Peanut Allergies: Research Brings Hope to New Therapies

Peanut allergy is one of the most common food allergies in children and has increased substantially over the past few decades. Research into potential therapies is proving promising, with new options on the horizon. Le Bonheur Children’s Hospital was one site in the largest peanut oral immunotherapy trial to date.

In this study, peanut allergic patients were given small amounts of peanut protein in the form of a powder. The powder was increased every two weeks until they were eating approximately one peanut’s worth.

“What happens is over time, you can slowly increase that dose in the patient to where they are tolerating an amount they otherwise wouldn’t have tolerated prior to the therapy,” states Dr. Jay Lieberman, Le Bonheur physician and Associate Professor at the University of Tennessee Health Science Center. “In some patients, if you challenge them at the end of the study, say six or twelve months later, they can eat upwards of 10 to 15 peanuts, whereas before they couldn’t even eat one.”

This product that was being studied at Le Bonheur recently went before the FDA, and the advisory committee voted to pass it on. It’s estimated the FDA will approve the product sometime within the next six months.

Other therapies being investigated beyond oral immunotherapy include patch immunotherapy, modified allergen therapies, and adding on a biologic medicine to one of the immunotherapies to either improve the efficacy of the immunotherapy or make it safer. “There’s a lot on the horizon, and it’s a good time to be a part of the food allergy community. For so long we haven’t had anything to treat these patients, and hopefully soon we’ll have more than one option,” notes Dr. Lieberman.

In the meantime, the recommended treatment is avoidance first, and emergency therapy, specifically in the form of epinephrine, if a reaction occurs.

What Causes Peanut Allergy?

No known root cause has been identified, but Dr. Lieberman explains there is no single cause—it is a multifactorial disease. “There’s a genetic component, an environmental component, and possibly a component of when these foods are introduced into the diet that can play a role into why some kids get peanut allergy and others don’t,” he explains.

One theory is the hygiene hypothesis, which means that as we become a more hygienic society and have less infectious disease, whether that be parasitic or bacterial diseases, our immune systems may shift to develop more allergies in general, not just peanut allergy. Delayed introduction of peanuts into a child’s diet may also play a part. “Studies have shown that allergic disease in general, meaning developing allergic antibodies to things like dust mites or peanuts, may be more apt to happen in patients who are not exposed to certain infectious agents early on,” adds Dr. Lieberman.

How Deadly Are Peanut Allergies?

Estimates for peanut allergy in the United States are somewhere between one and two percent of the population, with higher numbers in children and adolescents than the adult population. Parent awareness has increased as the rate of incidence has risen, but there’s still much to be learned about peanut allergy and its effects.

In terms of fatality, Dr. Lieberman says it’s hard to estimate. “I will say, it’s very important to understand that death due to food allergy, although tragic, is very rare overall but does occur. We know that when you look at cohort populations of food allergy related deaths, peanut is a very common trigger in those cohorts. So, we do feel that peanut seems to be a common trigger amongst fatal food anaphylaxis,” he cautions.

Fortunately, with new therapies coming to market, the risk of death due to peanut allergy may be diminished very soon.

To listen to an interview with Dr. Jay Lieberman, Associate Professor at the University of Tennessee Health Science Center, follow this link: https://radiomd.com/lebonheur/item/41040.