A carefully administered daily dose of peanuts has been so successful as a therapy for peanut allergies that a select group of children is now off treatment and eating peanuts daily, report doctors at Duke University Medical Center and Arkansas Children's Hospital.
"It appears these children have lost their allergies," says Wesley Burks, MD, Chief of the Division of Pediatric Allergy and Immunology at Duke. "This gives other parents and children hope that we'll soon have a safe, effective treatment that will halt allergies to certain foods."
Long-term tolerance in children with peanut allergies was documented for the first time by the presence of key immunologic changes, according to researchers at Duke and Arkansas Children's Hospital who presented their findings at the American Academy of Asthma and Immunology meeting in Washington, DC on March 15, 2009.
Tests of several immunologic indicators suggest the body builds tolerance quickly.
"At the start of the study, these participants couldn't tolerate one-sixth of a peanut," Burks said. "Six months into it, they were ingesting 13 to 15 peanuts before they had a reaction."
About four million Americans have food allergies, and allergies to tree nuts, such as peanuts, are the most common. Life-threatening reactions can occur from exposure to even a trace amount of peanuts, and nearly half of the 150 deaths attributed to food allergies each year are caused by peanut allergies.
Duke and Arkansas Children's Hospital began enrolling patients in studies five years ago to determine if incremental doses of peanut protein could change how the body's immune system responds to its presence. The doses start as small as 1/1000 of a peanut. Eight to 10 months later, the children are ingesting the equivalent of up to 15 peanuts per day. The children stay on that daily therapy for several years and are monitored closely.
Nine of the 33 children participating in the study have been on maintenance therapy for more than 2.5 years. After a series of food challenges, four of those children were taken off the treatment and continue to eat peanuts. Some have been off treatment for more than a year. Doctors keep tabs on any potential changes in their immune system via skin, blood and immune studies.
One of the tests used in the study looks at immunoglobulin E (IgE), a protein the body makes in response to peanut allergens. "If you have it, you're likely allergic, if you don't, you aren't," explained Burks.
Children in this study generally started with IgE levels greater than 25. "At the end of the study, their peanut IgEs were less than 2 and have remained that way since we stopped the treatment," he said.
For more information, visit http://www.dukehealth.org
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44:43The Age Defying Shoulderby DukeMedicine44 views
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