Megan was just two when she had her first allergic reaction to peanuts. “I don’t remember it at all, but my parents told me that they had given me a little Filipino cookie, and I ate it. Then I wasn’t able to breathe and I had to be rushed to the hospital and I nearly died. “ Since then, she’s done well to avoid potential allergens, but that has become harder now that she is in college. “It’s been common recently, especially with all the food options I have available to me now... In the last year, it’s been 5 or 6 times.” While she’s careful to monitor her food, she still faces risks from accidental exposure, usually due to cross-contamination or forgetting to check if certain foods were prepared with peanut oil.
Megan is not alone in her struggles. An estimated 15 million in the U.S. suffer from food allergies. Of those, roughly 200,000 Americans must seek emergency medical care after exposure each year. For those who suffer from food allergies, micromanaging exposure to allergens can be tedious. Sometimes, even close monitoring can still result in allergic reactions; one girl died when her boyfriend kissed her after ingesting peanut products. Another girl died after she ate a Rice Krispies treat made with peanut butter while at a summer camp. When one suffers from food allergies, it can introduce anxiety into even the most quintessentially benign daily occurrences.
Fortunately, a team of scientists offers some hope to people with food allergies. An article recently published in The Lancet Child & Adolescent Health offers a way to possibly train the body to not activate its allergic response. The researchers call themselves the PPOIT study team, which has been studying the long-term effectiveness of Probiotic and Peanut Oral Immunotherapy. The purpose of this treatment is to help the body develop a tolerance to the allergens.
To understand how this works, it’s important to have a general understanding of allergic reactions. Food allergies, like most other allergies, occur when the body produces antibodies to the antigens, or chemical markers, of a particular substance. When someone who has hypersensitive T-helper cells is first exposed to a certain antigen, the body’s T-helper cells release certain signals, which can tell B-cells to produce an antibody called Immunoglobulin E, or IgE. These IgEs can bind to what are called mast cells, which are responsible for recognizing the allergen’s antigens the next time it enters the body. The second time someone with a food allergy is exposed to their allergen, the mast cells will release lots of chemicals such as histamine, which triggers an inflammatory response like swelling or hives, as well as other physiological responses.
To prevent this from happening, the body must be trained not to activate its inflammatory response. The idea behind immunotherapy is that by slowly introducing increasing amounts of an antigen, the body will learn to secrete more Immunoglobulin G (IgG), which can prevent IgEs from binding to the cells which can activate a severe inflammatory response. Instead, the body will rely more on the white blood cells to take care of the foreign substance.
To help simplify how this works, here’s an analogy: imagine someone who is extremely afraid of flames seeing a lit candle at their workplace. At first, their fear may tempt them to do something extreme, like pulling a fire alarm, disrupting the workflow of the entire building. This is like the regular allergic response, a big reaction to something that really is not a problem. Immunotherapy would be like teaching that same person to maybe use a fire extinguisher. Is it still somewhat of an overreaction? Sure. The person might not be able to completely get rid of their fear of flames, and the reaction is still more than what’s really necessary, but at the very least, their response to such a fairly harmless flame won’t throw the whole building into chaos.
This therapy has been examined for quite some time now, but the results were someone inconclusive. However, the study conducted by the PPOIT team was the first to examine the long-term effects of this therapy on people with peanut allergies. Their study concluded with 67% of participants who received the experimental treatment being able to ingest peanuts after 4 years of treatment. It offers a remarkable possibility that food allergies may soon be a thing of the past.
The benefits of this treatment extends hope, primarily, to people with food allergies. This treatment could reduce the risk of contaminants or simple forgetfulness causing casualties, or even fatalities. It can avail more convenient sources of nutrients to people who must currently search for alternative, and sometimes pricier, alternatives to natural products. It can reduce the medical costs incurred by patients and their families. Furthermore, it could someday spare both allergy patients and businesses huge costs in legal fees.
While there is still more that needs to be done before this treatment can be widely implemented, it is well on its way. It could be only a few more years before people like Megan will not have to look at a peanut butter cookie as if it is a deadly last meal.
