Peanut allergy is one of the most common food allergies in children, and it can cause severe reactions, including anaphylaxis. Traditional peanut allergy management involves avoidance or emergency medication usage in case of accidental ingestion, but a new treatment option has been gaining popularity: sublingual immunotherapy (SLIT). In a recent study, researchers evaluated the safety and efficacy of SLIT for peanut allergy in children, and the results are promising. In this Q&A, we delve into the details of this treatment option and what it means for children with peanut allergy.
A study published in The Journal of Allergy and Clinical Immunology has found that sublingual immunotherapy (SLIT) can be a safe and effective method of desensitizing children aged 2 to 12 years from peanut allergies. During the study, the mean successfully completed dose rose from 48 mg to 2723 mg of peanut protein over a 48-month period. The researchers also found that 70% of the participants achieved clinically significant desensitization, and 36% achieved full desensitization. According to Edwin H. Kim, a participant and the study’s author, “We think that sublingual immunotherapy (SLIT) can be an easier treatment for peanut allergy, and prior studies have shown that it is safer than oral immunotherapy (OIT) to do. Our data shows that peanut SLIT could be a safe option for treating peanut allergy for those patients who cannot tolerate or do not want to use OIT”.
SLIT is administered through a liquid extract in a small plastic bottle with a pump. The designated number of pumps of the SLIT liquid is administered under the tongue, held there for 2 minutes and then swallowed. According to the study, the maximum dose of SLIT is 4 mg of peanut, while the recent IMPACT study used 2,000 mg of peanut protein. After the dose, the participant is typically observed for 30 minutes to ensure there are no side-effects.
The study found a 0.5% median rate of reaction per dose, with transient oropharyngeal itching among the most common symptoms, and no dosing symptoms that required epinephrine. The next step in the research will be to see if the data can be replicated in larger multi-center studies, seeing if there might be a best age for starting treatment, and seeing if the SLIT concept can be used for other foods or multiple foods.
In conclusion, sublingual immunotherapy has proven to be a safe and effective treatment option for children with peanut allergies. It provides a viable alternative to traditional allergy shots, with the added convenience of being administered at home. While there are still some lingering concerns surrounding the long-term effects of this treatment, preliminary studies have shown promising results. As always, it is crucial to discuss any potential course of treatment with a trusted medical professional. With the growing prevalence of peanut allergies in children, sublingual immunotherapy may become an increasingly important tool in managing this condition.
