Researchers look into the effectiveness of peanut sublingual immunotherapy, walnut and tree nut oral immunotherapy and wheat oral immunotherapy.
ATLANTA, GA – The search for a safe and effective treatment for food allergy continues as researchers investigate different forms of immunotherapy. The latest information in food allergy immunotherapy will be presented at the 2017 American Academy of Allergy, Asthma & Immunology (AAAAI) Annual Meeting including advances regarding the use of peanut, tree nut and wheat immunotherapy.
Peanut Sublingual Immunotherapy
“Peanut oral immunotherapy has been shown to induce sustained unresponsiveness in up to 50% of subjects,” said Edwin Kim, MD. “Although desensitization has been demonstrated with peanut sublingual immunotherapy (SLIT), its ability to induce sustained unresponsiveness has not been well described until now.”
Children from 1 to 11 years-old were treated with peanut SLIT for three to five years. SLIT is a type of allergen immunotherapy that is administered under the patient’s tongue.
Out of the 37 patients who completed the study, 86% were able to safely ingest over 300 milligrams of peanut and 32% were able to handle 5,000 milligrams, or about a fifth of an ounce. The 12 patients who passed the 5,000 milligram oral food challenge were re-challenged two to four weeks after stopping SLIT. Ten out of the twelve (27% of the total participants) passed the challenge, demonstrating sustained unresponsiveness.
Overall, the majority of the subjects were able to become desensitized and a smaller subset were able to obtain sustained unresponsiveness after long-term peanut SLIT.
Walnut and Tree Nut Oral Immunotherapy
A group of subjects with a median age of 9 years-old received 142 weeks of open label walnut oral immunotherapy after completing 38 weeks of blind, placebo-controlled treatment. The goal was to find how well the therapy desensitized the patients from walnut, as well as to a second tree nut such as pecans, cashew, hazelnut, and pistachios.
“Nine subjects underwent an oral food challenge by week 142. Desensitization to both walnut and a test tree nut was observed in 7 out of the 9 subjects,” said Robbie D. Pesesk, MD. “After four weeks off of walnut oral immunotherapy four out of those seven patients who were desensitized, or 57%, also demonstrated sustained unresponsiveness to walnuts and tree nuts and six out of seven subjects had sustained unresponsiveness to just walnut.”
The study is currently ongoing with additional subjects.
Wheat Oral Immunotherapy
Forty-six patients underwent a series of double-blind placebo-controlled food challenges to determine the safety and effectiveness of wheat oral immunotherapy. At each benchmark, the active group treated with a high-gluten, wheat-flour demonstrated higher successfully consumed doses.
“Lower and high dose wheat oral immunotherapy significantly increased the successful consumed dose of wheat one year into the study compared to the placebo,” said Robert A. Wood, MD, FAAAAI. “The lower and high doses were not statistically different regarding the successfully consumed dose or dosing symptoms.”
After two years of lower dose wheat oral immunotherapy, 30% of patients achieved desensitization and 13% had sustained unresponsiveness even after 8 to 10 weeks off of the therapy.
Research presented at the AAAAI Annual Meeting is published in an online supplement to The Journal of Allergy and Clinical Immunology .
The American Academy of Allergy, Asthma & Immunology (AAAAI) represents allergists, asthma specialists, clinical immunologists, allied health professionals and others with a special interest in the research and treatment of allergic and immunologic diseases. Established in 1943, the AAAAI has more than 6,900 members in the United States, Canada and 72 other countries. The AAAAI’s Find an Allergist/Immunologist service is a trusted resource to help you find a specialist. Editor's notes: Additional Information Food Allergy Symptoms, Diagnosis, Treatment & Management »
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