Aaron Chy, BSc General, PharmD Student
Before you start reading this, can you think of someone in your life who has a peanut allergy? In the past, you may have grown up around others who did, or maybe now you’re raising children who have friends with the allergy. Maybe even you yourself have an allergy to peanuts or other nuts.
Currently, almost 10% of individuals in western countries are reported to be allergic to peanuts – with children being the most affected, and overall rates increasing with time.
An allergy to peanuts, or any food group for that matter, is a collection of symptoms that can range in severity from one individual to another. The most cardinal symptoms include:
- Rash, hives, or bumps appearing on the skin
- Swelling of the lips, face and tongue
- Difficulty breathing
Symptoms often occur within minutes of exposure, and for those with severe allergies, reactions can even be life-threatening in the form of anaphylaxis, when breathing becomes difficult or even impossible.
What causes a peanut allergy?
In reality, a peanut allergy is a type of autoimmune disease. That is, it’s a reaction of the immune system to certain proteins in peanuts that are falsely recognized as foreign or dangerous. During an allergic attack, the immune system believes it’s fighting off some foreign or invasive substance. In reality, the reaction of the immune system itself is what causes harm; the inflammation and swelling can not only cause discomfort, but can be dangerous.
“Where my family comes from, allergies are unheard of. What has changed in the past few decades?
The concept of allergies may be totally unheard of to your parents or their parents, particularly if they originally lived in non-Western countries. Currently, a theory called the hygiene hypothesis is being proposed. This theory suggests that the recent increase in allergy prevalence has to do with our relatively recent focus on hygiene and cleanliness in Western society.
The idea is that, through countless generations, our immune systems have gotten used to being exposed to different bacteria and parasites. With advances in technology and medicine, it’s only recently that infants and newborns can grow up in environments that are almost entirely clean, which may contribute to immune imbalances that eventually lead to allergies.
Like any theory, the hygiene hypothesis is a hotly debated topic and yet to be proven. However, some of the main supporting evidence is that allergies tend to occur most frequently in first-generation immigrants with ancestry in countries where allergies are rare.
In addition, recent advances in treatments that affect the immune system have shown some success.
Antibody therapy? A potential next step.
In November of this year, a research group brought a new experimental drug forward in a clinical trial involving over 400 people. The drug, currently known only as AR101 (formal names typically aren’t assigned until after a drug is approved) is designed to reduce the immune response following exposure to peanut proteins. Over 24 weeks, participants ingested a dose of either AR101 or placebo once a day. To investigate the effects of AR101, participants were exposed to peanuts at the beginning and end of the 24 week period, to see if regular dosing of AR101 led to a change in how much peanut could be tolerated.
At the conclusion of the study, the results were very promising. Among individuals aged 4 – 17, AR101 was found to not only reduce the severity of allergic symptoms, but increase the amount of peanut protein that could be ingested before allergic symptoms got out-of-hand.
Hopefully, based on these results, we may see a treatment option for the common peanut allergy in the near future. Currently, modern medicine offers several options to respond to a peanut allergy (i.e. epinephrine and antihistamines), but we still don’t have an accepted method for increasing tolerance to peanuts.
The Bottom Line.
Peanut allergies are caused by the body’s immune system overreacting to certain proteins found in peanuts and peanut ingredients. It’s believed this reaction is the result of the body fighting what it believes to be an infection or foreign invader.
As for why peanut allergies seem to be something that largely only affects millennials and those living in the West, one theory proposes that modern advances in hygiene have led to “unchallenged” immune systems that are consequently imbalanced.
Hopefully, in the near future, medications that keep the immune system in check can open new doors to treating and controlling peanut allergies, which currently rank among the highest in food-related deaths.
As always, we hope you took away something valuable from this piece. If you have any questions or concerns regarding this article or others, feel free to reach out to us on Instagram, Facebook, or at email@example.com with your feedback. We’d love to hear from you.
- Okada H, Kuhn C, Feillet H, Bach JF. The ‘hygiene hypothesis’ for autoimmune and allergic diseases: an update. Clin Exp Immunol. 2010;160(1):1-9.
- Bloomfield SF, Stanwell-Smith R, Crevel RW, Pickup J. Too clean, or not too clean: the hygiene hypothesis and home hygiene. Clin Exp Allergy. 2006;36(4):402-25.
- The PALISADE Group of Clinical Investigators. AR101 oral immunotherapy for peanut allergy. N Engl J Med 2018;379:1991–2001.