post-title Update on food allergy treatments: Are we close to a cure? 2012-12-12 14:43:28 yes no Posted by

Update on food allergy treatments: Are we close to a cure?

By Philip N. Rancitelli, M.D., F.A.A.A.A.I Unfortunately, the prevalence of food allergies is increasing. Current estimates suggest 6-8 percent of children have food allergies, while about 2-4 percent of adults are affected. A handful of foods (peanut, tree nuts, seafood, cow’s milk, soy, and wheat) accounts for most reactions in children. Adults are more likely to react to nuts and […]

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By Philip N. Rancitelli, M.D., F.A.A.A.A.I

Unfortunately, the prevalence of food allergies is increasing. Current estimates suggest 6-8 percent of children have food allergies, while about 2-4 percent of adults are affected. A handful of foods (peanut, tree nuts, seafood, cow’s milk, soy, and wheat) accounts for most reactions in children. Adults are more likely to react to nuts and seafood. However, any food can cause an allergic reaction.

The current standard of care for treatment of food allergies is strict avoidance, but unfortunately accidental ingestions are common. Avoidance is difficult because common food allergens are found in a variety of foods, and food cross-contamination frequently occurs. Avoidance of foods can lead to nutritional deficits, especially with children who must avoid multiple foods. Obviously, better therapeutic approaches are needed, and recent research in this area has given hope to food allergy sufferers that a cure is near.

In 2005, the National Institute of Allergy and Infectious Diseases (NIAID) established The Consortium of Food Allergy Research (CoFAR) to study food allergies. Current research centers include Mount Sinai Medical Center, Johns Hopkins University, National Jewish Health, The University of Arkansas, and The University of North Carolina at Chapel Hill. Research has focused on disease modifying therapies with an emphasis on egg, cow’s milk and peanut.

Most research to date has focused on oral immunotherapy (OIT) and sublingual immunotherapy (SLIT). These methods utilize protocols in which patients are given increasing amounts of the food allergen by mouth in a research setting with close observation. Results have shown reduced food reactivity during treatment phases, but questions remain regarding whether these strategies induce long-term tolerance once treatment is discontinued. There are safety concerns as well.
Obviously, introducing a known allergen into the body is risky and could result in a severe reaction.

There are many other strategies under investigation that are promising.  Immunotherapy with genetically engineered foods is an interesting concept.  Theoretically, one could engineer a food protein with special characteristics that promote tolerance while minimizing the potential for an allergic reaction. Anti-IgE therapy is a consideration. IgE (a.k.a the allergic antibody) is found in high levels in allergy sufferers, and food-specific IgE drives allergic responses to food allergens.  Anti-IgE therapy is currently only FDA approved to treat allergic asthma, but theoretically it could work for any allergic condition. Chinese herbal therapy has been gaining widespread acceptance as a possible treatment for allergic diseases, but its mechanism of action remains unclear. Thus far, research has focused on Food Allergy Herbal Formula 2 (FAHF-2) with promising results. There are other therapies being considered as well.

Although the only currently approved treatment option for food allergies is strict avoidance, the explosion of research in this field should give hope to food allergy sufferers waiting for a true disease-modifying therapy. Unfortunately, more studies focusing on efficacy and safety will be required before any of these therapies gain widespread approval as alternatives to the current standard of care.

Working with an allergist/immunologist at Midwest Allergy, Asthma and Immunology you can be assured that you will be kept updated on all the current food allergy research. If you would like to read more in depth on this subject, the following article might be interesting to you:

Rancitelli P, Hofman A, Burks AW (2011) Vaccine Approaches for Food Allergies.
Curr Top Microbiol Immunol 352:55-69.

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