Effects of Exercise and Sleep Deprivation on Reaction Severity During Oral Peanut Challenge: A Randomized Controlled Trial.

Autor:	Dua S; Department of Allergy, Cambridge University Hospitals, Cambridge, UK. Electronic address: shelley.dua@addenbrookes.nhs.uk., Ruiz-Garcia M; Section of Paediatrics, Department of Medicine, Imperial College London, London, UK., Bond S; Cambridge Clinical Trials Unit, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, UK., Dowey J; Department of Economic History, London School of Economics, London, UK., Durham SR; Section for Allergy and Clinical Immunology, National Heart and Lung Institute, Faculty of Medicine, Imperial College, London, UK; Department of Allergy, Royal Brompton and Harefield NHS Foundation Trust, London, UK., Kimber I; Faculty of Biology, Medicine and Health, University of Manchester, Oxford Road, Manchester, UK., Mills C; Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, University of Manchester, Manchester, UK., Roberts G; NIHR Southampton Respiratory Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK; Faculty of Medicine, University of Southampton, Southampton, UK., Skypala I; Department of Allergy, Royal Brompton and Harefield NHS Foundation Trust, London, UK., Wason J; Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK., Ewan P; Department of Allergy, Cambridge University Hospitals, Cambridge, UK., Boyle RJ; Section for Allergy and Clinical Immunology, National Heart and Lung Institute, Faculty of Medicine, Imperial College, London, UK., Clark A; Department of Allergy, Cambridge University Hospitals, Cambridge, UK.
Jazyk:	angličtina
Zdroj:	The journal of allergy and clinical immunology. In practice [J Allergy Clin Immunol Pract] 2022 Sep; Vol. 10 (9), pp. 2404-2413.e1. Date of Electronic Publication: 2022 May 25.
DOI:	10.1016/j.jaip.2022.04.043
Abstrakt:	Background: The severity of allergic reactions to foods can vary markedly. Little is known of variations in reaction severity within or between individuals or the effects of cofactors. Objective: We examined the effects of sleep deprivation and exercise and repeat challenges on the severity and patterns of allergic reactions to peanut. Methods: In a randomized crossover study, adults with peanut allergy underwent 3 open peanut challenges in random order: with exercise after each dose, with sleep deprivation preceding challenge, and with no intervention. The primary outcome was eliciting dose, reported elsewhere. Reaction severity was a secondary outcome, evaluated using a weighted log-transformed numerical severity score. Analyses estimated the difference in severity between nonintervention challenge and challenges with exercise or sleep deprivation, adjusting for challenge order and using the highest dose tolerated by each individual across all their challenges. Symptom pattern reproducibility was assessed by comparing symptom sequences using pairwise sequence alignment to obtain a percentage match in symptom pattern. Results: Eighty-one participants (mean age 25 y) completed at least 1 postbaseline challenge. Sleep deprivation, but not exercise, significantly increased severity score by 48% (95% CI 12%-84%; P = .009) compared with no intervention. A 38% increase in severity was observed between the first and the last postbaseline challenge (95% CI 1%-75%; P = .044). The average pairwise match of symptoms within individuals was 82.4% and across individuals was 78.3%. Conclusions: A novel severity score demonstrates that sleep deprivation and repeated challenges increase reaction severity. Understanding factors affecting severity is essential for effective risk management. We also show that symptom patterns in repeat peanut challenges are similar within and between individuals. (Copyright © 2022 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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