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World Allergy Organization (WAO) Diagnosis and Rationale for Action against Cow’s Milk Allergy (DRACMA) Guideline update – XIV – Recommendations on CMA immunotherapy. World Allergy Organ J 2022; 15:100646. [PMID: 35539896 PMCID: PMC9061625 DOI: 10.1016/j.waojou.2022.100646] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 02/24/2022] [Accepted: 03/17/2022] [Indexed: 12/28/2022] Open
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Hamad A, Burks WA. Emerging Approaches to Food Desensitization in Children. Curr Allergy Asthma Rep 2017; 17:32. [PMID: 28429307 DOI: 10.1007/s11882-017-0700-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE OF REVIEW The purpose of this review is to highlight the recent advances in food desensitization in children with food allergy. RECENT FINDINGS Recent advancements in epicutaneous, sublingual, and oral immunotherapy for food allergy in the future may offer children with food allergy and their families a viable option to reduce risk or severity of anaphylaxis with phase III trials ongoing for two of these treatment modalities. Food allergy prevalence in children is estimated to be up to 8%. These children are at risk of significant allergic reactions and anaphylaxis. Food avoidance and use of antihistamines or epinephrine has been the standard of care for these patients. This approach also has a significant socioeconomic effects on patients and their families. Recent advancements in understanding food allergy have allowed for exploring new methods of treatment. There is an increasing interest in oral immunotherapy, epicutaneous immunotherapy, or sublingual immunotherapy for food allergy. There have been also innovative approaches to immunotherapy by modification of food allergens (to make them less allergenic while maintain their immunogenicity) or adding adjunctive treatments (probiotics, anti-IgE, etc.) to increase efficacy or safety.
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Affiliation(s)
- Ahmad Hamad
- Division of Allergy and Immunology, Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC, 27517, USA.
| | - Wesley A Burks
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, USA
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White BL, Shi X, Burk CM, Kulis M, Burks AW, Sanders TH, Davis JP. Strategies to Mitigate Peanut Allergy: Production, Processing, Utilization, and Immunotherapy Considerations. Annu Rev Food Sci Technol 2014; 5:155-76. [DOI: 10.1146/annurev-food-030713-092443] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Peanut (Arachis hypogaea L.) is an important crop grown worldwide for food and edible oil. The surge of peanut allergy in the past 25 years has profoundly impacted both affected individuals and the peanut and related food industries. In response, several strategies to mitigate peanut allergy have emerged to reduce/eliminate the allergenicity of peanuts or to better treat peanut-allergic individuals. In this review, we give an overview of peanut allergy, with a focus on peanut proteins, including the impact of thermal processing on peanut protein structure and detection in food matrices. We discuss several strategies currently being investigated to mitigate peanut allergy, including genetic engineering, novel processing strategies, and immunotherapy in terms of mechanisms, recent research, and limitations. All strategies are discussed with considerations for both peanut-allergic individuals and the numerous industries/government agencies involved throughout peanut production and utilization.
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Affiliation(s)
- Brittany L. White
- Market Quality and Handling Research Unit, Agricultural Research Service, US Department of Agriculture and
| | - Xiaolei Shi
- Department of Food, Bioprocessing and Nutrition Sciences at North Carolina State University, Raleigh, North Carolina 27695;, , ,
| | - Caitlin M. Burk
- Department of Pediatrics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599;, ,
| | - Michael Kulis
- Department of Pediatrics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599;, ,
| | - A. Wesley Burks
- Department of Pediatrics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599;, ,
| | - Timothy H. Sanders
- Market Quality and Handling Research Unit, Agricultural Research Service, US Department of Agriculture and
| | - Jack P. Davis
- Market Quality and Handling Research Unit, Agricultural Research Service, US Department of Agriculture and
- Department of Food, Bioprocessing and Nutrition Sciences at North Carolina State University, Raleigh, North Carolina 27695;, , ,
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Kulis M, Wesley Burks A. Oral immunotherapy for food allergy: clinical and preclinical studies. Adv Drug Deliv Rev 2013; 65:774-81. [PMID: 23099276 DOI: 10.1016/j.addr.2012.10.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Revised: 09/25/2012] [Accepted: 10/17/2012] [Indexed: 11/24/2022]
Abstract
Food allergies affect approximately 5% of the U.S. population and have increased in the last decade. In recent years, oral immunotherapy (OIT) has been tested in clinical trials for peanut, milk, and egg allergies in young children. OIT appears to be fairly well tolerated by most subjects and leads to desensitization with a greatly increased threshold of allergen required to induce reactions. Further approaches being investigated in preclinical studies in mouse models indicate the potential for using adjuvants, such as TLR9 agonists in combination with OIT; peptide OIT; and non-allergen specific applications such as herbal formulations. Further questions about OIT remain, including the optimal dosing and length of treatment; whether tolerance can be developed; and the exact cellular mechanisms resulting in protection following OIT. With many clinical trials underway across the United States and other countries, and a growing pipeline of preclinical research with translational potential, there is great hope for a widely applicable food allergy treatment.
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