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First Study of Oral Mucosal Immunotherapy for Peanut Allergy Elicits Robust Immunologic Response in Adults


AAAAI 2024. Oral mucosal immunotherapy delivered via metered-dose toothpaste produced a statistically significant increase in IgG4 and a decrease in IgE/IgG4 ratio.

Toothpaste-Delivered Oral Mucosal Immunotherapy for Peanut Allergy Elicits Robust Immunologic Response in Adults image credit dispenser: ©Piyathida P/stock.adobe.com
©Piyathida P/stock.adobe.com

Use of oral mucosal immunotherapy (OMIT), a novel delivery system for allergen immunotherapy, was associated with a statistically significant immunologic response in adults with physician-diagnosed food allergy, according to study results presented during a late-breaking abstract session at the 2024 American Academy of Allergy, Asthma, and Immunology (AAAAI) annual meeting, February 23-26, 2024, in Washington, DC.

The data, presented by study author William Berger, MD, of Allergy and Asthma Solutions, Trabuco Canyon, CA, is based on the delivery of food allergy desensitization through a “fully functional toothpaste,” created using stabilized allergen embedded in the medium, according to the study abstract. The toothpaste, used once daily, is measured with a metered dose dispenser. Berger supports the hypothesis that the pathway “interacts with Langerhans cells in the entire oral cavity to activate an immune response…”

Researchers used standard immunologic parameters to support diagnosis and to evaluate the effectiveness of the innovative delivery mechanism in 32 adults with documented food allergy. According to the study abstract, they used oral food challenges (OFC) and also assessed levels of peanut allergen components Ara h 2, 3, 6, 8, and 9 to confirm the diagnosis of peanut food allergy.

Berger reported an “excellent correlation” with Ara h 2 level of ≥1.75 kU/L and a positive OFC. Analysis also returned a statistically significant increase in IgG4 and a decrease in the IgE/IgG4 ratio in study participants who could tolerate ≥300 mg of peanut protein at end of the study. One participant exhibited signs of oral allergy syndrome, which suggests potential difficulty when interpreting OFC findings in this population.

“Our data support OMIT as a new effective approach to the management of food allergy providing a robust immunologic response in treated patients,” wrote Berger in the abstract’s conclusion. “Due to its targeted delivery and simple administration, it supports the goal of improved adherence,” the investigator stated in an earlier report of study findings.2

1. Berger, W. First study to evaluate oral mucosal immunotherapy (OMIT) for the treatment of food allergy. Abstract L15 presented at: 2024 American Academy of Allergy, Asthma, and Immunology Annual Meeting; February 23-26, 2024; Washington, DC. Accessed February 20, 2024. https://www.jacionline.org/pb-assets/Health%20Advance/journals/ymai/AAAAI_2024_February23-1707140438697.pdf
2. New study shows specially formulated toothpaste successful in peanut immunotherapy for adults. News release. American College of Allergy, Asthma, and Immunology. November 9, 2023. Accessed February 21, 2024. https://acaai.org/news/special-toothpaste-may-lower-risk-of-allergic-reactions-for-adults-with-peanut-allergy/

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