Current and Emerging Immunotherapeutic Approaches to Treat and Prevent Peanut Allergy

Darren S Miller; Michael P Brown; Paul M Howley; John D Hayball


Expert Rev Vaccines. 2012;11(12):1471-1481. 

In This Article

Risk Factors for Peanut Allergy

IgE-mediated peanut allergy is a complex trait with strong heritability but its genetic basis is currently unknown. Loss-of-function mutations within the filaggrin gene are associated with atopic dermatitis and other atopic diseases; therefore, filaggrin is a candidate gene in the etiology of peanut allergy.[34] Suggested potential risk factors for the development of peanut allergy include atopy, family history of peanut allergy and prenatal maternal consumption of peanuts.[11,35] Other suggested risk factors include infant consumption of peanuts and peanut oil,[36] and use of maternal breast creams containing peanut oil.[37] The consumption of soy milk or formula by infants was also implicated in early studies,[38] but more recent findings strongly suggest otherwise.[39,40] Recently, it was reported that the formation of Maillard reaction products by heating the major peanut allergens in the presence of sugars enhanced the allergenicity of Ara h 2 by increasing IgE binding capacity, presumably by exposing otherwise hidden immune-reactive moieties.[41] Interestingly, the overall incidence of peanut allergy is lower in Asian countries.[42] One possible explanation for this lower incidence is the method of food preparation. In Asian countries, peanuts are often eaten raw or boiled rather than fried in oil or roasted as is common in Western countries. Indeed the levels of Ara h 1, a major peanut allergen, are up to 22-fold higher in roasted than in raw peanuts.[43]