1932

Abstract

Peanut allergy is a common disease and the cause of severe, life-threatening allergic reactions and death. It is rarely outgrown; most pediatric patients carry the disease into adulthood. Peanut allergy poses a significant burden on the quality of life of sufferers and their families, which results mainly from the fear of accidental peanut ingestion but is also due to dietary and social restrictions. Current standard management involves avoidance advice, patient education, and provision of emergency rescue medication. Immunotherapy, commonly used to treat other allergic diseases, has shown promise as a disease-modifying therapy for peanut allergy. Results from studies of oral immunotherapy show high efficacy rates, improvement in quality of life, and a good safety profile. Treatment may result in sustained unresponsiveness in a proportion of patients, whereas others require ongoing treatment.

Loading

Article metrics loading...

/content/journals/10.1146/annurev-med-061014-094943
2016-01-14
2024-04-26
Loading full text...

Full text loading...

/deliver/fulltext/med/67/1/annurev-med-061014-094943.html?itemId=/content/journals/10.1146/annurev-med-061014-094943&mimeType=html&fmt=ahah

Literature Cited

  1. Bock SA, Muñoz-Furlong A, Sampson HA. 1.  2001. Fatalities due to anaphylactic reactions to foods. J. Allergy Clin. Immunol. 107:1191–93 [Google Scholar]
  2. Finkelman FD. 2.  2010. Peanut allergy and anaphylaxis. Curr. Opin. Immunol. 22:6783–88 [Google Scholar]
  3. De Leon MP, Rolland JM, O'Hehir RE. 3.  2007. The peanut allergy epidemic: allergen molecular characterisation and prospects for specific therapy. Expert Rev. Mol. Med. 9:11–18 [Google Scholar]
  4. Burks AW, Williams LW, Helm RM. 4.  et al. 1991. Identification of a major peanut allergen, Ara h I, in patients with atopic dermatitis and positive peanut challenges. J. Allergy Clin. Immunol. 88:2172–79 [Google Scholar]
  5. Burks AW, Williams LW, Connaughton C. 5.  et al. 1992. Identification and characterization of a second major peanut allergen, Ara h II, with use of the sera of patients with atopic dermatitis and positive peanut challenge. J. Allergy Clin. Immunol. 90:6 Pt. 1962–69 [Google Scholar]
  6. Koppelman SJ, Wensing M, Ertmann M. 6.  et al. 2004. Relevance of Ara h1, Ara h2 and Ara h3 in peanut-allergic patients, as determined by immunoglobulin E Western blotting, basophil-histamine release and intracutaneous testing: Ara h2 is the most important peanut allergen. Clin. Exp. Allergy 34:4583–90 [Google Scholar]
  7. Hourihane JO, Aiken R, Briggs R. 7.  et al. 2007. The impact of government advice to pregnant mothers regarding peanut avoidance on the prevalence of peanut allergy in United Kingdom children at school entry. J. Allergy Clin. Immunol. 119:51197–202 [Google Scholar]
  8. Pereira B, Venter C, Grundy J. 8.  et al. 2005. Prevalence of sensitization to food allergens, reported adverse reaction to foods, food avoidance, and food hypersensitivity among teenagers. J. Allergy Clin. Immunol. 116:4884–92 [Google Scholar]
  9. Venter C, Hasan Arshad S, Grundy J. 9.  et al. 2010. Time trends in the prevalence of peanut allergy: three cohorts of children from the same geographical location in the UK. Allergy 65:1103–8 [Google Scholar]
  10. Sicherer S, Muñoz-Furlong A, Burks A, Sampson H. 10.  1999. Prevalence of peanut and tree nut allergy in the US determined by a random digit dial telephone survey. J. Allergy Clin. Immunol. 103:4559–62 [Google Scholar]
  11. Sicherer SH, Muñoz-Furlong A, Sampson HA. 11.  2003. Prevalence of peanut and tree nut allergy in the United States determined by means of a random digit dial telephone survey. A 5-year follow-up study. J. Allergy Clin. Immunol. 112:61203–7 [Google Scholar]
