HealthWatch: Oral Immunotherapy Treats Food Allergies

News

 They are some of the most common foods in our American diet: peanuts, tree nuts, milk and eggs. But for a growing number of us, eating any of those can be life threatening. While the FDA is expected to approve a food allergy drug early next year, scientists are also looking at one surprising way to help the body adjust. 
Almost from the time she was born, little Juliette Lajcaj suffered from eczema.
“Raw, red, rashy. Those are three words I would use to describe it,” said Kristina Lajcaj, Juliette’s mom.
The skin rashes were a sign of possible allergies. In Juliette’s case doctors determined she was allergic to peanuts. For mom Kristina, whose older son is also allergic to nuts, it’s frightening.
Kristina said, “If he grabs a nut, or she grabs a nut, or if she grabs something her throat is going to close up and potentially cause her to die.” 
Anna Nowak, MD, a Pediatric Allergist is the director of clinical research at the Jaffe Food Allergy Institute. Dr. Nowak is testing a process called oral immunotherapy or OIT. For Juliette, OIT involves eating peanut butter, the very food that she is supposed to avoid.
“It starts with a tiny amount that she takes under supervision, during the visit.  Then she takes the same amount at home,” said Dr. Nowak.
Dr. Nowak says the patients testing OIT are carefully monitored. It’s a slow process over months, and while it’s still investigational, Dr. Nowak says it does increase tolerance. 
“We know this can be accomplished for most children. The big unknown is can we cure her of peanut allergy?” said Dr. Nowak.
For Kristina, anything that lessens the severity of her daughter’s allergic reaction down the road is worth trying now.  
Kristina shared, “Food is supposed to nourish your kids, not cause any type of issue like this.” 
Doctors stress that oral immunotherapy should not be started at home without a doctor’s supervision.  Kristina Lajcaj says Juliette did have an upset stomach after the initial treatments but has not shown any other side effects from the therapy. She does continue to carry medication with her, in case her daughter has a sudden reaction.
Contributors to this news report include: Cyndy McGrath, Field and Supervising Producer; Kirk Manson, Videographer; Hayley Hudson, Assistant Producer; Roque Correa, Editor.

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MEDICAL BREAKTHROUGHS
RESEARCH SUMMARY

TOPIC:     ORAL IMMUNOTHERAPY TREATS FOOD ALLERGIES
REPORT:    MB #4526

BACKGROUND: An allergy to tree nuts is one of the most common food allergies. Along with peanuts and shellfish, it is also one of the food allergens most frequently linked to anaphylaxis, a potentially life-threatening reaction that impairs breathing and can send the body into shock. Symptoms of a tree nut allergy include: abdominal pain, cramps, nausea and vomiting, diarrhea, difficulty swallowing, itching of the mouth, throat, eyes, skin or any other area, nasal congestion or a runny nose, nausea and shortness of breath. Skin-prick tests and/or blood tests may be used to determine the presence of allergen-specific immunoglobulin E, an antibody that binds to allergens and triggers the release of chemicals that cause symptoms.
(Source: https://acaai.org/allergies/types/food-allergies/types-food-allergy/tree-nut-allergy) 

TREATMENT: There is no special medicine for nut or peanut allergies and many people don’t outgrow them. The best treatment is to avoid the nut. That means not eating that nut, and also avoiding the nut when it’s mixed in foods. Staying safe means reading food labels and paying attention to what they say about how the food was produced. Some foods don’t contain nuts, but are made in factories that make other items that do contain nuts. The problem is the equipment can be used for both foods, causing “cross-contamination.” To immediately treat anaphylaxis, doctors recommend that people with a nut or peanut allergy keep a shot of epinephrine with them.
(Source: https://kidshealth.org/en/kids/nut-allergy.html) 
 
OIT: In Oral immunotherapy (OIT), food is consumed either in natural or processed form in gradually increasing doses, with the goal of establishing permanent tolerance to ingestion. Protocols vary considerably but typically include an initial rapid dose escalation day, followed by a buildup phase, and then a maintenance phase. OIT is a promising investigational therapy for food allergy. Clinical trials in peanut, milk, egg, and wheat allergy provide evidence that OIT can effectively desensitize a majority of individuals to a food allergen. The first prospective open-label uncontrolled study reported successful desensitization in 93 percent of 29 participants treated with peanut OIT and a reassuring safety profile, and provided evidence of immunomodulation. As approximately 30 percent of food-allergic children are reactive to more than one food, many would benefit from immunotherapy, which addresses more than one food allergy at a time.
(Source: https://www.karger.com/article/FullText/445391) 

FOR MORE INFORMATION ON THIS REPORT, PLEASE CONTACT:

Tildy LaFarge, PR Mt. Sinai
347-213-9110
Tildy.Lafarge@mountsinai.org

If this story or any other Ivanhoe story has impacted your life or prompted you or someone you know~to seek or change treatments, please let us know by contacting Marjorie Bekaert Thomas at mthomas@ivanhoe.com

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