HDHL Preventing peanut allergy through improved understanding of the transcutaneous sensitisation route novel food processing and skin care

Our proposal aims to understand how peanut processing methods and peanut co-administration with oils, as is standard during the industrial processing of peanuts, influences the development of peanut allergy through the skin. Cutaneous exposure of allergens is a crucial, but hitherto underexplored route of food sensitisation, that if understood could lead to the development of translatable strategies to prevent food allergy. Food processors require a greater understanding of how allergen exposure cause allergy so that they can adapt their processing methods to counteract these exposure processes. Furthermore, this proposed research aligns with on-going efforts across Europe to address the increasing problems associated with food allergy but it is unique in that it focuses on cutaneous allergen exposure, which is a field in desperate need of more systematic study. The assembled team of investigators (from the UK, Germany and France) joined by a peanut industry partner (Levantine) and patient and consumer representatives will aim to address the following hypotheses: Understanding the mechanisms by which: > Peanut proteins pass into the skin via the appendages to trigger an immune response. > Skin stretching that occurs during massage opens up the skin appendages allowing more peanut protein into the skin and leads to dendritic cell activation and induction of T helper 2 cell response. > Co-administration of peanut proteins and an oil to the skin increases allergenicity. > Skin barrier impairment and inflammation (AD) increases allergenicity. Test novel approaches to peanut allergy prevention whereby: > Modifications in peanut processing can reduce allergen exposure via the skin. > Meticulous hand hygiene reduces skin contamination with peanut protein. > Application of a barrier enhancing cream can strengthen the skin barrier, in particular in those with atopic dermatitis, and reduce the risk of transcutaneous sensitisation further.