NIAID’s food allergy treatment research program focuses on an approach called immunotherapy. This involves exposing a person to a food allergen in a controlled way to reduce their immune response to the allergen. The program also supports research on the use of lab-made antibodies to treat food allergy.
Immunotherapy
NIAID-supported researchers are studying three different forms of immunotherapy for food allergy: oral immunotherapy, sublingual immunotherapy, and epicutaneous immunotherapy.
Oral Immunotherapy
Oral immunotherapy involves eating small doses of a food that causes an allergy and gradually increasing the size of those doses. NIAID-funded clinical trials have helped show that oral immunotherapy is effective. Yet the strategy has several disadvantages. People who start oral immunotherapy must continue it indefinitely to remain protected. Also, many people experience allergic reactions and gastrointestinal side effects during treatment. As a result, NIAID is funding development of new approaches to oral immunotherapy to reduce side effects and improve outcomes. Some of the studies pair oral immunotherapy with other treatment strategies.
Learn more from these NIAID news releases:
- Oral immunotherapy induces remission of peanut allergy in some young children
- Oral immunotherapy shows promise as treatment for egg allergy
- Omalizumab improves efficacy of oral immunotherapy for multiple food allergies
- Monoclonal antibody improves cat allergen immunotherapy
Sublingual Immunotherapy
Sublingual immunotherapy involves placing small amounts of an allergen under the tongue. This approach has been successful for treating allergic rhinitis, also known as hay fever. Researchers are now studying it to treat food allergy. Clinical trials have found that sublingual immunotherapy has fewer side effects than oral immunotherapy and becomes more effective over time. But studies also show that oral immunotherapy helps people tolerate higher doses of foods than sublingual immunotherapy. Researchers aim to improve sublingual immunotherapy to generate strong, long-term tolerance of food allergens.
Epicutaneous Immunotherapy
In epicutaneous immunotherapy, a wearable patch delivers an allergen to the skin’s surface. A clinical trial showed in 2023 that a patch containing peanut protein was more effective than a placebo patch at desensitizing toddlers to peanut after one year of wear. The experimental patch also was more effective than placebo at increasing the amount of peanut the children could eat without an allergic reaction. Several years earlier, the NIAID Consortium for Food Allergy Research completed a small clinical trial of the patch in older children and young adults. After wearing the patch for a year, nearly half the participants could eat more peanuts without an allergic reaction than they could at the start of the study.
Learn more from The New England Journal of Medicine article Phase 3 Trial of Epicutaneous Immunotherapy in Toddlers with Peanut Allergy and the NIAID news release Skin patch to treat peanut allergy shows benefit in children.
Antibody Treatment
An NIAID-directed and -funded clinical trial showed in 2024 that an antibody medication commonly used to treat asthma increased the amount of peanut, tree nuts, egg, milk and wheat that multi-food allergic children as young as 1 year could consume without an allergic reaction. The medication, omalizumab, works by binding to the allergy-causing antibody called immunoglobulin E (IgE) in the blood. This prevents IgE from arming key immune cells responsible for allergic reactions, rendering these cells much less sensitive to stimulation by any allergen. Based on these study results, the Food and Drug Administration approved omalizumab for the reduction of allergic reactions that may occur with accidental exposure to one or more foods in adults and children aged 1 year and older with food allergy.
Learn more from the NIAID news release Antibody Reduces Allergic Reactions to Multiple Foods in NIH Trial and Statement: NIH Trial Data Underpins FDA Approval of Omalizumab for Food Allergy.
Scientific Advances
Oral Immunotherapy Induces Remission of Peanut Allergy in Some Young Children
Researchers found that giving peanut oral immunotherapy to highly peanut-allergic children ages 1 to 3 years safely desensitized most of them to peanut and induced remission of peanut allergy in one-fifth of them.
