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March 10, 2006

Waiting for Mr Goodbar to Clear

Peanut allergic individuals need to be careful of contact they have with those who have eaten products with peanuts, especially peanut butter. Allergens can linger in saliva for hours, meaning that people who are peanut allergic should be extremely with a kiss. So, hold off Auntie Deb, on that big kiss on your niece after enjoying your Peanut Butter Pattie cookie.

"A concern that becomes more pressing as peanut-allergic individuals enter pre-adolescence and adolescence is the concern about kissing, and especially with passionate kissing there is a risk for allergens to be transmitted in saliva," said Jennifer Maloney, M.D., of Mount Sinai Medical Center in New York.

Peanut-allergic patients can indeed suffer severe allergic or anaphylactic reactions when they come into contact with the oral fluids of a peanut eater. Dr. Maloney and her colleagues conducted a two-part study in which they measured levels of peanut antigens in saliva at various time points, and then evaluated various methods for washing them away.

They first asked 10 healthy volunteers to eat a sandwich containing two tablespoons of peanut butter. They then investigated which if any of several interventions might help to wash the allergens away. These included brushing teeth for two minutes, brushing plus rinsing twice with a "swish-and-spit" technique, rinsing twice alone, or chewing gum after waiting for thirty minutes post-peanut butter. The chewing gum intervention was delayed because the oils in peanut butter can break down the gum's consistency, which is why it's used to remove gum from hair.

"What we found, and this is a little bit surprising, three out of our 10 participants actually did not have measurable peanut in their saliva at five minutes after eating the sandwich," said Dr. Maloney.

Of the remaining seven volunteers, six cleared the allergen out of their saliva within one hour, and in the one person in whom Ara h 1 was detectable at the one-hour mark, the allergen had cleared by 4.5 hours.

"From this point of our investigation we can conclude that peanut is detectable in the majority of subjects after eating a meal with peanuts, and secondly we can conclude that it does leave the saliva over several hours," said Dr. Maloney.

When they looked at the intervention, they found that no single intervention was uniformly successful at removing peanut allergen from saliva, although in eight of nine gum chewers the peanut was removed from their saliva.

The best approach? Have boyfriends or girlfriends completely avoid the peanut foods. Dr. Maloney states, "However, if this isn't possible, we think that waiting several hours, possibly eating a meal in between would reduce levels below what would be a clinical problem, and that most likely would be a safe approach as well."

source: American Academy of Allergy, Asthma & Immunology

Posted by David at March 10, 2006 8:36 AM