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Clinical efficacy and immune regulation with peanut oral immunotherapy.

Publication ,  Journal Article
Jones, SM; Pons, L; Roberts, JL; Scurlock, AM; Perry, TT; Kulis, M; Shreffler, WG; Steele, P; Henry, KA; Adair, M; Francis, JM; Durham, S ...
Published in: J Allergy Clin Immunol
August 2009

BACKGROUND: Oral immunotherapy (OIT) has been thought to induce clinical desensitization to allergenic foods, but trials coupling the clinical response and immunologic effects of peanut OIT have not been reported. OBJECTIVE: The study objective was to investigate the clinical efficacy and immunologic changes associated with OIT. METHODS: Children with peanut allergy underwent an OIT protocol including initial day escalation, buildup, and maintenance phases, and then oral food challenge. Clinical response and immunologic changes were evaluated. RESULTS: Of 29 subjects who completed the protocol, 27 ingested 3.9 g peanut protein during food challenge. Most symptoms noted during OIT resolved spontaneously or with antihistamines. By 6 months, titrated skin prick tests and activation of basophils significantly declined. Peanut-specific IgE decreased by 12 to 18 months, whereas IgG(4) increased significantly. Serum factors inhibited IgE-peanut complex formation in an IgE-facilitated allergen binding assay. Secretion of IL-10, IL-5, IFN-gamma, and TNF-alpha from PBMCs increased over a period of 6 to 12 months. Peanut-specific forkhead box protein 3 T cells increased until 12 months and decreased thereafter. In addition, T-cell microarrays showed downregulation of genes in apoptotic pathways. CONCLUSION: Oral immunotherapy induces clinical desensitization to peanut, with significant longer-term humoral and cellular changes. Microarray data suggest a novel role for apoptosis in OIT.

Duke Scholars

Published In

J Allergy Clin Immunol

DOI

EISSN

1097-6825

Publication Date

August 2009

Volume

124

Issue

2

Start / End Page

292 / 300.97

Location

United States

Related Subject Headings

  • Treatment Outcome
  • T-Lymphocytes, Regulatory
  • Skin Tests
  • Peanut Hypersensitivity
  • Microarray Analysis
  • Male
  • Infant
  • Immunoglobulin G
  • Immunoglobulin E
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Jones, S. M., Pons, L., Roberts, J. L., Scurlock, A. M., Perry, T. T., Kulis, M., … Burks, A. W. (2009). Clinical efficacy and immune regulation with peanut oral immunotherapy. J Allergy Clin Immunol, 124(2), 292-300.97. https://doi.org/10.1016/j.jaci.2009.05.022
Journal cover image

Published In

J Allergy Clin Immunol

DOI

EISSN

1097-6825

Publication Date

August 2009

Volume

124

Issue

2

Start / End Page

292 / 300.97

Location

United States

Related Subject Headings

  • Treatment Outcome
  • T-Lymphocytes, Regulatory
  • Skin Tests
  • Peanut Hypersensitivity
  • Microarray Analysis
  • Male
  • Infant
  • Immunoglobulin G
  • Immunoglobulin E
  • Humans