Open access online calculator predicts peanut allergic reactions with high accuracy
Background: The Peanut Allergy Prediction Web Tool is a newly developed online aid, which calculates the probability of an individual's allergic reaction based on their SPT, Ara h 2-specific IgE (Ara h 2-sIgE) and/or basophil activation test (BAT) results. Objective: To validate the diagnostic performance of the online tool and assess its ability to discriminate between peanut-allergic (PA) and peanut-sensitised tolerant (PST) cases. Methods: Demographical data, clinical history, results for SPT, Ara h 2-sIgE, BAT and oral food challenge (OFC) outcomes were collected for paediatric cases with a confirmed peanut allergy status (PA or PST). Receiver operating characteristic (ROC) curve analysis, area under the curve (AUC) and sensitivity (S), specificity (Sp) positive and negative predictive values (PPV and NPV) were determined to assess the diagnostic performance of the tool using variations of one, two or three test results. Results: AUC value for all test results combinations exhibited excellent degrees of discriminative performance between PA and PST individuals. The BAT was the greatest single test performer (AUC=0.945; S=85%; Sp=97%; PPV=99%; NPV=71%). The two-test combination of Ara h 2-sIgE and BAT, (AUC=0.959; S=87%; Sp=97%; PPV=99%; NPV=74%) and the three-test combination (AUC=0.949; S=88%; Sp=89%; PPV=96%; NPV=74%) demonstrated the highest discriminatory ability and diagnostic accuracy. Conclusion: The Peanut Allergy Prediction Web Tool's diagnostic performance proves highly accurate using several different combinations of test results when classifying PA and PST cases. Future validation is needed to assess the tool's performance in predicting PA severity in comparison to OFC outcomes.
https://doi.org/10.1016/j.jaip.2025.05.016
Clinical and laboratory characteristics of cashew nut allergy in Korean children: Findings from a tertiary hospital
Objective: Cashew nut (CN) allergy is becoming increasingly prevalent and represents a major cause of tree nut-induced anaphylaxis in Korean children. This study investigated the clinical characteristics and laboratory findings of CN allergy in Korean children. Patients and methods: Sixty-four children with a history of CN ingestion, who underwent serum CN-specific immunoglobulin E (CN-sIgE) measurements from January 2013 to February 2023, were enrolled through a retrospective medical record review. The demographic characteristics, clinical profiles, and laboratory findings were evaluated. Result: Thirty-five patients had immediate-type reactions after exposure to CN (CN-allergic group), whereas 29 showed no symptoms after ingesting CN (CN-tolerant group). Over 60% of patients in the CN-allergic group were allergic to ≥ 1 other tree nuts and 17.1% had peanut allergies. In the CN-allergic group, cutaneous symptoms were most common (94.1%), followed by respiratory (35.3%), gastrointestinal (32.4%), and cardiovascular (2.9%) symptoms. Anaphylaxis due to CN exposure was observed in 51.4% of patients in the CN-allergic group. The median CN-sIgE level of the CN-allergic group was significantly higher than that of the CN-tolerant group (5.5 kUA/L vs. 0.06 kUA/L, P < 0.001). The optimal cutoff level for distinguishing the CN-allergic group from the CN-tolerant group was 0.55 kUA/L (sensitivity 94.29%, specificity 93.10%). Conclusion: Co-allergies to other tree nuts were common in children with CN allergy and more than 50% of patients with CN allergy experienced anaphylaxis. The optimal cutoff level for distinguishing between the CN-allergic and CN-tolerant groups was 0.55 kUA/L.
https://doi.org/10.15586/aei.v53i3.1289
Oral Immunotherapy with Standardized Peanut Extract: A Game-Changer for Peanut Allergy
Peanut allergy is a persistent and potentially life-threatening condition affecting millions worldwide, necessitating effective therapeutic strategies beyond strict avoidance. Oral immunotherapy (OIT) has emerged as a promising approach, with peanut (Arachis hypogaea) allergen powder dnfp (Palforzia Aimmune therapeutics Brisbane Calif]) being the first FDA-approved standardized OIT for peanut allergy. This review synthesizes current clinical evidence on PTAH (peanut-tolerant Arachis hypogea), focusing on its efficacy, safety, and long-term outcomes. A systematic literature search was conducted, analyzing key phase 3 trials, including PALISADE, ARTEMIS, and POSEIDON, as well as long-term extension studies such as ARC004 and ARC008. Findings indicate that PTAH significantly increases the peanut protein threshold tolerated by allergic individuals, reducing the risk of severe reactions upon accidental exposure. While adverse events such as gastrointestinal symptoms and anaphylaxis occur, they are generally manageable and decline over time with continued therapy. Notably, younger children in the POSEIDON trial exhibited higher desensitization rates, suggesting the potential benefits of early intervention. Long-term studies demonstrate sustained immune modulation, with reductions in peanut-specific IgE and an increase in IgG4, indicative of developing tolerance. Despite limitations such as adherence challenges and the need for ongoing maintenance dosing, PTAH represents a paradigm shift in peanut allergy management, offering improved safety and quality of life for patients and caregivers.
