However, both forms of immunotherapy still are in research stages, and because researchers have to follow patients for years, no one could say when a standard treatment might become available.
FISHY BEHAVIOR. Medical experts say people who have shellfish allergies often are allergic to fish, too.
Also, no one knows whether the effects of immunotherapy wear off over time, or whether a patient has to, say, keep receiving small amounts of the allergen to have a continued protective effect, says Dr. Wayne Shreffler, who is the chief of pediatric allergy and immunology and the director of Food Allergy Center at Massachusetts General Hospital. Shreffler has two oral-immunotherapy studies underway.
A study by Stanford University suggests that a blood test might help to predict which allergic patients might respond best to oral immunotherapy. (The study didn’t include sublingual immunotherapy.) That study, which was published in the January 2014 issue of The Journal of Allergy and Clinical Immunology, tested the blood of 20 children and adults who stopped oral immunotherapy and then were exposed to allergens. Researchers found differences in the DNA between the 13 patients who then had a reaction to the allergens and the seven who didn’t. Being able to distinguish those DNA differences between patients could help scientists to predict whether a patient is a good candidate for oral immunotherapy.
Another approach that Schneider and other researchers are trying is the use of monoclonal antibodies in peanut-allergic children. She and colleagues gave patients the medication omalizumab, which is approved for use in people over age 12 who have asthmatic reactions to airborne allergens. These patients then were given small amounts of peanuts, with the daily dose increased gradually over several months. By the end of the study, Schneider says, the patients were eating peanut flour that equated to the same amount of protein that’s found in 20 peanuts. In other words, those patients could tolerate eating 20 peanuts, Schneider says, or the equivalent amount in, say, peanut butter, peanut candy or peanut cookies. (Peanut flour is used in baked goods, filling, frosting and peanut butter.)
“The idea is that the monoclonal antibody drug helps bind up the patient’s own IgE against peanuts,” she says. In other words, the patient’s IgE antibodies are prevented from triggering allergic symptoms. Twelve of the 13 patients were able to get through the study fully, Schneider says. Stay tuned: Other research centers are conducting long-term studies on the effectiveness of monoclonal antibody medications.
“Food is such a big part of our lives—it’s hard for people who have food allergies,” says Dr. Octavia Pickett-Blakely, who is an assistant professor of medicine at Hospital of University of Pennsylvania and Perelman Center for Advanced Medicine.
Unfortunately, we aren’t sure when living with a food allergy will become significantly easier.
Mary Brophy Marcus has been a health reporter for 15 years. Her stories have appeared in USA Today, U.S. News & World Report and The Washington Post, among other publications.