The future of peanut allergy treatments

What is an allergy?

An allergy is an ‘exaggerated response from the body’s immune system to otherwise inert substances present in an environment’ [1] and are thought to be present - in some form - in around 6% of the UK population [2]. Exact causes of allergies are unknown, however there are risk factors, such as atopic dermatitis (also known as eczema, which causes ‘dry, itchy and inflamed skin’ [3]), but also genetic factors such as atopy, which is a genetic predisposition to immune responses against a wide range of substances [4]). Another risk factor for allergies, which has been brought to light by a study in the New England Journal of Medicine [5], showed that avoidance of foods during childhood (if you weren’t originally allergic to them) can cause allergies to develop as an adult, in the case of the study shown specifically in the case of peanut allergies, which is the one of the most prevalent allergies in adults, with around 4.6 million sufferers in the US [6], and is also one of the most dangerous allergies, as peanuts, as well as other tree nuts, are most likely to cause allergic reactions [2].

Why does it happen?

An allergic response is triggered by allergens, which are, as previously mentioned, substances which are ‘inert’, or not dangerous to the majority of the population, which illicit an immune response in those who have allergies, but what makes a substance an allergen, and how do they trigger immune responses? Specifically, in the case of food allergies, allergic reactions are caused by IgE - otherwise known as immunoglobulin E - which is a type of protein called immunoglobulin, which helps to recognise and destroy foreign bodies, which could present a threat to the body [7]). IgE is useful in protecting against parasitic worm infections, which can be difficult for the conventional immune system to deal with. However, IgE has the potential to do harm to the body, in response to some harmless substances. First, the body can become sensitised to allergens, with B cells producing IgE specific to the shape of the allergen, which binds to mast cells (cells that form part of the immune response [8]). Then, the allergen, upon second exposure, binds to the IgE on the mast cells, triggering degranulation, which is a reaction in which mast cells release inflammatory chemicals - such as histamine [9], causing the allergic reaction. Factors that contribute to a substance being an ‘allergen’ include, being abundant in the environment, since the immune system is more likely to respond to something that it encounters in larger quantities, having at least two sites to bind to IgE (to trigger degranulation - as a result of IgE’s Y shape, with the two binding sites at the top of the ‘Y’), being resistant to digestion so that they reach immune cells intact, and not in harmless fragments, and having disulfide bridges/bonds within the protein’s structure (so that the specific region on the antigen which binds to the antibody - IgE - is still intact) [10]. As a result, many proteins in foods, such as those found in cow’s milk and peanuts, are common allergens.

Peanut allergies are particularly prominent in the populations of a variety of countries, for example Anaphylaxis UK reports that 1 in 200 adults in the UK, and 1 in 50 children, have a peanut allergy [11]. Peanut allergies can have many lasting effects on sufferers, for example, it can trigger other related conditions, for example causing eczema to flare up, or even causing a severe asthma attack, among others, which could pose fatal, if not treated adequately. The social consequences, such as being overly cautious in situations that include eating food, such as at restaurants or even at home, instead of simply enjoying the meal. However, cutting edge innovation is occurring in the field, aiming to minimise and halt these effects altogether. 

Recent news of various promising technologies to combat peanut allergies are being revealed. Many clinical trials are in progress to constantly improve lives. These are yielding positive results.

What is being done to combat this?

Particularly The Natasha Clinical Trial, which focuses on oral immunotherapy (OIT) to desensitise participants to their allergies and aim to collect longer-term data for OIT to be practical as a form of treatment. [12]This began in 2023, as a randomised controlled trial with results expected in 2027. [12] This eases the anxiety and fears of having an allergic reaction - saving lives.

This trial's approach is giving daily doses of everyday food products (e.g. peanuts & milk), taken under strict medical supervision rather than expensive pharmaceuticals. [13] If tolerated, they are able to bring the 'doses' home and begin gradually increasing the dosage whilst being closely monitored. [12] Afterwards, 6-12 months, they will reach their maximum dose and are closely monitored for a year, in comparison to the control group. [12]Children such as Thomas Farmer, diagnosed with severe peanut allergy, are now able to consume 6 peanuts (as of 2024). [13]

Further, results from a 3-year study showed that the VIASKIN® Peanut patch is able to help children with peanut allergies become less sensitive to peanuts. [14] The trial focuses on learning how a drug patch can aid in reducing the risk of serious allergic reactions via epicutaneous immunotherapy. This delivers small amounts of peanut protein to train the immune system to tolerate peanuts. [14] This is completed for 1-3 and 4-11 years of age and is the final phase for 4-7 year olds. [15]

Moreover, this has shown great success with researchers reporting that after 3 years, over two thirds of children could eat 12-14 peanut kernels without issues (severe allergic reaction). [14] For the future, where even the trace of peanuts can be fatal, this provides a safety net for the next generation.

Despite such progress recently in developing/improving various immunotherapies by building onto current understanding of how allergies work. However, at the present it is still in clinical trials and mainly focuses on young people. Earlier this year, news of the drug, Palforzia, was discontinued, but current patients can continue the treatment. [16] This news is rather disappointing due to its potential; especially as an FDA approved immunotherapy option for children. Yet, no treatment currently has proven to cure allergies, but instead, they function to desensitise the body to tolerate the allergens instead.