https://doi.org/10.3390/app15094833
Ara h 2105-124-Specific TH2A Cells Drive Peanut Allergy in DRB1*15:01 Individuals: A Detailed Epitope Analysis
Background: The IgE-mediated CD4 T-cell response to peanut (Arachis hypogaea) is heterogeneous, yet TH2 cells remain central drivers of pathology. This study aimed to dissect this complexity at the epitope level by focusing on the HLA-DRB1*15:01-DRB5*01:01 haplotype. Specifically, we examined how distinct epitope-specific T-cell subsets shape the immunological landscape of peanut allergy in peanut-allergic (PA) versus non-peanut-allergic (NPA) individuals. Methods: Using in vitro and ex vivo MHC-II tetramer approaches, the phenotype, frequency, function, and transcriptome of CD4 T-cell responses to novel Ara h epitopes were assessed. Bulk RNA sequencing further characterised these T cells, allowing identification of subsets associated with TH2 polarisation in PA individuals. Results: Eleven HLA-DRB1*15:01 and DRB5*01:01-restricted epitopes were identified in Ara h 1, 2, 3, 6, 7, and 8 using tetramer-guided epitope mapping on cell lines, followed by ex vivo validation in peripheral blood. T-cell phenotype was epitope-dependent, with a distinct TH2A population specific to the epitope Ara h 2105-124 (Ara h 2 p14) detected only in PA donors. These TH2A cells were phenotypically and transcriptionally distinct, marked by high CRTH2/CD161, low CD27, IL-5 production, and gene enrichment in cytokine signalling and lipid metabolism. Other epitope-specific T-cell subsets displayed more heterogeneous gene profiles related to immune activation, differentiation, and antigen presentation, underscoring the complexity of peanut-specific responses even within a single HLA haplotype. Conclusion: These findings reveal that the strong TH2 bias in DRB1*15:01-DRB5*01:01 PA individuals arises from a distinct subset of Ara h 2 p14-specific TH2A cells characterised by a specialised metabolic and cytokine signalling program. At the same time, the functional diversity observed in non-Ara h 2 p14 subsets highlights the potential for leveraging these populations in tolerance-promoting therapies. Understanding the epitope-level heterogeneity of peanut-specific T-cells provides insight into the epitope-specific mechanisms driving peanut allergy and has potential implications for therapeutic interventions.
https://doi.org/10.1111/cea.70072
Does Medication Status Impact the Effectiveness of Nuts in Altering Blood Pressure and Lipids? A Systematic Review and Meta-Analysis
Context: Nut consumption is attributed to improvements in risk factors for cardiovascular disease (CVD), including high blood pressure (BP) and dyslipidemia. However, it is unclear whether these effects are altered with concurrent treatment with BP and lipid-lowering medication. Objective: We sought to investigate the effects of the consumption of whole tree nuts and peanuts (collectively termed nuts) on BP and lipids, and whether BP and lipid-lowering medication use alters these effects. Data sources: The MEDLINE, EMBASE, Scopus, and Web of Science databases were systematically searched through June 21, 2023, for randomized controlled trials (RCTs) assessing the effects of nut consumption on BP and/or lipids. Data extraction: Random effects meta-analyses (mean difference, 95% confidence interval [CI]) were conducted, with subgroup analyses based on reported participant use of BP or lipid-lowering medication, including medicated, unmedicated, unreported (ie, use not specified), and mixed (ie, included combined data from medicated and unmedicated participants). A total of 115 studies were included in the review, of which 109 were meta-analysed. Data analysis: Nut consumption significantly reduced triglycerides (TG), total cholesterol, low-density lipoprotein cholesterol, very-low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, and apolipoprotein B, with no effect on high-density lipoprotein cholesterol or blood pressure. Few studies were conducted in medicated participants only (n = 1 for lipid outcomes only), and for the studies including both medicated and unmedicated participants (ie, mixed), outcomes by medication use were not reported. Significant differences in TG and apolipoprotein B were observed between medication use groups, with nut consumption resulting in the largest reductions in unmedicated participants. Strong heterogeneity was observed with no evidence of publication bias. Conclusions: Lipid-lowering, but not BP-lowering benefits of nut consumption were observed; however, few studies reported the effect based on participants' medication status. Future studies are required to determine if there are additional benefits of including nuts in the diet of medicated patients with cardiovascular disease.
