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Peanut immunotherapy

Jarkko Mäntylä, Tuuli Thomander, Auli Hakulinen, Kaarina Kukkonen, Kati Palosuo, Helena Voutilainen, Anna Pelkonen, Paula Kauppi
INTRODUCTION: The standard care of severe food allergy in both adults and children means avoidance of allergens. In recent years promising results of oral immunotherapy (OIT) have been reported in children. In adults, information on OIT in severe food allergy is very limited. OBJECTIVE: We aimed to study if OIT is possible in adults. METHODS: We report OIT results in 10 adult patients with milk OIT, nine adult patients with peanut OIT, and four adult patients with egg OIT...
March 15, 2018: Immunity, Inflammation and Disease
Amy M Scurlock, Stacie M Jones
Advances in food allergy diagnosis, management, prevention and therapeutic interventions have been significant over the past two decades. Evidence based national and international guidelines have streamlined food allergy diagnosis and management, while paradigm shifting work in primary prevention of peanut allergy has resulted in significant modifications in the approach to early food introduction in infants and toddlers. Innovative investigation of food allergy epidemiology, systems biology, impact, and management has provided important insights...
March 7, 2018: Journal of Allergy and Clinical Immunology
Christopher P Parrish, Daniel Har, J Andrew Bird
PURPOSE OF REVIEW: The goal of this review is to provide the reader with an updated summary of published trial data regarding the use of oral immunotherapy (OIT), sublingual immunotherapy (SLIT), and epicutaneous immunotherapy (EPIT) for treatment of IgE-mediated food allergies. RECENT FINDINGS: Data from phase 2 trials for treatment of peanut allergy with OIT and EPIT reveal an increase in the threshold of reactivity for peanut-allergic children. Compared to EPIT, OIT promotes a greater increase in the threshold of reactivity; however, adverse events are more common with OIT...
February 22, 2018: Current Allergy and Asthma Reports
Thaís Pacheco-Soares, André de Oliveira Carvalho, Jucélia da Silva Araújo, Giliane da Silva de Souza, Olga L T Machado
Ric c1, an allergenic protein from Ricinus communis , is an insect α-amylase inhibitor that has become an occupational allergen. Ric c1 can cross-react with allergens from wheat, soybean, peanut, shrimp, fish, gluten, house dust, tobacco, and air fungus, thereby amplifying the concern and risks caused by Ricinus allergens. Two continuous IgE-binding epitopes were identified in Ric c1, both containing glutamic acid residues involved in IgE-binding and allergic challenges. We produced recombinant Ric c1 (rRic c1) in Escherichia coli , using primers from foliar R...
February 14, 2018: Bioscience Reports
Jaime Hopper, Courtney Hopp, Jessica Durbin
The prevalence of food allergies has doubled in the past 10 years. Peanut allergies are a significant public health issue and are the primary reason for food-related anaphylactic reactions that result in death. Evidence supports that early introduction of the peanut protein (or in combination with immunotherapy) to the highly allergic may safely desensitize patients, which could lead to less adverse allergic reactions and alter allergy management overall.
March 12, 2018: Nurse Practitioner
David Chiang, Xintong Chen, Stacie M Jones, Robert A Wood, Scott H Sicherer, A Wesley Burks, Donald Y M Leung, Charuta Agashe, Alexander Grishin, Peter Dawson, Wendy F Davidson, Leah Newman, Robert Sebra, Miriam Merad, Hugh A Sampson, Bojan Losic, M Cecilia Berin
BACKGROUND: The contribution of phenotypic variation of peanut-specific T cells to clinical allergy or tolerance to peanut is not well understood. OBJECTIVES: Our objective was to comprehensively phenotype peanut-specific T cells in the peripheral blood of individuals with and without peanut allergy (PA). METHODS: We obtained samples from PA individuals, including a cohort undergoing baseline peanut challenges for an immunotherapy trial (CoFAR6)...
January 30, 2018: Journal of Allergy and Clinical Immunology
Julie Wang, Hugh A Sampson
Food allergy is increasingly common in children, affecting about 4-8%. The mainstays of management remain allergen avoidance and emergency preparedness to treat allergic reactions with emergency medications. Unfortunately, these approaches are unsatisfactory for many patients and their families as the restrictions, constant vigilance and unpredictable severity of allergic reactions negatively impact quality of life. In recent decades, there has been significant interest in developing treatments for food allergy that lead to desensitization in order to increase thresholds for triggering allergic reactions and decrease the risk of reacting to allergen-contaminated food products...
January 25, 2018: Pediatric Allergy and Immunology
Ken-Ichi Nagakura, Sakura Sato, Noriyuki Yanagida, Makoto Nishino, Tomoyuki Asaumi, Kiyotake Ogura, Motohiro Ebisawa
BACKGROUND: Reports on oral immunotherapy (OIT) for anaphylactic food allergy are lacking. We investigated the efficacy and safety of peanut OIT for anaphylactic patients. METHODS: We enrolled 22 peanut anaphylactic patients who underwent OIT between 2011 and 2013, all of whom demonstrated anaphylaxis during a baseline double-blind, placebo-controlled food challenge. After starting in-hospital OIT, participants gradually increased ingestion to 795 mg of peanut protein per day at home and then took a maintenance dose (795 mg) daily...
