\n<\/p>\n
A<\/span>nabelle Terry, a slender, self-possessed 13-year-old, has heard the peanut butter story her entire life. At two and a half she ate nuts for the first time. Her mother, Victoria, had made a little treat: popcorn drizzled with melted caramel, chocolate and peanut butter. Anabelle gobbled it down. \u201cAnd afterward, I felt really sick,\u201d she says. A few minutes later she vomited on the kitchen floor.<\/p>\n There was more trouble ahead. A visit to an allergist confirmed that Anabelle was severely allergic to the peanut butter in the dessert, as well as to most other nuts. It began a life upheaval familiar to families of kids with allergies: learning to decode labels, to carry an EpiPen, and to interrogate friends and their parents about the ingredients in a birthday cake.<\/p>\n Every once in a while, there would be a slip-up. It might be a snack that someone hadn\u2019t scrutinized or a food package that didn\u2019t list all potential allergens. And every time, Anabelle\u2019s reactions got worse. Although she was just a schoolkid, she had to stay alert. \u201cEating lunch, all my friends would have PB&Js. And I\u2019d be like, I\u2019m going to sit a little bit farther away,\u201d she recalls. \u201cAnd going over to friends\u2019 houses after school, we always had to make sure: \u2018Hey, would you mind making a nut-free meal?\u2019\u201d<\/p>\n If you’re enjoying this article, consider supporting our award-winning journalism by subscribing. By purchasing a subscription you are helping to ensure the future of impactful stories about the discoveries and ideas shaping our world today.<\/p>\n Most of that caution is in Anabelle\u2019s past now. For the vast majority of patients, peanut allergy is an unpredictable, lifelong affliction. But thanks to a clinical trial that Anabelle entered when she was nine, she can now tolerate peanuts and tree nuts well enough to feel safe every day. The drug she received in that trial was approved for treating food allergies by the U.S. Food and Drug Administration last year, making it the second food allergy remedy to earn the agency\u2019s blessing since 2020. And an array of other clinical trials are tackling peanut allergy in a variety of ways, from new modalities for desensitizing patients to bold new applications of existing drugs. Some have reported striking successes. \u201cIt\u2019s an amazing time right now,\u201d says R. Sharon Chinthrajah, an associate professor at Stanford Medicine, who led the national trial Anabelle joined.<\/p>\n In fact, medicine\u2019s entire understanding of how to keep children safe from ever developing allergies is being rethought. With peanut reactions, for instance, there are real hopes that children can be protected\u2014definitely from the worst effects and maybe from any at all. \u201cThe future looks very bright for our patients to have more choices in different periods in their lifetime,\u201d Chinthrajah says. \u201cWe\u2019re not yet at the cure, but we\u2019re definitely moving along on the therapeutic front to be able to deal with this chronic disease.\u201d<\/p>\n Peanut allergies are perplexing, in part because they appeared so recently. Food reactions have occurred throughout recorded history, but widespread peanut problems didn\u2019t begin to surface until the 1990s. The effects on everyday life were dramatic: airlines began to deprive passengers of peanuts and announce that certain snacks might threaten someone else onboard. Elementary schools set aside peanut-free tables at lunch, and food manufacturers began to label their baked goods \u201cschool-safe\u201d to signal they were free of common allergens. Epinephrine auto-injectors, which can shut down severe allergic shock (and are usually called EpiPens, for the dominant trademarked version), were rare and carried mostly for the occasional beesting. Now they are a ubiquitous, nearly $3-billion product.<\/p>\n Scott Sicherer, a clinician and director of the Jaffe Food Allergy Institute at the Icahn School of Medicine at Mount Sinai in New York City, watched reports of peanut threats rise in real time. In 1997 he and his colleagues conducted the first survey of peanut and tree-nut allergy in the U.S., finding that 1.6 percent of adults and 0.6 percent of children described themselves as allergic based on reactions they had experienced. The group repeated the survey with a similar-size representative sample five years later and learned that the rate of nut allergies reported in children had doubled to 1.2 percent. In a third sampling, conducted 11 years after the first one, the overall rate tripled from that initial measurement to 2.1 percent of children, and peanut allergies were reported in 1.4 percent of kids.