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3. December 2020
from the University of British Columbia
It’s a world full of peanuts – or at least it can feel that way for kids with peanut allergies. A new study from researchers at the University of British Columbia and BC Children’s Hospital gives hope to parents and children at real danger from exposure to peanuts.
« Peanut allergies are often misperceived – it’s not a serious health problem. Although the risk of a fatal reaction to peanuts in peanut allergy patients is small, it has a significant impact on quality of life and many families feel hopeless in dealing with a problem that may seem unmanageable, « said the study’s lead author Dr. . Edmond Chan, Director of Child Allergy and Immunology at UBC Medical School and Clinical Investigator at BC Children’s Hospital Research Institute.
The study recently published in the Journal of Allergy and Clinical Immunology: In Practice is the first to show that children are exposed to a small, regular dose of an allergen (in this case, peanuts) in practice (outside of a clinical trial) effectively reduces the risk of allergic reactions.
The method of treatment known as oral immunotherapy involves gradually increasing the amount of peanuts (or peanut products) given to the child. One goal of treatment is desensitization, which allows the child to ingest a full serving of peanuts without causing a dangerous reaction. Another aim is to protect against accidental exposure and to reduce or eliminate the need for adrenaline injections in response to reactions. To maintain immunity, the child must continue to eat peanut products regularly.
In the course of this study, 117 preschool children – between the ages of 9 months and five years – with peanut allergies from across Canada were given a daily maintenance dose of 300 mg of peanut protein – the equivalent of about one peanut or a quarter teaspoon of peanut butter.
After a year, the researchers found that nearly 80 percent of preschoolers could eat 15 peanuts (equivalent to 4,000 mg of peanut protein) with no reaction during oral exposure monitored by allergy sufferers. And almost every child (more than 98 percent) who took part in the study was able to eat three to four peanuts with no response, which is enough to protect against 99 percent of accidental exposures.
Although some children in the study (Jan.. 4 percent) showed an allergic reaction during oral exposure monitored by allergy sufferers; the reactions were mild (14th. 5 percent) or moderate (six percent). Two children received adrenaline for moderate responses. There were no severe reactions.
This study follows another analysis by the same researchers last year that first demonstrated the safety of oral peanut immunotherapy for a large group of preschool children when offered as routine treatment in a hospital or clinic rather than within a hospital became clinical study.
« Thanks to oral immunotherapy, these children can now accidentally eat something with peanut butter – like a cookie or cake – and experience no reaction, which is wonderful news for families, » said lead study author Dr. . Lianne Soller, UBC allergy research manager at BC Children’s Hospital.
For Ravinder Dhaliwal, oral immunotherapy for her family and their six-year-old daughter Saiya, who was diagnosed with peanut allergy as a child, played a crucial role.
« Before starting therapy, our lives were frightened because every outing revolved around their food allergies, » Ravinder said. « Now we can go to a restaurant or a birthday party without being scared all the time. «
As one of the study participants, Saiya received maintenance therapy in the spring of 2018 and ate a small amount of peanut product every day. A year later, she was able to eat 20 peanuts in one session without having a reaction.
Today Saiya not only eats peanut butter sandwiches three times a week – she is enjoying the taste of peanut products for the first time in her life and asks for them as a reward.
« After oral immunotherapy, I’m no longer scared – it’s like having a shield to protect my child. The experience strengthened us all, « said Ravinder.
According to Chan and Soller, the earlier children undergo oral immunotherapy, the better. If this option is not checked, peanut allergies will most often last for life and the reactions can become more severe, which can lead to social isolation, bullying, and anxiety.
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