What Is Oral Immunotherapy?

What is oral immunotherapy?

If your child is allergic to pollen, pet dander, grass and other non-food allergens, he or she can get allergy shots, also known as allergy immunotherapy.

Allergy immunotherapy works by introducing a miniscule amount of an allergen into the body. The immune system responds appropriately to such a small amount of the allergen and doesn’t overreact, causing symptoms like hives, sneezing or a scratchy throat. Over time, the immune system can be desensitized to increasing amounts of the allergen, greatly reducing one’s allergy symptoms.

Unfortunately, food allergy sufferers have had to sit on the sidelines for immunotherapy treatments, as it has never been available for food allergens.

Until now!

Oral Immunotherapy Holds Promise

Oral immunotherapy operates under the same premise as other allergy immunotherapy treatments. But instead of receiving a shot, children with food allergies consume a small amount of the allergen, starting at just 0.1 milligram mixed in with applesauce or yogurt.

The first doses are given under direct supervision of an allergist, and if 0.6 milligrams are tolerated without an allergic reaction, the doses can continue at home on a daily basis.

Oral immunotherapy is still being studied and isn’t yet widely available, but the results are promising, with lead investigator Dr. Jonathan Bell reporting a 93 percent success rate in trials.

The goal of oral immunotherapy, Dr. Bell says, is to have children be able to eat as many as 10 peanuts a day without any sign of an allergic reaction. If the body can become desensitized to this amount of the allergen, cross-contamination could no longer be a worry. As it stands, trace amounts of peanuts found in packaged foods may cause a potentially fatal anaphylactic reaction. Living in fear of such a reaction from invisible contaminants is stressful, to say the least.

Once the ideal amount of the allergen can be consumed without consequence, that amount must continue to be consumed on a daily basis in order to keep the immune system primed.

Oral Immunotherapy Isn’t the Only Treatment on the Horizon

Another therapy called sublingual immunotherapy aims to accomplish the same desensitization as oral immunotherapy, but with the potential to cause milder reactions. Sublingual immunotherapy involves placing a small amount of liquid, which contains traces of the allergen, under the tongue.

Oral immunotherapy works well if the immune system doesn’t overreact into a full-blown allergic reaction. There is a bit of a grey area in which the body reacts and patients may experience moderate allergic reactions, but not necessarily a severe anaphylactic reaction. Sublingual immunotherapy appears to induce milder reactions, although these reactions happen more frequently than any reaction induced by oral immunotherapy.

Research also suggests that sublingual immunotherapy does not produce the same level of tolerance as oral immunotherapy, and it is more difficult to expose someone to high levels of an allergen using sublingual immunotherapy unless the allergen can be highly concentrated.

Finally, epicutaneous immunotherapy is also under investigation as a possible way to desensitize the body to a food allergen. The allergen is absorbed through the skin via a patch, much in the same way that nicotine patches deliver small amounts of nicotine to people weaning off of cigarettes. However, this immunotherapy appears to be most effective in children under the age of 12.

Would You Try Oral Immunotherapy?

What do you think of oral immunotherapy? Are you excited about this treatment possibility, or does the idea of intentionally exposing your child to an allergen scare you? Share your thoughts and experiences in the comments below!


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