TABLE 1.

Status of immunotherapies for food allergy

Class of therapy	Target	Therapy	Stage of development
Gut-targeted (microbiome, oral immunotherapy)	Gut dendritic cells	Palforzia*	FDA-approved, commercially available
	Gut microbiome	Fecal microbial transplant	Phase I studies in adults with peanut allergy5
	Gut microbiome	VE416 (commensal bacteria ± vancomycin and peanut OIT)	Phase I/II studies in adolescents and adults with peanut allergy50
	Gut microbiome and dendritic cells	PRT100 (probiotic Lactobacillus rhamnosus in combination with peanut OIT)	Phase IIb studies in children are underway, comparing whether superior to peanut OIT alone. Phase IIa study showed that 80% achieved SU.4
Skin-targeted	Cutaneous dendritic cells	Viaskin patch (egg/milk*/peanut*)	Egg: preclinical studies are ongoing Milk: completed phase II for ages 2-1745 Peanut: FDA application pending for ages 4-11; phase III ongoing for ages 1-3; phase II ongoing for adolescents and adults
Th2 pathway	TSLP	Tezepelumab	Preclinical study in mice showed decreased reaction when TSLP is blocked at the same time as IL-33 and IL-25.37
	IL-33	REGN3500	Preclinical study in mice showed decreased reaction when IL-33 is blocked at the same time as TSLP and IL-25.37
		Etokimab	Phase I study showed effective, short-lived results in peanut-allergic adults.47
Blocking antibody	Mast cell/basophil/IgE	Allergen IgG	No food allergen therapeutics available currently. Studies with cat and birch allergy were promising in phase I and phase II, respectively.73
Anti-IgE	FCERI	Omalizumab*	Ongoing phase III trial for monotherapy and as adjunct to OIT in multi-food–allergic children and adults.
		Ligelizumab	No studies available in food allergy models or humans.
Tyrosine Kinase Inhibitor	BTK	Ibrutinib	Phase 1 study in peanut and tree nut–allergic adults completed. No OFCs were done.74 Suppresses anaphylaxis in humanized mouse.
Th2 pathway	OX40	Anti-OX40	OX40L mediates Th2 skewing in mouse model of egg allergy.28
Allergen	Dendritic cells	ARA-LAMP-VAX	Phase I study ongoing in peanut-allergic adolescents.6
Th2 cytokines	IL-4Ralpha	Dupilumab	Phase I studies ongoing in peanut-allergic children as monotherapy and as OIT adjunct.7,8
	IL-13	Lebrikizumab	No studies available in food allergy models or humans.
JAK inhibitor	JAK1/2	Ruxolitinib	Preclinical study showed a decrease in symptoms in a mouse model of egg allergy.61
		Baricitinib	No studies available in food allergy models or humans.
		Upadacitinib
		Abrocitinib
		ASN002

^*Indicates therapies granted breakthrough status by the FDA.