Common factors, including exercise and lack of sleep, substantially decreased the threshold of reactivity in patients with peanut allergy, thus heightening the risk for an allergic reaction, according to data presented at the American Academy of Allergy, Asthma and Immunology Annual Scientific Meeting.
“The ground-breaking results from our TRACE study confirm anecdotal reports that exercise and lack of sleep can affect the amount of peanut it takes to trigger a reaction in people with peanut allergy,” Chun-Han Chan, PhD, team leader for food allergy policy at the Food Standards Agency, said in a press release. “This effect is important to help determine the unsafe levels of allergen in a food and whether a suitable margin of safety has been applied when deriving a reference dose for the allergic population.”
Chan and colleagues conducted the TRACE study to determine the effect of sleep deprivation and exercise among patients with peanut allergy (n = 126; mean age, 25 years).
Participants completed three open peanut challenges: exercise following each dose of peanut, sleep deprivation preceding each dose and no intervention. Challenges were completed in random order. The dose of peanut that triggered symptoms was measured in milligrams.
Common factors, including exercise and lack of sleep, substantially decreased the threshold of reactivity in patients with peanut allergy, thus heightening the risk for an allergic reaction.
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The mean dose of peanut protein that triggered symptoms was 214 mg. The exercise and sleep deprivation challenges reduced mean dose triggering symptoms by 45%, compared with nonintervention challenges. This finding suggests that exercise and sleep deprivation significantly increase the risk for an allergic reaction, according to the researchers.
During the baseline challenge, the mean eliciting doses for 1%, 5% and 10% of the population were 1.3 mg, 3.8 mg and 7 mg of peanut protein, respectively.
“The study provides important data to inform the development of reference doses to inform risk-based precautionary allergen labeling (such as ‘may contain’) to warn consumers of the unintentional presence of allergens in food,” Chan told Healio Primary Care Today. “Although not the focus of this study, the results have important clinical implications for allergic consumers on how exercise and sleep deprivation may increase their sensitivity, and if exposed, putting them at higher risk of having an allergic reaction to lower amounts of allergen.”
Individuals with food allergy should always practice safe allergen avoidance, she said.
She noted that a more clinically focused paper regarding the severity of reactions is being planned. – by Alaina Tedesco
Dua S, et al. Reaction thresholds in in peanut-allergic adults and the influence of exercise and sleep deprivation: A randomized controlled trial. Presented at: American Academy of Allergy, Asthma and Immunology Annual Scientific Meeting; Feb. 22-25, 2019; San Francisco.
Disclosures: Chan is an employee of the Food Standards Agency.