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The researchers conclude: “Peanut SLIT is able to safely induce clinical desensitization in children with peanut allergy, with evidence of immunologic changes suggesting a significant change in the allergic response. Further study is required to determine whether continued peanut SLIT is able to induce long-term immune tolerance.” Click here to read the abstract.
Meanwhile, research in oral immunotherapy is progressing under Dr Andy Clark at Addenbrooke’s Hospital, Cambridge, and in the US under Dr Wesley Burks. Other groups are doing similar work with milk and egg. Oral immunotherapy (OIT) works by slowly introducing small amounts of peanut into the children’s diets and gradually building up to larger amounts.
Despite the promising results, it has been stressed many times that oral immunotherapy is not yet ready for clinical use. Primarily, the safety of the therapy has to be demonstrated beyond doubt. There are also unanswered questions relating to the post-treatment stage. For example, how much peanut should desensitised subjects eat to maintain their state of protection and how often? Could the treatment lead to a false sense of security leading to lax behaviour?
One final message is vital in respect of both OIT and SLIT: The treatment must be conducted by medical experts in a clinical setting – it's a case of "don't try this at home”.
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July 2011: A novel approach to treating children with peanut allergy is reported in the media this month. The method being used by U.S. researchers is being heralded by some newspapers as a long-awaited "cure" and although the media language may overstate the case, there is indeed cause for hope among people with peanut allergy.
The treatment is known as sublingual immunotherapy (SLIT), in which peanut in solution is given under the tongue of the patient with peanut allergy. Over the course of treatment, this is intended to reduce sensitivity to the allergen.
The researchers report that 18 children aged one to 11 years completed 12 months of dosing, which was followed by a food challenge (where the patient eats the food to test whether the treatment has been successful). Dosing side effects were primarily occurring in the mouth. Not often did these require treatment. During the food challenges, the treatment group safely ingested 20 times more peanut protein than the placebo group.
The team also found evidence of immunologic changes in the group of children who were given the treatment suggesting a significant alteration in allergic response. For example, there was a decrease in skin prick test wheal size. And although peanut-specific IgE levels increased over the initial four months, they then steadily decreased over the remaining eight months.
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