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Clinical efficacy and immune regulation with peanut oral immunotherapy
Open accessAbstract
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 Peanut-allergic children underwent an OIT protocol including initial day escalation, build-up, 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 12–18 months, while IgG4 increased significantly. Serum factors inhibited IgE–peanut complex formation in an IgE-facilitated allergen binding assay. Secretion of IL-10, IL-5, IFN-γ, and TNF-α from PBMCs increased over 6–12 months. Peanut-specific FoxP3 T cells increased until 12 months and then decreased thereafter. Additionally, T cell microarrays showed downregulation of genes in apoptotic pathways. Conclusion OIT induces clinical desensitization to peanut, with significant longer term humoral and cellular changes. Microarray data suggest a novel role for apoptosis in OIT.
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Klunker, S., Saggar, L. R., Seyfert-Margolis, V., Asare, A. L., Casale, T. B., Durham, S. R., & Francis, J. N. (2007) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2007.05.034 · Cited by 129
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Dramburg, S., Hilger, C., Santos, A. F., de las Vecillas, L., Aalberse, R. C., Acevedo, N., Aglas, L., Altmann, F., Arruda, K. L., Asero, R., et al. (2023) · Pediatric Allergy and Immunology · doi:10.1111/pai.13854 · Cited by 298
Metadata
- Authors
- Jones, S. M., Pons, L., Roberts, J. L., Scurlock, A. M., Perry, T. T., Kulis, M., Shreffler, W. G., Steele, P., Henry, K. A., Adair, M., Francis, J. M., Durham, S., Vickery, B. P., Zhong, X., & Burks, A. W.
- Venue
- Journal of Allergy and Clinical Immunology
- Publisher
- Elsevier BV
- Published
- 2009-08
- Volume
- 124
- Issue
- 2
- Pages
- 292-300.e97
- ISSN
- 0091-6749 (ISSN-L)
- OpenAlex
- W1994095603
- Cited by
- 715
- References
- 1
- FWCI
- 44.30
- Type
- journal article
- Language
- en
- Open access
- green
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- Jones, S. M., Pons, L., Roberts, J. L., Scurlock, A. M., Perry, T. T., Kulis, M., Shreffler, W. G., Steele, P., Henry, K. A., Adair, M., Francis, J. M., Durham, S., Vickery, B. P., Zhong, X., & Burks, A. W. (2009). Clinical efficacy and immune regulation with peanut oral immunotherapy. Journal of Allergy and Clinical Immunology. https://doi.org/10.1016/j.jaci.2009.05.022
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