Immunotherapy for Peanut Allergy
調査の概要
詳細な説明
Peanut allergy is one of the most serious of the immediate hypersensitivity reactions to foods in terms of persistence and severity of the reaction and appears to be a growing problem. Allergen-specific immunotherapy (IT) is currently being examined as a treatment option because of the persistence of this hypersensitivity reaction and the lack of effective treatment. An understanding of the molecular mechanisms of peanut-specific IT is vital to ensure the eventual, successful treatment of peanut-allergic patients.
The goal of this proposal is to develop peanut immunotherapy (IT) for patients with peanut allergic reactions. This innovative application is designed to utilize the extensive knowledge of the allergens involved in peanut hypersensitivity to devise an immunotherapeutic approach that would lower the risk of anaphylactic reactions and would down regulate peanut-specific T cells in peanut-allergic patients. Previous attempts to utilize peanut-specific immunotherapy have been unsuccessful primarily because of the severe side effects of therapy.
The specific aim of the study is to desensitize/tolerize peanut-allergic subjects with peanut allergen-specific, sublingual immunotherapy (SLIT) and begin to determine the molecular mechanism of the peanut-specific T-cell response during SLIT.
The hypothesis is that peanut SLIT will desensitize patients with peanut allergic reactions by the induction of peanut specific regulatory T cells resulting in immune modulation of the peanut allergic reaction.
研究の種類
入学 (実際)
段階
- 適用できない
連絡先と場所
研究場所
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North Carolina
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Chapel Hill、North Carolina、アメリカ、27599
- University of North Carolina
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- Subjects between 6 and 35 years of age
- Diagnosed with peanut allergy by positive prick skin test, CAP FEIA of 15 Ku/L or greater
- History of significant clinical symptoms within one hour after ingestion of peanuts
- Family's compliance with all study visits
Exclusion Criteria:
- Subjects with medical history preventing a BDPCFC to peanut
- Subjects unable to cooperate with challenge procedure
- Subjects unable to be reached by telephone for follow-up
- Subjects with a history of severe anaphylaxis to peanut
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:なし
- 介入モデル:単一グループの割り当て
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
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実験的:Peanut protein solution
Subjects receiving the peanut sublingual peanut protein drops.
Sublingual Immunotherapy.
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Drops of peanut protein placed and held under the tongue for a specific time before swallowed.
他の名前:
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
時間枠 |
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A negative double-blind placebo controlled food challenge at the completion the two years of the study.
時間枠:When IgE level drops to less than or equal to 2 ku/L
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When IgE level drops to less than or equal to 2 ku/L
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二次結果の測定
結果測定 |
時間枠 |
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A change in the cytokine level between the baseline and each selected time point during the two years of the study.
時間枠:Drop in cytokine level
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Drop in cytokine level
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協力者と研究者
出版物と役立つリンク
一般刊行物
- Leung DY, Sampson HA, Yunginger JW, Burks AW Jr, Schneider LC, Wortel CH, Davis FM, Hyun JD, Shanahan WR Jr; Avon Longitudinal Study of Parents and Children Study Team. Effect of anti-IgE therapy in patients with peanut allergy. N Engl J Med. 2003 Mar 13;348(11):986-93. doi: 10.1056/NEJMoa022613. Epub 2003 Mar 10.
- Bock SA, Munoz-Furlong A, Sampson HA. Fatalities due to anaphylactic reactions to foods. J Allergy Clin Immunol. 2001 Jan;107(1):191-3. doi: 10.1067/mai.2001.112031.
- Sicherer SH, Munoz-Furlong A, Burks AW, Sampson HA. Prevalence of peanut and tree nut allergy in the US determined by a random digit dial telephone survey. J Allergy Clin Immunol. 1999 Apr;103(4):559-62. doi: 10.1016/s0091-6749(99)70224-1.
- Sicherer SH, Munoz-Furlong A, Sampson HA. Prevalence of peanut and tree nut allergy in the United States determined by means of a random digit dial telephone survey: a 5-year follow-up study. J Allergy Clin Immunol. 2003 Dec;112(6):1203-7. doi: 10.1016/s0091-6749(03)02026-8.
- Oppenheimer JJ, Nelson HS, Bock SA, Christensen F, Leung DY. Treatment of peanut allergy with rush immunotherapy. J Allergy Clin Immunol. 1992 Aug;90(2):256-62. doi: 10.1016/0091-6749(92)90080-l.
- Wilson DR, Torres LI, Durham SR. Sublingual immunotherapy for allergic rhinitis. Cochrane Database Syst Rev. 2003;(2):CD002893. doi: 10.1002/14651858.CD002893.
- Sloan AE, Powers ME. A perspective on popular perceptions of adverse reactions to foods. J Allergy Clin Immunol. 1986 Jul;78(1 Pt 2):127-33. doi: 10.1016/0091-6749(86)90002-3. No abstract available.
