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Peanut immunotherapy

Roxane Labrosse, François Graham, Anne Des Roches, Philippe Bégin
Food allergy is an important health issue that affects up to 8 % of the population. The management of allergic patients involves allergen avoidance and prompts the treatment of accidental reactions, as no curative treatment is available so far in routine practice. Oral immunotherapy (OIT) is a promising therapeutic alternative, but it is associated with frequent allergic reactions and cost-effectiveness issues. In hopes of reducing such reactions, a number of trials have used omalizumab, an anti-IgE monoclonal humanized antibody, as adjunctive therapy in OIT...
September 14, 2016: Archivum Immunologiae et Therapiae Experimentalis
Andrew J MacGinnitie, Rima Rachid, Hana Gragg, Sara V Little, Paul Lakin, Antonella Cianferoni, Jennifer Heimall, Melanie Makhija, Rachel Robison, R Sharon Chinthrajah, John Lee, Jennifer Lebovidge, Tina Dominguez, Courtney Rooney, Megan Ott Lewis, Jennifer Koss, Elizabeth Burke-Roberts, Kimberly Chin, Tanya Logvinenko, Jacqueline A Pongracic, Dale T Umetsu, Jonathan Spergel, Kari C Nadeau, Lynda C Schneider
BACKGROUND: Peanut oral immunotherapy is a promising approach to peanut allergy, but reactions are frequent, and some patients cannot be desensitized. The anti-IgE medication omalizumab (Xolair; Genentech, South San Francisco, Calif) might allow more rapid peanut updosing and decrease reactions. OBJECTIVE: We sought to evaluate whether omalizumab facilitated rapid peanut desensitization in highly allergic patients. METHODS: Thirty-seven subjects were randomized to omalizumab (n = 29) or placebo (n = 8)...
September 5, 2016: Journal of Allergy and Clinical Immunology
Yamini V Virkud, A Wesley Burks, Pamela H Steele, Lloyd J Edwards, Jelena P Berglund, Stacie M Jones, Amy M Scurlock, Tamara T Perry, Robert D Pesek, Brian P Vickery
BACKGROUND: Though peanut oral immunotherapy (OIT) is a promising investigational therapy, its potential is limited by substantial adverse events (AEs), which are relatively understudied. OBJECTIVE: To conduct a retrospective analysis pooling three pediatric peanut OIT trials, comprising the largest analysis of peanut OIT safety to date. METHODS: We pooled 104 peanut-allergic children from three peanut OIT studies. We catalogued AEs from parental report, daily symptom diaries, and dose escalations...
September 5, 2016: Journal of Allergy and Clinical Immunology
Brian P Vickery
No abstract text is available yet for this article.
September 6, 2016: Expert Review of Clinical Immunology
Brian P Vickery, Jelena P Berglund, Caitlin M Burk, Jason P Fine, Edwin H Kim, Jung In Kim, Corinne A Keet, Michael Kulis, Kelly G Orgel, Rishu Guo, Pamela H Steele, Yamini V Virkud, Ping Ye, Benjamin L Wright, Robert A Wood, A Wesley Burks
BACKGROUND: Oral immunotherapy (OIT) is an effective experimental food allergy treatment that is limited by treatment withdrawal and the frequent reversibility of desensitization if interrupted. Newly diagnosed preschool children may have clinical and immunological characteristics more amenable to treatment. OBJECTIVE: We sought to test the safety, effectiveness, and feasibility of early OIT (E-OIT) in the treatment of peanut allergy. METHODS: We enrolled 40 children aged 9 to 36 months with suspected or known peanut allergy...
August 4, 2016: Journal of Allergy and Clinical Immunology
Rachel L Peters, Thanh D Dang, Katrina J Allen
Food allergy continues to be a significant public health concern for which there are no approved treatments and management strategies primarily include allergen avoidance and pharmacological measures for accidental exposures. Food allergy is thought to result from either a failure to establish oral tolerance or the breakdown of existing oral tolerance, and therefore, experimental preventative and treatment strategies are now aimed at inducing specific oral tolerance. This may occur in infancy prior to the development of food allergy through the optimal timing of dietary exposure (primary oral tolerance induction) or as a treatment for established food allergy through oral immunotherapy (secondary oral tolerance induction)...
