Food allergyCurrent developments in peanut allergyPalmer, Kricia; Burks, WesleyAuthor Information Duke University Medical Center, Pediatric Allergy and Immunology, Durham, New Carolina, USA Correspondence to Wesley Burks, MD, Duke University Medical Center, Pediatric Allergy and Immunology, Box 2644, Durham, NC 27710, USA Tel: +1 919 681 2949; fax: +1 919 668 3750; e-mail: firstname.lastname@example.org Current Opinion in Allergy and Clinical Immunology: June 2006 - Volume 6 - Issue 3 - p 202-206 doi: 10.1097/01.all.0000225161.60274.31 Buy Metrics Abstract Purpose of review Peanut allergy is among the most serious, life-threatening food sensitivities, and recent studies indicate increasing prevalence, particularly among children. Our objective is to highlight recent advances in the immunology and treatment of peanut allergy. Recent findings Peanut sensitization may be both a Th1- and Th2-driven process, and cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) may play a role in regulating the response intensity. Preliminary work shows that the food matrix is important in the immune response to peanut and that purified peanut allergens may have little intrinsic stimulatory capacity. Studies characterizing peanut allergens have revealed Ara h 1 and Ara h 2 as the most potent allergens, but Ara h 3 may be more allergenic than previously thought. There appears to be a relationship between the diversity of IgE-binding patterns and the severity of clinical symptoms. Multiple novel approaches to treatment are being investigated, which include traditional Chinese medicine, various forms of modified immunotherapy and the use of adjuvants in modified immunotherapy. Summary By understanding the immunologic response to peanut and the roles of the major peanut allergens, it may be possible to predict those at risk for severe reactions, prevent peanut sensitization and effectively treat those already sensitized. Copyright © 2006 Wolters Kluwer Health, Inc. All rights reserved.