More targeted help for peanut allergies
Intestinal immune cells play a key role
Oral Immunotherapy helps many children with a peanut allergy. For some, however, it also leads to severe allergic reactions. In the specialist journal "Allergy", a team led by Young-Ae Lee explains the reasons for this - and how the treatment can be customized.
A peanut allergy is one of the most common and most dangerous food allergies. Sometimes even the smallest amounts of the protein-rich legumes are enough to trigger allergic reactions such as itching and swelling or even life-threatening anaphylaxis. For a long time, there was only one measure to counter this: peanuts had to be avoided as meticulously as possible. As many foods can contain traces of them, this was - and still is - a difficult task, even for the parents of affected children. Emergency medication must always be within reach.
Recently, children with a peanut allergy have been given the option of oral desensitization. "However, some children who receive this type of therapy have little or no response to the treatment," says Professor Young-Ae Lee, head of the "Molecular Genetics of Allergic Diseases" working group at the Max Delbrück Center. "In some cases, the preparation, which contains increasing doses of peanut allergens, also leads to anaphylactic reactions."
A team led by Lee and Professor Kirsten Beyer, head of the Pediatric Allergy Study Center section at Charité - Universitätsmedizin Berlin, now describes why children respond so differently to the therapy and how it could possibly be made safer and more effective in the future in the journal "Allergy". First author of the publication is Dr. Aleix Arnau-Soler from Lee's group. "In our study, we looked for molecular changes in the immune system of children who received oral immunotherapy - and we found them," explains Arnau-Soler.
Intestinal immune cells play a key role
For their study, the researchers examined the blood and the immune cells it contained from 38 children. The test subjects were on average seven years old and received oral desensitization at Charité due to a peanut allergy. Arnau-Soler and his colleagues determined the blood concentrations of allergy antibodies, the immunoglobulins, and inflammatory messengers, the cytokines, before and after the therapy.
The scientists also investigated the quantities of peanut proteins that the children's immune systems tolerated before and after treatment - in other words, the extent to which the desensitization had been successful. In addition, the researchers used modern omics technologies to understand which genes in the children's immune cells become active when they respond well to treatment when the cells come into contact with peanut proteins in the laboratory.
"Children who responded well to the treatment appeared to have a less reactive immune system even before starting the therapy. We found lower immunoglobulin and cytokine levels in their blood," reports Arnau-Soler. According to the researcher, these results could help to find out in advance of desensitization which children will particularly benefit from it and which have a higher risk of side effects.
In addition, the researchers were able to identify common differences in gene expression and DNA methylation patterns between the immune cells of children who responded well or poorly to the treatment. The latter plays a decisive role in the regulation of gene activity. "The differences play a particularly important role in certain immune cells, which are rarely found in the blood but are all the more common in the intestine, where they perform important tasks," says Arnau-Soler. These are both special T cells, which are part of the acquired immune system, and immune cells, which are part of the body's innate defenses.
New biomarkers enable personalized therapy
"Our results open the door to personalized approaches to treat peanut allergy - which affects three percent of all children in industrialized countries - more effectively and safely in the future," says Lee. "We now have potential biomarkers to find out how well a child will respond to the therapy and what risks are associated with it in each individual case, even before it begins." It is also conceivable that the length of treatment and the quantities of peanut allergens administered could be adapted to the patient's individual immune profile in the future.
The researchers are currently working on confirming their results in a further study. They also want to further investigate the intestinal immune cells found in the blood. "At the same time, we are working on a prognosis model so that we can use a simple blood test to better tailor oral desensitization to the individual child in the future," adds Arnau-Soler. This would take much of the fear out of peanut allergy.
Note: This article has been translated using a computer system without human intervention. LUMITOS offers these automatic translations to present a wider range of current news. Since this article has been translated with automatic translation, it is possible that it contains errors in vocabulary, syntax or grammar. The original article in German can be found here.
Original publication
Aleix Arnau‐Soler, Sarah E. Ashley, Ahla Ghauri, Alexander C. S. N. Jeanrenaud, Ingo Marenholz, Katharina Blumchen, Penelope Cibin, Alisa Iakupova, Norbert Hubner, Kirsten Beyer, Young‐Ae Lee; "Understanding the Variability of Peanut‐Oral Immunotherapy Responses by Multi‐Omics Profiling of Immune Cells"; Allergy, 2025-7-22
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