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EMP-123 is an investigational vaccine developed for the treatment of peanut allergy. It consists of three recombinant modified peanut protein antigens (Ara h 1, Ara h 2, and Ara h 3), each engineered with amino acid substitutions to disrupt major IgE-binding epitopes. These proteins are individually expressed in *E. coli* BLR(DE3), which are then killed by heat and phenol; the recombinant proteins remain encapsulated within the dead *E. coli* cells. The final product is a rectally administered suspension combining these three components in specific ratios based on protein content[1][2][3]. The mechanism of action involves allergen-specific immunotherapy aimed at inducing immune tolerance to peanut allergens while reducing IgE-mediated allergic responses[1][2]. In phase 1 clinical trials, EMP-123 showed some evidence of immunologic effect but was associated with frequent adverse reactions including severe allergic responses in a subset of patients[2][4]. Allertein Therapeutics is the developer[3][5].
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