Kids Food Allergies Blog

Doctors and scientists are working hard to find a solution to peanut allergies. Two approaches look promising: oral immunotherapy and the development of an allergy-free peanut.

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.

On to the allergy-free peanut. The good news at least two universities are doing groundbreaking work to develop an allergy-free peanut: N.C. A&T’s School of Agriculture and Environmental Sciences, through a United States Agency for International Development (USAID) grant, and the University of Georgia through a grant from the Georgia Commissioner of Agriculture. If these university research trials are successful, how might this work and how fast would this come to market? A University of Florida newsletter reports:

The next step would then be trying to find or create other stand-ins for the usual suspects of peanut allergens. If that were accomplished, then they would all have to be put together to produce a peanut plant that would replace those used by peanut farmers today.
“Don’t look for this to be something that you’ll see in the next twenty years or so,” said Peggy Ozias-Akins, a peanut genome researcher at the University of Georgia. “There’s a lot of genetics groundwork that we still have to lay before we even know if something like this can be done.

In addition to the long-time horizon, I am a skeptic of the allergy-free peanut. Why? I am guessing that it will be costlier than regular peanuts. Therefore, I would suspect that conventional peanuts will continue to be used by large-scale manufacturers in the products my daughter’s peers eat. So, even if there is a “peanut”-butter she will be able to eat — she will still be eating it by herself at a nut-free table while other kids enjoy their conventional peanut butter and jelly.

I guess five years isn’t so long to wait for oral immunotherapy. Just in time for my second child to enter kindergarten.

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.