  12. Sicherer SH, Muñoz-Furlong A, Godbold JH, Sampson HA. 12.  2010. US prevalence of self-reported peanut, tree nut, and sesame allergy: 11-year follow-up. J. Allergy Clin. Immunol. 125:61322–26 [Google Scholar]
  13. Pumphrey RSH, Gowland MH. 13.  2007. Further fatal allergic reactions to food in the United Kingdom, 1999–2006. J. Allergy Clin. Immunol. 119:1018–19 [Google Scholar]
  14. Lack G, Fox D. 14.  2003. Factors associated with the development of peanut allergy in childhood. N. Engl. J. Med. 348:977–85 [Google Scholar]
  15. Du Toit G, Roberts G, Sayre PH. 15.  et al. 2012. Identifying infants at high risk of peanut allergy: the Learning Early About Peanut Allergy (LEAP) screening study. J. Allergy Clin. Immunol. 131:1135–43 [Google Scholar]
  16. Fox AT, Sasieni P, du Toit G. 16.  et al. 2009. Household peanut consumption as a risk factor for the development of peanut allergy. J. Allergy Clin. Immunol. 123:2417–23 [Google Scholar]
  17. Du Toit G, Katz Y, Sasieni P. 17.  et al. 2008. Early consumption of peanuts in infancy is associated with a low prevalence of peanut allergy. J. Allergy Clin. Immunol. 122:5984–91 [Google Scholar]
  18. Du Toit G, Roberts G, Sayre PH. 18.  et al. 2015. Randomized trial of peanut consumption in infants at risk for peanut allergy. N. Engl. J. Med. 122:984–91 [Google Scholar]
  19. Ewan PW. 19.  1996. Clinical study of peanut and nut allergy in 62 consecutive patients: new features and associations. BMJ 312:70381074–78 [Google Scholar]
  20. Moneret-Vautrin DA, Rance F, Kanny G. 20.  et al. 1998. Food allergy to peanuts in France—evaluation of 142 observations. Clin. Exp. Allergy 28:91113–19 [Google Scholar]
  21. Sicherer SH, Burks AW, Sampson HA. 21.  1998. Clinical features of acute allergic reactions to peanut and tree nuts in children. Pediatrics 102:1e6 [Google Scholar]
  22. Hourihane JO, Kilburn SA, Dean P, Warner JO. 22.  1997. Clinical characteristics of peanut allergy. Clin. Exp. Allergy 27:6634–39 [Google Scholar]
  23. Wensing M, Penninks AH, Hefle SL. 23.  et al. 2002. The distribution of individual threshold doses eliciting allergic reactions in a population with peanut allergy. J. Allergy Clin. Immunol. 110:6915–20 [Google Scholar]
  24. Taylor SL, Moneret-Vautrin DA, Crevel RWR. 24.  et al. 2010. Threshold dose for peanut: risk characterization based upon diagnostic oral challenge of a series of 286 peanut-allergic individuals. Food Chem. Toxicol. 48:3814–19 [Google Scholar]
  25. Hourihane JO, Kilburn SA, Nordlee JA. 25.  et al. 1997. An evaluation of the sensitivity of subjects with peanut allergy to very low doses of peanut protein: a randomized, double-blind, placebo-controlled food challenge study. J. Allergy Clin. Immunol. 100:5596–600 [Google Scholar]
  26. Blom WM, Vlieg-Boerstra BJ, Kruizinga AG. 26.  et al. 2013. Threshold dose distributions for 5 major allergenic foods in children. J. Allergy Clin. Immunol. 131:1172–79 [Google Scholar]
  27. Sampson HA, Mendelson L, Rosen JP. 27.  1992. Fatal and near-fatal anaphylactic reactions to food in children and adolescents. N. Engl. J. Med. 327:6380–84 [Google Scholar]
  28. Sampson HA. 28.  2001. Utility of food-specific IgE concentrations in predicting symptomatic food allergy. J. Allergy Clin. Immunol. 107:5891–96 [Google Scholar]
  29. Lieberman JA, Glaumann S, Batelson S. 29.  et al. 2013. The utility of peanut components in the diagnosis of IgE-mediated peanut allergy among distinct populations. J. Allergy Clin. Immunol. Pract. 1:175–82 [Google Scholar]
  30. Nicolaou N, Poorafshar M, Murray C. 30.  et al. 2010. Allergy or tolerance in children sensitized to peanut: prevalence and differentiation using component-resolved diagnostics. J. Allergy Clin. Immunol. 125:1191–97.e13 [Google Scholar]