January 16, 2018: International Archives of Allergy and Immunology
Jennifer A Dantzer, Robert A Wood
Although omalizumab (anti-IgE) is currently only approved for the treatment of asthma and chronic idiopathic urticaria, it has also been studied as an off-label treatment for numerous allergic conditions, including use as an adjunct to allergen immunotherapy in the treatment of allergic rhinitis, asthma, venom hypersensitivity, and food allergy. We conducted a review of publications involving the use of omalizumab with allergen immunotherapy, by searching PubMed with key search terms of "omalizumab" and "immunotherapy...
January 5, 2018: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
G B Pajno, M Fernandez-Rivas, S Arasi, G Roberts, C A Akdis, M Alvaro-Lozano, K Beyer, C Bindslev-Jensen, W Burks, M Ebisawa, P Eigenmann, E Knol, K C Nadeau, L K Poulsen, R van Ree, A F Santos, G du Toit, S Dhami, U Nurmatov, Y Boloh, M Makela, L O'Mahony, N Papadopoulos, C Sackesen, I Agache, E Angier, S Halken, M Jutel, S Lau, O Pfaar, D Ryan, G Sturm, E-M Varga, R G van Wijk, A Sheikh, A Muraro
Food allergy can result in considerable morbidity, impairment of quality of life, and healthcare expenditure. There is therefore interest in novel strategies for its treatment, particularly food allergen immunotherapy (FA-AIT) through the oral (OIT), sublingual (SLIT), or epicutaneous (EPIT) routes. This Guideline, prepared by the European Academy of Allergy and Clinical Immunology (EAACI) Task Force on Allergen Immunotherapy for IgE-mediated Food Allergy, aims to provide evidence-based recommendations for active treatment of IgE-mediated food allergy with FA-AIT...
September 27, 2017: Allergy
Kazuma Kiyotani, Tu H Mai, Rui Yamaguchi, Poh Yin Yew, Mike Kulis, Kelly Orgel, Seiya Imoto, Satoru Miyano, A Wesley Burks, Yusuke Nakamura
B-cell receptors (BCRs) play a critical role in adaptive immunity as they generate highly diverse immunoglobulin repertoires to recognize a wide variety of antigens. To better understand immune responses, it is critically important to establish a quantitative and rapid method to analyze BCR repertoire comprehensively. Here, we developed "Bcrip", a novel approach to characterize BCR repertoire by sequencing millions of BCR cDNA using next-generation sequencer. Using this method and quantitative real-time PCR, we analyzed expression levels and repertoires of BCRs in a total of 17 peanut allergic subjects' peripheral blood samples before and after receiving oral immunotherapy (OIT) or placebo...
February 2018: Journal of Human Genetics
Si-Yin Chung, Christopher P Mattison, Casey C Grimm, Shawndrika Reed
Whole peanut or cashew extracts are usually used in immunotherapy. Reducing major allergen(s) in the extracts may lessen their side effects. Three methods were evaluated to reduce major allergens in peanut extracts: (1) p -aminobenzamidine; (2) magnetic agarose beads; and (3) extraction of a commercial peanut flour at pH 7, respectively. The first two methods were also used to reduce major allergens in cashew extracts. After treatments, samples were evaluated by SDS-PAGE. pABA-treated samples were also analyzed for IgE binding in western blot...
November 2017: Food Science & Nutrition
Hugh A Sampson, Wayne G Shreffler, William H Yang, Gordon L Sussman, Terri F Brown-Whitehorn, Kari C Nadeau, Amarjit S Cheema, Stephanie A Leonard, Jacqueline A Pongracic, Christine Sauvage-Delebarre, Amal H Assa'ad, Frederic de Blay, J Andrew Bird, Stephen A Tilles, Franck Boralevi, Thierry Bourrier, Jacques Hébert, Todd D Green, Roy Gerth van Wijk, André C Knulst, Gisèle Kanny, Lynda C Schneider, Marek L Kowalski, Christophe Dupont
Importance: Epicutaneous immunotherapy may have potential for treating peanut allergy but has been assessed only in preclinical and early human trials. Objective: To determine the optimal dose, adverse events (AEs), and efficacy of a peanut patch for peanut allergy treatment. Design, Setting, and Participants: Phase 2b double-blind, placebo-controlled, dose-ranging trial of a peanut patch in peanut-allergic patients (6-55 years) from 22 centers, with a 2-year, open-label extension (July 31, 2012-July 31, 2014; extension completed September 29, 2016)...
