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Sublingual immunotherapy for food allergy and its future directions

    Stephen A Schworer

    Department of Medicine, Division of Rheumatology, Allergy & Immunology, University of North Carolina School of Medicine, Chapel Hill, NC 27599, USA

    &
    Edwin H Kim

    *Author for correspondence:

    E-mail Address: edwinkim@email.unc.edu

    Department of Medicine, Division of Rheumatology, Allergy & Immunology, University of North Carolina School of Medicine, Chapel Hill, NC 27599, USA

    Published Online:https://doi.org/10.2217/imt-2020-0123

    Food allergy is an important medical problem with increasing prevalence throughout the world. Different approaches of food immunotherapy are being investigated including oral, epicutaneous and sublingual routes. Sublingual immunotherapy (SLIT) for food allergy involves placement of glycerinated allergen under the tongue daily to achieve allergen-specific desensitization. SLIT has been studied in the treatment of hazelnut, peach, apple, milk and peanut allergies with substantial focus on the treatment of peanut allergy. Phase II studies have shown SLIT for treatment of peanut allergy increases the tolerated dose of peanut by a substantial margin with fewer and less severe side effects than other modalities. This review discusses the mechanisms of SLIT, early studies of its use in food allergy and larger randomized controlled trials for treatment of peanut allergy. Future directions using the mechanisms involved in SLIT include oral mucosal immunotherapy for peanut allergy.

    Papers of special note have been highlighted as: • of interest; •• of considerable interest

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