August 6, 2016: Pediatric Allergy and Immunology
Elizabeth Feuille, Anna Nowak-Węgrzyn
Oral immunotherapy (OIT) is a promising investigational therapy for food allergy. Clinical trials in peanut, milk, egg, and wheat allergy provide evidence that OIT can effectively desensitize a majority of individuals to a food allergen. While a portion of subjects demonstrate sustained unresponsiveness, the majority regain sensitivity with allergen avoidance. The safety and tolerability of OIT continue to limit its use in some patients. Virtually all studies report adverse reactions that are more frequent during dose escalation but may also occur during maintenance therapy...
2016: Annals of Nutrition & Metabolism
F C van Erp, R J B Klemans, Y Meijer, C K van der Ent, A C Knulst
Instead of relying on crude peanut extract, component-resolved diagnostics (CRD) uses sensitization to allergenic proteins within peanut. In this review, we describe the recent advances and future perspectives of the use of CRD in the management of peanut-allergic patients. There is strong evidence that sensitization to Ara h 2 is the best predictor for clinically relevant peanut allergy in children and adults. Isolated sensitization to other peanut components is only rarely present in patients with systemic reactions to peanut...
2016: Current Treatment Options in Allergy
L Vila, A Amado
No abstract text is available yet for this article.
2016: Journal of Investigational Allergology & Clinical Immunology
Valérie Trendelenburg, Katharina Blümchen
During recent years increasing research has been conducted on casual treatment options for food allergy, with focus on oral immunotherapy (OIT) for hen's egg, cow's milk and peanut allergy. Several studies could show that OIT leads to desensitization or an increase of threshold. However, severe adverse events during this treatment are not uncommon. Whether OIT leads to a sustained, 'robust' development of tolerance in patients has not yet been thoroughly investigated. Besides OIT, some studies on sublingual (SLIT) and epicutaneous immunotherapy (EPIT) were performed, aiming to improve the safety profile...
July 2016: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
Sara Benedé, Ana Belen Blázquez, David Chiang, Leticia Tordesillas, M Cecilia Berin
Food allergy has rapidly increased in prevalence, suggesting an important role for environmental factors in disease susceptibility. The immune response of food allergy is characterized by IgE production, and new findings from mouse and human studies indicate an important role of the cytokine IL-9, which is derived from both T cells and mast cells, in disease manifestations. Emerging evidence suggests that route of exposure to food, particularly peanut, is important. Exposure through the skin promotes sensitization while early exposure through the gastrointestinal tract promotes tolerance...
May 2016: EBioMedicine
M Ponce, S C Diesner, Z Szépfalusi, T Eiwegger
IgE-mediated reactions to food allergens are the most common cause of anaphylaxis in childhood. Although allergies to cow's milk, egg, or soy proteins, in contrast to peanut and tree nut allergens, resolve within the first 6 years of life in up to 60% due to natural tolerance development, this process is not well understood. At present, there is no cure or treatment for food allergy that would result in an induction of tolerance to the symptom-eliciting food. Avoidance, providing an emergency plan and education, is the standard of treatment...
October 2016: Allergy
Kirsten Beyer, Bodo Niggemann
IgE-mediated immediate type reactions are the most common form of food allergy in childhood. Primary (often in early childhood) and secondary (often pollen-associated) allergies can be distinguished by their level of severity. Hen's egg, cow's milk and peanut are the most common elicitors of primary food allergy. Tolerance development in hen's egg and cow's milk allergy happens frequently whereas peanut allergy tends toward a lifelong disease. For the diagnostic patient history, detection of sensitization and (in many cases) oral food challenges are necessary...
June 2016: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
Kamal D Srivastava, Alyssa Siefert, Tarek M Fahmy, Michael J Caplan, Xiu-Min Li, Hugh A Sampson
BACKGROUND: Treatments to reverse peanut allergy remain elusive. Current clinical approaches using peanut oral/sublingual immunotherapy are promising, but concerns about safety and long-term benefit remain a barrier to wide use. Improved methods of delivering peanut-specific immunotherapy are needed. OBJECTIVE: We sought to investigate the efficacy and safety of peanut oral immunotherapy using CpG-coated poly(lactic-co-glycolic acid) nanoparticles containing peanut extract (CpG/PN-NPs) in a murine model of peanut allergy...
