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Saturday, 20 May 2023

Peanut allergy is on the rise. Here's how scientists are trying to help kids overcome it.

 Scientists are getting one step closer to having a solution for peanut allergy with the development of a peanut skin patch that helps children safely tolerate exposure to a small amount of the nuts.

Results from a late-phase clinical trial on the patch were recently published in the New England Journal of Medicine. For the study, researchers conducted a randomized double-blind trial in children between the ages of 1 and 3 of the Viaskin Peanut patch. The trial used 362 toddlers from eight countries who have been diagnosed with peanut allergy.

Of those, 244 were given the peanut patch (which included about one-thousandth of a peanut) and 118 received a placebo patch, to be worn between their shoulder blades daily for a year before the children went through screening for peanut challenges. (An allergy "challenge," in case you're not familiar with the term, involves giving a patient certain foods in increasing amounts.)

After 12 months, the researchers found that two-thirds of children with less sensitive peanut allergy who used the peanut patch could tolerate having the peanut protein equivalent of three or four peanuts. Those who had more sensitive allergy could tolerate the equivalent of having one peanut.

One to four peanuts doesn't sound like much, but it can be a lifesaver for children with peanut allergy who accidentally consume something that contains the nut. "As with any food allergy, there is often a worry that a child will have an accidental exposure and reaction," Dr. Terri Brown-Whitehorn, co-author of the peanut patch study and an attending physician with the division of allergy and immunology at Children's Hospital of Philadelphia, tells Yahoo Life. "Parents cannot always control what goes in a child's mouth and accidents do occur.

"Peanut allergy is one of the top causes of anaphylaxis and food-related deaths," Brown-Whitehorn continues. "Although deaths from food allergy are quite rare, it is the biggest concern."

This is far from the only advancement in treating peanut allergy over the last few years. Here's what you need to know.

What help is available for children with peanut allergy?

To date, there is only one oral treatment approved by the Food and Drug Administration to treat childhood peanut allergy. Palforzia is a form of oral peanut immunotherapy that slowly exposes children with peanut allergy to peanuts so that their immune system is less likely to react after they have an accidental exposure.

The treatment isn't perfect — children who undergo the therapy should continue to avoid peanuts and carry two epinephrine auto-injectors like EpiPens with them — but it may help protect kids from a severe reaction from an exposure, according to the American College of Allergy, Asthma, and Immunology.

Research has identified additional treatments that can help minimize the effect of peanut allergy on children. A clinical trial called IMPACT has found that giving highly allergic children between the ages of 1 and 3 a peanut protein powder can safely desensitize most — 71% — of them to peanuts. The study specifically found that the majority of allergic children who received the treatment could tolerate up to eight peanuts afterward. The treatment also caused the remission of peanut allergy in one-fifth of patients.

Another clinical trial from researchers at the University of North Carolina at Chapel Hill found that a peanut allergy treatment called sublingual immunotherapy (SLIT) is effective and safe in children with peanut allergy. The treatment involves taking a tiny amount of peanut protein (the equivalent of one-seventy-fifth of a peanut) under the tongue, where it's absorbed into the body. Of the 54 children in the study, 47 completed the treatment and 70% showed protection against accidental peanut exposures equivalent to about three peanuts. The researchers also found that 36% were fully desensitized to peanuts — meaning they could be exposed to about 16 peanuts.

"The other option is avoidance, but even with the most careful of patients and families, there can be accidental exposures," Brown-Whitehorn says.

Why is treating peanut allergy so important?

Peanut allergy has been increasing over the past two decades, with one study suggesting that peanut allergy in children has increased 21% since 2010.

"More kids are developing peanut allergies, and these can be very severe and life-threatening," Dr. Daniel Ganjian, a pediatrician at Providence Saint John’s Health Center in Santa Monica, Calif., tells Yahoo Life. "Peanut allergies affect even people who are not allergic to the nuts. Schools have no-peanut rules, so kids who don't have peanut allergies can't eat nuts. Parents are anxious about keeping kids safe. ... It affects everyone."

Can peanut allergy eventually be solved?

Research has shown that only about 20% of children with peanut allergy will eventually outgrow it. That's a big difference from other food allergies, such as dairy, egg and milk — about 80% of children with those allergies eventually outgrow them.

"The goal for many of the research studies is to have patients be able to tolerate an accidental exposure to food allergen," Brown-Whitehorn says. "Most of the time, patients who are allergic, especially with peanut, do not necessarily want to eat peanut butter and jelly sandwiches. They just want to know that they will not have a reaction with accidental exposure."

While peanut allergy may not be solved anytime soon, major medical groups, including the American Academy of Pediatrics, recommend exposing children to peanuts through peanut butter paste as early as 4 months old. (Research has found that exposing children at a young age can minimize peanut allergy.) "The hope is that peanut allergies will one day be a thing of the past," Ganjian says.

For those who already have the nut allergy, tolerance is a big step in the right direction.

"It is exciting that we have or will have options for families over time," Brown-Whitehorn says. "It is really exciting as a clinician to watch a child who used to react and have severe reaction to one-fiftieth of a peanut be able to tolerate the equivalent of one peanut without reaction or a child who had a severe reaction to one-half a peanut tolerate three peanuts. It is really amazing."

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