Keywords Peanut allergy, VLP peanut therapy, Oral immunotherapy, Immune tolerance, Clinical trials, Allergy treatment, Immunology, Safety profile, Food allergies, Innovative therapies   Summary In this conversation, Wayne Shreffler and Mo Shamji discuss the challenges and advancements in peanut allergy treatment. They explore current FDA-approved therapies, the innovative VLP peanut therapy, its mechanisms of action, safety profile, and the promising results from clinical trials. The discussion highlights the potential for a paradigm shift in allergy treatment towards inducing long-term immune tolerance.   Takeaways Peanut allergy affects millions and poses severe health risks. Current treatments include oral immunotherapy and Omalizumab. OIT can induce immune modulation but has limitations. VLP peanut therapy uses nanoparticles to promote tolerance. VLP peanut is designed to be safe and non-reactive. Early trials show promising safety and efficacy results. The goal is to achieve sustained protection from allergies. Immunological mechanisms are crucial for developing new therapies. The future of allergy treatment may shift towards immune re-education. Innovative platforms like VLP peanut could expand to other allergies.   Sound Bites "We have two currently that are FDA approved." "VLP peanut is designed to immunological tolerance." "The data have been very reassuring."  Chapters 00:00 Introduction to ITG Podcast 02:20 Current treatment options for peanut allergy 04:51 Innovative Approaches: VLP Peanut Therapy 06:14 Mechanism of action of VLP peanut 07:49 Assessing the risk for immediate allergic reactions 08:47 VLP Peanut Phase 1 trial 09:53 Safety data from skin prick test 10:24 Repeated subcutaneous administration of VLP Peanut 11:35 Biomarker data for dose-dependent immune response 12:42 Future Directions and Paradigm Shifts in Peanut Allergy Treatment 13:57 Future research direction on VLP Peanut