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Peanut allergen extract is a biological product derived from peanuts (*Arachis hypogaea*) containing a complex mixture of allergenic proteins, most notably Ara h 1, Ara h 2, and Ara h 3. It is used both diagnostically, in skin prick testing (SPT) to confirm peanut hypersensitivity, and therapeutically, as part of allergen-specific immunotherapy (AIT). The therapeutic formulation (standardized as Palforzia) is indicated to reduce the incidence and severity of allergic reactions, including anaphylaxis, following accidental exposure to peanuts in allergic individuals. The drug functions by inducing immunological desensitization; repeated and gradual exposure to increasing doses of the extract shifts the immune profile from a Th2-mediated allergic response to a Th1/Treg-mediated tolerant state. This process leads to an increase in allergen-specific IgG4 levels, induction of regulatory T-cells, and a reduction in IgE-mediated mast cell and basophil degranulation.
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