How Close Is Intralymphatic Immunotherapy for Food Allergies?

Food allergy treatment research is increasingly focused not only on improving efficacy but also on reducing the burden that existing therapies place on patients and families. Although oral immunotherapy and biologic therapies such as omalizumab have expanded the range of management options available in recent years, investigators continue to explore alternative approaches that could make immunotherapy more accessible, efficient, and potentially safer for broader patient populations.

One area drawing early interest is intralymphatic immunotherapy (ILIT), a delivery strategy already being studied and used in environmental allergies that involves targeted injections into lymph nodes rather than the prolonged schedules required with conventional allergy shots. While research in food allergies remains in its earliest stages, investigators are beginning to examine whether ILIT could eventually offer a shorter, more flexible treatment pathway for patients with food allergies.

In recognition of Food Allergy Awareness Month, HCPLive spoke with Christopher Brooks, MD, an allergy and immunology physician at The Ohio State University, about the emerging role of ILIT in food allergy research. Brooks discussed the current focus on safety, why the approach has gained attention among investigators seeking alternatives to traditional immunotherapy models, and what hurdles remain before ILIT could become a viable clinical option for food allergy management.

HCPLive: You're actively researching intralymphatic immunotherapy—a delivery route most clinicians probably haven't heard much about. Can you explain the concept and why it excites you? Where does it stand right now, and what would need to happen for it to become a real clinical option?

We're [at] the very start of using ILIT for food allergies. There was one group in California that started to do it for a short period of time, and they didn't continue their research in that area. We're essentially at a place [where] we are using ILIT right now for treatment of environmental allergies. Based on our knowledge, [it] potentially could be used to treat food allergies. We're very early on that.

We want to make sure that it's not going to cause an excessive number of food allergic reactions because, of course, the ultimate goal is to decrease the number of reactions that people have and help treat food allergies. We're at a place [where] we're trying to determine safety right now. Once we determine it [is] safe, then the next step is going to be making sure that it has enough effectiveness [to be] a good treatment option for patients.

HCPLive: What drew you specifically to intralymphatic immunotherapy as a research focus? It's not the dominant modality getting attention right now. What do you see in it that others might be underestimating?

What I saw when I was really stuck with just using conventional allergy shots for treatment of environmental allergies was that there wasn't much flexibility. For normal allergy shots for environmental allergies, patients have to come in initially weekly. It takes three months to 12 months of coming weekly. Then I have to do [it] monthly for a long period of time. There were a lot of patients [who] just couldn't do that, so [ILIT] was giving patients options. [It] started to become more important to me.

Currently, for environmental allergies, [I] offer normal allergy shots or subcutaneous immunotherapy, sublingual immunotherapy… and now ILIT.

With being involved in the ILIT world for environmental allergies and [being] approached from one of the leaders about… [whether we] would want to be involved in a clinical trial, potentially for the treatment of food allergies, that's how I got into that role. ILIT wasn't something that I had really [learned] back in training.

Read the first part of the Q&A focusing on personalized food allergy management here: Personalized Food Allergy Care Gains Momentum, With Christopher Brooks, MD