Stories about: peanut allergy

20-week treatment makes life safer for kids with peanut allergy

peanut allergy

A study last week in The New England Journal of Medicine suggests that exposing infants to peanuts can provide lasting protection against peanut allergy. But what about peanut-allergic children right now? They and their parents live a life of precautions — from pre-screening birthday party menus to segregation at the school lunch table — to avoid life-threatening consumption of even trace amounts of peanut.

Now, a multicenter study reports on a protocol combining the allergy medication omalizumab (Xolair) with controlled, gradually increasing peanut consumption. After 20 weeks, most initially allergic children could safely consume the equivalent of 8 to 10 peanuts at a time. Three months after stopping the medication, most had worked up to 16 to 20 peanuts.

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Food allergies: Turning tolerance back on

Mast cell food allergy
Mast cells don’t simply cause acute allergic reactions. They also turn off immune tolerance. But that could change. (Bruce Blaus/Wikimedia Commons)

Hans Oettgen, MD, PhD, is Associate Chief of the Division of Allergy and Immunology at Boston Children’s Hospital.  He leads a research group investigating mechanisms of allergic diseases.

Not long ago I received a wonderful email from “Sam,” an 18-year-old young man with peanut allergy. He was participating in a clinical trial of oral immunotherapy (OIT) being carried out by colleagues here at Boston Children’s Hospital.

In OIT, patients receive initially minute doses of the food to which they are allergic. Then, over many weeks, they ingest increasing amounts, under close medical monitoring at the hospital.

OIT’s goal is to get patients to tolerate previously allergenic foods by inducing their bodies to produce Treg cells, or regulatory T cells. These are the master controllers of our immune responses, and their actions include suppressing allergic responses to foods. Food ingestion, as in OIT, will eventually induce food-specific Treg cells, but it can be a long and cumbersome process. For Sam, ingesting escalating doses of peanuts proved difficult: His email described frequent reactions ranging from stomachaches and itchiness to difficulty breathing.

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This post may contain peanuts: Two-pronged treatment may ease severe allergies

Single peanut unsalted-ShutterstockTripp Underwood contributed to this post.

Families with peanut-allergic children live in fear that their child will ingest peanuts—even minute amounts—accidentally. Now, a small pilot study published in the Journal of Allergy and Clinical Immunology offers hope.

In the year-long study, immunologist Dale Umetsu, MD, PhD, and colleagues in the Division of Allergy and Immunology at Boston Children’s Hospital were able to get some children to tolerate as many as 20 peanuts at a time. Their protocol combines a powerful anti-allergy medication with a methodical desensitization process.

While it’s not a cure, the protocol may enable children to weather trace amounts of peanuts that might lurk in baked goods or foods “manufactured in a facility that processes peanuts.” Even a small amount of peanut tolerance could be lifesaving.

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Putting the brakes on food allergies could do a body good

This photo contains at least three food allergens. Can you find them? (Photo: bensonkua/Flickr)

About 3 million children in the U.S. have some form of food allergy, ranging in severity from mild to life-threatening. The number of children diagnosed with food allergies is rising: at Children’s alone, the percentage of new patients with food allergies jumped from 14 in 1998 to 46 in 2005.

The numbers don’t really describe what it means for a child to have an allergy to milk or other foods. At age 1, Brett Nasuti was diagnosed with allergies to 15 foods, including milk, nuts, and eggs. “When I was little, I got hives in the shape of my mom’s lips when she kissed me after drinking coffee with just a little milk in it,” he says.

The classic way of addressing a food allergy is through a vigilant avoidance of the food(s) that can trigger an anaphylactic reaction and prompt treatment of reactions when they do occur. That approach got a boost last year from the Massachusetts legislature, which passed a law requiring restaurants to educate their workers and managers about food allergies and print warnings in their menus reminding diners to tell their server about any food allergies in their party.

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