Sublingual Immunotherapy for Peanut Allergy and Induction of Tolerance

Launched by UNIVERSITY OF NORTH CAROLINA, CHAPEL HILL · Jun 13, 2011

Keywords

ClinConnect Summary

Allergy to peanuts and tree nuts affects approximately 1.4% of the population. Allergic reactions to peanut can be severe and life threatening and account for the vast majority of fatalities due to food-induced anaphylaxis. At present, there are no viable treatment options for patients with peanut allergy. The current standard of care is strict dietary elimination and emergency preparedness with an anaphylaxis kit in the event of an accidental reaction.

Our group and others have shown that oral immunotherapy can provide protection from anaphylaxis to a variety of food proteins. In addition...

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Eligibility criteria

• Inclusion Criteria:
• • Between ages 1 year to 12 years exclusive
• • Peanut specific IgE \> 0.35kU/L or a convincing clinical history of an allergic reaction to peanut within 1 hour of ingestion
• • Positive entry DBPCFC to 1 gram of peanut protein
• Exclusion Criteria:
• • History of severe anaphylaxis to peanut, defined as hypoxia, hypotension, or neurologic compromise (cyanosis or oxygen saturations \< 92% at any stage, hypotension, confusion, collapse, loss of consciousness, or incontinence)
• • Participation in any interventional study for the treatment of food allergy in the past 6 months
• • Known oat, wheat, or glycerin allergy
• • Eosinophilic or other inflammatory (e.g. celiac) gastrointestinal disease
• • Severe asthma (2007 National Heart Lung and Blood Institute (NHLBI) guidelines Criteria Steps 5 or 6 - Appendix 2)
• • Inability to discontinue antihistamines for skin testing and DBPCFCs
• • Use of omalizumab or other non-traditional forms of allergen immunotherapy (e.g., oral or sublingual) or immunomodulator therapy (not including corticosteroids) or biologic therapy within the past year
• • Use of beta-blockers (oral), angiotensin-converting enzyme (ACE) inhibitors, angiotensin-receptor blockers (ARB) or calcium channel blockers
• • Significant medical condition (e.g., liver, kidney, gastrointestinal, cardiovascular, hematologic, or pulmonary disease) which would make the subject unsuitable for induction of food reactions