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Sublingual Immunotherapy May Result in Desensitization and Remission for Peanut-Allergic Children

AAAAI News Release

October 10, 2023

Candace Archie, The American Academy of Allergy, Asthma & Immunology
(414) 272-6071

60% of peanut-allergic children in the test group experience desensitization to peanut protein after sublingual immunotherapy according to research from JACI, an official journal of the AAAAI.

Milwaukee, WI – Peanut sublingual immunotherapy (SLIT) is safe for young children and results in a greater likelihood of desensitization and remission, according to new research published in The Journal of Allergy and Clinical Immunology (JACI), an official journal of the American Academy of Allergy, Asthma & Immunology (AAAAI).

Conducted over a 36-month period, the double-blind, placebo-controlled study assessed the effectiveness of peanut sublingual immunotherapy (SLIT) on 50 children aged 1- to 4 years old. Participants were randomized to receive either a placebo or 4 mg of liquid peanut protein sublingually, under the tongue, with 25 participants receiving the peanut protein and 25 receiving a placebo.  

After 36 months of treatment, participants who were desensitized to at least 443 mg of peanut protein discontinued therapy for three months and then underwent an additional assessment for remission. Upon assessment, 60% of children in the study were found to experience desensitization to peanut protein, and 48% experienced remission three months after therapy. None of the placebo participants naturally outgrew their peanut allergy, and remission was seen only in the sublingual immunotherapy (SLIT) participants.

“Early childhood is a time when a child’s immune system is most adaptable. We are excited that peanut sublingual immunotherapy (SLIT) seems to be able to take advantage of this adaptability with not only the strongest desensitization that we have seen to date, but also the potential for 3-month remission of the peanut allergy” said Edwin Kim, MD, corresponding author for the study.

Higher rates of desensitization and remission were found in the group of 1- 2-year-old participants compared to the 2-3-year-old group and 3- 4-year-old group, which supports an advantage to early intervention.

Most side effects of the treatment were shown to have little difference between the placebo group and the immunotherapy group of participants, with the exception of “oropharyngeal itching.” The research noted oropharyngeal itching as the most common side effect, affecting 80% of peanut sublingual immunotherapy (SLIT) participants compared to only 28% of placebo participants, although no symptoms required epinephrine for participants. “The percentage of participants reporting skin, gastrointestinal, upper respiratory, lower respiratory or multi-system symptoms was not significantly different between peanut SLIT and placebo participants,” according to the study.

While larger trials are necessary to validate the findings, the results of the study are promising and suggest that early intervention with peanut sublingual immunotherapy (SLIT) warrants further exploration.
Read the full study.
The American Academy of Allergy, Asthma & Immunology (AAAAI) is the leading membership organization of more than 7,100 allergists, asthma specialists, clinical immunologists, allied health professionals and other professionals with a special interest in the research and treatment of allergic and immunologic diseases. Established in 1943, the AAAAI has more than 7,100 members in the United States, Canada and 72 other countries and is the go-to resource for patients living with allergies, asthma and immune deficiency disorders.