August 23, 2016

Preschoolers benefit from peanut allergy therapy

At a Glance

  • Researchers tested peanut oral immunotherapy in preschool-aged children with a newly diagnosed peanut allergy.
  • After the treatment, most children could eat peanut-containing foods without an allergic reaction.
Baby waiting for lunch in a garden Food allergy affects approximately 5% of children nationwide.filipw/iStock/Thinkstock

Peanut is one of the most common causes of food allergies. Allergic reactions to peanut can be mild, but they may also be severe and lead to a life-threatening allergic reaction called anaphylaxis. Peanut allergy usually starts in early childhood and lasts a lifetime. Avoiding exposure is the best way to prevent an allergic reaction. But steering clear of peanut is difficult, since it can be in foods you may not suspect.

Recent studies have shown that an experimental treatment called oral immunotherapy can reduce allergies to some foods, including peanut. A team of researchers led by Dr. Wesley Burks at the University of North Carolina at Chapel Hill tested the approach as an early intervention in preschool-age children newly diagnosed with peanut allergy. The work was partly supported by NIH’s National Institute of Allergy and Infectious Diseases (NIAID) and National Center for Advancing Translational Sciences (NCATS). Results were published online in the Journal of Allergy and Clinical Immunology on August 10, 2016.

The team enrolled 40 young children (9 to 36 months old) newly diagnosed with peanut allergy. The treatment involved eating small, gradually increasing amounts of peanut protein each day. Participants were randomly assigned to either a high-dose (target daily dose of 3,000 milligrams peanut protein) or a low-dose regimen (target dose of 300 milligrams). Data from a group of 154 peanut-allergic children who had received standard care and avoided peanut were used as a control.

Nearly all treated participants experienced some side effects, such as abdominal pain. These were generally mild and required little or no treatment. Three people withdrew from the study because of adverse effects. Two others withdrew for other reasons.

After receiving treatment for 29 months on average, participants ate a peanut-free diet for 4 weeks and then were evaluated for their ability to eat 5 grams of peanut protein. Almost 80% of treated participants had no allergic response. There was no significant difference between the low-dose and high-dose arms. In comparison, only 4% of the control group successfully introduced peanut into their diets. These results are substantially better than those in older children who had a longer duration of peanut allergy.

“This study provides critical evidence supporting the safety and effectiveness of peanut oral immunotherapy in treating young children newly diagnosed with peanut allergy,” says NIAID food allergy expert Dr. Marshall Plaut.

Researchers continue to monitor the participants to assess how long the treatment effects may last. Scientists note that this experimental therapy is still being tested in clinical trials and should be given only under medical supervision. Consult with a doctor before giving peanut products to an allergy-prone child.

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Reference: Early oral immunotherapy in peanut-allergic preschool children is safe and highly effective. Vickery BP, Berglund JP, Burk CM, Fine JP, Kim EH, Kim JI, Keet CA, Kulis M, Orgel KG, Guo R, Steele PH, Virkud YV, Ye P, Wright BL, Wood RA, Burks AW. J Allergy Clin Immunol. 2016 Aug 4. pii: S0091-6749(16)30531-0. doi: 10.1016/j.jaci.2016.05.027. [Epub ahead of print]. PMID: 27522159.

Funding: NIH’s National Center for Advancing Translational Sciences (NCATS), National Institute of Allergy and Infectious Disease (NIAID), and Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD); and the Thrasher Research Fund from the Departments of Pediatrics at Duke and UNC.