Low-dose and high-dose of oral immunotherapy (OIT) is safe and equally effective at suppressing allergic immune responses to peanut in children, suggests a study. Peanut OIT involves eating small, gradually increasing amounts of peanut protein daily. Previous studies showed that peanut OIT in older children can offer some protection against potentially life-threatening anaphylaxis caused by peanut exposure. This study, conducted by Wesley Burks, researcher at the University of North Carolina in the US, assessed whether giving OIT to younger children whose duration of peanut allergy was short could alter the course of the allergy and allow safe introduction of peanut into the diet. The study team enrolled 40 peanut-allergic children aged nine to 36 months. They randomly assigned participants to either high-dose peanut OIT with a target daily dose of 3,000 milligrams peanut protein or a low-dose regimen with a target dose of 300 milligrams. Nearly all participants experienced some side effects, such as abdominal pain, but these were generally mild, and required little or no treatment. After receiving OIT for 29 months on average, participants avoided peanut completely for four weeks before attempting to reintroduce it into their diets. Nearly 80 per cent of peanut-allergic preschool children successfully incorporated peanut-containing foods into their diets after receiving peanut OIT. In comparison to those peanut-allergic children who had avoided the therapy showed that OIT-treated children were more likely to successfully incorporate peanut into their diets, said the paper published in the Journal of Allergy and Clinical Immunology.
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