Monday, March 23, 2009

Hope – But Don’t Try This At Home

It’s all over the news – friends are calling me and emailing me, telling me about the latest study reported last week at a meeting of the American Academy of Allergy, Asthma and Immunology. (Read the New York Times report here.) In this study, peanut-allergic children were given a daily dose of peanut powder to desensitize them to peanut allergens.

Basically, by introducing tiny, carefully controlled amounts of the allergen on a daily basis, doctors are slowly building up resistance in the patients’ bodies. Eventually, the theory is that the patients’ bodies are retrained, so that they no longer view the peanut proteins as allergens.

Most of the children in the study are tolerating the therapy without suffering from allergic reactions. This is great news. It means that for most of the kids in the study, their bodies’ immune systems are being slowly retrained, so that they can eventually eat a few peanuts safely.

The doctors involved in the study believe that in two or three years, an actual treatment for peanut allergy may be developed, based on the findings from this study and other related studies going on throughout the world right now.

This is wonderful! At this point, there are two promising treatments – desensitization, and the Chinese herbal treatment FAHF-2.

Though we appear to be on the verge of breakthroughs, we still need to be careful. Doctors involved in this study (and others like them) are worried that people will run out and try these treatments at home, on their own, with disastrous results.

One reason why caution is essential is that the treatment does NOT seem to work for everyone.
Four kids dropped out of the study because they couldn’t tolerate the therapy – even the tiny doses involved in the therapy still caused allergic reactions. Since the therapy starts with a dose equivalent to 1/1000th of a peanut, that’s pretty disheartening for the parents of those four kids.

Another aspect to consider is that these studies are relying on carefully measured doses, in carefully monitored lab situations where help for anaphylactic reactions is immediately available. Most of us don’t have the capability to measure 1/1000th of a peanut accurately, nor the detailed knowledge of the protocols used in the testing to administer these doses safely. A doctor’s guidance is essential.

A third reason for caution is that all of the studies I’ve read about so far are using children with only a single allergy right now. Multiple allergies are difficult to account for in a controlled study, so doctors are only studying how desensitization works on a single allergy – throwing lots of allergies into the mix could greatly change doses, reactions, and chemical interferences.

So while the outlook on the horizon is rosy, don’t throw away your EpiPens yet. Keep your eyes and ears open for news, talk to your board-certified allergist, and follow the study results carefully. But don’t try this at home just yet. But in a few years, perhaps life will be much easier and safer for many of our children. Let’s keep our fingers crossed.

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