It’s National Peanut Day: Time to Understand the Anatomy of Peanuts
 
 
It’s National Peanut Day:  Time to Understand the Anatomy of Peanuts

Why is it important in general to understand the inner “workings” of various nuts?

All nuts are composed of many components or subparts.  The most common parts are fats, carbohydrates, vitamins, minerals, water and protein.  When it comes to peanut food allergy, the protein is the most important part.

Why is knowing the subparts very important in OIT?

It is very important to know the subparts of peanuts in OIT to better understand dosing.  When a patient is able to eat one peanut, what does that really mean?  It means how much actual “food allergy molecule protein” is that child now eating.  This is particularly important when understanding the concept of safety.

For example, if a patient can tolerate 8 peanuts daily after being treated with OIT, can the patient safely eat more than 8 peanuts at any time?  The answer lies in that patient’s immune system response to OIT.  If the patient has demonstrated improved clinical markers of sensitization and clinical evidence of tolerating high doses of peanut, the question of safety is answered more scientifically.

What are the different types of peanuts?

Peanut Comparison

There are several types of “typical” peanuts in the United States.  Please keep in mind species of peanuts in China, India and Africa have different protein structures and weights than US based peanut products.  The most common US peanut is the runner peanut.  It is available at any grocery store.  Since each type has different weights, it is important to discuss the properties of these peanuts with your allergist when deciding how much of which peanut to consume during maintenance.

How much protein is in one peanut?

On average, 10 grams of peanuts are used to pass a food challenge in any standard allergy practice office.  This is deemed a “pass” for non-allergic patients.  10 grams of runner peanuts equals 18-20 peanuts daily.  However, this is the total weight of the peanuts.  How much actual protein is in the 18-20 peanuts?  It depends on whether the peanuts are heavily roasted or not roasted at all.  If it is unroasted, the protein count ranges from 5-6 grams.  If it is heavily roasted, it can range from 4-6 grams.

Of greater interest is what amount of protein actually contains the high anaphylaxis risk epitope sequences of Ara h1, Ara h2 and Ara h3.  Early experiments to purify this protein resulted in some approximations of the dosing.  However, an exact amount of how much of these epitopes is unclear.  The likely percentage ranges from 5-15% of the total protein is comprised of the high risk sequences.

Why do the number of maintenance peanuts matter?

Based on the last question’s response, everyone’s immune system responds to peanut protein differently.  Some may respond very quickly to OIT and their maintenance dose can be 20 grams every month in order to successfully maintain a “sensitized” immune system.  However, others may need to eat 10 grams every day to maintain the same sensitization.

Again, the anatomy of the peanut is important.  It contains complex subparts of which the protein is most important.  Specific epitopes of the protein are of even greater importance for food allergy dosing and safety.  One goal of research at The Translational Pulmonary & Immunology Research Center (TPIRC) is to better study and define the anatomy of peanut protein responsiveness in order to fine tune each patient’s maintenance dose to ensure maximal safety and simultaneously ensure maximal long term benefit.

Inderpal Randhawa, MD

Chief Medical Officer, TPIRC

 

References:

U.S. Department of Agriculture, Agricultural Research Service. 2013. USDA National Nutrient Database for Standard Reference, Release 25.

10.4049/​jimmunol.169.2.882.  The Journal of Immunology July 15, 2002.  vol. 169  no. 2  882-887

 

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