期刊
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY
卷 135, 期 5, 页码 1240-U648出版社
MOSBY-ELSEVIER
DOI: 10.1016/j.jaci.2014.12.1917
关键词
Peanut allergy; sublingual immunotherapy; desensitization; food allergy; follow-up
资金
- National Institutes of Health (NIH)/National Institute of Allergy and Infectious Diseases (NIAID) [U19AI066738, U01AI066560]
- National Center for Research Resources (NCRR)/NIH [UL1 RR025780]
- NIH/National Center for Advancing Translational Sciences [UL1 TR000154]
- NCRR [UL1 TR000067, UL1 TR000039, UL 1 RR024128, UL1 RR 025005]
Background: We previously reported the initial results of the first multicenter, randomized, double-blind, placebo-controlled clinical trial of peanut sublingual immunotherapy (SLIT), observing a favorable safety profile associated with modest clinical and immunologic effects in the first year. Objective: We sought to provide long-term (3-year) clinical and immunologic outcomes for our peanut SLIT trial. Key end points were (1) percentage of responders at 2 years (ie, could consume 5 g of peanut powder or a 10-fold increase from baseline), (2) percentage reaching desensitization at 3 years, (3) percentage attaining sustained unresponsiveness after 3 years, (4) immunologic end points, and (5) assessment of safety parameters. Methods: Response to treatment was evaluated in 40 subjects aged 12 to 40 years by performing a 10-g peanut powder oral food challenge after 2 and 3 years of daily peanut SLIT therapy. At 3 years, SLIT was discontinued for 8 weeks, followed by another 10-g oral food challenge and an open feeding of peanut butter to assess sustained unresponsiveness. Results: Approximately 98% of the 18,165 doses were tolerated without adverse reactions beyond the oropharynx, with no severe symptoms or uses of epinephrine. A high rate (> 50%) discontinued therapy. By study's end, 4 (10.8%) of 37 SLITtreated participants were fully desensitized to 10 g of peanut powder, and all 4 achieved sustained unresponsiveness. Responders at 2 years showed a significant decrease in peanutspecific basophil activation and skin prick test titration compared with nonresponders. Conclusions: Peanut SLIT induced a modest level of desensitization, decreased immunologic activity over 3 years in responders, and had an excellent long-term safety profile. However, most patients discontinued therapy by the end of year 3, and only 10.8% of subjects achieved sustained unresponsiveness.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据