Tests of several immunologic indicators suggest
the body builds tolerance quickly.
"At the start of the study, these
participants couldn't tolerate one-sixth of a peanut," Burks said.
"Six months into it, they were ingesting 13 to 15 peanuts before they
had a reaction."
About four million Americans have food
allergies, and allergies to tree nuts, such as peanuts, are the most common.
Life-threatening reactions can occur from exposure to even a trace amount of
peanuts, and nearly half of the 150 deaths attributed to food allergies each
year are caused by peanut allergies.
Duke and Arkansas Children's Hospital began
enrolling patients in studies five years ago to determine if incremental
doses of peanut protein could change how the body's immune system responds
to its presence.
The doses start as small as 1/1000 of a
peanut. Eight to 10 months later, the children are ingesting the equivalent
of up to 15 peanuts per day. The children stay on that daily therapy for
several years and are monitored closely.
Nine of the 33 children participating in the
study have been on maintenance therapy for more than 2.5 years. After a
series of food challenges, four of those children were taken off the
treatment and continue to eat peanuts.
Some have been off treatment for more than a
year. Doctors keep tabs on any potential changes in their immune system via
skin, blood and immune studies.
One of the tests used in the study looks at immunoglobulin E (IgE), a
protein the body makes in response to peanut allergens. "If you have
it, you're likely allergic, if you don't, you aren't," explained Burks.
Children in this study generally started
with IgE levels greater than 25. "At the end of the study, their peanut
IgEs were less than 2 and have remained that way since we stopped the
treatment," he said.
Because the pool of children now off
treatment is so small, Burks says it's hard to say whether these children
simply outgrew their allergies or if the therapy did something to enhance
that outcome.
The next step is a blinded study in which
children on treatment are compared to a control group. First year results
were presented at the meeting by Stacie M. Jones, MD, a pediatric allergist
at Arkansas Children's Hospital. So far, the oral immune therapy appears to
be working.
"We see initial desensitization effects
of the treatment are real," Burks says. "Those children are now
able to eat up to 15 peanuts with no reaction, but the children not on
treatment have symptoms early on in the study."
Despite the news, Burks insists this
research is still ongoing and cautions parents and professionals against
trying any version on their own.
"In my clinic, I would do the same
things I've always done. Once diagnosed with a food allergy, I would
recommend they avoid the food. We have to wait for the studies to show the
treatment is safe, and to see desensitization start to work. We also want to
know the therapy works long term."
Burks also cautions that some people are too
sensitive to peanut allergens to be able to undergo the therapy.