It’s commonplace for people with environmental allergies to get multiple shots at one time with a mix of different allergens. So for example before I got pregnant with my third child, I was getting three shots with a mix of grass pollens, tree pollens, cat, dog and dust mites.
However for children with multiple severe food allergies, this approach had never been attempted, for fear of extreme reaction, until recently.
Kari Nadeau, an M.D./Ph.D. and an associate professor of allergies and immunology at Stanford University School of Medicine and Lucile Packard Children’s Hospital, began treating children in 2011 with oral immunotherapy for multiple allergens. Here’s quick summary of the story. It runs 10 pages long.
“Nadeau and others, however, were having success with a trial of a treatment known as oral immunotherapy that could desensitize children with severe peanut allergies. The treatment re-educated the hyperactive immune systems of allergy patients by giving them minute doses of peanut every day, gradually escalating the amount over the course of several years. Eventually patients build up their tolerance for the food, and it is no longer dangerous.”
But eliminating single food allergens at such a slow pace could take years so Nadeau wondered if they could do more together like the environmental allergens.
“Could patients be desensitized to more than one allergen at a time? No one had ever tried it, but more than a third of children with food allergies are allergic to more than one food. If it was safe to give patients x milligrams of one allergen, would it be safe to give them one-fifth of x milligrams of five different allergens, as long as the total dose remained the same? That would assume that allergens function in a linear, additive fashion — rather than a multiplicative one; it was also possible that they could interact with one another to produce a more severe reaction….”
By November 2011, Nadeau had FDA approval to begin testing and had raised enough money for two trials with 85 patients, who could be desensitized for up to five allergens.
The trials have been very successful and treated children are able to eat eggs, cake, pizza – all things that would have literally killed them before.
“Nadeau stresses that oral immunotherapy is still experimental. Her patients are not cured; they are desensitized enough that they can tolerate their former allergens. The reason that she doesn’t call it a cure is that the child must continue to eat a maintenance dose of the food every day to avoid regaining the allergy. She often explains to her patients, “If you get off it for three days, you may become sensitive again.” An egg-allergy trial found that when patients were taken off the maintenance dose for a month, roughly 60 percent regained the allergy (and there was no way to predict who those patients would be).”
With more than 5.9 million children in the United States with food allergies (1 in the 13 children in a classroom) and with that rate on the rise (1 in 10 children in preschool have food allergies), this may be an important treatment for many families who stress each day about what foods their kids could accidentally touch or eat.
So what so you think: Is this something you would be interested in checking out for your child? Has your allergist every discussed a similar treatment? What are you having to do now to prevent a severe reaction to food allergies?