Promising Peanut Allergy Treatment Shows Hope for Adults

NEW YORK — For millions of Americans living with severe peanut allergies, even a trace amount of the legume can trigger a life-threatening reaction. But a recent clinical trial offers a glimmer of hope, suggesting that adults can be desensitized to peanuts through a carefully managed oral immunotherapy program.

Chris Brookes-Smith, a 28-year-old from the U.K., knows this anxiety all too well. Ten years ago, he experienced a horrific allergic reaction after unknowingly consuming peanuts in a curry dish. “I knew I was in trouble after one bite,” he recalls. “within seconds there were spots on my lips. Within minutes I was vomiting. I could feel my throat closing up, hives forming in my armpits then over my whole body… My face going all puffy with the swelling.”

The trauma left an indelible mark. “I thought I was going to die,” Brookes-Smith says, his voice tinged with emotion.Photos taken in the hospital revealed the extent of the reaction. “I looked like a plucked turkey because my skin had blistered so much,” he says, adding that the hives felt “like boiling water had been poured over me.”

Peanut allergies are among the most common food allergies in the U.S., affecting an estimated one in 50 children and one in 200 adults, according to Food Allergy Research & Education (FARE). Allergic reactions occur when the body mistakenly identifies peanut proteins as a threat,triggering the release of chemicals that can cause symptoms ranging from mild skin irritation to anaphylaxis,a severe and potentially fatal reaction.

Brookes-Smith’s allergy was detected in infancy when he developed a rash as his mother prepared peanut butter sandwiches. As he grew older, each reaction seemed more severe, forcing him to live “on high alert hoping nothing bad happens.” Everyday activities like dining out became stressful ordeals.A love for travel was curtailed by the risk of encountering peanuts in foreign cuisines.

His mother eventually learned about a clinical trial at Guy’s and St Thomas’ NHS Foundation Trust and King’s College London,offering an innovative approach: desensitizing adults to peanuts by gradually training their bodies to tolerate the allergen. Despite initial reservations, brookes-Smith decided to participate.

The trial involved oral immunotherapy, a method already used to treat allergies to pollen and insect stings. Under close medical supervision, participants began by consuming tiny amounts of peanut powder mixed with yogurt. Over several months, the dosage was progressively increased, eventually leading to the consumption of whole peanuts.

by the end of the nine-month study,14 of the 21 participants,including Brookes-Smith,could consume the equivalent of five peanuts without experiencing allergic reactions.

Professor Stephen Till,who led the research,said the treament “has the potential to have a real impact on patients’ lives.”

“Most severe reactions occur because of mistakes, usually by somebody else, and miscommunication. so it provides them with some protection against that,” Till said. “They’ve taken control, if you like, of their peanut allergy now.”

The findings, published in the journal Allergy, demonstrate that adults with severe peanut allergies can increase their tolerance by as much as 100 times.

For Brookes-Smith, the experience was transformative. “The first time I went there and I ingest this stuff, my heart’s going a million miles an hour,” he says. “The big jump in fear was going from peanut dust to half a whole nut.” He found reassurance in the presence of doctors and nurses, equipped with emergency medications. “You’ve got 100 eyes on you—nothing is gonna happen.”

U.S. Efforts and Ongoing Research

While the U.K. trial offers promising results, similar research is underway in the United States. The National Institute of Allergy and Infectious Diseases (NIAID) is funding multiple studies exploring oral immunotherapy and other potential treatments for food allergies.Aimmune Therapeutics’ Palforzia, an oral immunotherapy drug for peanut allergy, was approved by the FDA in 2020 for use in children ages 4-17. While Palforzia doesn’t eliminate the allergy, it helps reduce the severity of reactions to accidental peanut exposure.

However, concerns have been raised about the long-term effectiveness and safety of oral immunotherapy, particularly the risk of allergic reactions during the desensitization process.A 2023 study published in The Lancet found that while oral immunotherapy can increase peanut tolerance, it also increases the risk of allergic reactions compared to strict avoidance.
This has led researchers to explore alternative approaches, such as epicutaneous immunotherapy (a skin patch) and sublingual immunotherapy (under-the-tongue drops), which may offer a safer way to desensitize patients.

A Controlled Approach is Crucial

Experts caution against attempting oral immunotherapy at home due to the risk of severe allergic reactions.”It is critical that oral immunotherapy be administered under the close supervision of a board-certified allergist,” says dr. Susan Smith, president of the American Academy of Allergy, Asthma & Immunology (AAAAI). “These procedures involve a risk of anaphylaxis, and patients must have immediate access to emergency medical care.”

Despite the challenges, the growing body of research on peanut allergy treatments offers hope for those living with this potentially life-threatening condition.

Brookes-Smith, who now eats four peanuts with his breakfast granola every day, reflects on his experience with gratitude: “It’s a marvelous feeling,” he says. “I’m no longer afraid of dying.” He hopes the treatment becomes widely available, so others with severe peanut allergies can experience the same freedom.

