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January 9, 2013 by MAE CHAN
Tongue Therapy Shows Promise In Treating Allergies


Nut and peanut allergies are getting more common in children, doubling over the past five years, however a new study supported by the National Institutes of Health (NIH) suggests that sublingual immunotherapy (SLIT) can reduce the allergic response to peanut in adolescents and adults.



Unlike traditional treatments for allergies where patients seek the care of physicians for allergy shots, sublingual immunotherapy treatment involves placing a drop of a serum under the tongue in the comfort of the patient’s home on a daily basis. In addition, this treatment typically only requires a visit to the allergist every six months. Research has found that allergy sufferers who receive sublingual therapy have few adverse reactions such as itching under the tongue or in the mouth.

Previous research has shown that those exposed over a long period of time to a low dose of an allergen does tend to decrease (or completely abate) the bodies allergic response to that allergen. It is a form of desensitization.

Pediatrician Fatima Arash, M.D., says that a high percentage of children can eliminate allergy sensitivities by incremental exposures to the allergen, especially eggs. "Under proper supervision, almost 70 percent of egg allergies can be reversed in children before the age of eight by incrementally exposing the immune system so that it gradually tames the defense mechanism and no longer reacts to antigens violently," she stated.

SLIT is a treatment approach in which, under medical supervision, people place a small amount of allergen under the tongue to decrease their sensitivity to the allergen. This is one of the first randomized, placebo-controlled studies to test the efficacy 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 results appear online in the January issue of the Journal of Allergy and Clinical Immunology.

In order to understand allergy well, you must first understand the concept that there are different classes of hypersensitivity reactions (aka allergy). Type 1 is the immediate "allergic" reaction that is mediated by IgE and histamine. The important thing to understand about a type 1 reaction is that it can potentially cause anaphylaxis if the reaction is bad enough.

The study enrolled 40 people aged 12 to 37 years with peanut allergy who were on a peanut-free diet. After an initial 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 food challenge. Fourteen 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 3 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. 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, the investigators hope that SLIT could one day help protect people with peanut allergy from experiencing severe allergic reactions in cases of accidental exposure. The researchers caution that people should not try peanut SLIT on their own because any form of immunotherapy carries a significant risk for allergic reactions. The therapy should be administered only under the guidance of trained clinicians.

Mae Chan holds degrees in both physiology and nutritional sciences. She is also blogger and and technology enthusiast with a passion for disseminating information about health.

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