Epicutaneous immunotherapy for the treatment of peanut allergy in children and young adults
Stacie M. Jones,Scott H. Sicherer,A. Wesley Burks,Donald Y.M. Leung,Robert Lindblad,Peter Dawson,Alice K. Henning,M. Cecilia Berin,David Y. Chiang,Brian P. Vickery,Robbie D. Pesek,Christine B. Cho,Wendy F. Davidson,Marshall Plaut,Hugh A. Sampson,Robert A. Wood +15 more
TLDR
Peanut EPIT administration was safe and associated with a modest treatment response after 52 weeks, with the highest responses among younger children, and when coupled with a high adherence and retention rate and significant changes in immune pathways, supports further investigation of this novel therapy.Abstract:
Background Peanut allergy is common, life-threatening, and without therapeutic options We evaluated peanut epicutaneous immunotherapy (EPIT) by using Viaskin Peanut for peanut allergy treatment Objective We sought to evaluate the clinical, safety, and immunologic effects of EPIT for the treatment of peanut allergy Methods In this multicenter, double-blind, randomized, placebo-controlled study, 74 participants with peanut allergy (ages 4-25 years) were treated with placebo (n = 25), Viaskin Peanut 100 μg (VP100; n = 24) or Viaskin Peanut 250 μg (VP250; n = 25; DBV Technologies, Montrouge, France) The primary outcome was treatment success after 52 weeks, which was defined as passing a 5044-mg protein oral food challenge or achieving a 10-fold or greater increase in successfully consumed dose from baseline to week 52 Adverse reactions and mechanistic changes were assessed Results At week 52, treatment success was achieved in 3 (12%) placebo-treated participants, 11 (46%) VP100 participants, and 12 (48%) VP250 participants ( P = 005 and P = 003, respectively, compared with placebo; VP100 vs VP250, P = 48) Median change in successfully consumed doses were 0, 43, and 130 mg of protein in the placebo, VP100, and VP250 groups, respectively (placebo vs VP100, P = 014; placebo vs VP250, P = 003) Treatment success was higher among younger children ( P = 03; age, 4-11 vs >11 years) Overall, 144% of placebo doses and 798% of VP100 and VP250 doses resulted in reactions, predominantly local patch-site and mild reactions ( P = 003) Increases in peanut-specific IgG 4 levels and IgG 4 /IgE ratios were observed in peanut EPIT-treated participants, along with trends toward reduced basophil activation and peanut-specific T H 2 cytokines Conclusions Peanut EPIT administration was safe and associated with a modest treatment response after 52 weeks, with the highest responses among younger children This, when coupled with a high adherence and retention rate and significant changes in immune pathways, supports further investigation of this novel therapyread more
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Journal ArticleDOI
Current Insights into Immunotherapy Approaches for Food Allergy
TL;DR: It is suggested that food immunotherapy can induce clinical desensitization with varying levels of safety, however lasting tolerance has not been demonstrated and treatment side effects and dosing logistics may make the therapies difficult for some supporting the need for alternative treatment approaches.
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Predicting probability of tolerating discrete amounts of peanut protein in allergic children using epitope‐specific IgE antibody profiling
Maria Suprun,Paul Kearney,Clive Hayward,Heather Butler,Robert Getts,Scott H. Sicherer,Paul Turner,Dianne E. Campbell,Hugh A. Sampson +8 more
TL;DR: IgE‐epitope profiling can accurately diagnose clinical peanut allergy and can be used to predict peanut allergy in animals and humans.
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Laser-facilitated epicutaneous immunotherapy with hypoallergenic beta-glucan neoglycoconjugates suppresses lung inflammation and avoids local side effects in a mouse model of allergic asthma.
Evgeniia Korotchenko,Victoria Schiessl,Sandra Scheiblhofer,Mario Schubert,Elfriede Dall,Isabella Anna Joubert,Helen Strandt,Theresa Neuper,Muamera Sarajlic,Renate Bauer,Mark Geppert,David Joedicke,Sabrina Wildner,Susanne Schaller,Stephan M. Winkler,Gabriele Gadermaier,Jutta Horejs-Hoeck,Richard Weiss +17 more
TL;DR: Allergen‐polysaccharide neoglycogonjugates increase immunization efficacy by targeting and activating dendritic cells via C‐type lectin receptors and reduce side effects.
