In one more of the rapidly developing field of immunotherapy in the treatment of allergy by training the oral tolerance mechanisms in our bodies, a group of 22 children (median age 11) with peanut allergies were fed under medical supervision a dose of peanuts made into flour and mixed in chocolate over several months.
The amount of peanut flour was slowly increased to a maximal dose of 800mg (approx 5 peanuts) each day followed by 30 weeks of maintenance. During this time 19 tolerated the up dosing and 800mg daily management dose and 2 had their management dropped to 200-400mg , I dropped out. Reactions were mild and no adrenaline was required during the exposure time.
The authors state:
We used a novel protocol using gradual up dosing, and higher maintenance dose resulting in a better outcome compared with rush protocols. There was a 1000-fold increase in the amount of peanut tolerated with a good safety profile. No serious adverse events occurred. Most subjects tolerated five peanuts and all were protected against amounts likely during accidental ingestion.
The role of the mucosal immune system in developing tolerance to foods such as peanuts where previously they were thought to be lifelong is a fascinating expansion of the ability to re-programme the immune system. My feelings are that additional key nutrients such as vitamin A and D as well as adjuvant probiotics will add value to these therapies and will herald a new and potentially life changing therapy in the next few years.
 Anagnostou K, Clark A, King Y, Islam S, Deighton J, Ewan P. Efficacy and safety of high-dose peanut oral immunotherapy with factors predicting outcome. Clin Exp Allergy. 2011 Mar 18. doi: 10.1111/j.1365-2222.2011.03699.x. [Epub ahead of print] View Abstract
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