Sustained unresponsiveness to peanut in subjects who have completed peanut oral immunotherapy Brian P. Vickery, MD, Amy M. Scurlock, MD, Michael Kulis,

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Presentation transcript:

Sustained unresponsiveness to peanut in subjects who have completed peanut oral immunotherapy Brian P. Vickery, MD, Amy M. Scurlock, MD, Michael Kulis, PhD, Pamela H. Steele, CPNP, Janet Kamilaris, RN, Jelena P. Berglund, PhD, Caitlin Burk, BA, Anne Hiegel, RN, Suzanna Carlisle, RN, Lynn Christie, RD, Tamara T. Perry, MD, Robbie D. Pesek, MD, Saira Sheikh, MD, Yamini Virkud, MD, MA, P. Brian Smith, MD, MHS, MPH, Mohamed H. Shamji, PhD, Stephen R. Durham, MD, Stacie M. Jones, MD, A. Wesley Burks, MD Journal of Allergy and Clinical Immunology Volume 133, Issue 2, Pages 468-475.e6 (February 2014) DOI: 10.1016/j.jaci.2013.11.007 Copyright © 2013 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 1 Conduct of the study. Journal of Allergy and Clinical Immunology 2014 133, 468-475.e6DOI: (10.1016/j.jaci.2013.11.007) Copyright © 2013 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 2 Food challenge results. Shown are the cumulative amounts of protein successfully ingested before onset of symptoms in TSs (blue circles) and TFs (red circles). Each circle represents 1 subject. Journal of Allergy and Clinical Immunology 2014 133, 468-475.e6DOI: (10.1016/j.jaci.2013.11.007) Copyright © 2013 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 3 Skin prick test (SPT) results. A, Average mean wheal diameters at baseline by outcome. B, Mean wheal diameters over time by outcome. Lines represent median values. *P < .05 and **P < .01. ns, Not significant. Journal of Allergy and Clinical Immunology 2014 133, 468-475.e6DOI: (10.1016/j.jaci.2013.11.007) Copyright © 2013 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 4 Peanut- and component-specific serum IgE levels during OIT. A-C, Longitudinal peanut-specific (Fig 4, A) and Ara h 1– and Ara h 2–specific (Fig 4, B) IgE levels are shown for individual subjects by outcome and for all components in all subjects (Fig 4, C). D and E, Peanut-specific IgE/total IgE ratio is shown for all subjects (Fig 4, D) and for individual subjects by outcome (Fig 4, E). All point estimates are medians with interquartile ranges (Fig 4, C). *P < .05, **P < .01, and ***P < .001. ns, Not significant. Journal of Allergy and Clinical Immunology 2014 133, 468-475.e6DOI: (10.1016/j.jaci.2013.11.007) Copyright © 2013 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 5 Peanut-specific serum IgG levels, IgG4 levels, and IgE/IgG4 ratios during OIT. A, Median values for all subjects’ longitudinal peanut-specific IgG and IgG4 and Ara h 2–specific IgG4 levels are shown. B, Peanut-specific IgG4 levels are shown for subjects by outcome. C and D, Peanut-specific IgE/IgG4 ratios are shown for all subjects (Fig 5, C) and by outcome (Fig 5, D). Lines represent medians. *P < .05 and **P < .01. ns, Not significant. Journal of Allergy and Clinical Immunology 2014 133, 468-475.e6DOI: (10.1016/j.jaci.2013.11.007) Copyright © 2013 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 6 Serum from subjects receiving peanut OIT inhibits FAB. A, FAB data are shown for all subjects in gray, with the mean linear regression slope coefficient indicated by the black line and 95% CIs indicated by the hatched line. B, FAB by outcome is shown, with lines representing medians. **P < .01. Journal of Allergy and Clinical Immunology 2014 133, 468-475.e6DOI: (10.1016/j.jaci.2013.11.007) Copyright © 2013 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E1 Regulatory T-cell numbers are not statistically different between the TS and TF groups at the time of SOFC. CD4+CD25+ forkhead box protein 3 (FoxP3)+ regulatory T cells are shown as a percentage of CD4+ T cells. Regulatory T-cell numbers were measured from PBMCs cultured with peanut proteins at the time of SOFC. Journal of Allergy and Clinical Immunology 2014 133, 468-475.e6DOI: (10.1016/j.jaci.2013.11.007) Copyright © 2013 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E2 The discriminative potential of baseline factors on OIT outcome. Receiver operating characteristic curves are shown in the figure. Optimal cut points for each factor are shown in tabular form below in descending order by area under the curve (AUC). PN, Peanut; SPT, skin prick test. Journal of Allergy and Clinical Immunology 2014 133, 468-475.e6DOI: (10.1016/j.jaci.2013.11.007) Copyright © 2013 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E3 The discriminative potential of end-of-study factors on OIT outcome. Receiver operating characteristic curves are shown in the figure. Optimal cut points for each factor shown in tabular form below in descending order by area under the curve (AUC). PN, Peanut; SPT, skin prick test. Journal of Allergy and Clinical Immunology 2014 133, 468-475.e6DOI: (10.1016/j.jaci.2013.11.007) Copyright © 2013 American Academy of Allergy, Asthma & Immunology Terms and Conditions