Australian researchers hail breakthrough after ‘life-changing’ tolerance persists for up to four years 
 
 Australian researchers have made a breakthrough in the treatment of peanut allergy in children. 
 
 A small clinical trial conducted at the Murdoch Children’s Research Institute has led to two-thirds of children treated with an experimental immunotherapy treatment being cured of their allergy. Importantly, this desensitisation to peanuts persisted for up to four years after treatment. 
 
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 “These children had been eating peanut freely in their diet without having to follow any particular program of peanut intake in the years after treatment was completed,” said the lead researcher, Prof Mimi Tang. 
 
 Peanut allergy is the most common cause of anaphylaxis, a life-threatening allergic reaction, and one of the most common causes of death from food allergy. 
 
 To combat this Tang, an immunologist and allergist, pioneered a new form of treatment that combines a probiotic with peanut oral immunotherapy, known as PPOIT. Instead of avoiding the allergen, the treatment is designed to reprogram the immune system’s response to peanuts and eventually develop a tolerance. 
 
 It’s thought that combining the probiotic with the immunotherapy gives the immune system the “nudge” it needs to do this, according to Tang. 
 
 Forty-eight children were enrolled in the PPOIT trial and were randomly given either a combination of the probiotic Lactobacillus rhamnosus with peanut protein in increasing amounts, or a placebo, once daily for 18 months. 
 
 At the end of the original trial in 2013, 82% of children who received the immunotherapy treatment were deemed tolerant to peanuts compared with just 4% in the placebo group. 
 
 Four years later, the majority of the children who gained initial tolerance were still eating peanuts as part of their normal diet and 70% passed a further challenge test to confirm long-term tolerance. 
 
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 Tang said the results were exciting and had been life-changing for participants. “The way I see it is that we had children who came into the study allergic to peanuts, having to avoid peanuts in their diet, being very vigilant around that, carrying a lot of anxiety with that and, at the end of treatment and even four years later, many of these children who had benefited from our probiotic peanut therapy could now live like a child who didn’t have peanut allergy.” 
 
 The results are published in the Lancet Child & Adolescent Health. 
 
 If confirmed by larger clinical studies, the broader hope is that this treatment can have an impact on the high rates of food allergy among children. 
 
 “This is a major step forward in identifying an effective treatment to address the food allergy problem in western societies,” Tang said. ||||| A breakthrough Melbourne-made treatment that is providing a long-term cure for children with a deadly peanut allergy may soon be widely available. 
 
 The experimental peanut-probiotic treatment led to 82 per cent of children who participated successfully being able to eat peanuts. Now, four years later, 80 per cent of those cured children are still eating peanuts. 
 
 "These children have been eating peanut freely in their diet without having to follow any particular program of peanut intake in the years after treatment was completed," said lead researcher Professor Mimi Tang. 
 
 The clinical trial was conducted at the Murdoch Children's Research Institute in Melbourne. 
 
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 Link More than 80 per cent of children in the Melbourne trial were cured of their peanut allergy. 
 
 Professor Tang hopes a product can be on the shelves in the next five years. 
 
 "This changes sufferers' lives. They can now eat peanuts. Their lives change completely," she said. 
 
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 "Our feedback is these kids are now going to parties without worry." 
 
 The treatment combines a small amount of peanut flour with a very high dose of the probiotic Lactobacillus rhamnosus​. 
 
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 Link Professor Mimi Tang of the Murdoch Childrens Research Institute with Dr Graeme Wald. Photo: Supplied 
 
 This bacterium, commonly found in small doses in yoghurt, is a known immune system modulator – it calms the immune system's response to things it would normally react to, reducing the severity of allergic reactions. 
 
 Paired together, the probiotic mix encourages the immune system to gradually tolerate larger and larger doses of peanut flour. 
 
 "Probiotics are very potent immune-modulating agents to shift the way the immune system responds. This particular probiotic has been shown in other situations to support tolerance-like responses. It creates an environment for the immune system to respond differently," Professor Tang said. 
 
 About 3 per cent of babies are born with a peanut allergy. Peanuts are among the most-common causes of anaphylaxis with hospital admissions over the past decade increasing five-fold in children under four. 
 
 In 2013 Professor Tang's team administered the therapy to 28 allergic children. 
 
 The amount of peanut flour was slowly increased over about 18 months, allowing the children to build up tolerance. At the end of the original trial, 82 per cent of treated children were happily eating peanuts as part of a normal diet. 
 
 In a follow-up study, researchers went back and re-tested those children for peanut allergy to determine if the treatment had lasted. 
 
 It had. They found that four years later, 80 per cent of those cured children were still showing no signs of allergic reaction to eating peanuts. 
 
 "These findings suggest our treatment is effective at inducing long-term tolerance, up to four years after completing treatment, and is safe," Professor Tang said. 
 
 
 
 "It also suggests the exciting possibility that tolerance is a realistic target for treating food allergy. This is a major step forward in identifying an effective treatment to address the food allergy problem in Western societies." 
 
 The institute will now work with a venture capital firm to fund the commercialisation of a treatment, which would involve doses of powder taken every day for 18 months. 
 
 With AAP ||||| Skin patch to treat peanut allergy shows benefit in children 
 
 NIH-funded study suggests patch is safe, convenient mode of treatment. 
 
 DBV Technologies, Copyright 2016 
 
 A wearable patch that delivers small amounts of peanut protein through the skin shows promise for treating children and young adults with peanut allergy, with greater benefits for younger children, according to one-year results from an ongoing clinical trial. The treatment, called epicutaneous immunotherapy or EPIT, was safe and well-tolerated, and nearly all participants used the skin patch daily as directed. 
 