<\/p>\n Since then, the prevalence has risen even more. A large national survey of parents conducted between 2015 and 2016 by researchers in Illinois and California found that food allergies affect 7.6 percent of U.S. children, and peanut allergy affects 2.2 percent. An analysis of health-care payment data in 2018 asked how many new diagnoses of peanut allergy there are among children born each year\u2014what statisticians call incidence, as opposed to prevalence\u2014and reported a rate of 5 percent. And what\u2019s more common is now also more dire: researchers at the Mayo Clinic have estimated that emergency-department visits for anaphylactic shock caused by foodborne allergies\u2014the kind of reaction that can squeeze shut airways and trigger heart attacks\u2014increased more than threefold between 2005 and 2014. The highest rate was for peanut allergies.<\/p>\n \u201cOne out of 10 individuals in the U.S., more than 33 million, has a food allergy,\u201d says Sung Poblete, CEO of Food Allergy Research and Education, an advocacy organization. \u201cOne out of 13 kids has food allergies. That\u2019s two kids out of every classroom.\u201d<\/p>\n Medicine\u2019s entire understanding of how to keep children safe from allergies is being rethought.<\/p>\n This increase\u2014which is happening around the world, though not at the same rate in every nation\u2014is a mystery. Food allergy is fundamentally a disease of inflammation. The immune system recognizes certain proteins in a food as unwelcome and launches a cascading reaction that often involves an antibody called IgE. The antibody triggers a whole-body inflammatory response: hives, swelling, vomiting, and, in the worst cases, crashing blood pressure and an inability to breathe. \u201cInflammatory diseases of many kinds are more common than they used to be,\u201d says Brian Vickery, a professor of pediatrics at the Emory University School of Medicine and director of the Food Allergy Program at Children\u2019s Healthcare of Atlanta, who is a principal investigator on multiple clinical trials. \u201cEczema, type 2 diabetes, atherosclerotic cardiovascular disease, cancer, depression\u2014all these things have inflammatory origins and are more common now.\u201d<\/p>\n The reasons seem to be varied. Researchers have proposed that cleaner modern life, early antibiotic exposure, and microbiome damage from detergents and surfactants\u2014all components of what\u2019s called the hygiene hypothesis\u2014might influence how often allergies develop. Genetics may predispose people to react to certain foods. There may be a clue as well in which foods provoke reactions. Up to 90 percent of food allergies are caused by just eight things: peanuts, milk, eggs, fish, crustaceans, tree nuts, wheat and soybeans. (These are the foods that, according to a 2004 U.S. law, have to be declared on labels; a separate 2021 law added sesame to the list.) Why these foods are especially allergenic also puzzles researchers. They contain complex proteins, which remain intact during digestion and may trigger the immune system in ways other foods do not; these proteins also may have similarities to common environmental allergens.<\/p>\n Regardless of the underlying causes, research is zeroing in on ways to mitigate food allergies. Peanut allergy is the priority because the disruptions it imposes have become so visible in society. But the hope is that some of the new approaches can be applied to other allergies\u2014and to help children such as Anabelle who experience more than one.<\/p>\n The first priority in tackling peanut allergy has been children who are at extraordinary risk, the ones whose lives are at stake if they consume something with the smallest cross-contamination from a manufacturing error.<\/p>\n People who suffer from seasonal allergies often receive allergy shots, a program of injections that gradually decreases their sensitivity and keeps their reactions at a level they can tolerate. Allergy shots were briefly tried for peanuts as well, but they were abandoned because of safety concerns, including the 1991 death of a trial participant who received a miscalculated dose. After that, patients\u2019 only remaining option was to change their diet, but mistakes and cross-contamination kept putting them at risk. It took more than a decade for immunologists to try a different method of desensitization for peanut allergies that had a century-old history: giving minuscule, escalating doses by mouth, a process called oral immunotherapy. A large international study in 2018 definitively proved that the approach worked, and it became the standard for treating kids whose families weren\u2019t willing to trust avoidance. In 2020 it led to the first-ever FDA approval of a therapy for peanut allergy, a powdered form of peanut protein with the trade name Palforzia that is dispensed over months in precisely metered doses.<\/p>\n That was a huge advance\u2014but, for some families, still not a solution. Initially Palforzia was not approved for children younger than four years of age. Dosing needed to be extremely precise and, according to some practitioners, was tricky to manage. Plus, the drug debuted at the start of the COVID pandemic, when repeat office visits for dose changes became especially challenging. And as the drug\u2019s own labeling acknowledges, taking it poses the possibility of reactions. That has left some allergy families searching for alternatives to oral immunotherapy. \u201cTen to 20 percent of patients can\u2019t finish the treatment because of the side effects,\u201d says Edwin H. Kim, an associate professor at the University of North Carolina at Chapel Hill School of Medicine and director of the UNC Food Allergy Initiative. \u201cAnd up to 10 percent of patients experience anaphylaxis at some point while they\u2019re on the treatment itself.