Perhaps the most exciting developments in the field of food allergy are new therapeutic approaches that modulate immune responses to foods (Nowak-Wegrzyn, 2003). These include tolerogenic peptides, recombinant epitopes, anti-IgE and DNA vaccination, as well as administration of Th1 type cytokines, such as interleukin (IL)-12 and interferon^, or strategies to antagonize the actions of Th2 cytokines, such as IL-4 and Il-5. The benefit of such approaches in food allergy was recently documented in a double blind randomized, placebo controlled, dose-ranging trial, in which a humanized monoclonal IgG1 antibody against IgE that recognizes and masks an epitope in the CH3 region of IgE responsible for binding to the FcReI on mast cells and basophils was administered subcutaneously in peanut allergic subjects (Leung et al, 2003). A statistically significant improvement (subjects increased their tolerance for peanuts from an average of 1.5 peanuts to 9 peanuts at one time) was seen between the highest dose and placebo. The long term benefit and practical application of this treatment is unknown but these initial results are promising for the population who are at risk of potentially fatal reactions from peanut allergy.
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