What is the difference between desensitization and tolerance in food allergy?

Example: Clinical efficacy and immune regulation with peanut oral immunotherapy. Jones SM et al. J Allergy Clin Immunol. 2009 Jul 2.

Oral immunotherapy (OIT) successfully induced desensitization in peanut allergy. Can OIT induce tolerance too?

Desensitization is an increase in threshold of ingested food antigen needed to cause allergic symptoms (achieved w OIT).

Tolerance is the induction of long-term immunologic changes with the ability to ingest food without symptoms and WITHOUT ongoing THERAPY.

The place of oral desensitization in the practice of allergy at this time is in flux - see why: http://goo.gl/gNKLD

"Sustained Unresponsiveness" is presently the preferred term to describe patients who were on OIT, stopped and had no reactions at that point

Related Reading

Adverse reactions during peanut oral immunotherapy home dosing. JACI, Volume 124, Issue 6, Pages 1351-1352 (December 2009).
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
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.
Sublingual and oral immunotherapy for milk allergy. Desensitization was lost in some cases within 1 week off therapy. JACI, 2011.

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