Peanut allergy protection limited after oral immunotherapy : Study

New York September 26, 2019. Food allergy affects up to approximately 8% of children and 4% of adults in the United States. When you have a food allergy, your body’s defense system (the immune system) reacts to a component of a food as if it’s harmful to the body. Symptoms vary and can range from mild to severe. You may experience an itchy mouth or throat, hives, vomiting, or stomach cramps. Some people have a life-threatening reaction called anaphylaxis, which may include trouble breathing and passing out.

Peanut :
one of the most common food allergies in USA

Peanut is
one of the most common food allergies nationwide. Previous studies have shown
that peanut oral immunotherapy (OIT) can desensitize adults and
children and prevent life-threatening allergic reactions. OIT involves
ingesting small, controlled amounts of peanut protein over time.

To help
determine the optimal duration and dose for OIT, a team led by Drs. Stephen
Galli and Kari Nadeau at Stanford University carried out a three-year study with
120 participants, aged 7 to 55, who were diagnosed with peanut allergy. The
research was supported in part by NIH’s National Institute of Allergy and
Infectious Diseases
(NIAID). Results were published online on September
12, 2019, in the Lancet.

otherwise avoiding peanut throughout the trial, 95 participants received
gradually increasing daily doses of peanut protein (up to 4 grams). Twenty-five
received a similar-looking placebo made of oat flour. After two years, the
researchers assessed the participants’ peanut tolerance with a food challenge:
gradually increasing the amount of peanut in a controlled environment.

researchers found that 83% of participants who received peanut OIT passed the
challenge without an allergic reaction, while only 4% on the placebo did.

Those who
passed the challenge were randomly assigned to receive either a reduced dose of
peanut protein of 300 milligrams daily or to stop OIT altogether and take the
oat flour placebo instead. One year later, only 37% of participants on the
reduced peanut dose could still tolerate a 4-gram dose of peanut at a food
challenge—and only 13% of those taking the placebo did so.

results confirmed findings from smaller trials that suggested most participants
didn’t maintain peanut desensitization after stopping or reducing

who passed the food challenges also had lower initial levels of allergic
antibodies to peanut protein
and other specific signs of allergic
activity in their blood.

“We hope that, with more research, blood tests can help us predict who may respond to OIT treatment,” says Dr. Alkis Togias of NIAID’s Division of Allergy, Immunology and Transplantation. “Future studies will also focus on identifying the optimal OIT regimens to maintain protection from serious allergic reactions.”

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