Growing up, peanut butter sandwiches were a staple of kids’ lunches, but the number of children reporting peanut allergies has changed that. Childhood peanut allergies now represent a quarter of all food allergies and can result in severe reactions. Recent clinical trials testing a patch that delivered peanut protein through the skin offers real hope that the allergic reaction to peanuts could be reduced or eliminated in children.
A survey of more than 38,000 parents identified 3,218 children with food allergies of which 25 percent were associated with peanuts. Peanut allergy was reported most often in children 6 to 10 years old and among white children the number was a staggering 48 percent and children in households earning $50,000 to $99,999 it was 42 percent and it’s on the rise.
The new treatment for peanut allergies involves wearing a patch that releases small amounts of peanut protein through the skin. This treatment is called epicutaneous immunotherapy or EPIT. Patches called Viaskin containing varying amounts of peanut protein have been developed. Researchers divided 74 people ranging in age from 4 to 25 with peanut allergies randomly into three groups and their sensitivity to peanuts was assessed. One group received patches with a high dose of peanut protein and second group received a low dose and one group received a placebo patch. New patches were applied daily. After one year, study participants’ abilities to consume at least 10 times the amount of peanut protein tolerated before the treatment was tested.
Treatment was successful in 46 percent of the low dose and 48 percent of the high dose groups as compared with 12 percent of the placebo group. Treatment of children aged 4 to 11 was significantly more successful than those 12 years or older. There were no serious reactions to the patches. Therefore, EPIT can be used to train the immune system to tolerate small amounts of peanuts reducing the consequences of accidental ingestions. EPIT is particularly useful for 10 to 15 percent of people who cannot tolerate the recently developed oral therapies.
Peanut oral immunotherapy is performed by giving small then gradually higher amounts of peanuts to children with peanut allergies. In one recent study, 40 allergic preschoolers were either given 3,000 or 300 mg of peanut protein for an average of 29 months. They then avoided peanuts for four weeks before reintroducing them into their diets. About 80 percent of the preschoolers with peanut allergy successfully tolerated peanuts regardless of the dose of peanut protein used in the therapy.
Food allergies were long considered too risky to be treated using immunotherapy. Many studies have now shown that children could be safely desensitized to food allergens including milk, eggs and, more recently, peanuts. For many, who have undergone immunotherapy, they regain their allergies unless they continue exposure to the allergen. So children with peanut allergies who have been successfully treated by immunotherapy need to eat peanuts to retain their tolerance. Hopefully, medical research can develop ways to safely eliminate food allergies and make school cafeterias safe places for all students, regardless of what is on the menu.