Using Commonly Available Food Products To Treat Food Allergy

Inclusion Criteria:

1. Age 6-23 years with IgE-mediated peanut allergy, or age 3-23 years with IgE-mediatedfood allergy to cow's milk

2. Past history consistent with IgE-mediated allergy to the relevant allergen

3. Allergic to cumulative ≤1.44 g protein (of the specific allergen) at baselineDBPCFC, prior to treatment allocation

4. Written informed consent (for young people under 16, consent from the parent/legalguardian (AND assent from the young person when the young person is age 6+ years)

Exclusion Criteria:

1. Required previous admission to an intensive care unit for management of an allergicreaction

2. Clinically significant chronic illness (other than asthma, rhinitis or eczema)

3. Moderate-severe eczema, defined as requiring more than once daily application of 1%hydrocortisone or equivalent topical calcineurin inhibitor as maintenance treatmentdespite appropriate use of emollients (eczema is not otherwise an exclusioncriteria)

4. Poorly controlled asthma within the previous 3 months (as defined by clinicianjudgement with reference to the International Consensus On (ICON) Pediatric Asthmaconsensus), or asthma requiring treatment with >5 days oral corticosteroids withinthe previous 3 months

5. Previous history of eosinophilic oesophagitis

6. Undergoing subcutaneous or sublingual immunotherapy to respiratory allergens, andnot yet established on maintenance dosing for at least 6 months

7. Undergoing allergen immunotherapy for food allergy and within the first year oftreatment

8. In CM-allergic children under consideration for desensitisation to CM:

• currently consuming CM-containing products other than extensively-heated milkin baked foods (e.g. biscuits, cakes)

• significant symptoms of non-IgE-mediated CM allergy within the previous 12months

9. Taking prebiotic or probiotic supplements and unwillingness to discontinue

10. Subjects receiving anti-IgE therapy, oral immunosuppressants, beta-blocker orAngiotensin Converting Enzyme (ACE) inhibitor

11. Tolerance to cumulative ≥1.44 g food protein at initial DBPCFC during screening

12. Objective allergic reaction to ≤4mg cow's milk protein or ½ Reese's puff inpeanut-allergic children, during screening

13. Objective reaction to the placebo at screening DBPCFC

14. Past or current medical issue, participation in another clinical trial or otherconsideration, which, in the opinion of the investigator, may pose additional risksfrom study participation, interfere with compliance or otherwise impact on thequality or interpretation of study data

15. Pregnancy

16. Direct personal or commercial relationship with a member of the local study teamdirectly involved with the conduct of the trial

17. Unwilling or unable to fulfil study requirements, including the requirement forappropriate supervision following dosing at home)