Unmet needs of children with peanut allergy

Abstract

Background: Peanut allergy is a potentially severe and lifelong allergy, with few effective treatments or preventive measures. Objective: To convene an expert panel of allergists, pediatricians, and advocates to discuss and highlight unmet needs in the prevention and management of peanut allergies. Methods: Literature searches of PubMed were performed. The panel evaluated published data on the prevention of peanut allergy, treatment of existing peanut allergy, and management of reactions after unintentional peanut exposures. Results: The following key unmet needs in the prevention and management of peanut allergy were identified: (1) enhancing and optimizing implementation of early peanut introduction as a means of preventing

High‐dimensional immune profiles correlate with phenotypes of peanut allergy during food‐allergic reactions

“…19,20 Except for skin testing and CRD, other novel approaches are not yet fully integrated into clinical care. Thus, the prediction of clinical reactivity based on biomarkers remains an unmet medical need in PA. 6,8 An in-depth understanding of the complex Th2 immune pathways underlying clinical reactivity is the central element towards biomarker discovery and precision diagnosis in PA. 10 Proinflammatory events proceed in effector tissues and are difficult to assess for diagnostic purposes, in contrast to serological markers. 6,[21][22][23][24] Recent progress in immunological endotyping based on cutting-edge technologies in flow and mass cytometry has opened new routes for immune marker discovery.…”

“…Clinical presentations, such as threshold reactivity, vary widely, which is part of the unpredictable nature of PA 8–10 . Several advances have already led to the discovery of diagnostic biomarkers associated with clinical outcome in PA.…”

Glycosylation-modified antigens as a tolerance-inducing vaccine platform prevent anaphylaxis in a pre-clinical model of food allergy

“…Starting at weaning, we sensitized mice using BLG plus cholera toxin (CT) as a mucosal adjuvant intragastrically (i.g.) once weekly for 5 weeks as described previously 7 . After five sensitizations, we challenged the mice intraperitoneally (i.p.)…”

“…Studies such as LEAP (Learning Early About Peanut Allergy) and EAT (Enquiring About Tolerance) have produced promising and impactful insight into early introduction to prevent the onset of food allergies — exposing infants to major food allergens in their diet alongside breastfeeding leads to significantly reduced onset of food allergy compared to control subjects in five-year longitudinal studies 5, 6 . While early introduction guidelines are gradually being adopted by pediatricians and allergists across the US, one of the biggest barriers to effective prevention is compliance with the rigorous schedule of daily feeding of specific amounts of allergen to infants for years, as well as the risk of exposing other children in the household who might already be allergic 7 . Because of these limitations for both preventative and therapeutic approaches, alternatives that can provide lasting non-responsiveness or even tolerance to different allergens in a limited number of doses are needed.…”

A Practical, Stepwise Approach to Peanut Oral Immunotherapy in Clinical Practice: Benefits and Risks

“…44 They also help address caregiver goals, expectations, and psychological barriers as well as identify facilitators for treatment strategies. 45,46 Additionally, educational tools may be helpful, such as counseling videos and patient checklists; these are being evaluated with the aim to improve parent and patient knowledge of OIT in the outpatient clinic setting. 47…”