Significant immunological changes that support peanut allergy remission in children found

Australian researchers have discovered important immunological changes that support remission of children’s peanut allergies, paving the way for new, more targeted treatments.

This study showed for the first time that certain genetic networks were rewired to facilitate the transition from peanut allergy to clinical remission after combined treatment with probiotics and oral peanut immunotherapy.

Led by Murdoch Children’s Research Institute (MCRI) and Telethon Kids Institute allergyThe study found that reprogramming this network essentially shuts down the allergic immune response that caused food allergies.

Principal Investigator Professor Mimi Tan of Murdoch Children said this was the first study to map complex genes to the genetic communication and connectivity underlying clinical remission of peanut allergies.

“Little was known about the immunological changes that led to remission of peanut allergies,” she said. Her previous work focused primarily on examining the level of gene expression, without investigating how genes interact with each other. However, genes do not work alone. Instead, biological responses are regulated by a large number of genes that communicate with each other, so it makes sense to investigate these interactions in more detail.

What we found was a major difference in network connection patterns between children with allergies and children in remission. These same changes were also seen when comparing the genetic networks before and after immunotherapy in children who achieved remission after immunotherapy. “

Mimi Tang, Principal Researcher, Murdoch Children’s Professor

Sixty-two children with peanut allergies in Melbourne participated in a randomized controlled trial and received probiotics and oral immunotherapy (gradual introduction of allergen foods) or a combination of placebo. After 18 months of treatment, 74% of patients who received the combination treatment achieved remission, compared with 4% in the placebo group.

Used in combination with probiotics in the trial, Oral Peanut Immunotherapy is an Australian biotechnology company focused on marketing new allergic immunotherapy treatments for children with life-threatening peanut allergies. It was PRT120, the main candidate for Prota Therapeutics.

A team led by Professor Tang also recently conducted another study in which two treatments, a combination of probiotics and oral peanut immunotherapy and oral peanut immunotherapy alone, are highly effective in inducing remission and desensitization. I showed that. About half of the treated children achieved remission and were able to discontinue treatment and eat peanuts safely and freely.

Dr Sarah Ashley of Murdoch Children said oral immunotherapy was able to successfully induce desensitization and remission, but desensitization often diminished after treatment was completed or even during continuous maintenance dosing. ..

“Specific changes in allergen-specific immune cells, called Th2 cells, are important for achieving sustained remission,” she said. Th2 cells are essential for the production of allergen-specific antibodies and the development of food allergies. Th2 signaling, which causes allergies, was found to be “off” in children in remission. “

Food allergies are a global public health concern affecting 10% of infants and 5-8% of children.

Dr Anya Jones of the Telethon Kids Institute said management relied on avoiding allergic foods and reduced quality of life because there was no cure for food allergies.

“Understanding the complex immune processes that support remission provides deeper insights into the key drivers of successful treatment and new targets for more effective treatments that provide patients with long-term solutions. Will potentially identify, “she said.

Ju Lee Ng’s daughter, Stella, 9, was diagnosed with a peanut allergy 18 months after birth after developing urticaria from a diet containing traces of nuts.

However, Ju Lee said Stella had been in clinical remission for almost four years after participating in the Murdoch Pediatric Allergy Trial and is now eating peanuts on a regular basis.

“Stella’s quality of life has improved considerably since the trial,” she said. Her level of anxiety has dropped dramatically and she has the freedom to enjoy different types of food. Stella constantly checks peanut food labels and no longer has to explain her allergies to her teachers and friends’ parents. She can now dig into the peanut M & M bag and enjoy it.

“Previously, I had to avoid traveling to countries that use a lot of peanuts in food, such as Malaysia, where my husband and I were from. Immediately after Stella achieved remission, we had a family to Thailand. I was very excited to be able to travel. We tried local food and enjoyed a wonderful vacation without the stress that Stella could have an allergic reaction. “

Ju Lee said he was relieved to know that he could develop a new treatment based on the latest research from Murdoch Children’s.

“This study will give great hope to families with children with peanut allergies,” she said. I want other families to feel as secure as a child who is free to eat peanuts without fear of reaction, “she said.

Researchers at the University of Melbourne, Royal Childrens Hospital, and the University of Western Australia also contributed to this study.