UAMS Researchers Find Promise in Experimental Peanut Allergy Treatment

By Nate Hinkel

 

The National Institutes of Health (NIH)-supported study suggests that sublingual immunotherapy (SLIT) can reduce the allergic response to peanut in adolescents and adults. With SLIT, doctors place a small amount of allergen under the patient’s tongue to decrease their sensitivity to the allergen. The study is the first randomized, placebo-controlled research to test the efficiency and safety of SLIT to treat peanut allergy and is one of several federally funded trials investigating immune-based approaches to preventing and treating food allergy.

The complete results appear online in the January 2013 issue of the Journal of Allergy and Clinical Immunology and can be found here.

“We are very excited about the positive benefits for peanut-allergic patients in this study and look forward to more research in this area,” said Stacie M. Jones, M.D., professor of pediatrics and chief of Allergy and Immunology at UAMS and Arkansas Children’s Hospital. “Sublingual immunotherapy is one of several new potential therapies for food allergy that hold tremendous promise for the future.”

The study was conducted by the Consortium of Food Allergy Research (CoFAR), which is a six-center clinical trials network funded by the NIH. The consortium aims to better understand the development and genetics of food allergy and to search for and test new therapies for children and adults with food allergy.

“We recruited subjects to this study and have participated actively in the SLIT trial,” said Amy Scurlock, M.D., associate professor in the UAMS College of Medicine. “We are grateful for the patients who participate in these studies. Without them, these important advances could not be realized.”

Jones is the site principal investigator at UAMS and Scurlock a co-investigator. Other co-investigators in the study include Tamara Perry, M.D., and Robbie Pesek, M.D., both associate professors in the UAMS College of Medicine.

The study enrolled 40 people between the ages of 12 and 37 with peanut allergy who were on a peanut-free diet. After an initial oral food challenge to measure how much peanut powder they could eat without having an allergic reaction, participants received 44 weeks of daily therapy, followed by a second oral food challenge. Researchers found that 14 of the 20 participants (70 percent) given peanut SLIT were able to consume at least 10 times more peanut powder than they could at the beginning of the study, compared with only three of the 20 participants (15 percent) given placebo.

After 68 weeks on peanut SLIT, on average, participants could consume significantly more peanut powder without having an allergic reaction, compared to after 44 weeks. Study investigators also observed that SLIT caused only minor side effects, such as itching in the mouth, suggesting that daily therapy is safe.

“Although more work is needed, we hope that SLIT could one day help protect people with peanut allergy from experiencing severe allergic reactions in cases of accidental exposure,” Jones said.

The study cautions that people should not try peanut SLIT on their own because any form of immunotherapy carries a significant risk for allergic reactions.

The multicenter study was supported by the NIH’s National Institute of Allergy and Infectious Diseases and conducted by CoFAR clinical sites in Baltimore; Chapel Hill, N.C.; Denver; and New York City. CoFAR investigators David Fleischer, M.D., associate professor of pediatrics in the Division of Pediatric Allergy and Immunology at National Jewish Health in Denver, and A. Wesley Burks, M.D., chair of the Department of Pediatrics at the University of North Carolina, Chapel Hill, led the trial.