***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Food allergy may be life-threatening , and patients affected need to receive accurate diagnoses and treatment . Hazelnut has often been implicated as responsible for allergic reactions , and trace quantities can induce systemic reactions . OBJECTIVE The aim of this study was to evaluate the efficacy and tolerance of sublingual immunotherapy with a st and ardized hazelnut extract in patients allergic to hazelnut . METHODS This was a r and omized , double-blind , placebo-controlled study . Inclusion criteria were a history of hazelnut allergy and positive skin prick test and double-blind placebo-controlled food challenge results . Patients were then r and omly assigned into 2 treatment groups ( hazelnut immunotherapy or placebo ) . Efficacy was assessed by double-blind , placebo-controlled food challenge after 8 to 12 weeks of treatment . Blood sample s were drawn for measurement of specific IgE , IgG(4 ) , and serum cytokines before and after treatment . RESULTS Twenty-three patients were enrolled and divided into 2 treatment groups . Twenty-two patients reached the planned maximum dose at 4 days . Systemic reactions were observed in only 0.2 % of the total doses administered . Mean hazelnut quantity provoking objective symptoms increased from 2.29 g to 11.56 g ( P = .02 ; active group ) versus 3.49 g to 4.14 g ( placebo ; NS ) . Moreover , almost 50 % of patients who underwent active treatment reached the highest dose ( 20 g ) , but only 9 % in the placebo . Laboratory data showed an increase in IgG(4 ) and IL-10 levels after immunotherapy in only the active group . CONCLUSION Our data confirm significant increases in tolerance to hazelnut after sublingual immunotherapy as assessed by double-blind , placebo-controlled food challenge , and good tolerance to this treatment BACKGROUND There are presently no available therapeutic options for patients with peanut allergy . OBJECTIVE We sought to investigate the safety , efficacy , and immunologic effects of peanut sublingual immunotherapy ( SLIT ) . METHODS After a baseline oral food challenge ( OFC ) of up to 2 g of peanut powder ( approximately 50 % protein ; median successfully consumed dose [ SCD ] , 46 mg ) , 40 subjects , aged 12 to 37 years ( median , 15 years ) , were r and omized 1:1 across 5 sites to daily peanut or placebo SLIT . A 5-g OFC was performed after 44 weeks , followed by unblinding ; placebo-treated subjects then crossed over to higher dose peanut SLIT , followed by a subsequent crossover Week 44 5-g OFC . Week 44 OFCs from both groups were compared with baseline OFCs ; subjects successfully consuming 5 g or at least 10-fold more peanut powder than the baseline OFC threshold were considered responders . RESULTS After 44 weeks of SLIT , 14 ( 70 % ) of 20 subjects receiving peanut SLIT were responders compared with 3 ( 15 % ) of 20 subjects receiving placebo ( P < .001 ) . In peanut SLIT responders , median SCD increased from 3.5 to 496 mg . After 68 weeks of SLIT , median SCD significantly increased to 996 mg ( compared with Week 44 , P = .05 ) . The median SCD at the Week 44 Crossover OFC was significantly higher than baseline ( 603 vs 71 mg , P = .02 ) . Seven ( 44 % ) of 16 crossover subjects were responders ; median SCD increased from 21 to 496 mg among responders . Of 10,855 peanut doses through the Week 44 OFCs , 63.1 % were symptom free ; excluding oral-pharyngeal symptoms , 95.2 % were symptom free . CONCLUSIONS Peanut SLIT safely induced a modest level of desensitization in a majority of subjects compared with placebo . Longer duration of therapy showed statistically significant increases in the SCD BACKGROUND Cross-reactivity between the major birch pollen allergen , Bet v 1 , and the apple protein , Mal d 1 , frequently causes food allergy . OBJECTIVE To investigate the effects of successful sublingual immunotherapy ( SLIT ) with birch pollen extract on apple allergy and the immune response to Bet v 1 and Mal d 1 . METHODS Before and after 1 year of SLIT ,  Bet v 1-sensitized patients with oral allergy syndrome to apple underwent nasal challenges with birch pollen and double-blind placebo-controlled food challenges with apple .  