The only treatment for peanut allergy, or any food allergy, is strict avoidance. However, accidental ingestion can lead to reactions, sometimes serious. In the July issue of the Journal of Allergy and Clinical Immunology, Blumchen et al reported a study of oral immunotherapy to peanut and children with a history of peanut induced anaphylaxis.Children underwent a rapid build-up protocol, and then a longer protocol with biweekly dose increases. Eventually, 14 of 23 patients tolerated a protective dose of at least 500 mg of peanut. However, mild to moderate side effects were common, and several reactions occurred. An editorial in the same journal issue, written by some of the most prominent food allergy researchers in the the country, stated the following: "Although everyone involved in patient care and in novel therapeutic research would like a treatment option to offer individuals with food allergy, now is not the right time. Further studies are needed to address...outstanding issues to determine whether this type of therapy is appropriate for clinical use." Some of the outstanding issues raised by the editorialists included the appropriate dosing and dose frequency, the safety of the treatment, and the fact that most studies have excluded those patients with a history of very severe reactions.
Allergy & Asthma Care of Fairfield County points out that, at this time, no type of oral immunotherapy is approved in the United States. All oral or sublingual immunotherapy, whether to foods or environmental allergens, is currently investigational and not proven safe or effective. If and when these treatments are truly proven safe and effective, and are FDA approved for use in patients, Allergy & Asthma Care will be thrilled to offer them.