https://doi.org/10.1093/nutrit/nuaf033
Pecan Intake Improves Lipoprotein Particle Concentrations Compared with Usual Intake in Adults at Increased Risk of Cardiometabolic Diseases: A Randomized Controlled Trial
Background: Pecan consumption consistently improves lipoproteins, but less research has investigated the effect of pecans on lipoprotein subfractions. Objectives: The aim was to investigate the effect of substitution of usual snack foods with 57 g/d of pecans on lipoprotein particle subfractions and apolipoproteins compared with continuing usual intake after 12 wk. Exploratory analyses evaluated effects on early markers of insulin resistance including the Lipoprotein Insulin Resistance Index (LP-IR), Diabetes Risk Index, and GlycA. Methods: A 12-wk, randomized, 2-armed parallel trial in adults at risk of cardiometabolic disease was conducted. Participants were instructed to either consume 57 g/d of pecans in place of usual snacks or to continue their usual intake. Plasma samples collected at baseline and 12 wk were analyzed for lipoproteins, apolipoproteins, and GlycA by proton nuclear magnetic resonance spectroscopy. Between-group differences in the change from baseline were evaluated with linear regression. Results: In total, 138 participants were randomly assigned (n = 69 per group) and 130 participants (pecan group n = 62; usual diet group n = 68) completed the trial. The pecan group had a greater reduction from baseline in the concentrations of apolipoprotein B (apoB) [-4.38 mg/dL; 95% confidence interval (CI): -8.02, -0.73], total low-density lipoprotein particles (-75.3 nmol/L; 95% CI: -144, -6.93), total triglyceride-rich lipoprotein particles (TRL-P) (-20.4 nmol/L; 95% CI: -33.8, -7.03), large (-1.47 nmol/L; 95% CI: -2.69, -0.26) and small (-11.3 nmol/L; 95% CI: -22.4, -0.27) TRL-P and the LP-IR (-4.42 points; 95% CI: -8.14, -0.69), and greater increases from baseline in the concentration of large high-density lipoprotein particles (0.35 μmol/L; 95% CI: 0.07, 0.63) compared with the usual diet group. Conclusions: Incorporating 57 g/d of pecans into the diet in place of usual snacks for 12 wk improved apoB, atherogenic lipoprotein subfractions, and the LP-IR in adults at risk of cardiometabolic diseases. This trial was registered at clinicaltrials.gov as NCT05071807.
https://doi.org/10.1016/j.tjnut.2025.03.014
Effect of Nut Consumption on Human Gene Expression: A Systematic Review of Clinical Trials
Context: The consumption of nuts has beneficial effects on cardiovascular health, body composition, cognitive functions, the intestinal microbiota, and satiety control, but how nuts and their nutrients impact related gene expression is unclear. Objective: We analyzed the effects of nut consumption on human gene expression as investigated in controlled clinical trials. Data Sources: This systematic review was conducted according to the PRISMA guidelines. The databases used in the search were MEDLINE/PubMed, Embase, and the Cochrane Library. Data Extraction: Randomized and nonrandomized controlled trials conducted to date that evaluated the effect of nut consumption on the mRNA expression of human genes were evaluated according to eligible criteria. Two authors screened and determined the quality of the studies; disagreements were resolved by the third author between May and June 2024. All authors were involved in analyzing the compiled data. Data Analysis: We selected 13 original articles. Most studies evaluated the effects of Brazil nuts, followed by studies using combinations of two or more nuts, with an interventional duration of six weeks to one year. The consumption of hazelnuts and Brazil nuts increased expression in antioxidant-related genes, while beneficial regulation of proinflammatory pathways (tumor necrosis factor - TNF, interleukin-6 - IL-6, and toll-like receptors 2 and 4 - TLR2 and TLR4) was reported after consumption of Brazil nuts. Genes involved in vascular inflammation (eg, ciclooxygenase-2 - COX-2) were downregulated after the consumption of mixed nuts, and the expression of selenoprotein - SELENOP and glutathione peroxidase 1 - GPX1 were regulated according to the presence of single nucleotide polymorphisms after the consumption of Brazil nuts. Finally, pistachio consumption reduced telomere oxidation (telomerase reverse transcriptase - TERT and WD repeat containing antisense to TP53 - WRAP53) and downregulated resistin and IL-6 genes. Conclusion: The consumption of nuts has beneficial effects on human health, modulating gene expression involved in the progression of chronic diseases, with emphasis on the pathways of inflammation, oxidative stress, and cardiovascular health.
