Oral Immunotherapy (OIT)
A new study has demonstrated that children who are allergic to peanuts can build up a tolerance by eating increasing amounts of peanut protein.
Children with an allergy to peanuts can build up a tolerance by eating increasing amounts of peanut protein a new study has demonstrated. This is a technique called oral immunotherapy (OIT).
Allergy to peanuts affects one in fifty children and the symptoms can include anaphylaxis, which can be life-threatening. The only way to prevent allergic reactions is to avoid foods containing nuts; however accidental reactions are very common.
The fear of accidental exposure to peanuts can seriously reduce the quality of life of those children who are affected and of their families and friends.
The study included 99 childrenwith peanut allergies who were between the ages of 7 and 16 years. The children were randomly assigned to one of two groups. The first group received OIT for 26 weeks using gradually increasing doses of peanut protein each day, up to 800mg. The second group, which was the control group, was told to avoid peanuts completely.
After 6 months, the children all took part in a double-blind placebo-controlled food challenge, where they gradually consumed increasing amounts of peanut protein. They were under medical supervision at all times, and researchers noted at what level they encountered allergic symptoms.
In the second part of the trial, the second group was also offered 26 weeks of OIT before another food challenge.
After the 6 months of OIT, 62% of the children passed the food challenge and were able to tolerate a daily dose of 1,400 mg of peanut protein, which is around 10 peanuts, whereas the control group was not. After the second phase of the trial, when all of children had undergone OIT, 54% were able to tolerate the food challenge. In addition, after 6 months of the therapy, 84-91% of the children could safely consume 800 mg of peanut protein, which is around five peanuts. This is 25 times the amount they could tolerate before the therapy.
Around a fifth of the children who received OIT reported adverse events, though these were mostly mild. In one patient, who withdrew from the trial, adrenaline was used to treat symptoms after only two doses of OIT.
Dr. Andrew Clark, fromAddenbrooke’s Hospital in Cambridge,who led the study said, “ This treatment allowed children with all severities of peanut allergy to eat large quantities of peanuts, well above the levels found in contaminated snacks and meals, freeing them and their parents from the fear of a potentially life-threatening allergic reaction."
Dr. Pamela Ewan, co-author from the study, says it is "an important advance in peanut allergy research." However, she also added the following cautionary note: "It is important to note that OIT is not a treatment people should try on their own, and it should only be done by medical professionals in specialist settings."
The technique was used as part of the STOP II trial, results of which are published in The Lancet.
With the caveat that this should not be tried at home
Around a fifth of the children who received OIT reported adverse events, though these were mostly mild. In one patient, who withdrew from the trial, adrenaline was used to treat symptoms after only two doses of OIT.
In a linked editorial to the study, Matthew J. Greenhawt, from the University of Michigan Food Allergy Center, adds that this technique is experimental, writing that "OIT is not ready for clinical use until the short-term effects have been comprehensively proven."
But the researchers are pleased with their positive results, as are the parents of the children.
"The families involved in this study say that it has changed their lives dramatically," says Dr. Clark.
Because quality of life is reduced in many sufferers of peanut allergies due to the threat of anaphylaxis, providing a way to neutralize this threat could be very helpful, the team adds.
