Immunotherapy Studied for Peanut Allergies

In a new study, children with peanut allergies experienced improved tolerance after taking low doses of peanut allergens that were gradually increased over time.

Exposing a person to low doses of a known allergen, a technique called immunotherapy, is not a new concept. The goal of immunotherapy is to desensitize the patient so that the body builds up a tolerance to the allergen. For example, immunotherapy has been used to treat seasonal allergies and vaccine allergies.

In the study, four children with peanut allergies received low doses of peanut allergens, which increased from 5 to 800 milligrams (equal to five whole peanuts) over a six-month period. One child experienced a severe allergic reaction called anaphylaxis during the study and was treated with adrenaline.

The authors found that immunotherapy improved peanut tolerance in all participants, including the child who developed anaphylaxis. The treatment was shown to protect against at least 10 peanuts, “more than is likely to be encountered during accidental ingestion,” the authors conclude in the journal Allergy. However, in order to maintain tolerance, immunotherapy must be continued regularly.

In a related study, published in the October edition of Journal of Allergy & Clinical Immunology, children with milk allergies experienced decreased allergy symptoms after undergoing milk immunotherapy. Similar studies are being conducted in people with egg allergies.

Because food allergies can be potentially life threatening, this therapy is not recommended for general use. Until the safety of this treatment is tested in a larger population, people with allergies should avoid foods that trigger their allergies.

For more information about peanut allergies, please visit Natural Standard’s Medical Conditions database.

Comments

[MM]

This is an interesting study! This study provides hope for parents of children with severe peanut allergies. I wonder how often you need to have a peanut OIT to maintain the tolerance.

[HH]

So if this works for peanuts and is also showing value with milk allergies, what about allergies to drugs? Sometimes people need certain medications to keep them alive, but we have to pump them up with steroids before giving them. Could this be a viable alternative to that? How long does it take before you have a "tolerance to the allergy?"

[Ruby Jameson]

FOUR children? Is that really enough of a sample to arrive at any sort of conclusion of the effectiveness of immunotherapy? If I was a parent of a child with an allergy, I'd surely be suspicious of this finding. I would also be curious about the age of the children in this study. I've read that peanut allergies often become less severe as the child grows older, and so I wonder if the children in this study were of an older age or were preschoolers? Could that be a factor? I hope there was a greater sample of children studied in the related milk/immunotherapy study mentioned here.

[David]

This information is positive for those with life-threatening peanut allergies. It is a good stepping stone for treating children with allergies in order to prevent anaphylactic reactions.

[Francine]

The information here states that immunotherapy is not a new idea..patients have been getting allergy shots for years, which was developed on the same idea. It will be interesting to see if physicians employ this practice in the future, in order to prevent anaphylactic reactions in patients.

[Tyler]

I'm not sure why the study did not use a larger sample size. It would have been interesting to see if any variation in the results would have been present if immunotherapy was administered to more children. Like Ruby mentioned, I'm also curious about the ages of these children and whether that could be a factor in how effective the immunotherapy was.

[SA]

As a mother, studies like these make me extremely nervous. If my child had a peanut allergy and had a successful period of desensitization to peanuts, what's to say that the tolerance wouldn't go away within (say) a month or so...or worse, within a few days? A 2005 German report (Rolinck-Werninghouse) of the immunotherapy of three kids with peanut allergies found that all three had a "moderate reaction" to peanuts after the allergen was eventually reintroduced. How long do the treatments need to continue? I wouldn't trust a child to leave the house without an Epi-pen, regardless of how successful the treatments were.

[Kratos]

I am also thinking of the same thing that SA is concerned about. Are there any data in proving long-term success with immunotherapy? While this therapy may offer new options for people, I think it is still important for us to remain cautiou,s as anaphylaxis is life-threatening.

[CC]

Good point SA. It might be like a vaccine where you would need a booster. Honestly I don't think you could answer that question yet because there just isn't enough information. And I also think it is important keep in mind that this is just to prevent life-threatening allergic reactions and not to get rid of the reaction completely.