https://doi.org/10.1093/nutrit/nuaf023
Unveiling the Impact of Peanut Consumption on Telomere Length in Young and Healthy Individuals: Insights from the ARISTOTLE Study: A Randomized Clinical Trial
Diet is a potential modulator of telomere length (TL), but the impact of individual dietary components, such as nuts, on TL in young, healthy individuals remains underexplored. Peanuts are rich in bioactive compounds that may influence TL. Therefore, to fill this gap of knowledge, this study aimed to investigate the effect of peanut consumption on TL in this specific population. Fifty-eight young, healthy individuals were randomized to one of three different intervention groups for 6 months each: (1) 25 g/day of skin-roasted peanuts (SRP); (2) 32 g/day of peanut butter (PB); (3) 32 g/day of a control butter (CB) (based on peanut oil). TL was measured by quantitative real-time PCR in saliva at baseline and at the end of the intervention. Our findings revealed significant between-group differences in TL changes, particularly between the SRP and CB groups over 6 months (mean difference: 0.53; 95% CI: 0.01, 1.05; p-value = 0.048). No significant difference was observed between PB and CB groups (mean difference: 0.12; 95% CI: -0.42, 0.66; p-value = 0.66). This study provides novel insights into the impact of peanut consumption on TL maintenance in young and healthy individuals. The findings highlight the potential benefits of incorporating peanuts into the diet as a means of promoting cellular health and longevity. Further research is warranted to elucidate the underlying mechanisms and validate these findings across diverse populations and longer time frames.
https://doi.org/10.3390/antiox14040467
Tariffs: China and USA Agree to Partially De-escalate for 90 Days
EU launches public consultation on potential countermeasures affecting nuts and dried fruits
On May 12, 2025, the United States and China released a joint statement outlining an agreement to substantially reduce tariffs on each other’s goods for an initial period of 90 days. As reported by CNN, each side agreed to lower tariffs on the other by 115 percentage points, bringing US tariffs on Chinese goods down from 145% to 30% and lowering Chinese tariffs on US goods from 125% to 10%. These changes took effect on May 14, 2025.
In other tariff news, on May 8, the European Commission announced a public consultation on a list of US imports that could become subject to EU countermeasures if ongoing EU-US negotiations do not result in a mutually beneficial outcome and the removal of the US tariffs. The list of products includes a broad range of nuts and dried fruits, including roasted almonds and pistachios; shelled and in-shell Brazil nuts, cashews, hazelnuts, macadamias, pine nuts, pistachios, pecans, and walnuts; roasted, prepared, and preserved peanuts; dates; dried apricots; dried figs; prunes; and dried grapes. The consultation will run until June 10, 2025.
To stay abreast of tariff changes affecting nuts and dried fruits, visit the INC’s Tariffs Timeline.
Pecans May Improve Lipoprotein Profiles and Insulin Resistance Markers in Adults at Cardiometabolic Risk
Eating two handfuls of pecans instead of usual snacks shows promise for reducing risk markers for heart disease and diabetes
A recent study published in the Journal of Nutrition investigated the effect of eating pecans instead of usual snacks on lipoprotein particle subfractions and markers related to insulin resistance in adults at increased risk for cardiometabolic diseases.
In this 12-week randomized controlled trial, 138 adults with elevated cardiometabolic risk were assigned to either consume 57 grams (about two handfuls) of pecans daily in place of their usual snacks, or to maintain their usual diet.
Pecan consumption was associated with significant improvements in several cardiovascular risk factors. Participants who ate pecans saw significant reductions in apolipoprotein B, total low-density lipoprotein particles, and triglyceride-rich lipoprotein particles, which are important contributors to atherosclerosis, as well as increases in large high-density lipoprotein particles, which are considered protective. The pecan group also saw improvements in the Lipoprotein Insulin Resistance Index, a marker linked to insulin resistance and type 2 diabetes risk.
These results suggest that replacing typical snacks with pecans can beneficially modulate lipid profiles and early markers of insulin resistance, potentially reducing the risk of cardiovascular disease and type 2 diabetes in adults with metabolic syndrome traits.
This study was funded by the American Pecan Council.
Hart, T. L., Kris-Etherton, P. M., & Petersen, K. S. (2025). Pecan Intake Improves Lipoprotein Particle Concentrations Compared with Usual Intake in Adults at Increased Risk of Cardiometabolic Diseases: A Randomized Controlled Trial. The Journal of Nutrition, 155(5), 1459–1465.