Peanuts are one of the most common triggers of severe food-induced allergic reactions, which can be fatal, and the prevalence of peanut allergy is increasing. However, there is currently no clinical treatment available for peanut allergy other than strict dietary elimination and, in cases of accidental ingestion, injections of epinephrine.
But a new multicenter clinical trial shows promise for sublingual immunotherapy (SLIT), a treatment in which patients are given daily doses, in gradually increasing amounts, of a liquid containing peanut powder. The patients first hold the liquid under the tongue for 2 minutes and then swallow it.
The two lead authors of the study, published in the January 2013 issue of the Journal of Allergy and Clinical Immunology, are David M. Fleischer, MD, of National Jewish Health in Denver, Colo., and Wesley Burks, MD, Curnen Distinguished Professor and Chair of the Department of Pediatrics in the University of North Carolina School of Medicine.
"These results are encouraging," Burks said. "The immune response was stronger than we thought it might be, and the side effects of this treatment were relatively small. However, the magnitude of the therapeutic effect was somewhat less than we had anticipated. That's an issue we plan to address in future studies."
In the study, 40 people with peanut allergy, ages 12 to 37 years, were randomized to receive daily peanut or placebo SLIT. All were given a baseline oral food challenge of up to 2 grams of peanut powder to test how much peanut powder they could consume without symptoms.
After 44 weeks, all were given a second oral food challenge. Those who were able to consume either 5 grams, or at least 10-fold more peanut powder than their baseline amount, were considered to be responders (i.e., desensitized to peanut). At 44 weeks, 70 percent of those who received peanut SLIT were responders, compared to 15 percent of those receiving placebo. Among the peanut-SLIT responders, the median amount of peanut powder they could successfully consume increased from 3.5 to 496 milligrams. After 68 weeks, that amount increased significantly, to 996 milligrams.
Of 10,855 peanut doses given through week 44 of the study, 63.1 percent were symptom-free. When oral/pharyngeal symptoms were excluded from the analysis, 95.2 percent of doses were symptom-free.
The study concluded that peanut SLIT safely induced desensitization in a majority of participants compared to placebo, and that longer duration of therapy led to significant increases in the amount of peanut powder people could safely consume.
However, Burks cautions, this is not a treatment that people should try on their own. For now it's a treatment that should only be given by medical professionals in a carefully monitored clinical trial, he said.
University of North Carolina Health Care: http://www.med.unc.edu
This press release was posted to serve as a topic for discussion. Please comment below. We try our best to only post press releases that are associated with peer reviewed scientific literature. Critical discussions of the research are appreciated. If you need help finding a link to the original article, please contact us on twitter or via e-mail.
About once a year, Florida harvester ants dig new nests, a mystery entomologists are eager to get to the bottom of.
The finding that male homosexuality has a strong genetic component should be a boon for gay rights – but it could backfire
Alan Turing, the man who pioneered computing, also forced the world to question what it means to be human
During sleep, the brain locks in existing memories and can even form new ones. Scientists say they are starting to understand how that happens. A midnight snack may interfere.
They walk among us. Natural experiments, living ordinary lives, unaware that their genes may hold the clue to the next superdrug.
A crowd at the Santa Barbara Zoo got a pleasant surprise when its latest star attraction, a baby giraffe, came out for a jaunt
A massive white matter tract at the back of the brain, overlooked for the past century, might be crucial for skills such as reading.
An award-winning book on optical illusions explains the science of tricking your brain.
Scientists investigating a huge die-off of starfish along North America's Pacific coast have identified a virus they say is responsible for a calamitous wasting disease that has wiped out millions of the creatures since it first appeared last year.
After 43,000 years in the Siberian permafrost, the remains of a mammoth may contain enough DNA to recreate the beast's genome