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Real world tree nut consumption in peanut-allergic individuals.
S. Shahzad Mustafa,Karthik Vadamalai,Theresa Bingemann,Mahta Mortezavi,Vivian Aranez,Allison Ramsey +5 more
TL;DR: The data indicate that peanut-allergic individuals who consume foods with precautionary labeling are most likely to consume tree nuts, and that cashew and pistachio had higher serum specific IgE levels compared with other tree nuts.
Journal ArticleDOI
Safety of Epicutaneous Immunotherapy in Peanut-Allergic Children: REALISE Randomized Clinical Trial Results
TL;DR: The Real Life Use and Safety of EPIT (REALISE) study as discussed by the authors is a phase 3 multicenter study consisting of a 6-month, randomized, double-blind, placebo-controlled period followed by open-label active treatment.
References
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Guidelines for the Diagnosis and Management of Food Allergy in the United States: Summary of the NIAID-Sponsored Expert Panel Report
Joshua A. Boyce,Amal Assa'ad,A. Wesley Burks,Stacie M. Jones,Hugh A. Sampson,Robert A. Wood,Marshall Plaut,Susan F. Cooper,Matthew J. Fenton,S. Hasan Arshad,S. Hasan Arshad,Sami L. Bahna,Lisa A. Beck,Carol Byrd-Bredbenner,Carlos A. Camargo,Lawrence F. Eichenfield,Lawrence F. Eichenfield,Glenn T. Furuta,Glenn T. Furuta,Jon M. Hanifin,Carol Jones,Monica Kraft,Bruce D. Levy,Phil Lieberman,Stefano Luccioli,Kathleen M. McCall,Lynda C. Schneider,Ronald A. Simon,F. Estelle R. Simons,Stephen J. Teach,Barbara P. Yawn,Barbara P. Yawn,Julie M. Schwaninger +32 more
TL;DR: The National Institute of Allergy and Infectious Diseases, working with 34 professional organizations, federal agencies, and patient advocacy groups, led the development of clinical guidelines for the diagnosis and management of food allergy, which include a consensus definition for food allergy.
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The Prevalence, Severity, and Distribution of Childhood Food Allergy in the United States
Ruchi Gupta,Elizabeth E. Springston,Manoj R. Warrier,Bridget Smith,Bridget Smith,Rajesh Kumar,Jacqueline A. Pongracic,Jacqueline A. Pongracic,Jane L. Holl +8 more
TL;DR: Findings suggest that the prevalence and severity of childhood food allergy is greater than previously reported and that disparities exist in the clinical diagnosis of disease.
Journal ArticleDOI
US prevalence of self-reported peanut, tree nut, and sesame allergy: 11-year follow-up
TL;DR: Although caution is required in comparing surveys, peanut allergy, TN allergy, or both continue to be reported by more than 1% of the US population and appear to be increasingly reported among children over the past decade.
Journal ArticleDOI
Clinical efficacy and immune regulation with peanut oral immunotherapy.
Stacie M. Jones,Laurent Pons,Joseph L. Roberts,Amy M. Scurlock,Tamara T. Perry,Mike Kulis,Wayne G. Shreffler,Pamela H. Steele,Karen A. Henry,Margaret Adair,James M. Francis,Stephen R. Durham,Brian P. Vickery,Xiao-Ping Zhong,A. Wesley Burks +14 more
TL;DR: Microarray data suggest a novel role for apoptosis in OIT, which induces clinical desensitization to peanut, with significant longer-term humoral and cellular changes.
Journal ArticleDOI
Oral immunotherapy for treatment of egg allergy in children.
A. Wesley Burks,Stacie M. Jones,Robert A. Wood,David Fleischer,Scott H. Sicherer,Robert Lindblad,Donald Stablein,Alice K. Henning,Brian P. Vickery,Andrew H. Liu,Amy M. Scurlock,Wayne G. Shreffler,Marshall Plaut,Hugh A. Sampson +13 more
TL;DR: These results show that oral immunotherapy can desensitize a high proportion of children with egg allergy and induce sustained unresponsiveness in a clinically significant subset.
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