A new trial led by Dr Robert Wood, director of Allergy & Immunology at John Hopkins Children's Center suggests that SLIT (under the tongue immunotherapy) may be as effective, and safer, than the oral immunotherapy (drinking tiny amounts of milk) which an earlier trial had showed to be effective for children with milk allergy.

While both approaches work by exposing the patient to progressively higher doses of the allergenic food, SLIT is done with lower doses - and therefore with lower risk for a severe allergic reaction. Researchers caution that both therapies can lead to violent allergic reactions in some patients, and should be always done under a doctor's supervision.

In the study, all 30 children from 6 to 17 were treated with milk drops under the tongue (SLIT) for several weeks until they built up their tolerance. Once minimum tolerance was achieved, the children were divided into two groups. Ten children continued their SLIT treatment while the other 20 consumed milk powder by mouth. After three months of treatment with increasingly higher doses of milk protein, all children underwent a food challenge, which involved drinking milk under a doctor's supervision.

All children in the "by mouth" group were able to drink on average seven times more milk without an allergic reaction or with mild symptoms than  before the treatment. Nine of the 10 children treated with milk drops under the tongue, were able to do so.

Children in both groups experienced allergic symptoms during the treatment. In the "under the tongue" group, 33% of the 3,619 doses of milk administered caused symptoms, compared to 35% of the 3,773 doses in the "by mouth" group. Most symptoms were mild, with the most common ones being mouth and throat itching and irritation.

www.hopkinschildrens.org

Courtesy of Science Daily

First published March 2010

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