New Treatments Fight Peanut Allergies with Peanut Protein
By Mike Howie
Food allergies are becoming more common every year in the U.S. An estimated 7.6 percent of children under 18 — nearly eight million individuals — and 11 percent of adults have some type of food allergy. Some of those adults report that they did not have food allergies as children. But new treatments could help people cope with their allergies.
Peanut allergies are particularly common, and there’s no cure. Anyone allergic to peanuts simply must avoid them. For those with only a mild allergy to peanuts, a small exposure isn’t necessarily a big deal. But for people with severe peanut allergies, eating a tiny portion of a product containing peanuts or even a product that came into contact with peanuts can trigger a serious reaction.
For about half of people with peanut allergies, just 100 milligrams of peanut protein — about one third of a peanut — is enough to cause a reaction. These reactions can range from itching or hives to difficulty breathing or, most seriously, anaphylaxis, which affects the entire body.
The world can be a stressful place when you’re constantly on the lookout for potential allergens. For some, it can lead to isolation, purposely staying away from anyone eating foods that could cause a reaction, even friends. Others risk exposure from people who don’t understand or disregard how severe a food allergy can be. Some people with food allergies may not even want to eat at all, particularly after experiencing a strong allergic reaction, and they can become obsessive about checking food labels.
There’s no test that can definitively determine whether someone is allergic to peanuts. While doctors can test for sensitivity to certain foods by measuring levels of IgE antibodies, which trigger allergic reactions, the only way to confirm an allergy is to have the patient eat the food in question. And that can be risky.
But it’s possible that small, repeated exposure to peanut protein can help lessen the severity of a peanut allergy. California-based Aimmune Therapeutics developed what they call oral immunotherapy (OIT) to do exactly that.
OIT involves ingesting a pill containing small amounts of peanut protein every day. The dose starts at half a milligram of the protein — about 600 times less than is found in a peanut — and slowly increases to about 300 milligrams, or about one peanut, over six months.
When Aimmune tested the treatment with 551 children and teens, 43 quit because of allergic reactions. But, after a year of treatment, about two thirds of the group could safely eat two peanuts. While the treatment doesn’t cure the allergy, it does provide an additional margin of safety that can make life less stressful for those with peanut allergies. It’s important to note, however, that people can become sensitive to peanuts again after ending therapy.
A similar experimental treatment uses a skin patch, manufactured by French company DBV Technologies, instead of pills. The coin-sized patches contain a quarter of a milligram of peanut protein — about one thousandth of what’s in a peanut — and are applied to a patient’s back or upper arm every day. The protein seeps into the patient’s skin but doesn’t enter the blood stream, which makes it less likely to cause anaphylaxis than oral therapy.
In a year-long trial of the patch that included 356 children, the most common side effect was a skin rash at the patch site. Nine out of every ten participants finished the study, but only one in every three patients could tolerate a dose of one to three peanuts. However, one patient with a particularly severe allergy benefitted from the treatment. Before the study, he would react to just 1/240th of a peanut. But after treatment, he could safely eat six peanuts.
A Safer Future
Thankfully, the world is slowly becoming more conscious of and hospitable toward people with food allergies. Airlines no longer serve peanuts as in-flight snacks. Schools provide strict guidelines for what foods can be provided for class treats. Food manufacturers are making stronger efforts to clearly label products that contain potential allergens. And new allergy treatments provide peace of mind to help people with allergies navigate the world.
These new treatments aren’t guaranteed to work, but they will be improved. When finalized treatments are available, patients will still need to find the one that works best for them — whether that’s a pill, a patch, or potentially a toothpaste.
Until then, it’s important for individuals with food allergies, even children, to advocate for their own safety in daily life. That may mean asking restaurant staff how the food is made or carrying auto-injectable epinephrine every day. Above all, it means being aware of foods that pose potential threats.
- What other food allergies could be treated with these approaches?
- How else could food allergies possibly be treated?
- Look at the food in your kitchen. How many include potential allergens?
- IgE Antibodies