 The ongoing trial is sponsored by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, and conducted by the NIAID-funded Consortium of Food Allergy Research (CoFAR), which is led by Hugh Sampson, M.D., of Icahn School of Medicine at Mount Sinai in New York. Stacie Jones, M.D., of the University of Arkansas for Medical Sciences and Arkansas Children’s Hospital, chairs the study. One-year outcomes are published online on October 26 in the Journal of Allergy and Clinical Immunology. 
 
 “To avoid potentially life-threatening allergic reactions, people with peanut allergy must be vigilant about the foods they eat and the environments they enter, which can be very stressful,” said NIAID Director Anthony S. Fauci, M.D. “One goal of experimental approaches such as epicutaneous immunotherapy is to reduce this burden by training the immune system to tolerate enough peanut to protect against accidental ingestion or exposure.” 
 
 CoFAR researchers at five study sites randomly assigned 74 peanut-allergic volunteers aged 4 to 25 years to treatment with either a high-dose (250 micrograms peanut protein), low-dose (100 micrograms peanut protein), or placebo patch. The investigators assessed peanut allergy at the beginning of the study with a supervised, oral food challenge with peanut-containing food. The patches were developed and provided by the biopharmaceutical company DBV Technologies under the trade name Viaskin. Each day, study participants applied a new patch to their arm or between their shoulder blades. 
 
 After one year, researchers assessed each participant’s ability to consume at least 10 times more peanut protein than he or she was able to consume before starting EPIT. The low-dose and high-dose regimens offered similar benefits, with 46 percent of the low-dose group and 48 percent of the high-dose group achieving treatment success, compared with 12 percent of the placebo group. In addition, the peanut patches induced immune responses similar to those seen with other investigational forms of immunotherapy for food allergy. Investigators observed greater treatment effects among children aged 4 to 11 years, with significantly less effect in participants aged 12 years and older. 
 
 “The clinical benefit seen in younger children highlights the promise of this innovative approach to treating peanut allergy,” said Daniel Rotrosen, M.D., director of NIAID’s Division of Allergy, Immunology and Transplantation (DAIT). “Epicutaneous immunotherapy aims to engage the immune system in the skin to train the body to tolerate small amounts of allergen, whereas other recent advances have relied on an oral route that appears difficult for approximately 10 to 15 percent of children and adults to tolerate.” 
 
 Nearly all of the study participants followed the EPIT regimen as directed. None reported serious reactions to the patch, although most experienced mild skin reactions, such as itching or rash, at the site of patch application. 
 
 “The high adherence to the daily peanut patch regimen suggests that the patch is easy-to-use, convenient and safe,” said Marshall Plaut, chief of DAIT’s Food Allergy, Atopic Dermatitis and Allergic Mechanisms Section. “The results of this study support further investigation of epicutaneous immunotherapy as a novel approach for peanut allergy treatment.” 
 
 Additional studies in larger groups of children are needed before the therapy could be approved for wider use. The CoFAR study continues to assess the long-term safety and effectiveness of peanut EPIT. After the first year, all participants began receiving high-dose daily patches, and they will continue in the study for a total of two and a half years of EPIT. 
 
 The work was funded by NIAID, NIH, under award numbers U19AI066738 and U01AI066560. Additional support was provided by NIH’s National Center for Advancing Translational Sciences. The ClinicalTrials.gov identifier for the study Epicutaneous Immunotherapy for Peanut Allergy (CoFAR6) is NCT01904604. The CoFAR clinical sites involved in the trial are Arkansas Children's Hospital in Little Rock, National Jewish Health in Denver, The Johns Hopkins University in Baltimore, Icahn School of Medicine at Mount Sinai in New York and the University of North Carolina at Chapel Hill School of Medicine. 
 
 NIAID conducts and supports research — at NIH, throughout the United States, and worldwide — to study the causes of infectious and immune-mediated diseases, and to develop better means of preventing, diagnosing and treating these illnesses. News releases, fact sheets and other NIAID-related materials are available at https://www.niaid.nih.gov. 
 
 About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov. 
 
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– Could a cure for peanut allergies be close? Australia's ABC reports that in a new study, 82% of participants saw their peanut allergies cured within the first 18 months of treatment. Four years later, 80% of the participants still showed no signs of an allergy, and 70% passed a further test meant to confirm long-term peanut tolerance, the Guardian reports. The research out of Australia's Murdoch Childrens Research Institute involved 48 children, some of whom were given an immunotherapy treatment and some of whom got a placebo. The children who still appeared to be cured four years later "had been eating peanut freely in their diet without having to follow any particular program of peanut intake," says Mimi Tang, the lead researcher. Tang, an immunologist and allergist, combined a probiotic with a method known as peanut oral immunotherapy—a high dose of the probiotic Lactobacillus rhamnosus was combined with peanut protein in increasing amounts. The probiotic is known to calm the immune system and reduce allergic reactions; the idea is to "reprogram" the way the immune system reacts to peanut intake, Tang explains. She hopes to have a product to market within five years, the Age reports. "For the first time, we could have products on the market that provide meaningful and long-lasting treatment benefits, which allow sufferers to eat peanut products without thinking about it, as part of a regular diet," says the CEO of a biotech firm working on a treatment doctors will be able to prescribe, per 9News. (Here's when and how you should feed your baby peanuts.)