Science is constantly finding new ways to wow us. Be it a means of traveling more efficiently, a piece of technology that enhances our day-to-day experiences, or a development that can help us live a little better or longer, there is always a new discovery or finding that is entirely worthy of our applause.
That’s especially true when it comes to the relatively underdeveloped – and unexplored – world of food oral immunotherapy.
For those of you who have ever been place on environmental allergen immunotherapy, food oral immunotherapy is similar. We start out feeding a patient their allergenic food starting at a level below the known allergic threshold. Then, we slowly increase the amount fed over time. The idea is that this slow, repeated exposure will increase the regulatory cells that inhibit allergy cells. When those regulatory cells are at high enough levels, they can inhibit the allergic cells.
But what is the current state of oral immunotherapy? What are the key risks, benefits, and how is the practice set to alter in the years to come?
The current state
Food allergies can be incredibly detrimental. Estimates suggest that in there are approximately 32 million Americans with food allergy (https://www.foodallergy.org/resources/facts-and-statistics) and every year 200,000 people require emergency room visits for food allergy reactions (https://www.foodallergy.org/resources/facts-and-statistics). There are 1.81 deaths per million people in the United States attributed to anaphylaxis from food allergy (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4165304/).
That’s where oral immunotherapy comes in. While it is not quite prime time, many of us Allergists have been using this tool for years and it has proven to be very effective. Therapies utilizing milk, for example, have been found to be incredibly beneficial to school-aged children (https://www.ncbi.nlm.nih.gov/pubmed/22897785), while oral immunotherapy to directly target egg allergies has also been proven to be very efficient (https://www.medscape.com/viewarticle/768858).
There are still the risk of some side effects. For example, many people utilizing such treatments have stated that they can develop difficulties when it comes to swallowing, vomit more than is usual, have an itchy mouth that cannot be dealt with, and suffer temporary bouts of wheezing. Some patients do experience anaphylaxis (which is a severe allergic reaction and some of the common symptoms are shortness of breath, wheezing, chest tightness, swelling of the throat or tongue) and it is relatively common to have gastrointestinal symptoms. If these cannot be endured through the course of the treatment, the effectiveness of the treatment may be limited. It is hoped that these issues will be ironed out over time, but at the moment they do exist. Some of us are hoping that Xolair (omalizumab) will also soon be indicated to help patients through Food oral immunotherapy. These studies have ALREADY started, and they are looking promising!
It is estimated that nearly 2.5 % of U. S. children may have an allergy to peanut, up 21% since 2010 (https://acaai.org/news/new-study-suggests-21-percent-increase-childhood-peanut-allergy-2010). This is perhaps the most concerning, most common and most unpredictable of the food allergens. But there is now new hope…
In January 2020, the FDA – the Food and Drug Administration of the United States, that approves drugs and oversees food for human consumption and safety- announced that it had approved the use of Palforzia, an oral immunotherapy medicine designed to assist those with peanut allergies. It has been designated for children, ages of 4 and 17 set to benefit. However, while the FDA has concluded that this treatment is effective and safe, it is still advised that sufferers refrain from eating peanuts. It is designed to reduce or eliminate the severe allergic response that occurs from accidental ingestion of peanut. It is not designed to allow free eating of peanut.
The FDA-approval of Palforzia opened the door to consider food not just a food, but also a medication. We at Relieve Allergy, Asthma & Hives have been using not only Palforzia, and not only peanut, but other items such as egg, milk, tree nuts, etc. in food oral immunotherapy. Imagine having a very allergic child and sending them off to college. It is extremely worrisome when you no longer have control or if you always wonder if your child will take care of themself. Now, imagine knowing that your child will not have anaphylaxis or if they do, will have a survivable anaphylaxis when they accidentally ingest food….that is the intent of food oral immunotherapy.
If you would like to be tested for your allergies or believe you might be a good candidate for food oral immunotherapy or would just like to understand your food allergies, Dr. Wendt and her staff at Relieve Allergy, Asthma & Hives would love to help. Read her book, What’s Eating Our Kids? A Parent’s Guide to Food Allergy, Intolerance, and Toxicity.
Call 480-500-1902 or request an appointment at https://relieveallergyaz.com/contact now! Begin your allergy testing journey with Dr. Wendt at Relieve Allergy in Scottsdale, Arizona—It’s time to take care of yourself!
Learn more about Dr. Wendt and Relieve Allergy Asthma & Hives at www.relieveallergyaz.com or connect with us: https://www.facebook.com/RelieveAllergy/, https://www.linkedin.com/in/julie-wendt/, https://x.com/RelieveAllergy, https://www.instagram.com/relieve_allergy/ or https://www.youtube.com/@JulieWendt-qx7jm
Relieve Allergy Asthma & Hives is located near Kierland Commons, 21803 N. Scottsdale Road Ste. 200, and has convenient evening and morning hours to accommodate your schedule. Dr. Wendt is also available for telemedicine appointments as appropriate. Most insurance plans are accepted.
DISCLAIMER: This blog is not meant to substitute for medical care by an Allergist-Immunologist nor is it intended to provide medical advice or imply a Physician-Patient relationship with its readers or their family. It is intended to provide guidance, direction, and moral support from someone experienced in testing and treating allergies. This is also not meant to be a “do-it-yourself” manual or a “how to” overcome your allergies. Some of the issues mentioned, whether allergic or look-a-like, can be dangerous or if left unchecked, deadly. Please develop a relationship with a Physician you trust to help you with diagnosis, advice, questions, and treatment regarding your and your family’s medical conditions.