November 14, 2017: JAMA: the Journal of the American Medical Association
Carlos Gamazo, Maddi García-Azpíroz, Juliana De Souza Rebouças, Gabriel Gastaminza, Marta Ferrer, Juan M Irache
BACKGROUND: Peanut allergy is the most common cause of anaphylaxis and food-related death. However, there is currently no approved immunotherapy treatment. Hence, this warrants the need for relevant and convenient animal models to test for adequate immunotherapies. MATERIALS & METHODS: In this study, we compared three mouse strains: CD1, BALB/c and C57, to select a model of peanut allergy. After that, we conducted then a therapeutic study using an immunogenic peanut extract encapsulated in nanoparticles made with polymer Gantrez(®) following the solvent displacement method...
November 2017: Immunotherapy
Jose C Jimenez-Lopez, Rhonda C Foley, Ella Brear, Victoria C Clarke, Elena Lima-Cabello, Jose F Florido, Karam B Singh, Juan D Alché, Penelope M C Smith
β-conglutin has been identified as a major allergen for Lupinus angustifolius seeds. The aim of this study was to evaluate the binding of IgE to five recombinant β-conglutin isoforms (rβ) that we overexpressed and purified and to their natural counterparts in different lupin species and cultivars. Western blotting suggested β-conglutins were the main proteins responsible for the IgE reactivity of the lupin species and cultivars. Newly identified polypeptides from "sweet lupin" may constitute a potential new source of primary or cross-reactive sensitization to lupin, particularly to L...
April 1, 2018: Food Chemistry
J Andrew Bird, Jonathan M Spergel, Stacie M Jones, Rima Rachid, Amal H Assa'ad, Julie Wang, Stephanie A Leonard, Susan S Laubach, Edwin H Kim, Brian P Vickery, Benjamin P Davis, Jennifer Heimall, Antonella Cianferoni, Andrew J MacGinnitie, Elena Crestani, A Wesley Burks
BACKGROUND: Peanut oral immunotherapy, using a variety of approaches, has been previously shown to induce desensitization in peanut-allergic subjects, but no products have been approved for clinical use by regulatory agencies. OBJECTIVE: We performed the first phase 2 multicentered study to assess the safety and efficacy of AR101, a novel oral biologic drug product. METHODS: A randomized, double-blind, placebo-controlled trial was conducted at 8 US centers...
October 30, 2017: Journal of Allergy and Clinical Immunology in Practice
Bruce J Lanser, Donald Y M Leung
The food allergy epidemic of recent years has led to the search for safe and effective methods of immunotherapy for foods. Studies of epicutaneous immunotherapy (EPIT) in mice have shown promising safety and efficacy data. Murine models have also identified probable mechanisms for the development of tolerance to food allergens, including the induction of regulatory T cells. Clinical data is lacking, but relatively small and early studies among peanut and cow's milk allergic subjects suggest that EPIT has an excellent safety profile, particularly compared to other methods of specific allergen immunotherapy...
October 28, 2017: Clinical Reviews in Allergy & Immunology
Audrey Dunn Galvin, Suzanne McMahon, Anne-Louise Ponsonby, Kuang-Chih Hsiao, Mimi L K Tang
BACKGROUND: We previously reported that Probiotic and Peanut Oral Immunotherapy (PPOIT) was effective at inducing sustained unresponsiveness compared with placebo in a double-blind, placebo-controlled randomized trial. This study evaluated the impact of PPOIT on health related quality of life (HRQL). METHOD: Fifty-one participants (PPOIT 24; Placebo 27) from the PPOIT trial completed Food Allergy Quality of Life Questionnaire (FAQLQ-PF) and Food Allergy Independent Measure (FAIM) at pre-treatment, end-of-treatment and 3-months after end-of-treatment...
October 20, 2017: Allergy
Marlotte M Vonk, Laura Wagenaar, Raymond H H Pieters, Leon M J Knippels, Linette E M Willemsen, Joost J Smit, Betty C A M van Esch, Johan Garssen
BACKGROUND: Antigen-specific immunotherapy (AIT) is a promising therapeutic approach for both cow's milk allergy (CMA) and peanut allergy (PNA), but needs optimization in terms of efficacy and safety. AIM: Compare oral immunotherapy (OIT) and subcutaneous immunotherapy (SCIT) in murine models for CMA and PNA and determine the dose of allergen needed to effectively modify parameters of allergy. METHODS: Female C3H/HeOuJ mice were sensitized intragastrically (i...
2017: Clinical and Translational Allergy
James W Mims
Recent advances in the diagnosis and management of allergic disease also lead to new clinical decisions for providers. Advances in component (or molecular) diagnostic testing for allergy continue to build in the literature, but diagnosing inhalant allergy remains largely unchanged clinically. Prevention of allergy has been demonstrated by preventing peanut allergy in high-risk infants by intentional oral exposure to promote tolerance. Immunotherapy options have increased, with literature supporting sublingual drops, sublingual tablets, and subcutaneous immunotherapy...
December 2017: Otolaryngologic Clinics of North America
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