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Peanut Allergy Treatment Trial In UK "A Success"

Posted by samzenpus on from the what-doesn't-kill-me dept.

cold fjord writes: "The BBC reports, 'Peanuts are the most common cause of fatal allergic reactions to food. There is no treatment so the only option for patients is to avoid them completely, leading to a lifetime of checking every food label before a meal. The trial ... tried to train the children's immune system to tolerate peanut. Every day they were given a peanut protein powder — starting off on a dose equivalent to a 70th of a peanut. Once a fortnight the dose was increased while the children were in hospital and then they continued taking the higher dose at home. The majority of patients learned to tolerate the peanut. ... Dr Andrew Clark, told the BBC: "It really transformed their lives dramatically, this really comes across during the trial. ... Dr Pamela Ewan added ... further studies would be needed and that people should not try this on their own as this "should only be done by medical professionals in specialist settings."' The story also notes, 'The findings, published in the Lancet, suggest 84% of allergic children could eat the equivalent of five peanuts a day after six months.'"

26 of 192 comments (clear)

  1. Standard practice... by Anonymous Coward · · Score: 5, Informative

    in treating various allergies in the past 10 years. Good studies since 70's.
    http://www.ncbi.nlm.nih.gov/pubmed/147019

    1. Re:Standard practice... by Shimbo · · Score: 3, Insightful

      It's not a particularly surprising result but it's one thing saying that after the fact, and another to do a good quality trial. 90-99% of science (well, to be honest, pretty much of everything worth doing) takes skill and patience rather than a moment of brilliance.

    2. Re:Standard practice... by DMiax · · Score: 5, Informative

      Correct. But I suspect the hurdle here was to isolate the allergenic factor and administering it correctly. It is not as simple as splitting a peanut in 70 parts: you have to find the right protein, isolate it and dose it. It can be a bitch to do. The results prove that the protein was the right one and that the doses were ok. Finally, the treatment does not work with any substance: there are things that will remain lethal whatever happens as our immune system just cannot catch them. So that is another good news.

    3. Re:Standard practice... by sjames · · Score: 4, Informative

      It seems that it WAS standard practice for a long time then medicine forgot all about it for a few years and decided avoidance was the only useful strategy.

      Now they seem to be back to the idea that desensitization works and avoidance just causes more allergies. Peanut allergy is a growing problem in the UK because expectant mothers were urged to avoid peanuts.

    4. Re:Standard practice... by Chrisq · · Score: 4, Interesting

      It is not as simple as splitting a peanut in 70 parts.

      Excuse my ignorance but why isn't it that simple? If you started feeding people with 1/70 of a peanut and worked your way up wouldn't that have the same effect as extracting the protein responsible fro the reaction and doing the same thing?

    5. Re:Standard practice... by Pino+Grigio · · Score: 3, Insightful

      The thing is, if you just use peanuts you can't charge £100 a shot for the drug.

    6. Re:Standard practice... by marsu_k · · Score: 5, Interesting

      My daughter's milk allergy (yes, milk allergy, not lactose intolerance) was treated this way. It started with an almost homeopathic dosage, one drop of milk diluted to 1/20 per day, gradually increasing the dosage over six months. Now she's able to use dairy products freely, which is great. But the treatment doesn't really get rid of the allergy, it just builds a resistance for it, requiring that she gets at least some milk protein in her diet daily. I'll echo the summary though - don't try this without a medical professional.

    7. Re:Standard practice... by uglyduckling · · Score: 3, Insightful

      Because these people tend to die when they eat peanuts. You need to know how to do it in a very careful, controlled manner otherwise people will die. Mostly children. That would be a bad thing.

    8. Re:Standard practice... by somepunk · · Score: 4, Informative

      Not every 70th part is the same. Not homogenous. There's different stuff on the surface, probably a couple layers, and then there's the germ of the seed vs the bulk which is food for the germinating plant, and so on.

      --
      Those people who think they know everything are a great annoyance to those of us who do. (Isaac Asimov)
    9. Re:Standard practice... by Paradise+Pete · · Score: 5, Insightful

      there is no really good reason that a tiny, tiny bit of peanut butter in a large meal won't work.

      Yes there is. Peanut butter, no matter how well you stir it, will have random clumps of the allergen and people will die. More stirring does not solve the problem. Random does not mean equal distribution. It means random distribution, some of which will be in larger clumps.

    10. Re:Standard practice... by jellomizer · · Score: 4, Informative

      However I could see a lot of parents trying this, to a disastrous effect, because it could be the kid who has extremely small tolerance, will get too much and hurt themselves. or increasing the dosage goes too fast for the child.

      The real benefit of giving these kids treatments, isn't so they can have a peanut butter sandwich, but have foods that have touched nuts, and go to school and sit at the same table as someone eating a Peanut butter sandwich.

      --
      If something is so important that you feel the need to post it on the internet... It probably isn't that important.
    11. Re:Standard practice... by 0100010001010011 · · Score: 3, Insightful

      Blend 70,000 peanuts. Administer to 1,000 people.

    12. Re:Standard practice... by _anomaly_ · · Score: 3, Insightful
      1,000 peanuts and 70,000 people

      ;-)

      --
      "I have no special gift, I am only passionately curious." - Albert Einstein
    13. Re:Standard practice... by ebh · · Score: 4, Interesting

      Who was it who said, "Most scientific discoveries aren't hailed with 'Eureka!', but rather with, 'Hmmm, that's weird.'"?

