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Sublingual immunotherapy for peanut allergy: Clinical and immunologic evidence of desensitization  Edwin H. Kim, MD, J. Andrew Bird, MD, Michael Kulis,

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Presentation on theme: "Sublingual immunotherapy for peanut allergy: Clinical and immunologic evidence of desensitization  Edwin H. Kim, MD, J. Andrew Bird, MD, Michael Kulis,"— Presentation transcript:

1 Sublingual immunotherapy for peanut allergy: Clinical and immunologic evidence of desensitization 
Edwin H. Kim, MD, J. Andrew Bird, MD, Michael Kulis, PhD, Susan Laubach, MD, Laurent Pons, PhD, Wayne Shreffler, MD, PhD, Pamela Steele, CPNP, Janet Kamilaris, RN, Brian Vickery, MD, A. Wesley Burks, MD  Journal of Allergy and Clinical Immunology  Volume 127, Issue 3, Pages e1 (March 2011) DOI: /j.jaci Copyright © 2011 American Academy of Allergy, Asthma & Immunology Terms and Conditions

2 Fig 1 DBPCFC after 12 months of SLIT or placebo. A, When challenged with 2,500 mg of peanut protein, subjects receiving peanut SLIT demonstrate an increased reaction threshold. Boxes represent interquartile ranges with lines at the median. Bars represent minimum and maximum values. ∗P = B, Association of DBPCFC outcomes with peanut-specific IgE from the day of challenge for active treatment. ∗∗P = .043. Journal of Allergy and Clinical Immunology  , e1DOI: ( /j.jaci ) Copyright © 2011 American Academy of Allergy, Asthma & Immunology Terms and Conditions

3 Fig 2 Titrated SPTs at baseline and after 12 months of peanut SLIT or placebo. After 12 months, peanut SLIT results in a decreased wheal size to peanut SPTs. Boxes represent interquartile ranges with lines at the median. Bars represent minimum and maximum values. ∗P = .020. Journal of Allergy and Clinical Immunology  , e1DOI: ( /j.jaci ) Copyright © 2011 American Academy of Allergy, Asthma & Immunology Terms and Conditions

4 Fig 3 Percentage of CD63+ activated basophils at baseline and after 12 months of peanut SLIT or placebo. After 12 months, peanut SLIT results in a decreased percentage of activated basophils when stimulated with 10−2 and 10−3 μg/mL crude peanut extract. Open boxes, Baseline; hatched boxes, 12 months. Boxes represent interquartile ranges with lines at the median. Bars represent minimum and maximum values. ∗P = ∗∗P = .009. Journal of Allergy and Clinical Immunology  , e1DOI: ( /j.jaci ) Copyright © 2011 American Academy of Allergy, Asthma & Immunology Terms and Conditions

5 Fig 4 Levels of peanut-specific immunoglobulins at baseline and after 12 months of peanut SLIT or placebo. A, After 12 months, peanut SLIT results in an increase in peanut-specific IgE levels over 4 months followed by a decrease over the subsequent 8 months. ∗P = ∗∗P = B, After 12 months, peanut results in an increase in peanut IgG4 levels. ∗∗∗P = Boxes represent interquartile ranges with lines at the median. Bars represent minimum and maximum values. Journal of Allergy and Clinical Immunology  , e1DOI: ( /j.jaci ) Copyright © 2011 American Academy of Allergy, Asthma & Immunology Terms and Conditions

6 Fig 5 Cytokine secretion after stimulation with crude peanut extract at baseline and after 12 months of peanut SLIT or placebo. A, After 12 months, peanut SLIT results in a decrease in IL-5 secretion. ∗P = B, After 12 months, a decrease in IL-13 secretion was found in both the peanut SLIT and placebo groups. Boxes represent interquartile ranges with lines at the median. Bars represent minimum and maximum values. Journal of Allergy and Clinical Immunology  , e1DOI: ( /j.jaci ) Copyright © 2011 American Academy of Allergy, Asthma & Immunology Terms and Conditions

7 Fig 6 Percentage of Treg cells at baseline and after 12 months of peanut SLIT or placebo. Although an increase in Treg cells was seen after 12 months of peanut SLIT, this did not reach significance. Boxes represent interquartile ranges with lines at the median. Bars represent the minimum and maximum values. Journal of Allergy and Clinical Immunology  , e1DOI: ( /j.jaci ) Copyright © 2011 American Academy of Allergy, Asthma & Immunology Terms and Conditions

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