If approved, a new treatment for peanut allergy will allow children to eat small amounts of peanuts without severe allergic…
If approved, a new treatment for peanut allergy will allow children to eat small amounts of peanuts without severe allergic reaction.
Share on Pinterest For some children, a trace amount of peanut can also be dangerous. Getty Images
For children with a peanut allergy, every bite shakes outside the home anxiety.
Exposure to trace amounts of peanuts in cakes, cookies or other foods from cross contamination can end with a serious allergic reaction and even hospitalization.
The results of a new study may lead to the approval of a new treatment that reduces the risk of these types of potentially fatal responses, which provides relief not only for children but also for their parents.
Treatment is not a cure for peanut allergy. It is also not designed so that the children can eat whole peanut butter and jelly sandwiches. Instead, the goal is to allow them to tolerate small amounts of peanuts.
“Being able to eat one or two peanuts for sure is a big improvement in the quality of life of the children – like when they go to a friend’s house overnight or to a potty, and they avoid peanuts, but can still inadvertently take a small amount of , says Stephen Tilles, one of the co-authors of the study and former president of the American College of Allergy, Asthma and Immunology.
For many children with peanut allergy this is enough protection.
“Some children never want to eat food with peanuts. They just want to be protected if they are exposed to it, says Dr. Tina Sindher, a clinical assistant at Sean N. Parker Center for Allergy & Asthma Research at Stanford University, who was not involved in the study. 19659005] The results of the research were presented on Sunday at the American College of Allergy, Asthma and Immunology in Seattle and published on the Monday in the New England Journal of Medicine.
In the study, 372 children with a known peanut allergy consumed an increasing amount of peanut protein every day in the sixth month, starting in minute amounts. This was followed by six months at a “maintenance dose” equivalent to a peanut daily.
This type of treatment is called oral immunotherapy and is designed to build up the immune system’s tolerance to an allergen.
After one year, over two thirds of these 4- to 17-year-olds could consume 600 milligrams of peanut protein – corresponding to two peanuts – during a food challenge “with only mild symptoms”.
In contrast, only 4 percent of 124 children who had taken a non-peanut powder throughout the study – placebo group – could tolerate the same amount of peanut protein.
Half of the children in the treatment group were also able to safely consume 1000 milligrams of peanut protein during the food challenge.
However, this treatment can not work for everyone.
Almost all children experienced some side effects during the study. The most common in children taking the peanut protein was gastrointestinal pain, vomiting, nausea, itchy skin, cough and irritation in the throat.
About one third of the children in the treatment group had only weak symptoms compared with 50% in the placebo group.
Severe side effects occurred in 4.3% of the children in the treatment group and less than 1% of the children in the placebo group.
In addition, 14 percent of the children in the study treatment group received injections of epinephrine for a severe allergic reaction compared with 6.5 percent of the children in the placebo group.
Some side effects were bad enough for some children to be released before the end of the study – almost 12 percent of the children in the treatment group. Sindher is not surprised at this high rate of precipitation.
“We are always seeing it at the clinic,” she said. “Some children do not tolerate oral immunotherapy. For example, some have an anaphylactic reaction to a dose they have taken for two or three consecutive weeks. There is a lot of variation in the real world.”
Unfortunately, it is not possible to predict which children will have bad reactions. “It’s hard to know who will be on treatment 1 or 2 years later.” Tilles. “But this trial suggested, at least after a year of therapy, that there are a large proportion of patients still in good shape.”
While the study made headlines among the allergy community, there were some approaches. The protein powder used in the study, known as AR101, was developed by Aimmune Therapeutics, who designed and sponsored the clinical trial. The New York Times reported that 5 of the 13 primary authors are employed by Aimmune Therapeutics. The others are paid to serve on the company’s scientific advisory committee.
The processing still needs approval from U.S. Food and Drug Administration before it will be available at the clinic. But there is probably a great demand for it.
According to the Food Allergy Research & Education website, the proportion of allergy in peanut or tree nuts among American children was more than tripled between 1997 and 2008.
About 40 percent of children with food allergies have experienced a severe allergic reaction like anaphylaxis.
This is not the only potential treatment for hazardous and fatal food allergies being investigated.
Several treatments for peanuts and other food allergies are currently being developed. Sindher said that many of these are designed to help children tolerate oral immunotherapy.
DBV Technologies has submitted an application to the FDA for an immunotherapy patch that produces very small amounts of peanut to the skin – microgram, not milligram.
Sanofi works with an immunotherapy delivered under the tongue. In addition to the peanut protein, this includes a compound that can increase the immune system’s tolerance to the peanut allergy.
Another treatment tested uses the omalizumab allergic drug Xolair beside immunotherapy. This drug blocks an antibody that is involved in peanut allergic reaction.
Stanford researchers also test a DNA vaccine that can reduce the body‘s inflammatory response to peanuts. The vaccine also does not contain the actual peanut proteins, so the risk of anaphylactic reaction during treatment is lower.
Sindher does not believe it.
“If anything, we see the presence of peanut allergies going up every year,” she said. “But we will come up with more treatments. We also try to learn more about food allergies to help prevent prevention strategies.”
A study from 2015 showed that the introduction of some infant babies at the beginning could reduce the risk of developing a peanut allergy.
These treatments can offer children more options than just “avoid, avoid, avoid” and transport two EpiPens wherever they go.
“If the treatments work, the children will be protected when they eat a peanut equivalent,” says Sindher. “This is what we call” bite-proof. “If a child accidentally gets a piece of a cake with peanuts in it, they will not have to be rushed to the hospital.”
There is a research line, but it can dramatically reduce the need for such treatments – genetic engineer a hypoallergenic peanut, something scientists are currently working on.