  2. Why? by Demonoid-Penguin · · Score: 4, Interesting

    Not why do it, but why does the treatment work? The cited Lancet article doesn't seem to offer any answers (or hint at any efforts to find them).... development of enzyme reserves??

    And what of the annecdotal relationship between peanut allergies and *not* breast feeding?

    1. Re:Why? by Anonymous Coward · · Score: 5, Informative

      Allergy is an immune system reaction to something that shouldn't be a problem in the first place. It thinks that something (in this case peanuts) is dangerous, and launches a full scale defense.

      The trick here is simply to get the immune system used to the substance causing the reaction, so that it will think it's normal, rather than becoming defensive. This seems to work, as long as you increase the dose slowly. The method has been used with some success against other allergies for some time, but trying it on an often fatal allergy like peanut allergy is new.

      Now, why peanut allergy is so much more dangerous than all the other allergies, I have no idea. But as this trial worked, it does indicate that peanut allergy works like any other allergy.

    2. Re:Why? by oneandoneis2 · · Score: 3, Interesting

      In terms of the actual mechanism: as far as I recall, immune cells develop with a random specificity: It's pure chance what they'll recognise.

      If they're exposed to something that they will react to in their development time, they die: This is how we prevent them from reacting to ourselves.

      So although it won't do anything to existing immune cells, the persistent presence of peanuts will at least prevent any new immune cells popping up that will react to them.

      --
      So.. it has come to this
  3. Luckily by Meneth · · Score: 4, Funny

    I've spent the last few years building up an immunity to iocaine powder. :)

  4. Re:the remaining 16% by sjames · · Score: 5, Interesting

    Contrary to the media hype, MOST people with peanut allergies don't have a fatal reaction. Just in case, the dosing was started in a hospital setting.

  5. Nutty parents by giorgist · · Score: 4, Interesting

    I know of parents that don't give peanuts to their kids since babies, just in case they have allergies. So the kid does not develop protection. They give them allergies out of paranoia

    1. Re:Nutty parents by gnoshi · · Score: 4, Interesting

      The advice being provided by the state-provided Maternal and Child Health Nurses in Australia (or at least, the ones I know of) is now to start giving children pulverized nuts (so they don't choke on them) as part of their diet from the very beginning of consuming food, apparently for this exact reason.

  6. Re:"There is no treatment" by uglyduckling · · Score: 3, Insightful

    Then you probably didn't have an anaphylactic "immediate hypersensitivity reaction after peanut ingestion" as the article says. If you had, your mother probably would have been terrified of putting you near a peanut ever again.

  7. Feed your kids, people by Gothmolly · · Score: 5, Insightful

    Feed your kids real food, people, and let them play in the dirt. Get a pet. If you want your kid to have a healthy normal life, expose them to things in normal life. If you wrap them in Triclosan-scented everything and feel them gluten/soy/sugarfree Brawndo for years, they'll never learn to metabolize or tolerate anything else. Life carries risk, and as much as public education has taught you that causality is a human construct, it ain't - learn to deal with things or they'll deal with you, you pussies.

    --
    I want to delete my account but Slashdot doesn't allow it.
    1. Re:Feed your kids, people by orgelspieler · · Score: 4, Insightful

      OK. So I have two kids. Both of them were raised essentially the same way. If anything, the younger was coddled more, and spent less time in daycare. Yet the elder has severe dairy allergy, and the younger has none. My brother and I grew up in the same house exposed to the same pets, playing in the same dirt. I am allergic to cats now. He is not. My wife has peanut allergy; her sister does not. The list could go on, but you get my point.

      Are you really implying that people should feed their kids food they're allergic to? "Well son, sure you can't breathe and you're covered in hives, but at least Gothmolly doesn't think you're a pussy!"

      Do you really think it's as simple as "go play in dirt and you won't get allergies"? I've got a different unsupported hypothesis pulled out of my ass. The reason why more sanitary countries have more allergies is because in the developing world, the people with allergies don't live long enough to pass their genes down to the next generation. Had I been born in some third world country, I would have died before I turned 10 due to respiratory problems.

  8. Louis CK covered this by Gravis+Zero · · Score: 3, Funny

    Louis CK: Of Course But Maybe

    --
    Anons need not reply. Questions end with a question mark.
  9. Re:suggestions are changing by mjr167 · · Score: 5, Informative

    And it is going to take a long time for those new recommendations to make their way into the general public. There are piles of parenting help books that old parents gleefully shovel onto new parents. There are articles and magazines and Grandma and the crotchety old lady down the street. Everyone has an opinion about how you should be raising your kids and how you are doing a shitty job at it and your kids are going to die or need therapy or be a bum because you didn't give them the special new omega whatever supplement that promotes brain growth.

    And the advice is constantly changing. My husband is the youngest of three. His eldest brother slept on his stomach as a baby. Their mom was told to put the middle one on her side using this bizarre wedge pillow everyone had to buy or your baby would die, and by the time he was born, we had decided that babies had to sleep on their back. They just recently came out telling us to keep kids in rear facing car seats until they are two and they are pretty much in booster seats until they turn 21 now.

    On top of that, you only ever really get one shot at being a parent. You might get a couple tries with different kids, but each kid is only ever a baby once.

    So give the parents a break. They've never done this before, are sleep deprived, are the scourge of all the non-parents in the grocery store, and all they really want to do is go home, drink a beer, watch a TV show that doesn't involve a super hero named 'Word Girl' from the planet Lexicon, fall asleep, and not get woken up by a 30 lb bouncing bundle demanding pancakes at 5AM on a Saturday.