“The big jump in fear was going from peanut dust to half a whole nut,” Brookes-Smith said.

FAQ: Peanut Allergies and Immunotherapy

Q: What is oral immunotherapy (OIT) for peanut allergies?
A: OIT involves gradually increasing a patient’s tolerance to peanuts by feeding them small,controlled doses of peanut protein over time,under medical supervision.Q: Is OIT a cure for peanut allergies?
A: No, OIT is not a cure. It aims to reduce the severity of allergic reactions to accidental peanut exposure, but patients must continue to avoid peanuts and carry an epinephrine auto-injector.

Q: Is OIT safe for everyone with peanut allergies?
A: OIT is not suitable for everyone. It carries a risk of allergic reactions and must be administered by a qualified allergist. Patients should be carefully screened before starting OIT.

Q: What are the potential side effects of OIT?
A: Common side effects include itching,hives,stomach pain,vomiting,and wheezing. In rare cases, anaphylaxis may occur.

Q: where can I find a doctor who offers OIT?
A: Consult the AAAAI website or FARE’s website for a list of board-certified allergists in your area who specialize in food allergies and OIT.

Considering the risks and benefits, would you consider enrolling in a clinical trial like this if you or a family member had a severe peanut allergy? Share your thoughts in the comments below

Archyde Exclusive: Hope for Adults with Peanut Allergies – An Interview with Dr. Eleanor Vance

Archyde News brings you an exclusive interview with leading allergist Dr. Eleanor Vance on the forefront of peanut allergy treatment and groundbreaking oral immunotherapy research.

Introduction: The Fight Against peanut allergies

Archyde News: Dr. Vance, thank you for joining us. Peanut allergies affect millions. Can you give us a rapid overview of the problem’s scope?

Dr. Vance: Thank you for having me. Absolutely. Peanut allergies are quite prevalent, affecting roughly 1 in 200 adults and 1 in 50 children in the US. These allergies can cause severe, even fatal, reactions. The good news is that research into treatments is very active.

Oral Immunotherapy: A New Hope

Archyde News: The recent clinical trials,particularly the one mentioned in the U.K. with Chris Brookes-Smith, showed remarkable results.Can you elaborate on this oral immunotherapy (OIT)?

Dr. Vance: OIT fundamentally aims to desensitize the body to peanut protein. Under strict medical supervision, patients begin with incredibly small doses of peanut, gradually increasing this over several months or even years.The goal is to help the body learn to tolerate peanuts to a degree that accidental exposure becomes less dangerous.

Archyde News: It’s a gradual process?

Dr. Vance: Indeed. As highlighted in the trial you mentioned, the initial doses are minuscule, ofen measured in micrograms. This controlled approach is crucial to minimize the risk of severe reactions. Constant monitoring is essential.

Safety and Challenges of OIT

Archyde news: Safety is surely a top concern. What are the potential side effects, and is OIT suitable for everyone?

Dr. Vance: OIT is not a cure and is not a fit for everyone. Common side effects may include mild itching, hives, or gastrointestinal symptoms. in rare instances, anaphylaxis can occur, which is why the treatment is strictly supervised.A proper diagnosis and thorough evaluation by a board-certified allergist are prerequisites.

The Future of Peanut Allergy treatments

Archyde News: Beyond OIT, what other promising avenues are being explored in peanut allergy treatment?

Dr. Vance: There are a few captivating paths.Epicutaneous immunotherapy— using a skin patch — and sublingual immunotherapy with under-the-tongue drops are showing promise and may be safer alternatives. Research into preventative measures for those children identified at high risk of developing a peanut allergy is also underway.

Practical Advice and Hope

Archyde News: For those who suspect they have a peanut allergy, what is your advice?

Dr. Vance: See an allergist for proper diagnosis. It is critical to have an accurate diagnosis. I recommend maintaining a detailed food diary, particularly paying great attention to any reactions, and always carrying an epinephrine auto-injector (EpiPen) and knowing how to use it in case of an emergency is also very critically important.

Archyde News: The clinical trial participants are very grateful for the new found freedom. What gives you hope for the future of peanut allergy treatments?

Dr. Vance: The expanding knowledge base. The clinical trials and research findings, and the increasing awareness about peanut allergies provide so much hope. We’re moving closer to helping with that constant fear and anxiety. OIT isn’t perfect,but for many,it represents a significant shift.

Reader Interaction

Archyde news: Thank you for your insights, Dr. Vance. A final question for our readers: Considering the risks and benefits, would you consider enrolling in a clinical trial like this if you or a family member had a severe peanut allergy? Share your thoughts in the comments below.

This interview has featured the opinions of a medical professional, representing their expert perspective. This is for informational purposes only and is not intended to be medical advice.