, with many parents disallowing peanuts in children’s diets.

The study found that infants who ate peanuts frequently from the first 11 months of their life were at a lower risk of developing peanut allergy at six years of age, even if they stopped eating peanuts a year prior.

The breakthrough research led to the reversal of global public health strategy for prevention of peanut allergy. New guidelines by the NHS were issued to advise parents to introduce peanuts during weaning in infancy. Internationally, the study also had an impact, with Australia, the US and the EU convening expert panels to update guidelines. In Australia, the effects were felt immediately, with 88% of infants consuming peanuts by 12 months, an increase from 28% just a decade later.

A follow-up study, EAT, expanded the list of allergens to six - egg, peanut, fish, milk, wheat, sesame – and found introducing these foods early can prevent them from developing an allergy.

The EAT study has provided us with a wealth of data that is still being analysed. As more research about early introduction of specific food allergens continues, we will get closer to new early introduction recommendations that will hopefully help to prevent food allergies in the future.– Speaking at the time, Professor Lack from the School of Life Course and Population Sciences

Indeed, since these studies, researchers from King’s have continued to explore food allergy. A study led by Professor Santos in 2019 found immunotherapy was a protection but not a cure. They looked at the underlying behaviour of patients’ cells and found it did not change with immunotherapy.

However, there is much to look forward to in allergy research. Professor Santos is now researching improved diagnostic tests for food allergies. A recent paper, published in The Journal of Allergy and Clinical Immunology, showed that a laboratory test using children’s plasma showed 98% specificity when testing for peanut allergy. The newer tests are more accurate than traditional blood pricking tests.

Professor Santos said: “Since I started, there have been a lot of exciting new developments [in food allergy research] with new diagnostic tests and new treatments emerging and making the transition to clinical practice. The number of publications, scientific meetings and clinicians and researchers in the field has increased significantly, which is very positive. I hope that we can stop the allergy epidemic and find curative treatments for food allergy and prevent its development in the future.”

In this story

Alexandra  Santos

Alexandra Santos

Clinical Professor of Paediatric Food Allergy

Gideon Lack

Gideon Lack

Professor of Paediatric Allergy