Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2018 Sep 25:9:2156.
doi: 10.3389/fimmu.2018.02156. eCollection 2018.

Adjuvanted Immunotherapy Approaches for Peanut Allergy

Brandi T Johnson-Weaver  1 , Herman F Staats  1   2   3 , A Wesley Burks  4   5 , Michael D Kulis  4   5
Affiliations
Review

Adjuvanted Immunotherapy Approaches for Peanut Allergy

Brandi T Johnson-Weaver et al. Front Immunol. .

Abstract

Food allergies are a growing public health concern with an estimated 8% of US children affected. Peanut allergies are also on the rise and often do not spontaneously resolve, leaving individuals at-risk for potentially life-threatening anaphylaxis throughout their lifetime. Currently, two forms of peanut immunotherapy, oral immunotherapy (OIT) and epicutaneous immunotherapy (EPIT), are in Phase III clinical trials and have shown promise to induce desensitization in many subjects. However, there are several limitations with OIT and EPIT, such as allergic side effects, daily dosing requirements, and the infrequent outcome of long-term tolerance. Next-generation therapies for peanut allergy should aim to overcome these limitations, which may be achievable with adjuvanted immunotherapy. An adjuvant can be defined as anything that enhances, accelerates, or modifies an immune response to a particular antigen. Adjuvants may allow for lower doses of antigen to be given leading to decreased side effects; may only need to be administered every few weeks or months rather than daily exposures; and may induce a long-lasting protective effect. In this review article, we highlight examples of adjuvants and formulations that have shown pre-clinical efficacy in treating peanut allergy.

Keywords: adjuvants; food allergy; immunotherapy; peanut allergy; vaccine.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Adjuvanted immunotherapy formulations are potential next-generation therapies that may modulate host immunity to treat peanut allergy. Pathogen-associated molecular patterns (PAMP) derived from pathogens, such as E. coli or L. monocytogenes, or probiotics, such as Lactobacillus and Bifidobacterium, or microbial components, such as CpG ODN may activate dendritic cells to induce naïve T cells to differentiate into more Th1 and/or Treg cells and less toward Th2 cells. Inhibitory ODNs that lack CpG and nanoemulsions may also lead to enhanced Treg and Th1 responses, respectively. Increased Th1 and/or Treg cells may suppress or balance peanut-specific Th2 responses to induce protective immunity against peanut. A reduction in peanut-specific Th2 immunity will also reduce the number of peanut-specific IgG1 and IgE antibodies. IgE bound to mast cells cross-linked by peanut antigens induces mast cell activation, which contributes to allergy symptoms. Adjuvants that reduce peanut-specific IgE or stabilize mast cells may prevent therapy-related adverse events and allow for higher doses of peanut to generate protective peanut-specific immune responses. Although immunotherapy with peanut alone appears to be a promising therapy to treat peanut hypersensitivity, safety and the lack of sustained unresponsiveness are potential limitations that may be addressed with adjuvants. Inclusion of vaccine adjuvants to peanut immunotherapy formulations offer potential benefits to peanut immunotherapy that that include, induction of durable protective immune responses in shorter dosing regimens with minimal adverse events.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Branum AM, Lukacs SL. Food allergy among children in the United States. Pediatrics (2009) 124:1549–55. 10.1542/peds.2009-1210 - DOI - PubMed
    1. Boyce JA, Assa'ad A, Burks AW, Jones SM, Sampson HA, Wood RA, et al. Guidelines for the diagnosis and management of food allergy in the United States: report of the NIAID-sponsored expert panel. J Allergy Clin Immunol. (2010) 126(6 Suppl.):S1–58. 10.1016/j.jaci.2010.10.008 - DOI - PMC - PubMed
    1. Fleischer DM. The natural history of peanut and tree nut allergy. Curr Allergy Asthma Rep. (2007) 7:175–81. 10.1007/s11882-007-0018-y - DOI - PubMed
    1. Bock SA, Munoz-Furlong A, Sampson HA. Fatalities due to anaphylactic reactions to foods. J Allergy Clin Immunol. (2001) 107:191–3. 10.1067/mai.2001.112031 - DOI - PubMed
    1. Sicherer SH, Munoz-Furlong A, Godbold JH, Sampson HA. US prevalence of self-reported peanut, tree nut, and sesame allergy: 11-year follow-up. J Allergy Clin Immunol. (2010) 125:1322–6. 10.1016/j.jaci.2010.03.029 - DOI - PubMed

Publication types

MeSH terms

LinkOut - more resources