A review of: Leung DYM, Sampson HA, Yunginger JW, et al., for the TNX-901 Peanut Allergy Study Group 2003 Effect of anti-IgE therapy in patients with peanut allergy. N Engl J Med 348:986–993; and Lack G, Fox D, Northstone K, Golding J, for the Avon Longitudinal Study of Parents and Children Study Team 2003 Factors associated with the development of peanut allergy in childhood. N Engl J Med 348:977–985

The number of infants, children, and adolescents who are at risk for systemic anaphylaxis is increasing; in one geographic area, 1.44% of the pediatric population has had epinephrine dispensed for first-aid, out-of-hospital treatment (1). In young patients, peanut allergy is the most common food trigger of anaphylaxis, and it is also the most common overall trigger, accounting for up to 50% of all anaphylaxis episodes in this age group (2). Recent articles on peanut allergy in The New England Journal of Medicine give reason for cautious optimism about prevention of peanut-induced allergic reactions by injecting the anti-IgE antibody TNX-901 (3), and about the possibility of prevention of sensitization to peanut by avoidance of newly identified risk factors for peanut allergy (4).

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