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JACI Highlights - July 2009Peanut oral immunotherapy shows potential for reducing clinical symptoms and improving regulation of immune response for peanut-allergic childrenStacie M. Jones, MD, Laurent Pons, PhD, Joseph L. Roberts, MD, PhD, Amy M. Scurlock, MD, Tamara T. Perry, MD, Mike Kulis, PhD, Wayne G. Shreffler, MD, PhD, Pamela Steele, CPNP, Karen A. Henry, RN, Margaret Adair, MD, James M. Francis, PhD, Stephen Durham, MD, Brian P. Vickery, MD, Xiaoping Zhong, MD, PhD, and A. Wesley Burks, MD The prevalence of peanut allergy in industrialized countries appears to be increasing. Peanuts and tree nuts are responsible for the majority of life-threatening or fatal reactions to foods. Currently, the best way to cope with a peanut allergy is to avoid foods that contain peanuts and carry self-injectable epinephrine and antihistamines to combat accidental exposure. However, it is difficult to maintain strict avoidance diets due to food labeling and undeclared allergens in commercially prepared foods. Oral immunotherapy and sublingual immunotherapy are treatments that are currently being explored to help patients cope with food allergies. These treatments have been found to help patients develop a tolerance for certain foods over time. In a study report to be published in an upcoming issue of The Journal of Allergy and Clinical Immunology, Jones et al. tested peanut oral immunotherapy to see if it could significantly reduce allergic reactions to peanuts in peanut-allergic children. They also studied the mechanisms that may contribute to this kind of immunological change. A group of 29 peanut-allergic children participated in the study that included oral ingestion of peanut allergen with a rapid increases in dose during the first day, followed by build-up and maintenance phases, and then oral food challenge. Patients’ clinical responses (allergic symptoms and skin tests) and immunological changes were evaluated. The authors found that peanut oral immunotherapy resulted in clinical desensitization in 93% of the children who completed more than 8 months of therapy. The authors also noted that several immunological mechanisms specific to peanut allergy were modified over the course of 18 months and resulted in significant long-term immunologic changes. Further studies are underway to test larger groups of children as well as additional study of the mechanisms by which immunotherapy causes these immunological changes. |
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