Peanut allergy: risk factors, immune mechanisms, and best practices for oral immunotherapy success

Tirumalasetty, Jyothi; Barshow, Suzanne; Kost, Laurie; Morales, Lu; Sharma, Reyna; Lazarte, Carlos; Nadeau, Kari

doi:10.1080/1744666x.2023.2209318

Cited by 9 publications

(3 citation statements)

References 86 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Peanut is a highly reported food allergen in children and adults [3,4]. Until 2020, management of peanut allergy was just based on strict avoidance, implying insecurity and high risk of accidental ingestion as well as frequent visits to the emergency rooms [26]. In 2020, a peanut allergen powder-dnfp (PTAH; Palforzia ® , Aimmune Therapeutics) was approved by the FDA and the EMA for OIT treatments of peanut allergy in children aged 4-17 years [27].…”

Section: Discussionmentioning

confidence: 99%

Purified Free Mannan Promotes Tolerogenic Responses in Peanut-Stimulated Human Dendritic Cells

Sánchez-Herrero,

Benito-Villalvilla,

Palomares

2024

Int Arch Allergy Immunol

View full text Add to dashboard Cite

Introduction: IgE-mediated peanut allergy is an important public health problem of increasing prevalence leading to anaphylactic reactions both in children and adults. Allergen-specific oral immunotherapy (OIT) is the single treatment with the potential capacity to modify the course of the disease, but it still faces some drawbacks in terms of efficacy, safety, patients’ adherence, and cost. Alternative strategies, including the use of novel adjuvants, to overcome such limitations are highly demanded. The main aim of this study was to search for potential novel adjuvants for peanut OIT by assessing the capacity of free purified mannan and different toll-like receptor ligands (TLR-Ls) to immunomodulate the responses of human monocyte-derived dendritic cells (hmoDCs) to peanut allergens. Methods: Monocytes were isolated from PBMCs of healthy donors and differentiated into hmoDCs. Flow cytometry, ELISA, coculture, and suppression assay were performed to assess the effects of TLR-Ls, mannan, and crude peanut extract (CPE) in hmoDCs. Results: Purified free mannan increased the expression levels of HLA-DR, CD86, CD83, and PD-L1 and induced a higher IL-10/IL-6 cytokine ratio in hmoDCs compared to the stimulation with different TLR-Ls. Mannan significantly increased the expression of HLA-DR, the maturation marker CD83, the tolerogenic marker PD-L1, as well as the production of IL-10, IL-6, and TNF-α in CPE-stimulated hmoDCs. Supporting these tolerogenic properties, mannan also significantly increased the frequency of FOXP3+ regulatory T cells generated by CPE-treated hmoDCs with functional suppressive capacity. Conclusions: We uncover that purified free mannan induces tolerogenic responses in human DCs stimulated with peanut allergens, suggesting mannan as a suitable potential novel adjuvant to be exploited in the context of OIT for peanut allergy.

show abstract

Section: Discussionmentioning

confidence: 99%

Purified Free Mannan Promotes Tolerogenic Responses in Peanut-Stimulated Human Dendritic Cells

Sánchez-Herrero,

Benito-Villalvilla,

Palomares

2024

Int Arch Allergy Immunol

View full text Add to dashboard Cite

show abstract

“…However, because of safety concerns, the potential for spontaneous resolution, and logistic constraints, the GA 2 LEN recommends OIT at this age based on individual profiles ( 43 ). Thus, a careful patient-centered evaluation remains a crucial prerequisite to OIT ( 55 – 58 ). The availability of surrogate markers would be an important asset in refining patient selection for OIT in the future ( Figure 1 ).…”

Section: Immune Signatures In Oitmentioning

confidence: 99%

Immune signatures predicting the clinical outcome of peanut oral immunotherapy: where we stand

Wanniang,

Boehm,

Codreanu-Morel

et al. 2023

Front. Allergy

View full text Add to dashboard Cite

Peanut allergy is a growing health concern that can cause mild to severe anaphylaxis as well as reduced quality of life in patients and their families. Oral immunotherapy is an important therapeutic intervention that aims to reshape the immune system toward a higher threshold dose reactivity and sustained unresponsiveness in some patients. From an immunological point of view, young patients, especially those under 3 years old, seem to have the best chance for therapy success. To date, surrogate markers for therapy duration and response are evasive. We provide a comprehensive overview of the current literature state regarding immune signatures evolving over the course of oral immunotherapy as well as baseline immune conditions prior to the initiation of treatment. Although research comparing clinical and immune traits in the first years of life vs. later stages across different age groups is limited, promising insights are available on immunological endotypes among peanut-allergic patients. The available data call for continued research to fill in gaps in knowledge, possibly in an integrated manner, to design novel precision health approaches for advanced therapeutic interventions in peanut allergy.

show abstract

“…Nevertheless, for desserts such as ice cream, highly refined peanut oil is generally used, and the likelihood of finding unrefined peanut oil, especially in a vanilla-flavored ice cream, is small. Additionally, in recent years, oral immunotherapy has been actively used in clinical practice to help individuals develop tolerance toward food allergies ( Maeda et al, 2022 ; Tirumalasetty et al, 2023 ). So, although some risk for unrefined peanut oils exists, it is relatively low.…”

mentioning

confidence: 99%

Revisiting the Newest Vital Sign Survey: Addressing Concerns About This Health Literacy Assessment Tool

Schol,

Ambrosio,

Yamada

et al. 2024

HLRP: Health Literacy Research and Practice

View full text Add to dashboard Cite

Peanut allergy: risk factors, immune mechanisms, and best practices for oral immunotherapy success

Cited by 9 publications

References 86 publications

Purified Free Mannan Promotes Tolerogenic Responses in Peanut-Stimulated Human Dendritic Cells

Purified Free Mannan Promotes Tolerogenic Responses in Peanut-Stimulated Human Dendritic Cells

Immune signatures predicting the clinical outcome of peanut oral immunotherapy: where we stand

Revisiting the Newest Vital Sign Survey: Addressing Concerns About This Health Literacy Assessment Tool

Contact Info

Product

Resources

About