Can peanut allergies be cured?

Peanuts are the most common food allergy in children under age 18 and the third-most common food allergy in adults, according to the non-profit organization Food Allergy Research & Education (FARE). Learning you or your child have a peanut allergy can be scary.

FARE notes, only about 20 percent of children with peanut allergies outgrow them over time. This means if you or your child suffer from a peanut allergy, your new normal consists of deciphering food labels, avoiding foods that don’t list ingredients, and always carrying your Epinephrine auto-injector (Epi Pen), just in case.

Understanding food allergies

Anyone can be allergic to any type of food. However, most food allergies consist of one or more of the nine most common food allergens:

• milk
• egg
• fish
• shellfish
• tree nuts
• peanuts
• wheat
• soybeans
• sesame

Peanuts versus tree nuts

Understanding the difference between peanut and tree nut allergies is the first step to avoiding triggers.

Peanuts

Contrary to its name, a peanut is not a nut. A peanut is a type of legume, which grows in a pod underground. You can be allergic to peanuts, but not allergic to other types of legumes like beans, peas or lentils.

Tree nuts

• Nuts (walnuts, pecans, almonds, etc.) grow on trees, giving them the obvious moniker “tree nuts.”
• Being allergic to tree nuts does not mean you are allergic to peanuts.
• However, some people may be allergic to both peanuts and tree nuts.

What is a peanut allergy?

When someone has a peanut allergy, their immune system treats certain peanut-proteins as a threat and reacts accordingly to attack them. This reaction releases antibodies that cause inflammatory responses throughout the body ranging from inconvenient symptoms like hives, swelling or vomiting, to life threatening symptoms like blood pressure changes and the inability to breathe (also called anaphylaxis).

Can peanut allergies be reversed?

A peanut allergy cannot be “cured,” but doctors and scientists have been working to determine treatments to desensitize the body and build tolerance to peanut proteins. This approach lessens the severity of symptoms in case of an accidental exposure.

Immunotherapy treatments for peanut allergies

Immunotherapy consists of slowly introducing a small amount of peanut protein, allowing your body to become desensitized to the allergen. As desensitization occurs, the amount of peanut protein increases slowly, helping ease the severity of reactions. While helpful, immunotherapy is not a cure, and ongoing treatment is necessary.

Peanut allergy immunotherapy should only be done in a clinic by a food allergy expert because even a small amount of peanut protein can cause anaphylaxis. If anaphylaxis occurs, immediate access to emergency treatment is necessary to restore normal breathing. Do not attempt peanut allergy immunotherapy without your doctor present.

Oral immunotherapy. Oral Immunotherapy (OIT) involves swallowing slightly increased doses of peanut protein over time to build tolerance. A peanut-protein powder, Palforzia, is FDA-approved to treat peanut allergies via OIT. 

Sublingual Immunotherapy. Sublingual Immunotherapy (SLIT) involves placing small amounts of allergen under the tongue. Though similar to OIT, SLIT often causes fewer, less severe symptoms due to the allergen’s route of absorption.

Monoclonal Antibodies. Antibody treatment is administered by injecting medicine to introduce the immune system to the allergen. The medicine enters the bloodstream and binds to the proteins that cause allergic reactions, called antibodies. Once bound to the antibodies, the medicine makes the immune system less sensitive to a certain allergen. One FDA-approved antibody treatment for peanut allergies available on the market is omalizumab.

Is peanut allergy immunotherapy right for you?

You and an allergist should work together to determine if immunotherapy is right for you. Your decision should consider the following:

• Have you successfully been able to avoid peanut exposure?
• What is your risk of exposure and is it increasing?
• How severe are your allergic reactions?
• What are your goals for immunotherapy?

The most appropriate decision for you might still be peanut avoidance because immunotherapy is not a cure for peanut allergies. Those who choose immunotherapy must still have an anaphylaxis emergency plan in place and carry an Epi-pen with them in case of accidental exposure.

Your allergist might recommend immunotherapy if:

• accidental exposure to peanuts causes you severe allergic reactions
• you want to consume peanuts as part of your diet

Future treatments

Researchers are working on additional monoclonal antibodies and other methods to block allergic responses including:

• Nanoparticles: Researchers are exploring the use of nanoparticles in immunotherapy to block immune responses.
• Probiotics: Trials are investigating if probiotics can help lessen symptoms of peanut allergies.
• Epicutaneous immunotherapy: Also called “The peanut patch,” epicutaneous immunotherapy involves wearing an adhesive skin patch (like a nicotine patch) which contains peanut allergens to decrease sensitivity.