Peanut Oral Immunotherapy
If you’re reading this post, I imagine you’ve heard about the “allergy desensitization studies” or “oral immunotherapy studies” that are taking place at several major medical facilities across the United States.
- Mount Sinai School of Medicine, New York; Principal Investigator: Hugh Sampson, M.D.
- Johns Hopkins University School of Medicine, Baltimore; Principal Investigator: Robert Wood, M.D.
- Duke University School of Medicine, Durham, NC; Principal Investigator: Wesley Burks, M.D.
- University of Arkansas Children’s Hospital Research Institute, Little Rock; Principal Investigator: Stacie Jones, M.D.
- National Jewish Medical and Research Center, Denver; Principal Investigator: Donald Leung, M.D., Ph.D.
Some studies focus on milk or eggs. Others, peanuts. From what I understand, in these trials, allergic individuals ingest increasing doses of an allergen. As they are able to safely ingest more of the allergen, the immune system is strengthened to better tolerate the allergen and protect against future allergic reactions.
Sounds like the same concept as an allergy shot. And preliminary findings of these trials seem encouraging, though the results are not yet conclusive. So why am I so reluctant to consider it? If an allergy shot goes bad — you might be uncomfortable for a couple of days. But food allergies seem like an entirely different (and more severe) animal. And the reactions can be much more rapid and severe, with more dire consequences. My daughter’s reaction to peanut is so high that her allergist no longer feels comfortable skin testing her for fear of sending her into anaphylaxis. Why on earth would I purposely ask her to swallow peanuts?
On the other hand - maybe the severity of her allergic reactions makes this type of treatment even more important and dare I say necessary. As she makes her way in the world, inadvertent exposure to her allergens seems nearly inevitable. Even if oral immunotherapy can’t “cure” her allergies — but rather lessen the severity of her reaction to them — it might be worthwhile to consider.
The results of 2 clinical trials seem illustrative.
Johns Hopkins conducted a trial of 11 young children and teens (ages 6-17) with proven milk allergies. At the beginning of the study, all 11 kids exhibited symptoms after ingesting 40 milligrams of milk protein. At the end of the trial, the researchers gave the kids an 8,140-milligram challenge: 10 out of 11 passed.
Duke conducted a trial of 20 peanut-allergic children who were initially given the equivalent of 1/3,000 of a peanut. Most were eating a peanut a day within six months with little reaction. By the end of the Duke peanut desensitization trial — 19 out of 20 (95%) participants were able to tolerate 8 grams of peanut protein, or the equivalent of more than 13 peanuts.
Maybe this idea isn’t so crazy after all. Or is it?
If anyone has direct experience with these trial studies, please share your experiences here.
April 28th, 2008 at 7:15 pm
Not involved in the studies. However, my son has been using sublingual allergy drops (similar to oral immunotherapy in that it goes in the mouth, but the proteins are squeezed into drops) for the past 3.5 years. I believe they help him a great deal. Other than the drops, he is drug free. I love that he doesn’t take zrytec–he’s a happier kid, not in a fog or hyper. I have seen his numbers come down. The dosage in his drops are based on his RAST tests, which are conducted every six months. His allergist is participating in some of the oral immunotherapy studies being conducted throughout the country. Sublingual therapy is slower than oral immunotherapy. They don’t give them as much of the protein at a time and build it up more slowly. I have always felt it was safe and in addition to my son know of many other people who use this treatment. I can’t wait until we hear more about the oral immunotherapy studies. They sound so promising.
April 29th, 2008 at 2:49 pm
You should do some research and post on “alternative” therapies. I’d be interested in your take on them.
May 7th, 2008 at 6:24 am
[…] As I’ve written before, I am optimistic about oral immunotherapy. So is Dr. Wesley Burks, food allergy expert at Duke University Medical Center, an integral researcher at one of the five research centers conducting the oral immunotherapy trials. According to Reuters, Dr. Burks says that immunotherapy may be available within the next five years. […]
July 22nd, 2008 at 4:42 pm
They are not as scary as they sound. The study is started with such a small amount of the protein that most reactions would be very mild. My son as an IGE level of over 100 and the intial introductions have been good! So there is hope for all, I believe.