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Oral and Sublingual
Immunotherapy
OIT and SLIT are treatments for anaphylactic food allergies.
What is Oral Immunotherapy (OIT)?
OIT is a treatment for anaphylactic food allergies.
For over a decade, allergists across the US have been using OIT to treat patients who have IgE-mediated food allergies.
OIT teaches the immune system to tolerate a food. This is accomplished by the patient eating microgram to milligram amounts of the allergen under specific safety parameters.
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Here at the Institute, we use real foods - such as peanut butter and bagels - to teach our patients' immune systems to grow tolerance to their allergens.
What is Sublingual Immunotherapy (SLIT)?
Like OIT, SLIT is a treatment for anaphylactic food allergies.
SLIT teaches the immune system to tolerate a food. This is accomplished by the patient placing microgram to milligram amounts of an allergen-containing solution under their tongue and holding the solution in place for a few minutes.
Like OIT, SLIT follows specific safety parameters and is performed under the strict supervision of Dr. Hoyt.
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SLIT solutions are formulated based on the patient's specifdic food allergy
Who may be a candidate for OIT and/or SLIT?
OIT and SLIT may - or may not - be a great treatment option for your child or yourself.
OIT and SLIT are used to treat IgE-mediated food allergies in children and adults.
An IgE-mediated food allergy is a food allergy that involves allergic antibodies called IgE. When these antibodies sense their allergen (such as what happens with a child with peanut allergy eats a peanut), the antibodies trigger the immune system to react. That reaction is called anaphylaxis and may involve hives, swelling, trouble breathing, vomiting, and potentially death, especially if not treated promptly with an epinephrine auto-injector (such as EpiPen or AuviQ).
Patients of any age, including infants, may qualify for OIT. They must:
Have IgE-mediated food allergy (one or more)
Be willing to participate within safety guidelines
Attend multiple in-office appointments (unless participating in a Comfort Concierge plan)
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Patients may qualify for SLIT when they are mature enough to hold the solution under their tongues. As with OIT, they must:
Have IgE-mediated food allergy (one or more)
Be willing to participate within safety guidelines
Attend multiple in-office appointments (unless participating in a Comfort Concierge plan)
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Neither OIT nor SLIT is the right management plan for every patient with IgE-mediated food allergy. Patients and their families must be in the right season of life to commit to OIT or to SLIT.
What risks are associated with OIT and SLIT?
Both OIT and SLIT do carry risks.
Because OIT involves daily ingestion of small amounts of the allergen, there is a risk of anaphylaxis. Many children participate in OIT with few or mild symptoms, and this likely is because we at the Institute proceed with conservative protocols and counsel our families at length about safety parameters. Dosing outside of safety parameters, such as when a child has a fever, can lower the threshold to have an allergic reaction.
OIT also carries the risk of eosinophilic esophagitis (EOE). EOE is a non-anaphylactic food allergy that causes inflammation of the esophagus.
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SLIT also carries many of the same risks of OIT; however, these risks are significantly less likely to occur.
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The risks of OIT and SLIT are discussed at length with our families prior to embarking on the treatment, and we continue to revisit the safety parameters throughout therapy.
Is either OIT or SLIT right for my child?
The answer to this question is personalized to every patient.
At the Institute, we do not recommend nor do we start all patients with IgE-mediated food allergy on OIT or SLIT. That is because these are not necessarily the best treatment plans for all patients - strictly avoiding the allergen is still the best management plan for some children and adults with food allergies. At the Institute, these patients participate in our Avoidance Program.
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When OIT versus SLIT?
OIT and SLIT both induce tolerance to a food; however, OIT typically has the power to induce a higher level of tolerance than does SLIT.
SLIT is a great approach for a patient, such as a teenager, who would like to be protected from having a severe allergic reaction if they accidentally take a bite of an allergen-containing food. SLIT has a lesser side effect profile and, thus, is easier regarding scheduling.
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OIT is a great approach when a family would like the child to be able to eat more than a bite of the allergen, and many young children who participate in OIT are able to incorporate the allergen into their diets.
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We personalize our recommendations based on evidence and based on your family's unique season of life.
Each of our patients receives personalized recommendations, and each family's goals are critical to clarifying so that the best treatment plan can be developed. Through shared decision-making, we work with our patients and their families to determine the best management plan for the current season of their lives.
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If you would like your child or yourself evaluated for OIT or SLIT, please contact our office to schedule a Comprehensive Food Allergy Consultation.
Hear Dr. Hoyt discuss OIT and SLIT.
Check out this episode of the Food Allergy and Your Kiddo podcast!
Click play below to listen here, or tune in wherever you listen to your favorite podcasts!