Food allergy is consistently one of the most anxiety-provoking illnesses for patients or their caregivers, especially if the problem is life-threatening. Eating is something we do several times a day, and the fear that danger lurks within every bite can seriously affect one’s mental well-being. Whereas desensitization treatment has been used for the treatment of allergic rhinitis and asthma for many decades, previous attempts to develop vaccines for food allergy have ended in failure.
In the last two years, several studies of oral peanut desensitization have been published. While the majority of patients could be successfully desensitized, this treatment is limited by the high rate of adverse reactions and the need for close monitoring.
Sublingual desensitization is a new method of administering desensitization treatment for patients suffering from house dust mite and pollen allergies. Recent studies have shown effectiveness for patients suffering from allergic rhinitis and asthma. The advantages of this form of treatment include convenience and safety. A recent study of sublingual desensitization for peanut allergy shows encouraging results. The study was carried out at Duke University in North Carolina and Massachusetts General Hospital in Boston. Eighteen children were given sublingual drops of a peanut allergen extract or placebo at increasing doses. None of the patients suffered severe adverse reactions, with only oral itching as the most significant side effect. After 12 months of treatment, those who took the extract could tolerate 20 times the amount of peanut given in an oral challenge than those who took placebo. The average amount tolerated was 1700mg, which was equivalent to 6 – 7 peanuts. Presumably, these patients could continue to eat peanuts regularly to maintain their desensitized state thereafter.
We have started to perform sublingual peanut desensitization using the same extract recently and several patients have been successfully desensitized. We are hopeful that this would become a viable alternative for the majority of patients suffering from peanut allergy.