Oral tolerance induction in peanut allergy

Peanut allergy is common, potentially severe and rarely resolves. Currently, there is no definitive therapy ("cure") for peanut allergy.

The aim of this study was to investigate whether peanut oral immunotherapy (OIT) can induce tolerance to peanuts.

Four peanut-allergic children underwent OIT. The diagnosis was proven by pre-intervention oral challenges.

OIT was then administered as daily doses of peanut flour increasing from 5 to 800 mg of protein with 2-weekly dose increases.

All subjects tolerated immunotherapy "up dosing" to 800 mg protein and i.m. adrenaline was not required. Each subject tolerated at least 10 whole peanuts (2.38 g protein) in post-intervention challenges.

The authors concluded that OIT was well tolerated and conferred protection against peanuts.

References:
Successful oral tolerance induction in severe peanut allergy. Clark AT, Islam S, King Y, Deighton J, Anagnostou K, Ewan PW. Allergy. 2009 Feb 17.

Specific oral tolerance (SOTI) cannot be recommended for routine clinical practice for food allergy treatment yet - JACI http://goo.gl/AKBy

Peanut oral immunotherapy is not ready for clinical use - From the experts in the field. JACI, 2010 http://goo.gl/YipT

Office-based oral immunotherapy for food allergy is safe and effective - according to Texas allergist group that use it http://goo.gl/S4N8W

Therapies for peanut allergy: Sustained oral tolerance over desensitization is the goal, we are not there yet. http://goo.gl/mXsyt

Peanut oral immunotherapy (20 peanuts) induces desensitization, however questions about long-term tolerance remain. JACI, 2011.

Oral immunotherapy for peanut allergy - interview with Dr. Wesley Burks: clearly 15-20% will not tolerate the treatment http://goo.gl/U45UB

Eosinophilic esophagitis after specific oral tolerance induction for egg protein http://goo.gl/fzmip
Peanut Allergy: An Evolving Clinical Challenge (review), 2011.
The place of oral desensitization in the practice of allergy at this time is in flux - see why: http://goo.gl/gNKLD
Image source: Roasted peanuts as snack food, Wikipedia, public domain.