Exposing children with peanut allergy to proteins from the legume is an approved treatment to reduce the risk of allergic reactions, and now we have evidence it also works in adults
By Carissa Wong
24 April 2025
Peanuts are one of the most common foods people are allergic to
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Adults with peanut allergy reduced their risk of reactions by eating a little peanut protein every day as part of a trial. This approach is already approved in the US for children with the condition.
Peanut allergy occurs when the immune system mistakenly identifies proteins in the legume as a threat. It responds by producing more IgE antibodies, which are a vital part of the immune response, but go into overdrive with allergic reactions. As a result, inflammation ramps up, causing symptoms such as swelling, itching and vomiting. In extreme cases, it can lead to anaphylactic shock, a life-threatening reaction that can affect someone’s breathing or their heart rate.
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Until recently, the only solution was to avoid peanuts, but an intervention called oral immunotherapy was approved for children with the allergy in the US in 2020. This involves training the immune system to tolerate the allergen by exposing it to gradually increasing doses of peanut proteins.
However, it was unclear if the approach also worked in adults. “Most of the life of a peanut allergic individual is spent as an adult, but we’ve had no treatment to reduce their underlying reactivity to peanuts,” says Stephen Till at King’s College London. “There are some grounds for suspecting that adults would be more hard to desensitise than children because your immune system is easier to modify when you’re younger.”
To fill this knowledge gap, Till and his colleagues recruited 21 adults with peanut allergy. At the start of the study, the participants were only able to eat up to an eighth of a peanut, on average, before having an allergic reaction.