\u201d<\/p>\n Kim is participating in research into two other methods for presenting smaller doses of peanut allergens to the immune system safely: sublingually (under the tongue) and on the skin. The skin method involves a patch containing peanut protein that is applied daily at home for as many as three years; the patch always contains the same dose but is gradually applied for escalating amounts of time. In a phase 3 clinical trial, the results of which were published in 2023, 67 percent of toddlers who were too young to receive Palforzia and who wore the patch were able to raise the amount of peanut protein they could safely consume to the equivalent of three or four peanuts. That was twice as many children as in the placebo group.<\/p>\n The hope for the patch, which has not yet been approved by the FDA, is that it will be easier for kids to tolerate because of its lower dose and easier for parents to manage logistically. Lora Milburn\u2019s son, Vance, wore it for a year as a trial participant. He was eight months old when he started showing allergy symptoms\u2014too young to have words for what he was experiencing\u2014and four years old when he entered the trial through Kim\u2019s clinic. He was expected to finish the trial in August of this year, and his mother already thinks his sensitivity is diminished. She does not know whether he received the real treatment or a placebo, but she has noticed the way he reacts to the patch. \u201cSome days he doesn\u2019t really complain about it; some days he\u2019s scratching his back against the wall trying to get the itchies out,\u201d she says. \u201cBut he knows why we\u2019re doing it. If it\u2019s nighttime, he\u2019s like, \u2018Mommy, take my patch off, put my new patch on.\u2019\u201d<\/p>\n All these exposure therapies\u2014the patch, the oral doses, the version that goes under the tongue\u2014target reactions to specific peanut allergens. But a separate cadre of researchers has envisioned the struggle to control peanut responses as an entryway to remodeling the way that the immune system reacts to food more broadly.<\/p>\n Jen Christiansen: Sources: \u201cFood Allergy Facts and Statistics for the U.S.,\u201d published by FARE (Food Allergy Research & Education), July 2024, foodallergy.org (prevalence data); \u201cThe Epidemiology of Multifood Allergy in the United States: A Population-Based Study,\u201d by Christopher M. Warren et al., in Annals of Allergy, Asthma & Immunology, Vol. 130; May 2023 (multiallergy reference)<\/p>\n In 2013 they began testing the efficacy of an existing drug, a monoclonal antibody named omalizumab (marketed as Xolair) that is already approved for severe asthma caused by allergies. \u201cIt\u2019s an anti-IgE biologic, and IgE antibodies are at the center of the whole allergic inflammatory cascade,\u201d Chinthrajah explains. \u201cAnd the beauty of something like that, where you\u2019re targeting allergic inflammation, is that it has the potential to help all allergies.\u201d<\/p>\n Investigators launched a trial that admitted children and adults who showed allergies to peanuts and at least two other foods; Anabelle Terry was one of the participants. Using a complex study design with several stages, the scientists tested whether regular doses of the injectable drug worked better to reduce allergic sensitivity than did placebos; whether shorter or longer courses of the drug made a difference; whether it worked best alone or combined with oral immunotherapy; and how often and in what amounts people could consume allergenic food once they stopped the treatment.<\/p>\n In 2024 the researchers (a very large team working in multiple medical centers) published the first results. In children aged one to 17 years, 67 percent of those who received the drug were able to eat the equivalent of four peanuts, enough to keep them safe from any accidental exposure. Based on those results, and anticipating more data, the FDA immediately approved Xolair as a protection against peanut allergy.<\/p>\n Participating in the trial was a significant commitment for families. Jennifer Jennison\u2019s son, Jack, was two years old and allergic to eggs, peanuts and cashews\u2014among other foods\u2014when the trial accepted him at its Atlanta site. Every two weeks she or her husband, David, would take time off work to bring their son for an injection. After around seven months, the protocol added tests of small doses of food allergens in applesauce to the office visits; after several hours of observation to make sure the dose was safe, the family carried home boxes of premeasured allergen powder for Jack to eat every day. And in a third phase, Jack progressed to a daily maintenance regimen with actual food: powdered egg white, a cashew and seven Reese\u2019s Pieces.