Sequential hypoallergenic boiled peanut and roasted peanut oral immunotherapy

Tao, Billy; Morris, Scott; Grzeskowiak, Luke E.; Smith, William B.; Forsyth, Kevin; Chataway, Tim

doi:10.1111/cea.13024

Cited by 13 publications

(20 citation statements)

References 7 publications

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“…A small, open-label study used modified (boiled) peanut prior to roasted peanut for OIT showed that boiled peanut could reduce SPT wheal size and increase peanut IgG4. 139 There is significant interest in whether modified (baked) milk accelerates acquisition of tolerance to unheated milk. 43,140 Recently, a randomized controlled trial (RCT) of baked milk ingestion did show a significant change in ability to eat unheated milk at the end of 1 year (88.1% (37/42) vs 66.7% (28/42) avoiding baked milk, P < .018).…”

Section: Clinic Al Mark Er S and Pro Cedur Al Fac Tor S Of Tre Atmementioning

confidence: 99%

Recent developments and highlights in food allergy

Eiwegger

Hung

Diego

et al. 2019

Allergy

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The achievement of long-lasting, safe treatments for food allergy is dependent on the understanding of the immunological basis of food allergy. Accurate diagnosis is essential for management. In recent years, data from oral food challenges have revealed that routine allergy testing is poor at predicting clinical allergy for tree nuts, almonds in particular. More advanced antigen-based tests including component-resolved diagnostics and epitope reactivity may lead to more accurate diagnosis and selection of therapeutic intervention. Additional diagnostic accuracy may come from cellular tests such as the basophil activation test or mast cell approaches. In the context of clinical trials, cellular tests have revealed specific T-cell and B-cell populations that are more abundant in food-allergic individuals with distinct mechanistic features.Awareness of clinical markers, such as the ability to eat baked forms of milk and egg, continues to inform the understanding of natural tolerance development.Mouse models have allowed for investigation into multiple mechanisms of food allergy including modification of epithelial metabolism, and the induction of regulatory cell subsets and the microbiome. Increasing numbers of children who underwent food immunotherapy enlarged the body of evidence on mechanisms and predictors of treatment success. Experimental immunological markers in conjunction with clinical determinants such as lower age and lower initial specific IgE appear to be of benefit.More research on the optimal dose, preparation, and route of application integrating a high-level safety and efficacy is demanded. Alternatively, biologics blocking TSLP, IL-33, IL-4 and IL-13, or IgE may help to achieve that. K E Y W O R D Sallergy treatment, biologics, food allergy, immune tolerance, immunotherapy | 2357 EIWEGGER Et al.

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Section: Clinic Al Mark Er S and Pro Cedur Al Fac Tor S Of Tre Atmementioning

confidence: 99%

Recent developments and highlights in food allergy

Eiwegger

Hung

Diego

et al. 2019

Allergy

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show abstract

“…To date, 27 linear epitopes have been recognized within the molecule of Ara h 1, of which the two most potent epitopes are found within the amino acid residues 139 to 147 and 175 to 183 (Matsuo, Yokooji, & Taogoshi, ). Recently, 36 T‐cell epitopes of Ara h 1 have been identified (Ramesh et al., ), which is useful as T‐cell epitopes may play a significant role in development of immunotherapy treatments (Tao et al., ). This information can help the food processing scientists to study the alteration in IgE binding epitopes to lower adverse events yet maintain T‐cell epitopes for immunotherapy purposes.…”

Section: Molecular Characteristics Of Peanut Allergensmentioning

confidence: 99%

“…Dot blot analyses demonstrated the immunoreactivity of boiled and fried peanut samples up to varying degrees, which suggests that boiling and frying may not have the potential to diminish the immunoreactivity and generate hypoallergenic peanuts (Comstock et al., ). Furthermore, a recent study suggests that extensive boiling of peanut for 8 hr can reduce the IgE binding activity up to eightfold while extended boiling for 12 hr significantly reduced the immunoreactivity by up to 19‐fold (Tao et al., ). The transfer of these allergens to boiled water could explain the loss of these allergens from the peanut that leads to a significant reduction in immunogenicity (Beyer et al., ; Mondoulet et al., ; Zhang, Zhu et al., ).…”

Section: Effects Of Processing On Peanut Allergens and Immunogenicitymentioning

confidence: 99%

“…Most importantly, the recent research suggests that extensively boiled peanut may serve as a safe product for immunotherapy as it decreases the immunoreactivity and maintains its T‐cell proliferation ability (Tao et al., ). The initial trial on immunotherapy through sequentially boiled peanuts indicates that extensively boiled peanuts reduce the chance of adverse events during the course of the immunotherapy, while still effective in desensitizing the patients (Tao et al., ; Turner et al., ).…”

Section: Effects Of Processing On Peanut Allergens and Immunogenicitymentioning

confidence: 99%

See 1 more Smart Citation

Peanut Allergy: Characteristics and Approaches for Mitigation

Shah

Shi

Ashley

et al. 2019

Comp Rev Food Sci Food Safe

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Peanut allergy has garnered significant attention because of the high sensitization rate, increase in allergy, and severity of the reaction. Sufficiently reliable therapies and efficient mitigating techniques to combat peanut allergy are still lacking. Current management relies on avoiding peanuts and nuts and seeds with homologous proteins, although adverse events mostly occur with accidental ingestion. There is a need for hypoallergenic peanut products to protect sensitized individuals and perhaps serve as immunotherapeutic products. Alongside traditional practices of thermal and chemical treatment, novel processing approaches such as high‐pressure processing, pulsed ultraviolet light, high‐intensity ultrasound, irradiation, and pulsed electric field have been performed toward reducing the immunoreactivity of peanut. Covalent and noncovalent chemical modifications to proteins also have the tendency to alter peanut allergenicity. Enzymatic hydrolysis seems to be the most advantageous technique in diminishing the allergenic potential of peanut. Furthermore, the combined processing approach (hurdle technologies) such as enzymatic hydrolysis followed by, or in conjunction with, roasting, high pressure and heat, ultrasound with enzymatic treatment, or germination have shown a significant reduction of peanut immunoreactivity and may emerge as useful techniques in reducing the allergenicity of peanut and other foods. This study represents our current knowledge about the alterations in allergenic properties of peanut via different processing mechanisms as well as evaluating its future potential, geographical based data on increasing sensitization, clinical relevance, eliciting dose, and current management of peanut allergy. Furthermore, the molecular characteristics and clinical relevance of peanut allergens have been discussed.

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“…41 A potential treatment strategy is omalizumab, and Vetander and colleagues publish data to suggest that an individualized dosing can prevent reactions in patients with food allergy. 44 Promising but needs to be tested against conventional OIT protocols. 43 An alternative route is to utilize an allergen that has been processed to reduce its allergenicity without reducing its immunogenicity.…”

Section: Food Allergymentioning

confidence: 99%