  31. Vadas P, Perelman B. 31.  2003. Presence of undeclared peanut protein in chocolate bars imported from Europe. J. Food Prot. 66:101932–34 [Google Scholar]
  32. Schäppi GF, Konrad V, Imhof D. 32.  et al. 2001. Hidden peanut allergens detected in various foods: findings and legal measures. Allergy 56:121216–20 [Google Scholar]
  33. Avery NJ, King RM, Knight S, Hourihane JO. 33.  2003. Assessment of quality of life in children with peanut allergy. Pediatr. Allergy Immunol. 14:5378–82 [Google Scholar]
  34. Primeau MN, Kagan R, Joseph L. 34.  et al. 2000. The psychological burden of peanut allergy as perceived by adults with peanut allergy and the parents of peanut-allergic children. Clin. Exp. Allergy 30:81135–43 [Google Scholar]
  35. Sampson H. 35.  1999. Food allergy. Part 2: diagnosis and management. J. Allergy Clin. Immunol. 103:981–89 [Google Scholar]
  36. Kapoor S, Roberts G, Bynoe Y. 36.  et al. 2004. Influence of a multidisciplinary paediatric allergy clinic on parental knowledge and rate of subsequent allergic reactions. Allergy 59:2185–91 [Google Scholar]
  37. Yu JW, Kagan R, Verreault N. 37.  et al. 2006. Accidental ingestions in children with peanut allergy. J. Allergy Clin. Immunol. 118:2466–72 [Google Scholar]
  38. Ewan P, Clark A. 38.  2001. Long-term prospective observational study of patients with peanut and nut allergy after participation in a management plan. Lancet 357:9250111–15 [Google Scholar]
  39. Bock SA, Atkins F. 39.  1989. The natural history of peanut allergy 1. J. Allergy Clin. Immunol. 83:5900–4 [Google Scholar]
  40. Ferdman RM, Church JA. 40.  2006. Mixed-up nuts: identification of peanuts and tree nuts by children. Ann. Allergy Asthma Immunol. 97:173–77 [Google Scholar]
  41. Ewan PW, Clark AT. 41.  2005. Efficacy of a management plan based on severity assessment in longitudinal and case-controlled studies of 747 children with nut allergy: proposal for good practice. Clin. Exp. Allergy 35:6751–56 [Google Scholar]
  42. Hourihane JO, Roberts SA, Warner JO. 42.  1998. Resolution of peanut allergy: case-control study. BMJ 316:71401271–75 [Google Scholar]
  43. Skolnick HS, Conover-Walker MK, Koerner CB. 43.  et al. 2001. The natural history of peanut allergy. J. Allergy Clin. Immunol. 107:2367–74 [Google Scholar]
  44. Ho MHK, Wong WHS, Heine RG. 44.  et al. 2008. Early clinical predictors of remission of peanut allergy in children. J. Allergy Clin. Immunol. 121:3731–36 [Google Scholar]
  45. Anagnostou K, Clark A, King Y. 45.  et al. 2011. Efficacy and safety of high-dose peanut oral immunotherapy with factors predicting outcome. Clin. Exp. Allergy 41:91273–81 [Google Scholar]
  46. Jones SM, Pons L, Roberts JL. 46.  et al. 2009. Clinical efficacy and immune regulation with peanut oral immunotherapy. J. Allergy Clin. Immunol. 124:2292–300.e97 [Google Scholar]
  47. Blumchen K, Ulbricht H, Staden U. 47.  et al. 2010. Oral peanut immunotherapy in children with peanut anaphylaxis. J. Allergy Clin. Immunol. 126:183–91.e1 [Google Scholar]
  48. Varshney P, Jones SM, Scurlock AM. 48.  et al. 2011. A randomized controlled study of peanut oral immunotherapy: clinical desensitization and modulation of the allergic response. J. Allergy Clin. Immunol. 127:3654–60 [Google Scholar]
  49. Anagnostou K, Islam S, King Y. 49.  et al. 2014. Assessing the efficacy of oral immunotherapy for the desensitisation of peanut allergy in children (STOP II): a phase 2 randomised controlled trial. Lancet 383:99251297–304 [Google Scholar]
