# Immune progression and plasticity in relation to child age

> **NIH NIH UM1** · MASSACHUSETTS GENERAL HOSPITAL · 2022 · $234,978

## Abstract

Oral immunotherapy (OIT) for peanut allergy has been the most studied interventional strategy
for children with established allergy and is now the focus of an industry-sponsored phase 3 trial
– one of the first in a field currently lacking any approved therapy. For the majority of patients
treated, they can tolerate OIT adequately and it induces a substantial shift in the dose of
allergen that elicits a reaction to a level well above most accidental ingestions, so long as they
maintain consistent therapeutic exposure. This transient state of clinical protection, or
`desensitization' as it is often referred to by allergists, is deemed an acceptable outcome by
many patients, but there are limitations. For one, when in a desensitized state, unlike someone
who is in true remission, there is some ongoing risk of treatment-associated reactions,
especially with co-factors of inter-current illness, exercise, NSAID use, and others. Secondly,
many patients find it very difficult to adhere to a chronic therapy. Therefore, even without the
goal of ad lib peanut consumption, OIT would be a more beneficial intervention if efficacy were
more durable and easier to maintain after an initial course of treatment. In fact, from several
studies of children from school age and above, about 1/3 of patients do achieve a more durable
benefit from OIT, defined by being able to avoid peanut for a month or more and remaining
clinical tolerant to a clinically significant exposure. Those patients who achieve this more robust
benefit tend to have lower peanut specific IgE levels at baseline, suggesting that there may be
important immunological differences about them, but they are otherwise hard to identify. A just
published study, however, suggests that young age at the time of OIT may also be associated
with persistent tolerance after immunotherapy. This proposal would directly test the hypothesis
that younger patients achieve OIT-induced tolerance at higher rates and would generate the
clinical data and samples necessary to explore the immune mechanisms of age-dependent
disparities.

## Key facts

- **NIH application ID:** 10416402
- **Project number:** 4UM1AI130934-06
- **Recipient organization:** MASSACHUSETTS GENERAL HOSPITAL
- **Principal Investigator:** WAYNE G SHREFFLER
- **Activity code:** UM1 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $234,978
- **Award type:** 4C
- **Project period:** 2017-03-01 → 2024-02-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10416402

## Citation

> US National Institutes of Health, RePORTER application 10416402, Immune progression and plasticity in relation to child age (4UM1AI130934-06). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10416402. Licensed CC0.

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