[Health]

I saw this reported on the news here in South Africa, so the news is obviously a big thing. But I agree with SA. I think there still needs to be a lot more developed before anything can be conclusive, and I'm hoping that fewer children are involved in the process of testing!

[alex]

This is very interesting and can prevent many future peanut allergic reactions. I believe the same immunotherapy has been used to treat lactose intolerant patients. Patients with lactose intolerance are exposed to small amounts of lactose with increased increments over time. It should be worthwhile to see if this same immunotherapy can apply to any allergic reaction.

[Shauna]

As other readers had already mentioned, four patients is barely a good sample size for any study. Besides, one of the patients had an anaphylactic reaction to the treatment, which would be 25% of the study population. Therefore, I don’t think the results of this would apply. Moreover, desensitization is a very long, meticulous and quite costly process. To apply this to the general population would not be the most timely and cost-effective method.

[Mercedes]

There is currently a clinical trial looking at peanut immunotherapy that is using escalating doses of sublingual peanut extract to develop tolerance over time. The study has 40 participants aged 12-40 years, and it is expected to be complete in September 2010. Be on the look out for some potentially interesting results!

[Brittan]

It would surely be helpful to find out how long the tolerance would last and if the tolerance would escalate after an increasing number of treatments. Definitely an interesting field of research that could be beneficial to a great number of patients.

[PK]

This study offers hope for parents of children who have severe peanut allergies. It would be interesting to know when the last allergen exposures before the start of the immunotherapy were. I want to know if a recent full-blown exposure to the peanut allergen would affect the effectiveness of the immunotherapy.

[MC]

PK brings up a good point. Does anyone know the duration of antibodies or immunoglobulin activiation/deactivation that takes place in our bodies after a reaction? A second exposure to allergen shortly after another may cause more harm or additive adverse events.

[Kayla]

First of all, I'd like to say that four children is not a sufficient sample size. And one of the four kids experienced an anaphylactic reaction. I don't think the numbers look encouraging here. Maybe if this is conducted with a larger population, the results would balance out and would be applicable.

[MG]

That's true. If one child had an anaphylactic reaction, then the study would have shown that as 25%!! I am not sure if a larger population size would balance out the results; however, it would provide a closer representation of the real life population than the four kids alone.

[Nurse Sarah]

Certainly, it would be difficult to find many willing participants for this sort of study. Besides, don't allergies like these tend to diminish with age in many cases? Is it really worth risking children's lives to study this? Why not test adults with peanut allergies? Personally, I think if more women breastfed their children, it would greatly reduce many of these food-type allergies. Not to mention the multitude of other health benefits they receive.

[Lilly S.]

I recently heard that today far more children are affected with peanut allergies than 10 or 20 years ago. There are a few possible explanations for this. Based on a survey, the Centers for Disease Control and Prevention (CDC) found that food allergy diagnoses went up 18% from 1997 to 2007 (in kids). Some argue that since an allergy is triggered by an immune response, children who are never exposed to certain environmental factors or foods may have an impaired immune system. More children being diagnosed today with allergies could be due to medical advances in the past 10 to 20 years and not an increase in actual allergy cases.

[Sarah]

I would like to add to Lilly’s comment above. I believe this is called the “Hygiene Hypothesis.” It argues that individuals who grow up in rural environments or on farms are exposed to different allergens starting at an early age. They have fewer allergies than people who grew up in very sanitized and protected environments.

[William Dublois]

This technique could be very beneficial in a number of applications. Allergies occur because the immune system simply cannot handle a particular foreign entity entering the patient’s system. If the immune system can be trained and strengthened to respond adequately in the appropriate situation, then this could greatly improve a number of lives. This is especially true in the patients with extreme hypersensitivities that lead to anaphylactic reactions. Simply being in the same room as peanuts can sometimes trigger a life-threatening response. People in this situation should not have to live their lives in constant fear, and hopefully, advances in this technique can make that a reality.