Kids Food Allergies Blog

In today’s New York Times — there is an article about a scientist who is recruiting clinical trial patients for an experimental treatment for curing allergies and asthma.  I’m always interested in possible cures for allergies and asthma — but this is one trial I’m not rushing to sign up for.  How does it work?

A dressing crawling with pin-size hookworm larvae is applied to the arm for several days to make sure that the squirming freeloaders infiltrate the patient’s system.   Huh?  What does that have to do with allergies?  According to the scientist behind the study, Dr. Pritchard (immunologist-biologist at the University of Nottingham), an allergic reaction is triggered when the worms infiltrate the patient’s skin.  Pritchard asserts that “the worms have found a way of switching off the immune system in order to survive.  That’s why infected people have fewer allergic symptoms.”  Initial tests of his theory have been positive.

(T)he National Health Services ethics committee let him conduct a study in 2006 with 30 participants, 15 of whom received 10 hookworms each. Tests showed that after six weeks, the T-cells of the 15 worm recipients began to produce lower levels of chemicals associated with inflammatory response, indicating that their immune systems were more suppressed than those of the 15 placebo recipients. Despite playing host to small numbers of parasites, worm recipients reported little discomfort.   Trial participants raved about their allergy symptoms disappearing …Some allergy sufferers cannot wait (for a larger-scale version of the initial trial). The moderator of the Yahoo group, Jasper Lawrence, a Silicon Valley entrepreneur, has started a clinic in Mexico, to offer the unproven therapy (a basic worm “inoculation” costs $3,900).

Even if this is the safest, most successful treatment on the planet — can you imagine telling an allergic child that you are going to put crawling worms all over their skin?  And doing it?  I have gone to great lengths to tell my child that having allergies is not her fault — nothing that she is being punished for.  This cure seems contrary to my teachings.  Seems like more of a CBS Survivor Challenge than a medical cure.   I’m not even sure that this trial applies to food allergies or to kids.  Even if it does and it goes mainstream — we’ll be running the other way.  And fast.  And with my luck, my kid’s allergic to worms too.

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.