The treatment is called sublingual immunotherapy, or SLIT, and involves the administration of liquefied peanut protein under the patient’s tongue. This site of administration is as crucial as it is strategic for the vasculature here bypasses both the stomach, which could result in digestion of some or all of the protein, as well as the liver where the protein could be metabolized.
The advantage is that much less protein need be administered compared to other therapies. Indeed the initial dose is a miniscule 0.0002 mg!
This dose is gradually increased over months to 2 mg. To put these amounts into perspective one average peanut contains 300 mg of peanut protein. According to Kim, about 100 mg of this protein is sufficient to trigger a severe allergic reaction. It is also this trace amount of peanut protein which can show up in food “manufactured in a facility that processes peanuts”.
Kim and colleagues have followed 48 patients for 5 years being administered 2 mg daily. Their research was recently published in the Journal of Allergy and Clinical Immunology and showed that 67% of these patients were able to tolerate at least 750 mg of peanut protein without serious side effects. Furthermore 25% could tolerate a whopping 5,000 mg!
This study resulted in a successful phase 2 clinical trial and offers hope to those suffering from this most dangerous allergy.
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