It seems contraindicated, but immunologists say one of the best treatments for peanut allergies in children may be gradual exposure to peanuts, according to The Wall Street Journal.
There’s no doubt the exposure therapy is controversial and can be extremely dangerous if not approached carefully and properly with close monitoring in place. Peanuts, as with tree nuts, are one of the most deadly food allergens known to man, and have been on the rise in the past several decades, giving rise to heated debates regarding whether public schools should be “peanut free” or not.
Those who are allergic to peanuts are likely to suffer anaphylaxis, a condition in which their body goes into a systemic shock after being exposed to the allergen, often very quickly. As the airway constricts and blood pressure drops, the anaphylactic patient suffers a severe deprivation of oxygen that often leads to death.
While there are emergency treatments available for anaphylactic shock, such as Epinepherine, that can quickly help reverse symptoms of shock with a quick injection, it requires the drug to be carried with the allergic individual and kept up-to-date. That can be a challenge for some children and adults, and it is not always effective if the allergic reaction is too far advanced. After airway closure, brain death occurs in just four minutes.
New England Food Allergy Treatment Center has a different philosophy – that perhaps a more proactive approach is to gradually introduce peanuts to allergic people, so that they become immune to the allergic properties. This is a form of immunotherapy, and the method for children here is to eat carefully measured doses of peanut protein, usually mixed into yogurt, pudding or apple sauce, in a treatment known as oral immunotherapy. The treatment goal is to gradually increase the doses of allergens to desensitize their bodies to peanuts so that they no longer suffer allergic reactions when exposed.
Immunotherapy is a common treatment for people with environmental allergies, such a seasonal allergies, but environmental allergies are almost never fatal. It’s definitely a controversial treatment for peanut allergies, according to Jeffrey Factor, founder and medical director of the center, which opened in 2010 and has been gaining popularity since, in part due to its extremely high success rate.
“We have a 90-92% success rate of cure. We usually start with a 0.1-milligram dose of peanut protein—just a few flecks of peanut flour that look like grains of sand. Over the next five hours or so, the dose is gradually increased to about 6 milligrams. If the peanut protein is tolerated, patients are sent home with a plastic bin holding individual containers of the dose, which they take daily. They return to the center every two weeks for ever-larger doses until they graduate to whole peanuts or peanut M&M’s. They are considered desensitized when they can tolerate about 10 peanuts daily and then must continue a maintenance dose indefinitely. Treatment usually lasts 10 to 12 months and is often covered by private insurance.”
Cynthia Hower, mother of five year old Natalie who has a documented peanut allergy, said she is aware of the risks and that it may not work for everyone, but feels the success rate makes it worth trying.
“I know it’s a risk. I know it’s not a cure. I’ve heard of some children not being able to continue with the process. But I’ve also heard of many success stories.”
About a third of those who receive the treatment test completely negative to peanut allergies after a year or so, says Dr. Founder, which is a tremendous success rate. Others may only have mild reactions that are difficult to detect and not life-threatening after the therapy, but it’s important to be followed up frequently and continue maintenance desensitization.
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