Oral immunotherapy

What is oral immunotherapy?

Immunotherapy is a treatment for allergy that increases tolerance and reduces reactions to an allergy trigger, such as peanut. Oral immunotherapy is taken by mouth, rather than by injection, and is the most promising method for food allergy based on current research.

Is it new?

Immunotherapy was first described over 100 years ago by Dr Noon for the treatment of pollen allergy (hay fever) and has traditionally been given by injection. However, food allergy immunotherapy is new and our studies showing success in peanut allergy were published in the Lancet in 2014.

What does it involve?

Oral immunotherapy involves giving gradually increasing amounts of the ‘allergen’ (allergy trigger), starting with very small amounts. As the dose slowly increases, the body’s immune system is reprogrammed, from an allergic reaction (harmful), to a tolerant reaction (good).

How is it given?

It is typically given as a daily dose of a characterised allergen, mixed into food such as a few spoonfuls of yoghurt, and eaten.

What is the treatment process?

Oral immunotherapy process

Oral immunotherapy involves two phases: up-dosing and maintenance.

During the up-dosing phase, the first dose is given in a clinic, supervised by medical specialists. If this is tolerated, then the same dose is taken every day at home for two weeks. The dose is then stepped up in the clinic through a series of stages, each followed by the same dose at home for two weeks. In this way, the dose is slowly increased. At the end of this phase, the top dose is reached.

This is followed by the maintenance phase when the same dose is taken daily, and later reduced to weekly.

How long are clinic visits?

Up-dosing in oral immunotherapy typically requires a 2.5-hour visit, with medical specialists on hand to ensure that the allergen is safely tolerated. Occasionally a visit may be longer if there are side effects that require treatment.