Oral Desensitization for Peanut Allergy
This week the Lancet reported results of an oral desensitization study in children with peanut allergy. Peanut allergic children age 7-16 were gradually exposed to increasing oral doses of peanut over a six month period. The goal of the study was to achieve a level of desensitization that would allow the children to safely ingest 1400 mg of peanut protein (about 10 peanuts) without symptoms.
At the end of the study period, 62% of the children had reached the target goal and were able to tolerate 1400 mg of peanut protein. 84% were able to tolerate 800 mg of peanut protein, the equivalent of about five peanuts. In the untreated control group, none of the children were able to tolerate the full dose of peanut protein. Side effects in the group receiving peanut including vomiting, itching of the mouth and wheezing. One child had an allergic reaction to the peanut severe enough to require an injection of epinephrine.
This is another study showing that oral desensitization to peanut in peanut allergic children can be successful and relatively safe. The process does require significant time and effort and is associated with some risk. It is a procedure that cannot be undertaken at home and requires careful monitoring in an allergy specialist’s clinic or hospital setting.
Is it worth the effort? Currently, oral desensitization may significantly reduce the risk of a life threatening allergic reaction occurring in a peanut allergic child who is exposed to peanut by mistake. The procedure is not a cure and does not allow children to enjoy peanut butter or a granola bar without concern of a reaction.