Peanut Oral Immunotherapy: a Current Perspective

Patrawala, Meera; Shih, Jennifer; Lee, Gerald; Vickery, Brian P.

doi:10.1007/s11882-020-00908-6

Cited by 45 publications

(37 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Finally, as more therapies like Palforzia emerge, parents will face new forms of communication work. For instance, oral immunotherapies (OIT) like Palforzia are generally not considered curative in that patients cannot consume their allergen freely (Patrawala et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

Parents’ Communication Work in the Management of Food Allergies

Bute

Bowers

Park

2021

Health Communication

View full text Add to dashboard Cite

The National Academies of Sciences, Engineering, and Medicine (NASEM, 2017) has identified food allergies as a critical public health issue that significantly affects quality of life for patients and their families. Despite the crisis-level status of food allergies, especially in children, there are currently no curative treatments. As a result, impacted families must learn how to carry the burden of disease management. Using an expanded application of the concept of communication work (Donovan-Kicken et al., 2012), this study features data from interviews with 26 parents of food allergic children and explores how parents navigate the nuances of food allergy maintenance while negotiating and preserving valued relationships and identities through everyday talk. Results revealed that parents used communication to legitimate food allergy, balance potential face-threats with identity and relational goals, and coordinate care with spouses. Due to the lack of therapeutic treatment options, we found that parents utilize communication work, which is both demanding and effortful, as a form of disease management.

show abstract

Section: Discussionmentioning

confidence: 99%

Parents’ Communication Work in the Management of Food Allergies

Bute

Bowers

Park

2021

Health Communication

View full text Add to dashboard Cite

show abstract

“…19,21 This approach has been increasingly studied over the past 10 years demonstrating proof of the process of desensitization. 22 The phases of POIT include the initial dose escalation phase (IDE), updosing phase (UDP), and maintenance phase (MP). The UDP provides increasing amount of allergen until the targeted maintenance dose is reached.…”

Section: Data Sourcesmentioning

confidence: 99%

Peanut Allergen Powder-dnfp: A Novel Oral Immunotherapy to Mitigate Peanut Allergy

2020

View full text Add to dashboard Cite

Objective: To review data on efficacy and safety of peanut allergen powder-dnfp (PAP; Palforzia), a novel oral immunotherapy for peanut allergy, a common food allergy. Data Sources: A PubMed/CINAHL search in English was performed from inception to June 30, 2020, using the search words peanut allergy, desensitization, ARA101, and peanut oral immunotherapy. Study Selection and Data Extraction Quantification: Published phase 2 and 3 clinical trials, documents presented to the Food and Drug Administration, and supplemental study documentation were reviewed. Articles evaluated PAP’s pharmacology, pharmacokinetics, mechanism of action, efficacy, and safety. Data Synthesis: PAP was efficacious and safe for treatment of peanut allergy in mostly Caucasian children, 4 to 17 years old. A key phase III clinical trial showed a statistically significant difference (primary end point) between PAP 600 mg and placebo groups (67.2% vs 4%; P < 0.001). During initial dose escalation and updosing phases, gastrointestinal and respiratory tract allergic reactions (ARs) were more common in the PAP group. More epinephrine rescue was used in the PAP group. Relevance to Patient Care and Clinical Practice: Oral immunotherapy for desensitization of peanut allergy was shown to reduce the severity of reactions if accidental allergen exposure occurs. Risk evaluation and mitigation strategy certification is required for pharmacies, health care providers, and clinics. More data in real-world populations will enhance its effectiveness. Conclusions: In patients 4 to 17 years old, PAP mitigated ARs, including anaphylaxis, that may occur with accidental peanut exposure. Although there are risks, it was efficacious in more than two-thirds of participants in phase 2 and phase 3 efficacy trials.

show abstract

“…We also for the first time generated transplastomic lettuce plants expressing CTB‐FIX without an antibiotic selection marker (‘marker‐free’ CTB‐FIX) and evaluated stability of protein expression in subsequent generations in the absence of the selectable marker gene. Oral administration of marker‐free (MF) CTB‐FIX expressed in chloroplasts in an edible crop together with the availability of established scale‐up protocols (cGMP hydroponics, Daniell et al., 2020 ) and recent FDA approval of orally delivered Ara h protein expressed in peanut cells to treat peanut allergy (Bird et al., 2018 ; Patrawala et al., 2020 ; Tilles and Petroni, 2018 ; Vickery et al., 2018 ) should facilitate regulatory approval for clinical studies in humans for sustainable management of haemophilia B.…”

Section: Introductionmentioning

confidence: 99%

Preclinical development of plant‐based oral immune modulatory therapy for haemophilia B

Srinivasan

Herzog

Khan

et al. 2021

Plant Biotechnology Journal

View full text Add to dashboard Cite

Anti-drug antibody (ADA) formation is a major complication in treatment of the X-linked bleeding disorder haemophilia B (deficiency in coagulation factor IX, FIX). Current clinical immune tolerance protocols are often not effective due to complications such as anaphylactic reactions against FIX. Plant-based oral tolerance induction may address this problem, as illustrated by the recent first regulatory approval of orally delivered plant cells to treat peanut allergy. Our previous studies showed that oral delivery of plant cells expressing FIX fused to the transmucosal carrier CTB (cholera toxin subunit B) in chloroplasts suppressed ADA in animals with haemophilia B. We report here creation of the first lettuce transplastomic lines expressing a coagulation factor, in the absence of antibiotic resistance gene. Stable integration of the CTB-FIX gene and homoplasmy (transformation of~10 000 copies in each cell) were maintained in both T1 and T2 generation marker-free plants. CTB-FIX expression in lyophilized leaves of T1 and T2 marker-free plants was 1.0-1.5 mg/g dry weight, confirming that the marker excision did not affect antigen levels. Oral administration of CTB-FIX to Sprague Dawley rats at 0.25, 1 or 2.5 mg/ kg did not produce overt adverse effects or toxicity. The no-observed-adverse-effect level (NOAEL) is at least 2.5 mg/kg for a single oral administration in rats. Oral administration of CTB-FIX at 0.3 or 1.47 mg/kg either mixed in food or as an oral suspension to Beagle dogs did not produce any observable toxicity. These toxicology studies should facilitate filing of regulatory approval documents and evaluation in haemophilia B patients.

show abstract

Peanut Oral Immunotherapy: a Current Perspective

Cited by 45 publications

References 35 publications

Parents’ Communication Work in the Management of Food Allergies

Parents’ Communication Work in the Management of Food Allergies

Peanut Allergen Powder-dnfp: A Novel Oral Immunotherapy to Mitigate Peanut Allergy

Preclinical development of plant‐based oral immune modulatory therapy for haemophilia B

Contact Info

Product

Resources

About