Bet v 1-specific and Mal d 1-specific serum antibody levels and proliferation in P BMC s and allergen-specific T-cell lines ( TCLs ) were determined . Bet v 1-specific TCLs were mapped for T-cell epitopes . RESULTS In 9 patients with improved nasal provocation scores to birch pollen , apple-induced oral allergy syndrome was not significantly reduced . Bet v 1-specific IgE and IgG(4 ) levels significantly increased . Bet v 1-specific T-cell responses to all epitopes and those cross-reactive with Mal d 1 significantly decreased . However , neither Mal d 1-specific IgE and IgG(4 ) levels nor Mal d 1-induced T-cell proliferation changed significantly . In contrast , Mal d 1-specific TCLs showed increased responses to Mal d 1 after 1 year of SLIT . CONCLUSION This longitudinal study indicates that pollen SLIT does not efficiently alter the immune response to pollen-related food allergens , which may explain why pollen-associated food allergy is frequently not ameliorated by pollen immunotherapy even if respiratory symptoms significantly improve . CLINICAL IMPLICATION S SLIT with birch pollen may have no clinical effect on associated apple allergy INTRODUCTION Treatment of food allergy essentially consists of food avoidance , but immunotherapy with food is emerging as a new therapeutic option . OBJECTIVE To evaluate clinical improvement and immunological changes in patients with peach allergy following sublingual immunotherapy ( SLIT ) with a Prup3 quantified peach extract .  METHODS A r and omized , double-blind , placebo-controlled clinical trial with peach SLIT was conducted . We assessed clinical efficacy after 6 months of treatment by means of double-blind , placebo-controlled oral challenges with peach and also evaluated immunological changes ( basophil activation test [ BAT ] and determination of sulphidoleukotriene production ) following stimulation with peach peel and pulp , rPrup3 , rMald 1 , and rMal d 4 stimulation . We also measured specific IgE and IgG4 to Pru p3 . RESULTS After 6 months of SLIT ( T6 ) , the active group showed a 3-fold improvement in tolerance to Prup3 and a significant increase in IgE to rPrup3 and in sLT production following stimulation with peach peel and rPrup3 . There was also a significant increase in BAT results after stimulation with rPrup3 at 1 month of SLIT ( T1 ) . Statistically significant between-group differences were only observed for BAT with peach peel and pulp at T1 and T6 and for BAT with rPru p3 at T6 . No changes were observed in BAT with rMal d 1 or rMal d 4 or in IgG4 levels to nPrup3 . CONCLUSIONS SLIT with a Pru p 3 quantified peach extract is clinical ly effective and leads to an increase in basophil activation and sulphidoleukotriene production following stimulation with rPru p3 and peach peel in the first months of treatment BACKGROUND Open-label oral immunotherapy ( OIT ) protocol s have been used to treat small numbers of patients with peanut allergy .  Peanut OIT has not been evaluated in double-blind , placebo-controlled trials . OBJECTIVE To investigate the safety and effectiveness of OIT for peanut allergy in a double-blind , placebo-controlled study . METHODS In this multicenter study , children ages 1 to 16 years with peanut allergy received  OIT with peanut flour or placebo . Initial escalation , build-up , and maintenance phases were followed by an oral food challenge ( OFC ) at approximately 1 year . Titrated skin prick tests ( SPTs ) and laboratory studies were performed at regular intervals . RESULTS Twenty-eight subjects were enrolled in the study . Three peanut OIT subjects withdrew early in the study because of allergic side effects . During the double-blind , placebo-controlled food challenge , all remaining peanut OIT subjects ( n = 16 ) ingested the maximum cumulative dose of 5000 mg ( approximately 20 peanuts ) , whereas placebo subjects ( n = 9 ) ingested a median cumulative dose of 280 mg ( range , 0 - 1900 mg ; P < .001 ) . In contrast with the placebo group , the peanut OIT group showed reductions in SPT size ( P < .001 ) , IL-5 ( P = .01 ) , and IL-13 ( P = .02 ) and increases in peanut-specific IgG(4 ) ( P < .001 ) . Peanut OIT subjects had initial increases in peanut-specific IgE ( P < .01 ) but did not show significant change from baseline by the time of OFC . The ratio of forkhead box protein 3 (FoxP3)(hi ) : FoxP3(intermediate ) CD4 + CD25 + T cells increased at the time of OFC ( P = .04 ) in peanut OIT subjects . CONCLUSION These results conclusively demonstrate that peanut OIT induces desensitization and concurrent immune modulation . The current study continues and is evaluating the hypothesis that peanut OIT causes long-term immune tolerance BACKGROUND There are no treatments currently available for peanut allergy . Sublingual immunotherapy ( SLIT ) is a novel approach to the treatment of peanut allergy . OBJECTIVE We sought to investigate the safety , clinical effectiveness , and immunologic changes with SLIT in children with peanut allergy . METHODS In this double-blind , placebo-controlled study subjects underwent 6 months of dose escalation and 6 months of maintenance dosing followed by a double-blind , placebo-controlled food challenge . RESULTS Eighteen children aged 1 to 11 years completed 12 months of dosing and the food challenge . Dosing side effects were primarily oropharyngeal and uncommonly required treatment . During the double-blind , placebo-controlled food challenge , the treatment group safely ingested 20 times more peanut protein than the placebo group ( median , 1,710 vs 85 mg ; P = .011 ) . Mechanistic studies demonstrated a decrease in skin prick test wheal size ( P = .020 ) and decreased basophil responsiveness after stimulation with 10(-2 ) μg/mL ( P = .009 ) and 10(-3 ) μg/mL ( P = .009 ) of peanut . Peanut-specific IgE levels increased over the initial 4 months ( P = .002 ) and then steadily decreased over the remaining 8 months ( P = .003 ) , whereas peanut-specific IgG4 levels increased during the 12 months ( P = .014 ) . Lastly , IL-5 levels decreased after 12 months ( P = .015 ) . No statistically significant changes were found in IL-13 levels , the percentage of regulatory T cells , or IL-10 and IFN-γ production . CONCLUSION Peanut SLIT is able to safely induce clinical desensitization in children with peanut allergy , with evidence of immunologic changes suggesting a significant change in the allergic response . Further study is required to determine whether continued peanut SLIT is able to induce long-term immune tolerance Most patients with birch pollen allergy report oral allergy symptoms after eating fresh apples and other vegetable foods . Major birch pollen and apple allergens , Bet v 1 and Mal d 1 , are highly homologous ; as a consequence , pollen‐specific immunotherapy ( SIT ) might be expected to improve apple hypersensitivity Background : Peanut allergy is common , potentially severe and rarely resolves causing impaired quality of life . No disease‐modifying treatment exists and there is therefore a need to develop a therapeutic intervention Between 1973 and 1985 , 114 children , aged 2 to 14 years , underwent double-blind , placebo-controlled , food challenge ( DBPCFC ) to peanut .  Thirty-two of 46 children with symptoms produced by DBPCFC to peanut  were included in this longitudinal evaluation . Contact was made with the 32 subjects 2 to 14 years after their positive DBPCFC to peanut .  All 32 subjects had exhibited a positive puncture skin test to peanut at the time of the original evaluation . Sixteen subjects had experienced symptoms caused by accidental peanut ingestion in the year before contact . Eight subjects had reacted to accidental ingestion in more than 1 year but less than 5 years before contact . Eight subjects had completely avoided peanut since the original evaluation and positive DBPCFC . No subjects could be demonstrated to have " outgrown " their peanut reactivity . All subjects tested continued to have skin reactivity to a puncture skin test with peanut extract . It appears uncommon for peanut-sensitive patients to lose their clinical reactivity , even after many years have elapsed . In addition , data were collected concerning reactions to other legumes and other ( nonlegume ) nuts . Only two patients with DBPCFC to peanut reacted on DBPCFC to soy or pea 
    Output:
    
AUTHORS ' CONCLUSIONS There is insufficient evidence for using OIT or SLIT to treat allergy to fruit , specifically related to peach and apple .
Mild or moderate adverse reactions were reported more frequently in people receiving OIT or SLIT .
However , these reactions could be treated successfully with medications