<\/p>\n Jack\u2019s experience is similar to Anabelle\u2019s. She was in the same arm of the trial and now eats a daily dose of peanuts, walnuts and cashews to keep her protection up. But what happened to the Jennisons afterward shows that no peanut-allergy protection is perfect yet. Convincing a child to eat the same foods every day is no small task. First Jack refused his maintenance dose of cashew. After a while he started to resist the Reese\u2019s Pieces, too.<\/p>\n The Jennisons live in Atlanta, the corporate home of Chick-fil-A, and seemingly every kid\u2019s birthday party features the restaurant\u2019s nuggets as well as a cake\u2014which both contain eggs. \u201cFor us, eggs are the most important,\u201d Jennifer says. \u201cI still feel more comfortable with the cross-contamination risk of peanut knowing that he had built up a tolerance. But for now we\u2019re back to avoidance.\u201d<\/p>\n B<\/span>ecause new approaches to desensitization have worked so well for severely affected kids, researchers have begun to address the needs of those who are somewhat less allergic. For instance, some kids can eat half a peanut before suffering a reaction. That\u2019s a tiny amount from the perspective of a nonallergic person, but it\u2019s a huge, life-threatening dose to a highly allergic one. Such people, whom some immunologists call \u201chigh threshold,\u201d include possibly 800,000 kids with peanut allergies just in the U.S. But their triggers are so different from those of highly allergic people that they had been excluded from some trials of desensitization strategies. Indeed, immunology didn\u2019t have a clear understanding of whether desensitization that started from their baseline would even achieve the same results as in highly allergic kids.<\/p>\n All of that is now changing because after years of diagnosing patients in this class, medical practitioners could perceive that the group was being left behind. \u201cWe would have children who maybe would eat half of a serving before they would start to have symptoms,\u201d Sicherer says. \u201cAnd what we would tell those individuals is: \u2018Your symptoms weren\u2019t so bad, so you\u2019re not really that much in danger. You still need to avoid it, but if there were a small accident, maybe you would be okay.\u2019\u201d<\/p>\n Jackson Esteves was 10 months old when his parents discovered his allergies. His mother, Holly, who was so thoughtful about her children\u2019s diets that she made her own baby food, was starting to introduce him to solids. She made a spinach pancake for her older daughter, slid a few morsels onto Jackson\u2019s high-chair tray, and then watched in horror as raised red hives rippled down his body. The pancake contained eggs, and tests showed that Jackson was allergic to them\u2014and to dairy, sesame, tree nuts and peanuts.<\/p>\n The diagnosis sent the Esteveses, who live on Long Island in New York State, hurtling into a landscape familiar to other allergy families. \u201cI was suddenly attuned to every food label,\u201d Holly says now, 10 years later. \u201cI was learning how to modify recipes. I became very insecure in social settings, family parties, birthday parties. I had to bring everything for him.\u201d What made it even more complex was that no one else in the family\u2014Jackson\u2019s parents, his older sister, or a younger sister who was born soon after the pancake incident\u2014shared Jackson\u2019s allergies.<\/p>\n The Esteves family didn\u2019t know it at the time, but Jackson\u2019s allergies concealed a kernel of promise. Although he was extremely reactive to some foods, medicine considered him just minimally allergic to peanuts\u2014and that made him eligible for a new trial launched by Sicherer and a team of researchers from several institutions, called CAFETERIA. (Allergy researchers seem to be exceptionally fond of complex acronyms. \u201cCAFETERIA\u201d comes from \u201cChallenging to Foods with Escalating Thresholds for Reducing Food Allergy.\u201d The Xolair study was known as OUtMATCH, which stood for \u201cOmalizumab as Monotherapy and as Adjunct Therapy to Multi-Allergen Oral Immunotherapy in Food Allergic Children and Adults.\u201d)<\/p>\n Starting in 2019, children between four and 14 years old consumed escalating doses of peanut butter, first under medical supervision and then at home, first with a carefully measured eighth of a teaspoon and increasing every eight weeks until they were consuming one tablespoon daily. Then they were asked to eat two tablespoons of peanut butter\u2014the amount that would go in a sandwich, which an allergic child would never try to consume\u2014every week for 16 weeks but not necessarily in daily doses. Finally, they had to refrain for eight weeks before being tested a final time.<\/p>\n It worked. Among the 32 kids in the peanut-eating arm of the study (as opposed to a control group that avoided peanuts), every child achieved the study\u2019s final goal of consuming the equivalent of about three tablespoons of peanut butter without a reaction.