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Help for deadly peanut allergies

January 03, 2019 | UCI Health
young boy in blue shirt opening peanuts

Newly approved immunotherapy treatments hold promise of relief for children who suffer severe peanut allergies, says UCI Health allergist Tiffany Jean, MD.

“I’m very excited about these immunotherapy treatments,” says Jean, a UCI School of Medicine assistant professor of allergy and immunology who specializes in the diagnosis and treatment of asthma, food allergies and primary immunodeficiencies, particularly in children.

“An oral dose and a patch are expected to become available sometime in the coming year,” Jean says. “The oral therapy has shown the highest success, with up to 80 percent of children responding favorably.

“That means our specialty can offer our patients something beyond avoidance.”

Clinical trial success

Results from a Phase 3 clinical trial published late last year in the New England Journal of Medicine demonstrated that allergic children exposed to gradually increasing amounts of peanut protein every day for six months were able to tolerate exposure of up to one or two peanuts.

That’s a tiny amount, but it may be enough to protect against allergic reactions that can range from:

  • Mild itching
  • Hives
  • Vomiting
  • Wheezing
  • Swelling
  • Anaphylactic shock, which can lead to death

Food allergy symptoms are most common in babies and children, but they can appear at any age, according to the American College of Asthma, Allergy and Immunology.

More people are developing allergies

In fact, for reasons not well understood, food allergies are on the rise, increasing more than 50 percent in a decade, according to the most recent statistics from the U.S. Centers for Disease Control & Prevention. In a similar period, allergies to tree nuts and peanuts among children more than tripled.

Today, about 2 percent of children are allergic to peanuts, Jean says.

Because of the heightened dangers, the U.S. Food and Drug Administration requires labeling on food products for the most common allergens:

  • Milk
  • Egg
  • Peanut
  • Tree nuts
  • Wheat
  • Soy
  • Fish
  • Crustacean shellfish

It recently asked the same for sesame seed products.

Many restaurants now request information about food allergies before service, and airlines have pretty much stopped serving peanuts as snacks.

Avoiding allergens isn’t foolproof

But allergic reactions can be provoked by unseen allergens on surfaces or in foods, or by previously undiagnosed food allergies.

Simply touching a surface where a peanut butter sandwich recently sat or eating a handful of popcorn infused with a peanut product may send a child to the emergency room or require a shot of epinephrine to stave off anaphylactic shock. Epinephrine is a life-saving medication which opens up airways after a severe allergic reaction.

Once a child experiences a severe allergic reaction, further testing is warranted to identify the type and range of causes.

“I recommend that families who have children with food allergies see a pediatric allergist to help them manage it,” Jean says. “We can clarify, confirm, educate and offer any new treatments that are coming up.”

Food desensitization

“Immunotherapy is a model therapy, but it’s not perfect,” Jean says. “It only gives a temporary tolerance, so a maintenance dose will be required to ensure that the allergic reaction doesn’t return.

She recommends that parents try to expose their infants to a wide variety of foods earlier to try to prevent allergies.

“Early introduction of food to prevent food allergies is much preferable to immunotherapy, which comes after the fact,” Jean says, noting that UCI Health Allergy & Immunology Services is planning to start a food desensitization program.

“If children can be desensitized to food, that’s very exciting for our field. It takes away a lot of familial stress and helps improve quality of life.”

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