Sound Science: New Developments for Those Who Deal With Peanut Allergies

Research was recently published that provides some hope in finding a practical treatment for individuals living with peanut allergies.

Many headlines covering this research in the news suggest the possibility of a “cure” for individuals living with food allergies today. We thought it would be important to hear directly from key experts to provide knowledgeable insights and a bit more perspective.

First off, how many people are impacted by food allergies?

The Food and Drug Administration (FDA) regulates eight major food allergens that affect 15 million people in the U.S. living with food allergies. The eight major allergens are milk, eggs, wheat, soy, fish, shellfish, tree nuts and peanuts. It is important to know that peanuts account for 90 percent of the reactions in the U.S. Likewise, the American Academy of Allergy, Asthma and Immunology (AAAAI) lists peanuts as “the most prevalent allergen . . . and the most prevalent of food allergic children.”

Peanut allergies affect up to one percent of the U. S population with symptoms ranging from mild to severe. The most severe can result in anaphylaxis – a life threatening allergic reaction where the immune system overreacts releasing chemicals in response to the offending food. If untreated, an anaphylactic reaction can be fatal.

Did this study find a cure for food allergies?

Not quite. But the findings show promise.

The study, a follow-up of an earlier double-blind placebo, randomized controlled trial of 62 children with peanut allergy, sought to evaluate the effects of a combination of probiotic and peanut immunotherapy after four years.

Professor Mimi Tang, group leader at the Murdoch Children’s Research Institute in Australia and study director, states, “The original study evaluated [this] by food challenge, a controlled condition where specific foods are introduced to confirm a reaction, after 2-6 weeks secondary elimination. We found that 82 percent of PPOIT (probiotic and peanut oral immunotherapy) treated children achieved sustained unresponsiveness as compared with 3.6 percent of placebo treated children.”

In other words, 82 percent of patients who received treatment did not experience a reaction to peanut after stopping treatment.

“These children were advised to continue eating peanut as part of their normal diet, said Tang. "Four years later, 85 percent (48 of 56) participants from the original study were re-assessed for peanut intake, and around half also evaluated for sustained unresponsiveness by food challenge after 8 weeks secondary elimination. Of the children who were sustained unresponsive in the original study, 80 percent were still eating peanut and 70 percent (of those who had a challenge) were found to have maintained their sustained unresponsiveness.”  

While promising, Dr. Wayne Shreffler at Boston’s MassGeneral Hospital and research colleagues across the globe believe “oral immunotherapy is and will be helpful for many individuals, but we also worry that through the lens of sharing stories on social media and by way of often over-exuberant news media, this therapy enjoys an undeserved shine.”

Were there any limitations to this study?food allergy sign

Limitations are always important to discuss and understand.

In this study, Dr. Tang was very clear in communicating the limitations. She identified and discussed the low rate of participation as a main limitation in the food challenge to assess for sustained unresponsiveness.

“The results are from a single study conducted in a single centre,” Tang said. “Findings must be confirmed in a follow-up study to be sure that the effects are reproducible and consistent in different settings.”

Dr. Tang goes on to recommend that “more trials that involve larger numbers of participants, different age groups and different food allergens and OIT [oral immunotherapy] should be included as a control group.”

Be skeptical of headlines

Dr. Andrew Craig, health consultant at the American Peanut Council, has pointed out the recent headlines were “more hyperbole than fact; the result of saturated media coverage which repetitiously hammered out a message to the world that peanut allergy had been ‘cured’.”

As future research evolves, Tang recommends individuals to continue with current management and as advised by a qualified health provider.

“The impact of any potential treatment on quality of life is also important to understand – any new treatment should offer an improved quality of life,” she explains.

What’s the bottom line?

It’s unlikely any practical or affordable application from the results of this clinical trial would be available anytime in the very near future. It’s also important to understand these studies are valuable to identify treatments that could be used to minimize any reaction to an accidental ingestion or cross-contact.

Until a new treatment is available, education and an effective food allergy management plan should be a priority.  It’s important to stay vigilant about reading labels, politely educate and inform those around you of food allergies, and maintain emergency medication and contact information in the unfortunate incident of an emergency.

Tony Flood, Megan Meyer, PhD, and Laura Kubitz contributed to this post. 

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