Peanut Allergies

By July 19, 2020 December 21st, 2020 noggin blog

Food allergies, in general, are an exciting field these days

Advances are being made on a regular basis for many of them, in terms of preventing food allergies, diagnosing them more accurately and predictively, and now in treating them as well.  In the past, treatments focused on strict allergen avoidance with management of symptoms that may occur upon accidental exposures.  Little else was available.

Recently, however, treatment paradigms with food allergies have changed significantly for several of the most common food allergies, including peanut, tree nut, milk, and egg.  Of all of these, perhaps none is more important than with peanut allergies, which affect over 3 million people in the United States and are responsible for approximately 25-30% of all food related anaphylaxis deaths.  Peanut allergies are one of the most common life threatening conditions that we address as physicians.  It is also one of the allergies that has undergone that greatest and most exciting progress in terms of treatment.

In most cases, children diagnosed with peanut allergies are quoted statistics asserting their likelihood of outgrowing the allergy, typically somewhere around 20%.  These numbers depended on the severity of the allergy, the age of the patient at diagnosis, the presence of other allergic symptoms, and other factors.  In the past, there would be no mention of treatment to reduce or eliminate the allergy.  That has now changed.  Today, several local allergists can
offer effective treatment of peanut allergies through allergen desensitization for patients aged 5 years and older.  This exciting treatment can, over time, reduce or eliminate allergic reactions to peanut in patients with known peanut allergy.  This is incredibly exciting, and has shown very promising results in the early goings, with success rates often noted of approximately 85% in most studies. In many of these, patients are able to eat peanuts of unlimited
quantities with no reaction at all.

The details of the peanut desensitization protocol are variable.  It is most often done through an oral route, known as Oral Immunotherapy (OIT), with the ingestion of incrementally increasing amounts of a peanut protein powder over 8-12 months.  This starts with an amount much smaller than that found in a single peanut, and escalates over time to patients eating 8-10 actual peanuts on a daily basis with no reaction.  Desensitization can also be done through a peanut patch, which provides a similarly increasing amount of peanut exposure over time.  There are other methods are in use as well, though with less frequency or experience than the oral powder or the patch.

For patients with peanut allergy, this is a very important and even life saving change in the treatment of peanut allergy.  If you have a peanut (or milk, tree nut, or egg) allergy or know of somebody allergic, and this interests you, please consult your personal allergist for more information and to consider if this treatment might available to you.  It can certainly be a life saver.

Written By: Dr. Joshua D. Levin, Dad of Three