Table 1.

Allergen-specific immunotherapy approaches for peanut allergy

Approach	Study subjects and inclusion criteria	Immunizing reagent	Effects	Publication
Subcutaneous immunotherapy	Human adults including those with anaphylaxis	Peanut extract	↑ oral tolerance and ↓ SPT; high rate of systemic reactions	1997 [15]
OIT	Children with no history of severe anaphylaxis	Peanut flour	54–84% desensitized to target maintenance doses; side effects in 47 and 81% of treated subjects; ↑ IgG4	2011 [16] and 2014 [18]
SLIT	Children [31] and adults [32] with no history of severe anaphylaxis	Liquid peanut extract	↑ oral tolerance; mild side effects; ↓ SPT; ↑ IgG4 and ↓ basophil activation	2011 [31] and 2013 [32]
EPIT	Children with no history of severe anaphylaxis	Patch containing 100 μg of peanut proteins	↑ oral tolerance in up to 67% mild side effects; ↑ IgG4	2014 [41]
Recombinant hypoallergenic peanut allergens and bacterial adjuvants	Human adults with no history of severe anaphylaxis	mAra h 1–3 plus heat/phenol-inactivated E. coli	↓ SPT; ↓ basophil activation; high rate of systemic reactions	2013 [52]
Recombinant hypoallergenic peanut allergens	Murine model of peanut anaphylaxis	mAra h 2	Reduced clinical symptom scores and histamine release	2001 [48]
	RBL-2H3 cells and PBMCs from 4 peanut-allergic patients	mAra h 2	Partially reduced IgE reactivity with retained T cell reactivity	2005 [45]
Peanut extract and bacterial adjuvants	Brown Norway rat model for peanut allergy	Peanut extract plus L. casei Shirota	Downregulation of peanut allergic response in 2 of 8 rats	2008 [69]
	Balb/c mice	Peanut extract, cholera toxin and CpG	Prevention of oral sensitization by previous subcutaneous administration of the mix	2007 [131]
	Peanut-allergic C3H/HeJ mice	Modified Ara h 1–3 plus HKLM	Reduced histamine levels, peanut-specific IgE, bronchial constriction and anaphylaxis symptoms	2003 [50]
	Peanut-allergic C3H/HeJ mice	HKE-mAra h 1–3	Reduced production of IL-4, IL-5 and IL-13 by splenocytes and long-term downregulation of peanut hypersensitivity	2003 [51]
T cell epitope-based peptide vaccines	Peanut-allergic C3H/HeJ mice	30 overlapping Ara h 2 20-mers	Reduced histamine release and anaphylaxis symptoms	2007 [81]
DNA-based vaccines	AKR/J mice	Complex of chitosan and Ara h 2-encoding DNA	Reduction of peanut-induced anaphylaxis, reduced level of IgE	1999 [86]
	AKR/J, Balb/c and C3H/HeJ mice	Plasmid DNA encoding Ara h 2	Strain-dependent induction of allergic sensitization	1999 [87]
Hypoallergenic transgenic plants	Western blot with sera from peanut-allergic patients	Seed proteins from transgenic peanut plants with silenced Ara h 2 and Ara h 6	Significant reduction of IgE-binding	2008 [96]