<\/p>\n That result was \u201camazing,\u201d says Patricia Fulkerson, chief of the food-allergy section of the National Institute of Allergy and Infectious Diseases, which funded the escalation study. \u201cA 100 percent response rate is hard not to be happy with.\u201d<\/p>\n Jen Christiansen; Source: \u201cNational Trends in Emergency Department Visits and Hospitalizations for Food-Induced Anaphylaxis in US Children,\u201d by Megan S. Motosue et al., in Pediatric Allergy and Immunology, Vol. 29, August 2018 (emergency department data)<\/p>\n The study\u2019s authors say it needs to be repeated in more kids and at different medical centers. Jackson, who turned 11 this year, has been able to eat peanuts safely since he completed his participation in CAFETERIA; he\u2019ll even eat a PB&J once in a while, although it is not a favorite food. Most of his allergies to other foods remain unaffected, but \u201che was a success story\u201d all the same, his mother says. \u201cHe\u2019s over peanut allergy.\u201d<\/p>\n Even though the CAFETERIA study worked at its small scale and the different approach in the OUtMATCH trial resulted in an FDA drug approval, those tests and others share a limiting feature: they are hard for both the children going through them and the parents guiding them. The kids have to push themselves to swallow something that has made them ill in the past and that still, even in tiny doses, might produce an unpleasant reaction. Parents have to endure the stress of watching their children undergo food challenges to test their progress, knowing that life-threatening anaphylaxis might result.<\/p>\n Plus, for highly allergic people, the most that desensitization can offer is to keep them safer, not completely safe. \u201cUltimately we\u2019re not curing the allergy,\u201d Vickery says. \u201cWe\u2019re kind of providing a protective shell around the patient, a way to defend them against an accidental exposure. They\u2019re still reading labels, they\u2019re still avoiding the food, they are still carrying their epinephrine.\u201d What families long for is something that could make peanut allergy just go away.<\/p>\n A newly proposed treatment might manage that by rewriting the immune system\u2019s memory of antigens\u2014although research into it is in such early stages that results have been reported for only one patient, and the first small clinical trial is just beginning.<\/p>\n The treatment involves successive administration of two drugs, both made by biotechnology company Regeneron. The first drug, dupilumab (marketed as Dupixent), is a monoclonal antibody that is already FDA-approved for treating moderate to severe eczema and asthma and a few other conditions; it works by blocking the action of specific cytokines, signaling proteins that encourage the production of IgE. The second, linvoseltamab, is also an antibody and recently received FDA approval for treating relapsed or refractory multiple myeloma. This cancer affects plasma cells, a category of white blood cell that produces antibodies, including IgE.<\/p>\n Investigators initially thought that dupilumab could be a solo treatment for peanut allergy. But several trials showed that although peanut-specific IgE levels went down under its influence, there was no long-term practical benefit. Even immediately after a course of the drug in one trial, participants were unable to tolerate peanuts. In another test, drug recipients showed improved peanut tolerance right away, but it dropped three months later. IgE availability bounced back.<\/p>\n That led researchers to look at the second drug, which deals a mortal blow to the cells where IgE is manufactured. In mice and monkeys, administering a dose of linvoseltamab during an ongoing course of dupilumab destroyed the cells producing IgE. Continuing the dupilumab while the plasma cells grew back suppressed allergic inflammation and kept the animals\u2019 immune systems from restarting the overreactions.<\/p>\n \u201cThis is very different than other approaches of trying to build tolerance in patients or trying to just decrease IgE,\u201d says Jennifer Maloney, who leads Regeneron\u2019s therapeutic work on immune, inflammatory and infectious diseases. \u201cThis is something that potentially could remove that allergic antibody from the person.\u201d<\/p>\n The company has shared results from just one patient so far, a 20-year-old man with multiple severe allergies. Regeneron described his treatment at the J. P. Morgan Healthcare Conference in January 2025, documenting a dramatic drop in his IgE production during the dupilumab course and after the linvoseltamab was given. His case has not yet been published in a peer-reviewed journal, but the company is now recruiting a small group of patients for an early-phase trial that will primarily test safety. Vickery plans to enroll one patient at Emory, where linvoseltamab is already being used to treat cancer patients.<\/p>\n \u201cWe\u2019re going to learn something really important,\u201d he says. \u201cIf we wanted to cure the disease and make it go away, would this be a viable approach to doing so? If it doesn\u2019t work, we\u2019re going to learn things about why it didn\u2019t work and what we might need to do in the next trial.