Peanut remains preeminent as the food allergen most associated with severe and fatal allergic reactions. Reactions are frequent despite patients' best efforts to avoid peanut. In the future, better information sharing and communication between families and both schools and restaurants may lead to a decrease in the rate of severe reactions induced by exposure to peanut outside the home. Reaction severity may increase over time but up to 25% of young peanut allergic individuals may outgrow their peanut allergy. Personalized care plans and education programmes may have an impact on avoidance of peanut and on the appropriate responses of caregivers. Peanut's allergenicity may be affected by the method of cooking, with roasted peanuts appearing more allergenic than boiled or fried peanuts. Immunotherapy with modified peanut allergens and DNA based vaccines may soon move from animal studies to clinical trials.
Division of Infection Inflammation and Repair, Southampton University Hospitals NHS Trust, Southampton, UK
Correspondence to Dr Jonathan O'B. Hourihane, Division of Infection Inflammation and Repair, Mailpoint 218, Southampton University Hospitals NHS Trust, Tremona Road, Southampton SO16 6YD, UK. Tel: +44 2380 79 4939; fax: +44 2380 79 5023; e-mail: firstname.lastname@example.org