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TOPLINE:

Children with peanut allergy who achieved remission with sublingual immunotherapy (SLIT) had lower basophil activation before treatment and greater suppression of basophils at 1 year than those who experienced treatment failure, a new study showed. Basophil activation might serve as predictive biomarker of treatment success, the study authors suggested.

METHODOLOGY:

• Researchers evaluated whether basophil activation predicted clinical outcomes in children with peanut allergy who received SLIT as part of a randomized controlled trial.
• They focused on data from 19 children who received peanut SLIT for 36 months, followed by a 3-month avoidance period, to evaluate remission.
• Blood samples were collected throughout the trial to measure basophil activation via CD63 expression and CD203c upregulation in response to stimulation with varying concentrations of peanut extract (1000 ng/mL, 100 ng/mL, 10 ng/mL, or 1 ng/mL) and anti-immunoglobulin E.
• Clinical outcomes were defined as remission (tolerating 4443 mg of peanut protein at 36 and 39 months), desensitization (tolerating 4443 mg at 36 months but less than 4443 mg at 39 months), and treatment failure (tolerating less than 4443 mg at 36 months).

TAKEAWAY:

• Among the children who achieved remission, CD63 expression was significantly suppressed at 1 year across all peanut concentrations. Those with treatment failure showed no such change.
• Children who achieved remission also had significantly lower basophil activation at baseline than children with treatment failure.
• Compared with placebo, SLIT reduced basophil activation with the lower peanut concentrations (100, 10, and 1 ng/mL) at 1 year, and this difference persisted through 36 months.

IN PRACTICE:

“These data indicate that lower basophil activation at baseline and suppression of basophils within the first 12 months may be key to success on peanut SLIT,” the study authors wrote. “Future studies should focus on defining how quickly basophil suppression occurs in subjects that go on to achieve remission.”

SOURCE:

Jessica R. Humphrey, MS, with the University of North Carolina School of Medicine, Chapel Hill, North Carolina, was the corresponding author of the study, which was published online on April 15 in the Journal of Allergy and Clinical Immunology.

LIMITATIONS:

Additional studies with more patients are needed to replicate the findings, the authors noted.

DISCLOSURES:

The research was supported by grants from the National Institutes of Health and Food Allergy Research and Education. One author received research funding from the Department of Defense. Another author disclosed consulting for 10 pharmaceutical companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.