\u201d<\/p>\n T<\/span>here is another goal of peanut-allergy science. It\u2019s the ultimate goal: prevention, not desensitization or cure. And that may be possible for children being born now, thanks to a British study that has been running for more than a decade\u2014and to a snack.<\/p>\n In the early 2000s Gideon Lack, an immunologist then at Imperial College London, went to Tel Aviv to give a talk on how food allergies were rising around the world. He asked the audience, all Israeli pediatricians and allergists, how many of them had treated children with peanut allergy. From his own experience in the U.K., he expected every hand to shoot up. Only a few did.<\/p>\n This low show of hands was extraordinary, and it immediately presented an opportunity to ask why the U.K. and Israel were so different. After returning home, Lack set up a survey to compare national rates of peanut allergy. To rule out some undetected genetic difference in the Israeli kids, he chose to limit the survey to Jewish children, recruiting roughly 5,000 in each country. The results revealed that the occurrence of peanut allergy in Israeli kids was one-tenth the rate among U.K. ones. A second set of questions posed to a subset of the children, 77 in the U.K. and 99 in Israel, hinted at why the rates were so different. Before their first birthday, Israeli children frequently ate peanuts, often in a ubiquitous snack called Bamba\u2014something like Cheetos but coated in peanut butter instead of cheese. By the time they were 14 months old, almost 80 percent of the Israeli children were eating at least a few grams of peanut protein every month. In contrast, 80 percent of the British children had never tasted peanuts.<\/p>\n Early introduction clearly will prevent peanut allergy. \u201cIt does work. It\u2019s the right thing to do.\u201d \u2014Gideon Lack, King’s College London<\/p>\n It made sense that kids in the U.K. weren\u2019t eating peanuts because at the time, medical authorities there and in the U.S. recommended that allergy-causing foods be kept out of the diets of children from allergy-prone families until they were three years old. Lack and his team wondered whether the Israeli experience showed that this well-meaning advice might be wrong. They set up a fresh study, recruiting families with infants who were between four and 10 months old and had severe eczema or showed evidence of egg allergy, signs that their IgE production was already disrupted. The babies were tested for preexisting peanut allergy, and if they were negative, they went into one of two groups. The families of one group were told to keep their children from eating peanuts until they were five years old. The rest of the families were encouraged to introduce their kids to peanut products, preferably Bamba or peanut butter.<\/p>\n When the investigators tested the children five years later, the differences were stark. Among the children told to avoid peanuts, 13.7 percent developed peanut allergies. Among the children who began eating peanuts early, only 1.9 percent did\u2014an 86 percent difference.<\/p>\n Lack published the results in 2015, working with a team primarily from King\u2019s College London, where he had moved to research pediatric allergies. This study, called LEAP (for \u201cLearning Early About Peanut Allergy,\u201d in a departure from long acronyms), caused an earthquake in allergy science. Anthony Fauci, at the time the director of NIAID, which helped to fund it, said it had \u201cthe potential to transform how we approach food-allergy prevention.\u201d<\/p>\n Two more studies cemented the findings. In one, published the following year, children from both arms of the LEAP study were asked to not eat peanut products in their sixth year. Allergy rates rose further among the children who had refrained from peanuts all along, but children who started eating peanut products early maintained their low rates of allergy.<\/p>\n In a third, published in 2024, the team went back to children who had been in the LEAP study and were at least 12 years old to check whether the preventive effect lasted. It had. In the group that refrained from peanuts up to age five, 15.4 percent were allergic to peanuts. In the group that ate peanut products early, only 4.4 percent had bad reactions. Early introduction \u201coverwhelmingly will prevent peanut allergy,\u201d Lack says. \u201cIt clearly has been shown that it does work. It\u2019s the right thing to do.\u201d<\/p>\n But there have been persistent challenges to implementing that idea. Health authorities no longer recommend that parents avoid feeding allergy-related foods for three years\u2014but most national and international guidelines still recommend exclusive breastfeeding for six months, and the cultural pressure to maintain that time frame is immense. In 2019 the American Academy of Pediatrics did revise its guidance to allow the introduction of potential allergens at four to six months for children who seem likely to be at high risk, indicated by symptoms of eczema.