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so lets talk through the process of what peanut desensitization therapy might look at if you are beginning with sublingual immunotherapy and then transitioning into oral immunotherapy sublingual immunotherapy as I mentioned earlier uses very low doses of allergen that are delivered to the mucosal space under the surface of the tongue your first dose of sublingual immunotherapy for peanut is only a fraction of a microgram of peanut protein the equivalent of approximately one one-millionth of a peanut will do that dose in the office youll hold the drop in place under your tongue for two minutes giving the antigen presenting cells in the mucosal area a chance to travel to the drop capture the allergen and then take it back to your local lymph nodes and start to stimulate the immune response once the two minutes are up youll swallow take a sip of water rinse your mouth out and drink some more once weve examined you in the office and observed you for 30 minutes we will have confirmed t