A randomized controlled study of peanut oral immunotherapy: Clinical desensitization and modulation of the allergic response

Varshney, Pooja; Jones, Stacie M.; Scurlock, Amy M.; Perry, Tamara T.; Kemper, Alex R.; Steele, Pamela H.; Hiegel, Anne M.; Kamilaris, J.; Carlisle, Suzanne; Yue, Xianchang; Kulis, Mike; Pons, Laurent; Vickery, Brian P.; Burks, A. Wesley

doi:10.1016/j.jaci.2010.12.1111

Cited by 494 publications

(514 citation statements)

References 25 publications

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“…3), which likely corresponds to the reduction of the numbers of IgEproducing cells. This result was concordant with the results based on serum peanut-specific IgE levels (P = 0.034 and 0.62, respectively, in OIT and placebo groups), and also several reports demonstrating that serum peanut-specific IgE levels were significantly decreased by the treatment of OIT [13,21,24,25]. We observed one common IGHE clone among two pre-treated OIT and five pre-treated placebo samples (Supplementary Table 5), but this clone was still retained in the samples after OIT and placebo treatment.…”

Section: Discussionsupporting

confidence: 91%

“…In this study, we analyzed the samples obtained in a randomized controlled study of peanut OIT reported previously [13]. Among them, we studied 12 subjects who received peanut OIT and 5 subjects received a placebo due to the sample limitation.…”

Section: Patient Samplesmentioning

confidence: 99%

“…Among them, 12 patients received peanut flour and the remaining 5 patients received a placebo until the final oral food challenges. In this analysis, we focused on IGHA, IGHE, and IGHG, which have been reported to associate with food allergy [13,[21][22][23][24][25]. In the expression analysis using real-time qPCR, we observed the tendency of Table 1 Mapping pattern of BCR reads in a healthy donor Number of reads (%) -not mapped decrease of IGHE expression after OIT compared to before OIT (P = 0.052) but not in placebo group (P = 0.63) (Fig.…”

Section: Bcr Expression and Sequencing Of Oit Samplesmentioning

confidence: 99%

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Characterization of the B-cell receptor repertoires in peanut allergic subjects undergoing oral immunotherapy

Kiyotani

Yamaguchi

et al. 2017

J Hum Genet

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B-cell receptors (BCRs) play a critical role in adaptive immunity as they generate highly diverse immunoglobulin repertoires to recognize a wide variety of antigens. To better understand immune responses, it is critically important to establish a quantitative and rapid method to analyze BCR repertoire comprehensively. Here, we developed "Bcrip", a novel approach to characterize BCR repertoire by sequencing millions of BCR cDNA using next-generation sequencer. Using this method and quantitative real-time PCR, we analyzed expression levels and repertoires of BCRs in a total of 17 peanut allergic subjects' peripheral blood samples before and after receiving oral immunotherapy (OIT) or placebo. By our methods, we successfully identified all of variable (V), joining (J), and constant (C) regions, in an average of 79.1% of total reads and 99.6% of these VJC-mapped reads contained the C region corresponding to the isotypes that we aimed to analyze. In the 17 peanut allergic subjects' peripheral blood samples, we observed an oligoclonal enrichment of certain immunoglobulin heavy chain alpha (IGHA) and IGH gamma (IGHG) clones (P = 0.034 and P = 0.027, respectively) in peanut allergic subjects after OIT. This newly developed BCR sequencing and analysis method can be applied to investigate B-cell repertoires in various research areas, including food allergies as well as autoimmune and infectious diseases.

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Section: Discussionsupporting

confidence: 91%

Section: Patient Samplesmentioning

confidence: 99%

Section: Bcr Expression and Sequencing Of Oit Samplesmentioning

confidence: 99%

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Characterization of the B-cell receptor repertoires in peanut allergic subjects undergoing oral immunotherapy

Kiyotani

Yamaguchi

et al. 2017

J Hum Genet

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“…However, none of the OIT protocols to date have demonstrated an increase in Th1 type cytokines. Furthermore, the only description of low levels of Th2 type cytokines (IL-5 and IL-13) produced from PBMCs was reported in two OIT protocols for peanut allergy (Blumchen et al 2010;Varshney et al 2011). Figure 3 summarizes the immunological mechanisms of OIT for food allergies that have been described to date.…”

Section: Mechanisms Of Oit In Food Allergymentioning

confidence: 99%

Food Allergy and the Oral Immunotherapy Approach

Cabrera

Urra

2014

Arch. Immunol. Ther. Exp.

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Food allergy represents an increasing health problem, with children being the most affected population. The symptoms can appear within minutes or hours of ingesting the offending food, producing skin manifestations, respiratory, gastrointestinal and anaphylactic reactions in the severe forms. Food allergy is established by the loss of tolerance to food proteins, and is characterized by an altered balance of regulatory T (Treg) cells and the shift to Th2 type cytokines in the intestinal lamina propria. We have described the contribution of different factors in establishing oral tolerance, such as the antigenic exposition route, the gut microenvironment, and the timing of the food introduction. Apart from avoiding the food, immunotherapy is the only intervention which produces oral desensitization to food proteins. Among the underlying immunological mechanisms of oral immunotherapy (OIT) are the changes in humoral immunity (a decrease of allergen-specific IgE and an increase of allergen-specific IgG4) and cellular changes such as the increased number of FoxP3 ? Treg cells. At present, the experiences of OIT with various foods are offering promising results. OIT appears to be safe producing low adverse reactions, and effective in inducing desensitization in most subjects with food allergy.

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“…Most recently, 1 controlled study was performed in the United States and another uncontrolled one in Europe. [61][62] the details of all uncontrolled and controlled studies are summarized in Table 1. [56-58-59-61-62].…”

Section: Studies Of Oit For Peanut and Tree Nut Allergiesmentioning

confidence: 99%

The Progress of Food Allergy Concept, Classifications and Diagnosis

Kamal-Alahmad¹

2016

IJNFS

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Food allergies, defined as an immune response to food proteins, affect as many as 8% of young children and 5% of adults in most countries, and their prevalence appears to be rising like all allergic diseases, In addition to well-recognized urticaria and anaphylaxis triggered by IgE antibody-mediated immune responses. Food allergy is a rapidly growing public health concern because of its increasing prevalence and life-threatening potential. Food allergic reaction can be further subdivided into IgE mediated and non IgE mediated. The diagnosis of food allergy is made from the history, supported by investigations and by responses to avoidance of specific food triggers. So in this work we want to introduce some concepts in food allergy such as classification of allergic and diagnosis of food triggers and finally how to manage this problem and minimize the prevalence of food allergy.

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A randomized controlled study of peanut oral immunotherapy: Clinical desensitization and modulation of the allergic response

Abstract: Background-Open-label oral immunotherapy (OIT) protocols have been used to treat small numbers of patients with peanut allergy. Peanut OIT has not been evaluated in double-blind, placebo-controlled trials.

Cited by 494 publications

References 25 publications

Characterization of the B-cell receptor repertoires in peanut allergic subjects undergoing oral immunotherapy

Characterization of the B-cell receptor repertoires in peanut allergic subjects undergoing oral immunotherapy

Food Allergy and the Oral Immunotherapy Approach

The Progress of Food Allergy Concept, Classifications and Diagnosis

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