Peanut allergy cure one step closer
Melbourne researchers have made a breakthrough in the search for a cure for peanut allergies with a new potential treatment found to have long lasting results.
The vast majority of children given a trial peanut allergy treatment can still safely eat peanuts four years afterwards – as part of an exciting small clinical trial at the Murdoch Children’s Research Institute (MCRI).
The study, which initially involved 62 children has provided the strongest evidence yet that a cure may be possible for deadly peanut allergies, providing hope to thousands of Australians living with allergies every day.
"These children had been eating peanut freely in their diet without having to follow any particular program of peanut intake in the years after treatment was completed," said lead researcher Professor Mimi Tang.
Natalie Flanjnik’s 13-year-old son Joel was diagnosed with an egg and peanut allergy when he was a baby. She’s been watching the study with interest, and says an effective treatment would be amazing.
When Joel was about three he touched peanuts on the floor at a theme park, and a rash broke out up his arm. Another time I kissed him on the cheek after having Vietnamese food for lunch, and he developed a rash on his cheek.
“Now, if we’re out and he’s forgotten his EpiPen, he sometimes won’t eat because he panics. It’s just this constant worry.”
Reprogramming the immune system
The peanut allergy study involved splitting the children into two groups. Some were given a placebo, while others were given a combination of a probiotic (Lactobacillus rhamnosus), together with peanut protein, every day for 18 months. The peanut protein quantity was gradually increased over time.
The treatment was designed to reprogram the immune system’s response to the peanut protein.
The results at the end of the original trial in 2013 were extremely promising: 82 per cent of children who received the probiotic and peanut oral immunotherapy (PPOIT) had become tolerant to peanuts and could eat them without a reaction, compared to just four per cent from the placebo group.
Now, four years later, a follow up study published in The Lancet Child and Adolescent Health has found that the majority of those children who gained tolerance (80 per cent) are still able to eat peanuts as part of their normal diet – indicating this potential treatment could have long lasting effects.
“The importance of this finding is that these children were able to eat peanut like children who don’t have peanut allergy and still maintain their tolerant state, protected against reactions to peanut. We are now examining whether these beneficial effects of our novel treatment have also resulted in improved quality of life,” said Prof. Tang.
“These findings suggest our treatment is effective at inducing long-term tolerance, up to four years after completing treatment, and is safe,” she said.
Ten-year-old Olivia became involved in the trial when she was just two and a half. Previously a small bite of a peanut butter sandwich would cause her lips to swell.
Her mother Tanya May says being part of the PPOIT trial changed her life.
Olivia has never had an anaphylactic reaction, so we’ve been really lucky. She can now eat peanuts. At least now there is no pressure when we go out, she goes to a friend’s house, or on camp. We can completely relax about all those things.
Allergies on the rise
According to the Murdoch Children’s Research Institute, the prevalence of food allergies has risen 350 per cent in just the last 20 years – and peanut allergies have increased at the greatest rate. Peanut allergies affect around 1 in 50 children , and in some cases, can cause a severe allergic reaction (anaphylaxis) which can be deadly.
Bupa GP Dr Tim Ross says the new research is exciting because it opens a new range of possibilities when it comes to desensitising people to allergies.
“Using probiotics to desensitise people to allergies is quite a new approach,” he said.
“Most desensitisation up until now has been injections in the arm. Particularly for kids, being able to take something like this orally is much easier. There is much work going on at present looking at the interaction between the gut and metabolism, inflammatory response and immune response. This study is an example involving the immune response.”
While there is no proven explanation so far as to why allergies are on the rise, scientists have a few possible theories which they’re looking into, which include:
Hygiene: less exposure to infections in early childhood may be associated with an increased risk of allergy
Delayed introduction to foods such peanuts, tree nuts or egg in young children
Changes in the way we process food
Dr Ross says there’s a popular theory that the increasing use of disinfectants and sterilisers in the home could be playing a part.
The theory is that the immune system is there to fight infection and other threats to the body. If you don’t expose your immune system to these things, it finds something else to react to. This might be your own body, or foods. Antibacterial hand washes and wipes are marketed against a “dirty world” yet this world is exactly what our immune systems are designed to operate within. A sterile environment is artificial and leads to abnormal immune behaviours.
While the results of the study are promising, larger clinical trials will need to be undertaken before a treatment is made available to the public, which is likely to take years.
Professor Tang hopes this could open the door to finding treatments for other food allergies too.
“This is a major step forward in identifying an effective treatment to address the food allergy problem in Western societies,” she said.