- Jansen JJ, Kardinaal AF, Huijbers G, Vlieg-Boerstra BJ, Martens BP, Ockhuizen T. Prevalence of food allergy and intolerance in the adult Dutch population. J Allergy Clin Immunol. 1994 Feb;93(2):446-56. doi: 10.1016/0091-6749(94)90353-0.
- Sampson HA. Food allergy. J Allergy Clin Immunol. 1989 Dec;84(6 Pt 2):1062-7. doi: 10.1016/0091-6749(89)90154-1. No abstract available.
- Bock SA, Atkins FM. Patterns of food hypersensitivity during sixteen years of double-blind, placebo-controlled food challenges. J Pediatr. 1990 Oct;117(4):561-7. doi: 10.1016/s0022-3476(05)80689-4.
- Valentine MD, Schuberth KC, Kagey-Sobotka A, Graft DF, Kwiterovich KA, Szklo M, Lichtenstein LM. The value of immunotherapy with venom in children with allergy to insect stings. N Engl J Med. 1990 Dec 6;323(23):1601-3. doi: 10.1056/NEJM199012063232305.
- Scadding GK, Brostoff J. Low dose sublingual therapy in patients with allergic rhinitis due to house dust mite. Clin Allergy. 1986 Sep;16(5):483-91. doi: 10.1111/j.1365-2222.1986.tb01983.x.
- Tonnel AB, Scherpereel A, Douay B, Mellin B, Leprince D, Goldstein N, Delecluse P, Andre C. Allergic rhinitis due to house dust mites: evaluation of the efficacy of specific sublingual immunotherapy. Allergy. 2004 May;59(5):491-7. doi: 10.1111/j.1398-9995.2004.00456.x.
- Canonica GW, Passalacqua G. Noninjection routes for immunotherapy. J Allergy Clin Immunol. 2003 Mar;111(3):437-48; quiz 449. doi: 10.1067/mai.2003.129.
- Morris DL. Treatment of respiratory disease with ultra-small doses of antigens. Ann Allergy. 1970 Oct;28(10):494-500. No abstract available.
- Holt PG, Sly PD, Smith W. Sublingual immunotherapy for allergic respiratory disease. Lancet. 1998 Feb 28;351(9103):613-4. doi: 10.1016/S0140-6736(05)78425-7. No abstract available.
- Grosclaude M, Bouillot P, Alt R, Leynadier F, Scheinmann P, Rufin P, Basset D, Fadel R, Andre C. Safety of various dosage regimens during induction of sublingual immunotherapy. A preliminary study. Int Arch Allergy Immunol. 2002 Nov;129(3):248-53. doi: 10.1159/000066779.
- Bousquet J, Michel FB. Specific immunotherapy in asthma. Allergy Proc. 1994 Nov-Dec;15(6):329-33. doi: 10.2500/108854194778816562.
- Morris DL, Kroker GF, Sabnis VK, Morris MS. Local immunotherapy in allergy. Chem Immunol Allergy. 2003;82:1-10. doi: 10.1159/000071537.
- Taams LS, Vukmanovic-Stejic M, Smith J, Dunne PJ, Fletcher JM, Plunkett FJ, Ebeling SB, Lombardi G, Rustin MH, Bijlsma JW, Lafeber FP, Salmon M, Akbar AN. Antigen-specific T cell suppression by human CD4+CD25+ regulatory T cells. Eur J Immunol. 2002 Jun;32(6):1621-30. doi: 10.1002/1521-4141(200206)32:63.0.CO;2-Q.
- Li XM, Serebrisky D, Lee SY, Huang CK, Bardina L, Schofield BH, Stanley JS, Burks AW, Bannon GA, Sampson HA. A murine model of peanut anaphylaxis: T- and B-cell responses to a major peanut allergen mimic human responses. J Allergy Clin Immunol. 2000 Jul;106(1 Pt 1):150-8. doi: 10.1067/mai.2000.107395.
- Lee SY, Huang CK, Zhang TF, Schofield BH, Burks AW, Bannon GA, Sampson HA, Li XM. Oral administration of IL-12 suppresses anaphylactic reactions in a murine model of peanut hypersensitivity. Clin Immunol. 2001 Nov;101(2):220-8. doi: 10.1006/clim.2001.5122.
- Cohen J. Statistical power analysis for the behavioral sciences. 2nd edition ed. Hillsdale, NJ: Erlbaum, 1988.
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
研究の完了 (実際)
試験登録日
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最初の投稿 (見積もり)
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投稿された最後の更新 (見積もり)
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最終確認日
詳しくは
本研究に関する用語
キーワード
その他の研究ID番号
- 1R21AT002557-02 (米国 NIH グラント/契約)
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