A recent study published in the Journal of Allergy and Clinical Immunology suggests that peanut sublingual immunotherapy (SLIT) is a safe and effective method for inducing desensitization and remission in children between the ages of 1 and 4 who suffer from peanut allergies.
The research, led by Dr. Edwin H. Kim from the University of North Carolina at Chapel Hill, focused on assessing the safety and efficacy of SLIT in young children with peanut allergies. The study involved 50 participants who were randomly assigned to receive either SLIT or a placebo. The researchers observed several key findings that support the effectiveness of SLIT in treating peanut allergies in this age group.
Notably, the actively treated group, as compared to the placebo group, exhibited a significantly higher median cumulative tolerated dose, with the SLIT group reaching 4,443 mg compared to the placebo group’s 143 mg. Additionally, the SLIT group showed a higher likelihood of passing the 36-month double-blind, placebo-controlled food challenge, with a success rate of 60% compared to 0% in the placebo group.
Moreover, the SLIT group had a higher likelihood of achieving remission, with a rate of 48% compared to 0% in the placebo group. Interestingly, the study revealed that one- to two-year-old children had the highest rate of desensitization and remission, followed by two- to three-year-olds and three- to four-year-olds.
This suggests that younger children may respond more favorably to peanut SLIT. The research also tracked longitudinal changes in peanut skin prick testing, peanut-specific immunoglobulin (Ig)G4, and the peanut-specific IgG4/IgE ratio. These markers of immune response were found to change significantly in the SLIT group but remained stable in the placebo group.Â
While some SLIT participants reported oropharyngeal itching, no major differences were observed in the occurrence of skin, gastrointestinal, upper respiratory, lower respiratory, or multisystem adverse events between the SLIT and placebo groups. This suggests that SLIT is generally safe, with adverse events being manageable.Â
Dr. Kim noted, “The desensitization levels we saw were higher than expected and on par with levels we normally would only expect with oral immunotherapy.” He added, “Just as important, rather than wearing off quickly, we were excited to see that over 60 percent stayed protected three months after stopping the treatment.” This long-lasting protection is a promising outcome for the treatment’s efficacy.Â
It’s worth mentioning that some of the study’s authors disclosed their affiliations with the pharmaceutical and biotechnology industries, which could potentially introduce some bias into the findings. However, the study’s results provide valuable insights into the potential of peanut SLIT as a safe and effective treatment for peanut allergies in young children. Further research and clinical trials may be needed to confirm and expand upon these promising results.Â
The study highlights the positive impact of peanut sublingual immunotherapy on children aged 1 to 4 with peanut allergies, with significant desensitization and remission rates observed. The research suggests that this approach could offer an alternative method for managing peanut allergies in young children, offering hope for those affected by this potentially life-threatening condition.Â
Journal Reference Â
Edwin H. Kim et al, Desensitization and remission after peanut sublingual immunotherapy in 1- to 4-year-old peanut-allergic children: A randomized, placebo-controlled trial, Journal of Allergy and Clinical Immunology (2023). DOI: 10.1016/j.jaci.2023.08.032. Â
