Current developments in peanut allergy

Purpose of review: Peanut allergy is amoung the most srious, life-treatening food sensitivities, and recent studies indicate increasing prevalence, particularly amound children. Our objective is to highlight recent advances in the immunology and treatment of peanut allergy. Recent findings: Peanut sensitization may be both a Th1- and Th2-driven process, and cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) may play a role in regulating the response intensity. Preliminary work shows that the food matrix is important in the immune response to peanut and that puified peanut allergens may have little intrinsic stimulatory capacity. Studies characterzing peanuts allergens have revealed Ara h 1 and Ara h 2 as the most potent allergens, but Ara h 3 may be more allergenic than previously thouhjt. There appears to be a relationship between the diversity of IgE-binding patterns and the severuty of clinical symptoms. Multiple novel approaches to treatment are being investigated, which include traditional Chinese medicine, various forms of modified immunotherapy and the use of adjuvants in modified immunoterapy. Summary: By understanding the immunlogic response to peanut and the roles of the major peanut allergens, it may be possible to predict those at the risk for severe reactions, prevent peanut sensitization and effectively treat those already sensitized.