The future of food allergy treatment seems brighter than ever.
- We now have a tool that can help decrease the chances of developing a peanut allergy in high risk infants.
- There are currently two treatment options in development, that can reduce the chances of having an allergic reaction after an exposure to the allergenic food.
- Oral Immunotherapy (OIT) allows for the liberal introduction of an allergenic food into the diet.
What is Oral Immunotherapy?
Oral Immunotherapy is an experimental tool that can allow most patients to introduce an allergenic food into their diet, without provoking an allergic reaction. It begins typically with daily administration of a small amount of solution of the allergenic food. New higher doses are given in the clinic typically once a week, and these are continued daily at home. Eventually the actual food itself is administered in increasing amounts. Once we finish this build up phase and reach a maintenance dose, the food can be liberally introduced into the diet on a daily basis to maintain the desensitization.
Before starting OIT, we discuss at length the pros and cons of this procedure. We also discuss other alternatives like continuing to avoid the food. If the food allergy history is questionable, skin or lab testing and possibly an oral food challenge may need to be performed. Protocols and length of treatment vary depending on the food in question and severity of the allergy.
Currently the different food allergies that can be treated like this include: peanuts, tree nuts, egg, milk, soy, sesame, among others. Recent reports have shown that about 85% of patients reach the maintenance dose.
What OIT is not
OIT is not a cure for food allergies. This procedure allows us to desensitize a person to a food allergy safely introducing it into their diet, but the state of desensitization can be quickly lost if we do not continue to eat the food on a daily basis. There are risks involved in doing this including developing gastrointestinal symptoms and allergic reactions.
But I have more questions
There are many references in the medical literature describing this tool in detail including safety, efficacy, and impact on quality of life. Here is just a sampling of them:
Oral desensitization for food hypersensitivity.
(Land MH, Kim EH, Burks AW. Immunol Allergy Clin North Am. 2011 May; 31(2): 367–376)
Effect of oral immunotherapy to peanut on food-specific quality of life.
Factor JM1, Mendelson L, Lee J, Nouman G, Lester MR.Ann Allergy Asthma Immunol. 2012 Nov;109(5):348-352.e2
Advances in food allergy oral immunotherapy: toward tolerance.
Hussey Freeland DM, Fan-Minogue H, Spergel JM, Chatila TA, Nadeau KC.Curr Opin Immunol. 2016 Oct;42:119-123
Please feel free to contact us to go over the details. We would love to hear from you!