<\/p>\n Lack worries this approach doesn\u2019t provide exposure as early in life as the immune system needs; the children in the LEAP study and in an unrelated 2016 study of early introduction began peanut exposure at four and three months, respectively. \u201cTo introduce peanuts effectively in a four-month-old baby, they need to be trained to eat solids already,\u201d he says. \u201cIf you start the weaning process at four months, then the baby may not get peanut butter in significant quantities until five to six months of age. And if it\u2019s a baby with eczema, it\u2019s too late.\u201d<\/p>\n The challenge of prevention at this point may be not the science of immunology but rather the science of implementation. Scientists have to persuade parents and health-care providers that it\u2019s safe to implement new knowledge. Immunologists and allergists are aware that early feeding prevents allergy. Pediatricians, who have to handle many additional issues in young children\u2019s lives, might not have caught up. But \u201can allergist isn\u2019t going to see somebody who doesn\u2019t have peanut allergy already,\u201d NIH\u2019s Fulkerson says. \u201cYou have to get the pediatricians involved because they\u2019re the ones who see the babies first.\u201d<\/p>\n A<\/span>s many advances as there have been in the past decade, scientists worry that the fundamentals of peanut allergy still elude them. Why it exists, what triggers it, what keeps the immune system from outgrowing it\u2014these basic questions remain unanswered. But the ability to tackle them is growing. \u201cThis field is still relatively early in its development compared with oncology or respiratory medicine, which are targeting very specific biological pathways with very specific precision treatments,\u201d Emory\u2019s Vickery says. \u201cWe\u2019re not close to that yet. But can I see that on the horizon? Yes.\u201d<\/p>\n The very latest approaches may involve new technologies. At the University of California, Los Angeles, a team led by Andre Nel has developed a lipid nanoparticle that uses mRNA\u2014the same technology used in the COVID vaccines that were developed rapidly in 2020\u2014to create fragments of peanut allergens. Those fragments are presented to specific cells. In mice, the treatment damped down the IgE cascade that triggers anaphylaxis.<\/p>\n But this is a difficult time for biomedical research, given political decisions in the White House and its newly created Department of Government Efficiency (DOGE) to cancel much of the science emanating from the NIH and the National Science Foundation. Peanut allergy may be due for particular attention from the Trump administration. The president\u2019s Secretary of Health and Human Services, Robert F. Kennedy, Jr., has several times endorsed an unsupported contention that peanut allergy is caused by childhood vaccinations. Earlier this year \u201cpeanut allergies\u201d appeared on a list of topics that would cause grants to get extra scrutiny within the NIH.<\/p>\n Despite the potential political interference, for now the future seems bright for patients such as Anabelle Terry. As she grows up, the science that has reduced the risks of her allergy is growing along with her. It already has improved her life. It might one day change it for good. \u201cIf I go off to summer camp, I have to go away from the other kids for a while and take my nuts to make sure nobody else who has a nut allergy gets sick,\u201d she says. \u201cGoing on vacations, I always have to bring a giant bag of nuts with me in my backpack. It would feel pretty nice just being able to go in for a little visit and just get a shot. That would let off a big burden.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":" Anabelle Terry, a slender, self-possessed 13-year-old, has heard the peanut butter story her entire life. At two and a half she ate nuts for the first time. Her mother, Victoria, had made a little treat: popcorn drizzled with melted caramel, chocolate and peanut butter. Anabelle gobbled it down. \u201cAnd afterward, I felt really sick,\u201d she<\/p>\n","protected":false},"author":1,"featured_media":16823,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[58],"tags":[10081,151,533,146,10080,1162,6767],"class_list":{"0":"post-16822","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-science","8":"tag-allergy","9":"tag-deadly","10":"tag-free","11":"tag-kids","12":"tag-peanut","13":"tag-threat","14":"tag-treatments"},"_links":{"self":[{"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/posts\/16822","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=16822"}],"version-history":[{"count":0,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/posts\/16822\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/media\/16823"}],"wp:attachment":[{"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=16822"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=16822"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=16822"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}On supporting science journalism<\/h2>\n