Clinical Efficacy and Immune Regulation with Peanut Oral
Clinical efficacy and immune regulation with peanut oral immunotherapy Stacie M. Jones, MD,a Laurent Pons, PhD,b Joseph L. Roberts, MD, PhD,b Amy M. Scurlock, MD,a Tamara T. Perry, MD,a Mike Kulis, PhD,b Wayne G. Shreffler, MD, PhD,c Pamela Steele, CPNP,b Karen A. Henry, RN,a Margaret Adair, MD,b James M. Francis, PhD,d Stephen Durham, MD,d Brian P. Vickery, MD,b Xiaoping Zhong, MD, PhD,b and A. Wesley Burks, MDb Little Rock, Ark, Durham, NC, New York, NY, and London, United Kingdom Background: Oral immunotherapy (OIT) has been thought to noted during OIT resolved spontaneously or with induce clinical desensitization to allergenic foods, but trials antihistamines. By 6 months, titrated skin prick tests and coupling the clinical response and immunologic effects of peanut activation of basophils significantly declined. Peanut-specific OIT have not been reported. IgE decreased by 12 to 18 months, whereas IgG4 increased Objective: The study objective was to investigate the clinical significantly. Serum factors inhibited IgE–peanut complex efficacy and immunologic changes associated with OIT. formation in an IgE-facilitated allergen binding assay. Secretion Methods: Children with peanut allergy underwent an OIT of IL-10, IL-5, IFN-g, and TNF-a from PBMCs increased over protocol including initial day escalation, buildup, and a period of 6 to 12 months. Peanut-specific forkhead box protein maintenance phases, and then oral food challenge. Clinical 3 T cells increased until 12 months and decreased thereafter. In response and immunologic changes were evaluated. addition, T-cell microarrays showed downregulation of genes in Results: Of 29 subjects who completed the protocol, 27 ingested apoptotic pathways.
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