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A recent study found that adults with a peanut allergy experienced a decreased likelihood of allergic responses by consuming a small amount of peanut protein daily as part of a clinical trial. This therapeutic strategy is already authorized in the United States for pediatric patients with the same condition.
Peanut allergies develop when the body’s defenses mistakenly perceive proteins within the legume as harmful. This prompts the immune system to generate increased levels of IgE antibodies—normally vital for immune function—leading to an overreaction. Consequently, inflammation escalates, giving rise to symptoms such as swelling, pruritus, and emesis. In severe scenarios, anaphylaxis can occur, posing a life-threatening reaction that compromises respiration or cardiac function.
Oral Immunotherapy for Peanut Allergy
Previously, complete avoidance of peanuts was the sole recourse. However, oral immunotherapy—a method designed to retrain the immune response—gained approval in 2020 in the US for use in children. This treatment introduces progressively larger, controlled doses of peanut proteins to accustom the immune system to the allergen.
The efficacy of this approach for adults, however, remained uncertain. Stephen Till, affiliated with King’s College London, clarifies, “Most of an individual’s life with a peanut allergy is spent as an adult, yet we lacked effective treatments to diminish their fundamental sensitivity to peanuts. There were indications suggesting adults might be more resistant to desensitization than children since the immune system is more adaptable at a younger age.”
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Study Details and Findings
To address this gap in knowledge, Till’s research team enrolled 21 adults diagnosed with peanut allergy. At the outset of the trial, subjects could only tolerate an average of one-eighth of a peanut before experiencing an allergic reaction.
The researchers administered a daily dose equivalent to 1/40th of a peanut for two weeks. Subsequently, the dosage incrementally increased every two weeks over several months, until participants could consistently and safely consume the protein equivalent of four whole peanuts daily for one month.
- Three participants withdrew from the study due to allergic reactions.
- An additional three participants ceased involvement for reasons unrelated to the treatment.
- Cezmi Akdis of the Swiss Institute of Allergy and Asthma Research remarked that these attrition rates are considered acceptable within such treatment paradigms.
Positive Outcomes of Oral Immunotherapy
The remaining 15 participants underwent an allergy challenge test, consuming escalating quantities of peanut protein under close supervision. Strikingly, all but one participant could ingest the equivalent of five peanuts without experiencing an allergic reaction.
Furthermore, analysis of blood samples drawn from participants before and after undergoing oral immunotherapy revealed heightened levels of IgG antibodies. These antibodies antagonize the effects of IgE antibodies, typically responsible for allergic responses.
Akdis remarked, “This shows great promise. This strategy could mitigate the anxiety experienced by adults with peanut allergy concerning the inadvertent consumption of peanut-contaminated foods.”
It is important to note that the trial was preliminary. Larger, more extensive trials are necessary to corroborate these results and clarify the longevity of the protective effects. Akdis suggests, “Long-term, daily or regular doses of peanuts are likely required to sustain tolerance to the allergen. Given people routinely take medication daily, it is conceivable that those affected by peanut allergies would readily adhere to such an ongoing method.”
Individuals should never attempt to self-treat allergies without proper medical guidance.