ALG-003 / v1.0
Cashew and its relationship to pistachio
A new source profile distinguishing cashew clinical evidence from data that cannot be transferred to other preparations.
Development dossier · No validated formula, clinical dosing schedule or established finished-preparation BUD.
Primary clinical source
NUT CRACKER is a cohort of 50 cashew-OIT patients with 15 observational controls. It reported desensitisation and clinical pistachio cross-tolerance in assessed co-allergic patients. Reactions occurred, including home epinephrine use. It is not a randomised comparison or proof of universal safety.
Technical identity
Cashew and pistachio remain separate materials and dossiers. Record species, processing, lot and analytical basis. Clinical cross-desensitisation does not permit material substitution or a potency conversion without specific evidence.
Profile use
This profile supports a literature discussion with a specialist. It provides no recipe, thermal process, clinical regimen or BUD. Product development requires a full OIT dossier and study of the actual matrix and package.
Sources and references
- Elizur A et al. Cashew oral immunotherapy for desensitizing cashew-pistachio allergy (NUT CRACKER study)Allergy. 2022;77:1863–1872Primary clinical study abstract; DOI 10.1111/all.15212Cashew OIT cohort and pistachio cross-desensitisation; no pistachio syrup or peanut suspension stability data2026-09-12
- Santos AF et al. EAACI guidelines on the management of IgE-mediated food allergyAllergy. 2025;80:14–36; online 2024Abstract and published guideline recommendations; DOI 10.1111/all.16345Specialist clinical recommendations; not stability evidence for local syrups or suspensions2026-09-12
- EMA — Guideline on Allergen Products: Production and Quality IssuesEMEA/CHMP/BWP/304831/2007, 2008Sections 2, 4.1.1, 4.2.4, 4.3, 4.4.3–4.4.5; pp. 4–13Industrial biological-allergen quality guidance; principles adapted explicitly, not a compounding authorisation or a food-OIT recipe2026-09-12