Clinical Efficacy and Immune Regulation With Peanut Oral Immunotherapy

By S. Jones, L. Pons, Joseph L. Roberts, A. Scurlock, T. Perry, M. Kulis, W. Shreffler, Pamela H. Steele, K. A. Henry, Margaret Adair and 5 more. Journal of Allergy and Clinical Immunology, 2009

691 citations recorded by the source corpus.

Background Oral immunotherapy (OIT) has been thought to induce clinical desensitization to allergenic foods, but trials coupling the clinical response and immunologic effects of peanut OIT have not been reported. Objective The study objective was to investigate the clinical efficacy and immunologic changes associated with OIT. Methods Peanut-allergic children underwent an OIT protocol including initial day escalation, build-up, and maintenance phases, and then oral food challenge. Clinical response and immunologic changes were evaluated. Results Of 29 subjects who completed the protocol, 27 ingested 3.9 g peanut protein during food challenge. Most symptoms noted during OIT resolved spontaneously or with antihistamines. By 6 months, titrated skin prick tests and activation of basophils significantly declined. Peanut-specific IgE decreased by 12–18 months, while IgG4 increased significantly. Serum factors inhibited IgE–peanut complex formation in an IgE-facilitated allergen binding assay. Secretion of IL-10, IL-5, IFN-γ, and TNF-α from PBMCs increased over 6–12 months. Peanut-specific FoxP3 T cells increased until 12 months and then decreased thereafter. Additionally, T cell microarrays showed downregulation of genes in apoptotic pathways. Conclusion OIT induces clinical desensitization to peanut, with significant longer term humoral and cellular changes. Microarray data suggest a novel role for apoptosis in OIT.

Subfields: Immunology and Allergy, Pharmacology, Pulmonary and Respiratory Medicine

View Paper: https://www.semanticscholar.org/paper/e6e011c917dfe6179704c6b2ca504cc9ec320bfe

How researchers see this paper

The researchers whose trusted networks rank it highest, strongest advocate first. Every researcher gets a different order.

1. D. Wallace
2. L. Cox
3. J. Blessing-Moore
4. D. Bernstein
5. H. Nelson
6. Michael Nelson
7. D. Khan
8. Christopher Calabria

Citations in the corpus

• Allergen immunotherapy: a practice parameter third update. (2007, background): “The oral approach has been largely abandoned for inhalant allergens but has been pursued for treatment of food allergy in children.(174,176,439,440) Presently, immunotherapy for inhalant allergens through the oral route is limited to sublingual administration, with subsequent swallowing of the extra”