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Immunotherapy for peanut allergies: A Q&A

Immunotherapy for peanut allergies: A Q&A

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Results from a clinical trial using anti-peanut allergy therapy has doctors eyeing the possibility of a new drug that could help change this life-threatening condition into more of a nuisance.

The trial tested the efficacy of a new immunotherapy that isolates certain peanut proteins and exposes allergic individuals to minute amounts of the substance. The idea is to strictly regiment the small dosages, and allow the immune system to get used to the peanuts without reacting adversely.

Sharon Chinthrajah, MD, clinical associate professor of medicine, led the effort at Stanford, which was one of 66 sites to take part in the study. I had a chance to talk more with Chinthrajah about her thoughts on the trial and what it means for the future of food allergies overall. Here’s a clip from our conversation:

What’s the main thing that parents of children with severe peanut allergies should understand about the outcome of the trial?

Two out of three patients who were treated with daily AR101 oral immunotherapy were able to tolerate two peanuts after one year of therapy. Now, this isn’t a permanent cure, but taking roughly the equivalent of one peanut every day can change a patient’s and family’s quality of life. AR101 has the potential to be the first FDA-approved therapeutic for peanut allergy, paving the way for more treatment options and greater access.

What do you say to people who may want to try to desensitize themselves or their children to a food allergen on their own?

We highly discourage desensitization at home without the guidance of trained allergists and clinical staff. The Sean N. Parker Center for Allergy and Asthma Research at Stanford provides tremendous education and training about how to make this a safe process and how to take precautions with dosing. There is still a lot we are trying to understand.

Can you speak to some of the other work that’s being pursued in food allergy desensitization? Is there ongoing research to see if oral immunotherapy could work for other allergy-triggering foods, like eggs or shellfish?

Multiple therapies are currently being explored, such as a phase-3 study investigating a peanut patch that delivers very small amounts of peanut via the skin. Other trials include under-the-tongue immunotherapy with peanut combined with another compound that may stimulate the efficiency of the immunotherapy process. There are also a large number of phase-2 studies showing success in oral immunotherapies for eggs, dairy, wheat, shellfish, tree nuts — even for multi-allergen oral immunotherapy, where patients are treated for multiple food allergens simultaneously.

Our center has investigated combining certain drugs targeting allergic pathways with oral immunotherapies for patients with peanut, milk and multiple food allergies. Our goal is to identify approaches and markers that can help clinicians best deliver safe and efficacious therapy for food-allergy patients, and we’re excited to continue applying these principles in studies we’re designing for the future.

Photo by Radu Marcusu

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