J Allergy Clin Immunol: Long-term sub-tongue immunotherapy to treat peanut allergies in children.

Peanut sub-tongue immunotherapy (SLIT) has been shown for 1 year to induce moderate clinical desensitization in allergic children.
studies of oral immunotherapy, skin immunotherapy and SLIT have shown that longer treatment times can bring additional benefits.
we tried to investigate safety, clinical effects, and immunological changes with long-term SLIT in children with peanut allergies.
1 to 11 years of age with peanut allergy received an extension of 2mg/d peanut protein to maintain SLIT for up to 5 years.
with a peanut skin test rash of less than 5mm and peanut-specific IgE levels of less than 15kU/L were allowed to stop treatment early.
after completing SLIT dosing, desensitized was assessed with up to 5,000 mg of peanut protein using a double-blind, placebo-controlled food challenge (DBPCFC).
further assess continuous non-reactiveness by using the same DBPCFC without exposure to peanuts after 2 to 4 weeks.
37 of the 48 subjects completed three to five years of peanut SLIT, of which 67% (32/48) successfully consumed 750 mg or more during DBPCFCs.
addition, 25 percent (12/48) passed 5,000 mg of DBPCFC without clinical symptoms, and 10 of the 12 showed sustained non-reactiveness after 2 to 4 weeks.
side effects were reported in 4.8% of doses, with one of the most common reports of itching in the mouth and throat.
side effects of needing antihistamine therapy were uncommon (0.21%) and no epinephrine was used.
peanut skin test wheat rash, peanut-specific IgE levels and alkali-like cell activity decreased significantly, peanut-specific IgG4 levels increased significantly after peanut SLIT.
SLIT for extended treatment provides clinically significant desensitization therapy for most children with peanut allergies, taking into account the convenience and good safety of the drug.
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