Peanut Allergies Unshelled: New Treatment and Preventive Measures Have you ever felt the craving for a warm peanut butter and condensed milk toast? While most of us can probably relate, peanut allergy is one of the most common food allergies. It typically develops in early childhood and persist in around 80% of patients for life [1, 2]. In severe cases, life-threatening symptoms can occur after ingestion of even a small trace of peanut. The presence of these traces in everyday meals makes it challenging to avoid accidental ingestion. In the past, “treatment” of peanut allergy was largely limited to complete avoidance. However, recent studies have brought forward ways to prevent as well as manage this common condition: Let’s delve into them and crack the peanut allergy! In 2015, a landmark clinical trial published in the New England Journal of Medicine suggested that the introduction of peanuts in the diets of infants at risk could prevent the development of peanut allergy [3]. The mechanism is called desensitization: a treatment to increase the body’s tolerance to peanuts by exposing the infant to an increasing amount of peanut antigen, the allergy-causing component in peanuts. Termed “oral immunotherapy,” desensitization can modify the developing immune system of infants so that peanuts can be recognized by the body as a safe food instead of a threat. In May 2017, after taking recent evidence into consideration, the United States National Institute of Allergy and Infectious Diseases (NIAID) recommended early introduction of peanuts to infants at risk, especially to those aged four to six months with severe eczema and/or egg allergy [4]. Preliminary immunological test should be conducted to infants with severe eczema and/or egg allergy to ensure safety and to determine the preferred method of the administration of dietary peanut. However, their recommendation for infants who had already been identified as allergic was avoidance. In 2023, further data from a new study urged the promotion of this preventive intervention to the general population [5]. Compared to the marginal reduction of 4.6% by targeting only the highest-risk infants with severe eczema, extending the scope to all infants could lower the prevalence by 77%. The study also showed that the older a child grows, the less effective the intervention would become. This could explain the tenfold lower rate of peanut allergy in the children in Israel,
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