The Grown Up Peanut Immunotherapy (GUPI) trial, is the first study entirely for adults and has also yielded positive results. [17] Resulting in more inclusiveness towards treatment for all ages affected, instead of simply focusing on children, where in reality the condition can affect anyone. Moving forward, this development boosts the morale and wellbeing of the population, as the sufferers and their loved ones are able to adapt to a more positive relationship with food.

References:

1. Dougherty JM, Alsayouri K, Sadowski A. Allergy [Internet]. Nih. StatPearls Publishing; 2023 [cited 2026 Mar 21]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK545237/#article-17372.s6 

2. FSA. Around 6% of the UK adult population have a food allergy, new report from the Food Standards Agency finds | Food Standards Agency [Internet]. food.gov.uk. 2024 [cited 2026 Mar 21]. Available from: https://www.food.gov.uk/news-alerts/news/around-6-of-the-uk-adult-population-have-a-food-allergy-new-report-from-the-food-standards-agency-finds 

3. Mayo Clinic. Atopic dermatitis (eczema) - Symptoms and causes [Internet]. Atopic dermatitis (eczema). Mayo Clinic; 2023 [cited 2026 Mar 21]. Available from: https://www.mayoclinic.org/diseases-conditions/atopic-dermatitis-eczema/symptoms-causes/syc-20353273 

4. Justiz Vaillant AA, Modi P, Jan A, Syed HA. Atopy [Internet]. PubMed. Treasure Island (FL): StatPearls Publishing; 2020 [cited 2026 Mar 21]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK542187/ 

5. Du Toit G, Roberts G, Sayre PH, Bahnson HT, Radulovic S, Santos AF, et al. Randomized Trial of Peanut Consumption in Infants at Risk for Peanut Allergy. The New England Journal of Medicine [Internet]. 2015 Feb 26 [cited 2026 Mar 21];372(9):803–13. Available from: https://www.nejm.org/doi/full/10.1056/nejmoa1414850 

6. Warren C, Lei D, Sicherer S, Schleimer R, Gupta R. Prevalence and characteristics of peanut allergy in US adults. Journal of Allergy and Clinical Immunology [Internet]. 2021 Feb 9 [cited 2026 Mar 21];147(6). Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC12341317/ 

7. Schroeder HW, Cavacini L. Structure and function of immunoglobulins. Journal of Allergy and Clinical Immunology [Internet]. 2010 Feb [cited 2026 Mar 21];125(2):S41–52. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3670108/ 

8. Fong M, Crane JS. Histology, Mast Cells [Internet]. PubMed. Treasure Island (FL): StatPearls Publishing; 2023 [cited 2026 Mar 21]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499904/ 

9. Espinosa E, Valitutti S. New roles and controls of mast cells. Current Opinion in Immunology [Internet]. 2017 Nov 13 [cited 2026 Mar 21];50:39–47. Available from: https://www.sciencedirect.com/science/article/abs/pii/S0952791517300882 

10. Bannon GA. What makes a food protein an allergen? [Internet]. Current allergy and asthma reports. 2004 [cited 2026 Mar 21]. Available from: https://www.academia.edu/64144805/What_makes_a_food_protein_an_allergen 

11. Anaphylaxis UK. Peanut allergy & tree nut [Internet]. Anaphylaxis UK. 2023 [cited 2026 Mar 21]. Available from: https://www.anaphylaxis.org.uk/fact-sheet/peanut-and-tree-nut-allergy/ 

12. NARF. The Natasha Allergy Research Foundation [Internet]. The Natasha Allergy Research Foundation. 2024 [cited 2026 Mar 21]. Available from: https://www.narf.org.uk/the-natasha-clinical-trial-update 

13. University of Southampton . Natasha Trial May Allow Children With Food Allergies To Live Without Fear | University of Southampton [Internet]. Southampton.ac.uk. 2024 [cited 2026 Mar 21]. Available from: https://www.southampton.ac.uk/news/2024/05/natasha-trial.page 

14. Anaphylaxis UK. Peanut allergy patch shows promising long-term results in 3-year study [Internet]. Anaphylaxis UK. 2025 [cited 2026 Mar 21]. Available from: https://www.anaphylaxis.org.uk/peanut-allergy-patch-shows-promising-long-term-results-in-3-year-study 

15. Dbv technologies. ViaskinTM Peanut | DBV Technologies [Internet]. dbv technologies . 2023 [cited 2026 Mar 21]. Available from: https://dbv-technologies.com/pipeline/viaskin-peanut/ 

16. King's College London. Daily doses of peanuts tackle allergic reactions in adults [Internet]. King’s College London. 2025 [cited 2026 Mar 21]. Available from: https://www.kcl.ac.uk/news/daily-doses-of-peanuts-tackle-allergic-reactions-in-adults

17. Anaphylaxis UK. Palforzia® peanut oral immunotherapy – update [Internet]. Anaphylaxis UK. 2026 [cited 2026 Mar 21]. Available from: https://www.anaphylaxis.org.uk/palforzia-peanut-oral-immunotherapy-update/

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