Longitudinal antibody responses to peanut following probiotic and peanut oral immunotherapy in children with peanut allergy

Kuang-Chih Hsiao, Anne-Louise Ponsonby, Sarah Ashley, Cassandra Yuen Yan Lee, Lalita Jindal, The PPOIT Study Team, Mimi L. K. Tang

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6 Citations (Scopus)

Abstract

Introduction: Probiotic and Peanut Oral Immunotherapy (PPOIT) is effective at inducing sustained unresponsiveness (SU) at end-of-treatment and this effect persists up to 4 years post-treatment, referred to as persistent SU. We sought to evaluate (i) how PPOIT altered peanut-specific humoral immune indices, and (ii) how such longitudinal indices relate to persistent SU. Methods: Longitudinal serum/plasma levels of whole peanut- and peanut component- (Ara-h1, -h2, -h3, -h8, -h9) specific-IgE (sIgE) and specific-IgG4 (sIgG4) antibodies were measured by ImmunoCAP and salivary peanut-specific-IgA (sIgA) by ELISA in children (n = 62) enrolled in the PPOIT-001 randomized trial from baseline (T0) to 4 years post-treatment (T5). Multivariate regression analyses of log-transformed values were used for point-in-time between group comparisons. Generalized estimating equations (GEE) were used for longitudinal comparisons between groups. Results: Probiotic and Peanut Oral Immunotherapy was associated with changes in sIgE and sIgG4 over time. sIgE levels were significantly reduced post-treatment [T5, PPOIT vs. Placebo ratio of geometric mean (GM): Ara-h1 0.07, p =.008; Ara-h2 0.08, p =.007; Ara-h3 0.15, p =.021]. sIgG4 levels were significantly increased by end-of-treatment (T1, PPOIT vs. Placebo ratio of GM: Ara-h1 3.77, p =.011; Ara-h2 17.97, p <.001; Ara-h3 10.42, p <.001) but levels in PPOIT group decreased once treatment was stopped and returned to levels comparable with Placebo group by T5. Similarly, salivary peanut sIgA increased during treatment, as early as 4 months of treatment (PPOIT vs. Placebo, ratio of GM: 2.04, p =.014), then reduced post-treatment. Conclusion: Probiotic and Peanut Oral Immunotherapy was associated with broad reduction in peanut-specific humoral responses which may mediate the clinical effects of SU that persists to 4 years post-treatment.

Original languageEnglish
Pages (from-to)735-746
Number of pages12
JournalClinical and Experimental Allergy
Volume52
Issue number6
DOIs
Publication statusPublished - Jun 2022
Externally publishedYes

Keywords

  • antibody responses
  • desensitization
  • oral immunotherapy
  • peanut allergy
  • probiotic
  • remission
  • sustained unresponsiveness

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