TOPLINE:

In children and adolescents with probable peanut allergy, exposure to peanuts in the air — by having an open bag of peanuts held under their nose — typically did not lead to allergic reactions or any need for medical treatment.

METHODOLOGY:

• Researchers conducted a prospective study of 323 participants with suspected peanut allergy (mean age, 9.7 years; 57.9% boys) to examine clinical responses to a standardized peanut inhalation challenge.
• During the challenge, a 300-g bag of peanuts was opened approximately 30 cm below the nose, shaken, and held in place for 10 minutes.
• Reactions were classified as objective (visible or measurable signs such as urticaria, erythema, or respiratory symptoms, including a ≥ 12% reduction in forced expiratory volume in 1 second) or subjective (other symptoms such as nausea, cough, or pruritus).

TAKEAWAY:

• Overall, 3.1% of participants had objective reactions, and 12.4% reported subjective reactions.
• Symptoms included sneezing, nasal congestion, skin itching, or mild respiratory discomfort, the researchers reported.
• Four participants received medical treatment, including one participant with sneezing and pruritus, one who experienced abdominal pain after the challenge, and two whose forced expiratory volume decreased but were otherwise asymptomatic.
• No serious adverse events were observed, and no participants required hospitalization or emergency care.

IN PRACTICE:

“The pragmatic and safe challenge protocol we employed may serve as a valuable tool in clinical practice, especially in counselling patients and families concerned about airborne peanut exposure,” the authors of the study wrote.

SOURCE:

Håvard Trønnes, MD, Haukeland University Hospital, Bergen, Norway, was the corresponding author of the study, which was published online on December 11 in the International Archives of Allergy and Immunology.

LIMITATIONS:

None of the participants had a peanut allergy confirmed by a double‑blind, placebo‑controlled food challenge, and some participants may have developed tolerance to the allergen before the challenge. The controlled 10-minute challenge may not reflect airborne exposures in the real world.

DISCLOSURES:

Some of the researchers reported having financial ties to companies, including Nestlé, Ferring, ALK, Sanofi, Pfizer, AstraZeneca, and MSD.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.