A randomized controlled study of peanut oral immunotherapy: Clinical desensitization and modulation of the allergic response Pooja Varshney, MD, Stacie.

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Presentation transcript:

A randomized controlled study of peanut oral immunotherapy: Clinical desensitization and modulation of the allergic response Pooja Varshney, MD, Stacie M. Jones, MD, Amy M. Scurlock, MD, Tamara T. Perry, MD, Alex Kemper, MD, MPH, MS, Pamela Steele, CPNP, Anne Hiegel, RN, Janet Kamilaris, RN, Suzanne Carlisle, RN, Xiaohong Yue, MS, Mike Kulis, PhD, Laurent Pons, PhD, Brian Vickery, MD, A. Wesley Burks, MD Journal of Allergy and Clinical Immunology Volume 127, Issue 3, Pages 654-660 (March 2011) DOI: 10.1016/j.jaci.2010.12.1111 Copyright © 2011 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 1 Cumulative amount of peanut protein ingested at OFC by peanut OIT and placebo subjects (*P < .001) after 12 months of therapy. Individual subjects are shown as diamonds (peanut OIT) or squares (placebo); lines designate median values. Journal of Allergy and Clinical Immunology 2011 127, 654-660DOI: (10.1016/j.jaci.2010.12.1111) Copyright © 2011 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 2 Titrated skin prick testing. Change in median wheal size from baseline to time of OFC in peanut OIT and placebo subjects (*P < .001). Boxes represent 25% to 75% quartiles; whiskers represent range. Lines designate median values. Journal of Allergy and Clinical Immunology 2011 127, 654-660DOI: (10.1016/j.jaci.2010.12.1111) Copyright © 2011 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 3 Changes in serum immunoglobulin levels during treatment with peanut OIT and placebo. A, Peanut-specific IgE (*P ≤ .01). B, Peanut-specific IgG (*P < .05). C, Peanut-specific IgG4 (*P ≤ .001). Boxes represent 25% to 75% quartiles; whiskers represent range. Lines designate median values. Journal of Allergy and Clinical Immunology 2011 127, 654-660DOI: (10.1016/j.jaci.2010.12.1111) Copyright © 2011 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 4 Changes in secreted cytokine responses for subjects receiving peanut OIT and placebo. PBMCs were cultured with peanut protein for 72 hours; cytokines were measured via ELISA. A, IL-5 (*P ≤ .02). B, IL-13 (*P ≤ .03). Journal of Allergy and Clinical Immunology 2011 127, 654-660DOI: (10.1016/j.jaci.2010.12.1111) Copyright © 2011 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 5 Change in FoxP3hi: FoxP3intermediate CD4+CD25+ T cells from baseline to time of OFC. PBMCs were stimulated with crude peanut extract and tetanus toxin for 7 days and then stained for Treg markers. Individual subjects are shown for peanut OIT (A) and placebo (B) groups. *P = .04. ns, Not significant. Journal of Allergy and Clinical Immunology 2011 127, 654-660DOI: (10.1016/j.jaci.2010.12.1111) Copyright © 2011 American Academy of Allergy, Asthma & Immunology Terms and Conditions