Effects of oral immunotherapy on immune tolerance

Food allergy (FA) research over the past several decades has contributed landmark studies with impactful data that have improved our understanding of FA-related immunopathology, epidemiology, natural history, and clinical best practices. In 2020, Food and Drug Administration–approved peanut oral immunotherapy (OIT) became the first treatment for immunoglobulin (Ig)E–mediated FA (IgE-FA). Drawing on decades of basic and translational science in the field of mucosal immunology and tolerance,1 OIT is based on the evidence that daily oral administration of a controlled amount of food protein leads to increased eliciting thresholds and reduced severity of allergic reactions.