The Process Of Oral Immunotherapy (OIT): What It Involves

You might have wondered what oral immunotherapy (OIT) is and how it functions.

OIT desensitizes individuals to food allergens such as peanuts. Ideally, patients consume the food(s) they were once allergic to without reaction after completing their treatment. The process is not arduous or painful, but it does require a certain amount of patience and diligence.

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In the OIT process, the desired end dose of the food allergen is decided by a test, such as consuming eight peanuts without an allergic response. Then the starting dose is calculated, typically 1/100,000 of the end dose (for peanuts).

An end target of eight peanuts means the starting dose would be 0.001mg of peanut protein.

About The First Day

The protocol here may vary among treatment professionals.

The first day of OIT, sometimes called rush immunotherapy, takes up to eight hours. The day begins with a vital-signs test and a physical exam. Then, the first dose of the food allergen protein is given, diluted with distilled water and often flavored with Kool-Aid or something similar.

Every 15 minutes the patient’s vital signs are taken and another slightly elevated dose is given.

When the patient notices any allergic response (e.g., hives, stomach discomfort, itchy mouth) the first day is concluded and the patient is monitored for another hour.

The final dose that the patient consumed without having a reaction will be the dose they go home with and take twice per day.

Everyday Routine

After the first day, the daily dose needs to be taken every 12 hours (or within 9 to 15 hours). Every four to seven days, the patient returns to the treatment office to receive an elevation dose. Most protocols involve 18 to 22 elevations after the first day.

The next indicated dose is given at the treatment facility, and the patient is monitored for an hour afterward. If he or she has no or minimal reaction to the dose, they will go home and take the new dose twice daily. If the elevation dose causes a severe enough reaction, the elevation will be delayed.

Most individuals require adjustments as they go through the OIT process, including some delayed elevations; they slow but do not harm the treatment result. Delays can also be made for special events or vacations that interfere with office visits.

Treatment Conclusion

Eventually a maintenance dose is given at the treatment center for about one week, after which the patient will no longer need to avoid the food allergen. They must continue taking daily maintenance doses for typically three to five years following OIT.

If OIT interests you, consult with your doctor or an allergist and do your own research. It perhaps goes without saying, but desensitization should never be attempted without the supervision of professionals trained in OIT.

Source: OIT Center; Dallas Allergy
Photo credit: Marcin Chylinski

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