  50. Lucendo AJ, Arias A, Tenias JM. 50.  2014. Relation between eosinophilic esophagitis and oral immunotherapy for food allergy: a systematic review with meta-analysis. Ann. Allergy Asthma Immunol. 113:6624–29 [Google Scholar]
  51. Bégin P, Winterroth LC, Dominguez T. 51.  et al. 2014. Safety and feasibility of oral immunotherapy to multiple allergens for food allergy. Allergy Asthma Clin. Immunol. 10:11 [Google Scholar]
  52. Tang M, Ponsonby A, Orsini F. 52.  2015. Administration of a probiotic with peanut oral immunotherapy: a randomized trial. J. Allergy Clin. Immunol. 135:3737–44 [Google Scholar]
  53. Schneider LC, Rachid R, LeBovidge J. 53.  2013. A pilot study of omalizumab to facilitate rapid oral desensitization in high-risk peanut-allergic patients. J. Allergy Clin. Immunol. 132:61368–74 [Google Scholar]
  54. Bégin P, Dominguez T, Wilson SP. 54.  et al. 2014. Phase 1 results of safety and tolerability in a rush oral immunotherapy protocol to multiple foods using omalizumab. Allergy Asthma Clin. Immunol. 10:17 [Google Scholar]
  55. Vickery BP, Scurlock AM, Kulis M. 55.  et al. 2014. Sustained unresponsiveness to peanut in subjects who have completed peanut oral immunotherapy. J. Allergy Clin. Immunol. 133:2468–75 [Google Scholar]
  56. Syed A, Garcia MA, Lyu S-C. 56.  et al. 2014. Peanut oral immunotherapy results in increased antigen-induced regulatory T-cell function and hypomethylation of forkhead box protein 3 (FOXP3). J. Allergy Clin. Immunol. 133:2500–10 [Google Scholar]
  57. Cavkaytar O, Akdis CA, Akdis M. 57.  2014. Modulation of immune responses by immunotherapy in allergic diseases. Curr. Opin. Pharmacol. 17:30–37 [Google Scholar]
  58. Kim EH, Bird JA, Kulis M. 58.  et al. 2011. Sublingual immunotherapy for peanut allergy: clinical and immunologic evidence of desensitization. J. Allergy Clin. Immunol. 127:3640–46.e1 [Google Scholar]
  59. Varshney P, Jones SM, Pons L. 59.  et al. 2009. Oral immunotherapy (OIT) induces clinical tolerance in peanut-allergic children. J. Allergy Clin. Immunol. 123:2, Suppl. 1S174–74 [Google Scholar]
  60. Gorelik M, Narisety SD, Guerrerio AL. 60.  et al. 2014. Suppression of the immunologic response to peanut during immunotherapy is often transient. J. Allergy Clin. Immunol. 135:51283–92 [Google Scholar]
  61. Wood RA, Sampson HA. 61.  2014. Oral immunotherapy for the treatment of peanut allergy: Is it ready for prime time?. J. Allergy Clin. Immunol. Pract. 2:197–98 [Google Scholar]
  62. Allen K, O'Hehir R. 62.  2011. The evolution of oral immunotherapy for the treatment of peanut allergy. Clin. Exp. Allergy 41:1172–74 [Google Scholar]
  63. Sampson HA. 63.  2013. Peanut oral immunotherapy: Is it ready for clinical practice?. J. Allergy Clin. Immunol. Pract. 1:115–21 [Google Scholar]
  64. Wasserman RL, Factor JM, Baker JW. 64.  et al. 2014. Oral immunotherapy for peanut allergy: multipractice experience with epinephrine-treated reactions. J. Allergy Clin. Immunol. Pract. 2:191–96 [Google Scholar]
  65. Greenhawt MJ, Vickery BP. 65.  2015. Allergist-reported trends in the practice of food allergen oral immunotherapy. J. Allergy Clin. Immunol. Pract. 3:133–38 [Google Scholar]
  66. Sheikh A, Nurmatov U, Venderbosch I, Bischoff E. 66.  2012. Oral immunotherapy for the treatment of peanut allergy: systematic review of six case series studies. Prim. Care Respir. J. 21:141–49 [Google Scholar]
  67. Nurmatov U, Venderbosch I, Devereux G. 67.  et al. 2012. Allergen-specific oral immunotherapy for peanut allergy. Cochrane Database Syst. Rev.9:CD009014
/content/journals/10.1146/annurev-med-061014-094943
Loading
/content/journals/10.1146/annurev-med-061014-094943
Loading

Data & Media loading...

  • Article Type: Review Article
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error