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SLIT for food?


Although the traditional treatment for IgE-mediated food allergy is life-long avoidance, there are several small studies suggesting that sublingual immunotherapy (SLIT) for foods may be safe and effective.   The potential advantage of active immunotherapy is not just to broaden a person's dietary choices, but rather to protect them from accidental exposure, as when dining out.  This will undoubtedly be an area of ongoing research. 

Here are the references:

Laubach S, Steele P, Kamilaris J, Pons L, Kulis M, Schreffler W, Burks A. Safety of Sublingual Immunotherapy (SLIT) for Peanut Allergy. J Allergy Clin Immunology, 2008; 121:S96-S96.   SLIT for peanut seems well-tolerated, no information yet about its effectiveness. 

 
Fernandez-Rivas M, Garrido Fernandez S, Nadal JA, Alonso MD, de Durana D, Garcia BE, Gonzalez-Mancebo E, Martin S, Barber D, Rico P, Tabar AI. Randomized double-blind, placebo-controlled trial of sublingual immunotherapy with a Pru p 3 quantified peach abstract. Allergy 2009; 64:876-883. Six months of peach SLIT resulted in tolerance to 3 to 9 times as much peach as at the start, significant decreases in the size of the skin prick test, and significant increases in specific IgE and IgG4.
 

Pineda F, Enrique E, Malek T, Bartra J, Basagana M, Tella R, Castello J, Alonso R, de Mateo J, Cerda-Trias T, San Miguel-Moncin M, Palacios R, Cistero-Bahima A. Sublingual immunotherapy for hazelnut food allergy: a long-term efficacy, tolerability and safety Survey. J Allergy Clin Immunology 2008; 121:S137-S137. Hazelnut SLIT decreased serum antigen-specific IgE, increased antigen-specific IgG, and increased IL-10.