Interpreting success or failure of peanut oral immunotherapy
Shijie Cao, Cathryn R. Nagler
Shijie Cao, Cathryn R. Nagler
Published January 18, 2022
Citation Information: J Clin Invest. 2022;132(2):e155255. https://doi.org/10.1172/JCI155255.
View: Text | PDF
Commentary

Interpreting success or failure of peanut oral immunotherapy

Abstract

Peanut oral immunotherapy (OIT) was recently approved by the US FDA. However, not all patients respond to OIT, and there is a high likelihood of regaining sensitization to peanuts after cessation of treatment. It is important, therefore, to identify biomarkers that impact and predict OIT outcomes. In this issue of the JCI, Monian, Tu, and colleagues describe distinct subsets of peanut-reactive CD4+ Th cell phenotypes and gene signatures with relevance to OIT outcomes using single-cell RNA-Seq and paired T cell receptor (TCR) α/β sequencing. The insights obtained will inform the development of therapeutics that target these Th cell phenotypes or deplete peanut-specific Th2 cells to achieve sustained nonresponsiveness in food allergy.

Authors

Shijie Cao, Cathryn R. Nagler

×

Figure 1

Association between clinical responses of OIT and peanut-reactive CD4+ T cells.

Options: View larger image (or click on image) Download as PowerPoint
Association between clinical responses of OIT and peanut-reactive CD4+ T...
Monian, Tu, and co-authors (11) assessed the transcriptomes of CD154+ and CD137+ peanut-reactive CD4+ Th cells from peripheral blood of patients with peanut allergy undergoing OIT. Suppression of Th1-conv and Th2A-like cell populations was associated with positive outcomes of OIT. Gene expression by Tfh2-like cells correlated with peanut-specific IgE levels, supporting the role of Tfh2 cells in class switching to IgE. Finally, the authors identified baseline inflammatory gene signatures, mostly present in Th1 and Th17 cell populations, that associated with treatment failure. These signatures suggest a potential role for these genes and Th1 and Th17 cells as predictors or influencers of OIT outcomes (dashed arrows).