Birthday parties and meetings with friends used to bring danger for Sarah because of her potentially deadly allergy to peanuts. But after receiving treatment to build up her immune system's tolerance to peanuts as part of a Murdoch Children's Research Institute (MCRI) research project, Sarah is now free to enjoy socialising without fear.
Doctors diagnosed Sarah's allergy when she was still an infant and her mum, Antoinette, says it was a frightening and life-altering discovery. "People think it's a lifestyle choice. It's not," Antoinette says. "People need to realise that consuming food that you are allergic to won't just make you ill, it could potentially lead to anaphylaxis. It is absolutely terrifying."
Peanut is the most common cause of life-threatening allergic reactions (anaphylaxis). Currently, the only treatment for peanut allergy is to avoid peanut. This causes lifestyle restrictions and anxiety about accidentally eating peanut, especially when eating out.
Project lead Professor Mimi Tang and MCRI researchers have been trialling two new oral immunotherapy (OIT) treatments – a peanut OIT on its own (increasing daily doses of peanut protein) or peanut OIT combined with a probiotic.
Results show that both peanut allergy treatments, the rapid escalation high dose OIT and the combination OIT plus probiotic achieved remission in around half of patients who were treated, and full desensitisation in an additional quarter of treated patients. Three quarters of patients achieved protection against standard serve amounts of peanut. Both treatments led to significant and substantial improvement in quality of life after 12 months – the first treatments that have been shown to do this.
"Addition of a probiotic did not significantly improve effectiveness compared to oral immunotherapy, however it appeared to enhance tolerability of the treatment, with fewer gastrointestinal symptoms, especially in children between one and five years of age," says Prof Tang. "High dose peanut oral immunotherapy provides meaningful benefit to treated children".
Dr Paxton Loke of MCRI said that, remarkably, 99 per cent of children who achieved remission and ceased treatment were eating peanut as frequently as they liked in the 12 months after stopping treatment.
Antoinette says she often tells her children what a privilege it is to be part of trials that are helping other kids with food allergies. "What the MCRI researchers are doing with food allergies right here in Australia is remarkable," she says.
The Allergy and Immunology Foundation of Australia (AIFA) awarded Professor Mimi Tang the Ann Kupa Food Allergy Research Grant in 2021 to extend this work. This grant will fund a study investigating the underlying mechanisms that support remission of allergy, which will lead to better long-term treatments for peanut allergy. Read more: Immune mechanisms underpinning remission of allergy
The new research was published in The Lancet Child & Adolescent Health https://www.thelancet.com/journals/lanchi/home
Probiotic peanut oral immunotherapy versus oral immunotherapy and placebo in children with peanut allergy in Australia (PPOIT-003): a multicentre, randomised, phase 2b trial
AIFA is the only Australasian charity that is specifically funding allergy and immunology research.
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Content updated 2022