New studies shine light on oral immunotherapy and oral food challenges in allergic children

Two new studies being presented at the American College of Allergy, Asthma and Immunology (ACAAI) Annual Scientific Meeting in Orlando shine a spotlight on oral immunotherapy and oral food challenges (OFCs) in children, showing that both procedures are safe for young patients and can be life-changing for families navigating food allergies.

In one study, researchers explored how oral immunotherapy (OIT) – which relies on supervised oral food challenges to gradually desensitize children to the foods to which they are allergic – affects quality of life. Seventy-four children ages 0–12 underwent OIT between 2020–2022, targeting allergens such as peanut, tree nuts, sesame, egg, and milk. Parents completed standardized quality-of-life questionnaires before and after treatment.

The researchers found that 64% of children were able to freely eat the allergen after OIT, while the remainder maintained protective doses to guard against accidental exposure. Parents reported dramatic enhancements in day-to-day life, with scores on the Food Allergy Quality of Life Questionnaire improved significantly after OIT. Nearly 90% of families noted better confidence and reduced anxiety around meals, social situations, and cross-contamination risks.

"In our study, Quality of Life scores got better in 88% of patients, indicating oral immunotherapy can transform daily life for young patients and their families," said Lamya Jaigirdar, DO, lead author of the study. "The burden of food allergy goes beyond physical health-it affects mental well-being and can involve social engagement. Seeing such clear improvements is encouraging for the whole family."

A second abstract, a medically challenging case, describes two high-risk infants with confirmed peanut allergy who achieved complete tolerance through a structured, medication-free oral immunotherapy protocol that began with raw peanut introduction prior to roasted peanut exposure.

Two infants, one 6 months-old and one 10 months-old, were started on a therapy of doses of raw peanuts, and then, once tolerance was achieved, were given roasted peanuts. Both were later able to consume peanuts daily without symptoms, and at 3-year follow-up, both patients tolerate all forms of peanut without restriction or reaction.

To our knowledge, this is the first reported success of peanut allergy reversal in infancy. We know that early introduction of peanut reduces allergy risk, but there are no protocols for treating confirmed peanut allergy in infancy. The raw-then-roasted peanut protocol offers a promising new approach and should be considered in early immunotherapy strategies for high-risk allergic infants."

Rachel Kado, MD, allergist, co-author of the study and ACAAI member

Taken together, the two studies underscore the pivotal role of OFCs in food allergy care – both as a diagnostic tool and as a cornerstone of therapies like OIT. For families, they can provide clarity, peace of mind, and in many cases, newfound freedom in daily life.

Abstract Title: Quality of Life of Pediatric Patients After Completing Oral Immunotherapy

Presenter: Lamya Jaigirdar, DO

Abstract Title: First Documented Peanut Allergy Immunotherapy Success in Infants Using Raw-Then-Roasted Exposure

Presenter: Morgan Schmidt, BA