August 2016: Journal of Allergy and Clinical Immunology
B Tao, K Bernardo, P Eldi, N Chegeni, M Wiese, A Colella, A Kral, J Hayball, W Smith, K Forsyth, T Chataway
BACKGROUND: Current peanut oral immunotherapy is hampered by frequent adverse events. It has been shown that boiling can reduce peanut allergenicity. Hypoallergenic peanut products have the potential to reduce treatment-related reactions during desensitization. OBJECTIVE: To show that extended boiling (for up to 12 h) can progressively reduce peanut allergenicity while retaining T cell reactivity. METHODS: Raw peanuts were boiled for half, 1, 2, 4 and 12 h in deionized water...
July 2016: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
Philip E Johnson, Rebekah L Sayers, Lee A Gethings, Anuradha Balasundaram, Justin T Marsh, James I Langridge, E N Clare Mills
Profiling allergens in complex food ingredients used in oral food challenges and immunotherapy is crucial for regulatory acceptance. Mass spectrometry based analysis employing data-independent acquisition coupled with ion mobility mass spectrometry-mass spectrometry (DIA-IM-MS) was used to investigate the allergen composition of raw peanuts and roasted peanut flour ingredients used in challenge meals. This comprehensive qualitative and quantitative analysis using label-free approaches identified and quantified 123 unique protein accessions...
June 7, 2016: Analytical Chemistry
Vincent Dioszeghy, Lucie Mondoulet, Emilie Puteaux, Véronique Dhelft, Mélanie Ligouis, Camille Plaquet, Christophe Dupont, Pierre-Henri Benhamou
Allergen-specific immunotherapy has been proposed as an attractive strategy to actively treat food allergy using the following three different immunotherapy routes: oral (OIT), sublingual (SLIT) and epicutaneous (EPIT) immunotherapy. Regulatory T cells (Tregs) have been shown to have a pivotal role in the mechanisms of immunotherapy. The aim of this study was to compare the phenotype and function of Tregs induced in peanut-sensitized BALB/c mice using these three routes of treatment. We show that although EPIT, OIT and SLIT were all able to effectively desensitize peanut-sensitized mice, they induced different subsets of Tregs...
April 11, 2016: Cellular & Molecular Immunology
Scott P Commins, Edwin H Kim, Kelly Orgel, Mike Kulis
Food allergies have increased in prevalence over the past 20 years, now becoming an important public health concern. Although there are no therapies currently available for routine clinical care, recent reports have indicated that immunotherapies targeting the mucosal immune system may be effective. Oral immunotherapy is conducted by administering small, increasing amounts of food allergen; it has shown promise for desensitizing individuals with peanut, egg, or milk allergies. Sublingual immunotherapy also desensitizes allergic patients to foods-two major studies have examined the effects of sublingual immunotherapy in subjects with peanut allergies...
May 2016: Current Allergy and Asthma Reports
Alessandro Buonomo, Eleonora Nucera, Domenico Schiavino
PURPOSE OF REVIEW: Food allergy has risen in prevalence worldwide and is one of the main causes of anaphylaxis, especially in children. The only possible therapeutic approach is specific immunotherapy. This review describes the recent approaches using allergenic molecules for specific immunotherapy. RECENT FINDINGS: Hypoallergenic tropomyosins from Metapenaeus ensis have been cloned and constructed by direct mutagenesis or epitope deletion and have been successfully used in shrimp-sensitized mice...
June 2016: Current Opinion in Allergy and Clinical Immunology
James W Mims
PURPOSE OF REVIEW: Advances in the prevention and treatment of food allergy have been published in the last few years and are placed in context using a review format. RECENT FINDINGS: Preventing food allergy has been studied for years with questions of whether avoidance or exposure was a better strategy. Recent research has suggested that peanut allergy can be substantially reduced in high-risk infants through intentional oral exposure. For children with food allergy, the primary treatment remains avoidance, but controlled trials have shown some success with oral immunotherapy and sublingual immunotherapy...
June 2016: Current Opinion in Otolaryngology & Head and Neck Surgery
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