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Eugenie Obina
Professor Bright
UWP 1
10 March 2014
Desensitize Me
A food allergy does not control oneself. Instead, one should actually control his or her
food allergies. This disorder should be thought as minor interjections in the human body. Small
interjections could eventually disappear after a while. The only way that could happen is if one
forces them to vanish. With food allergies, a way to actually make them disappear is if one starts
the desensitization process. Because food allergies are on the rise in our society, we should
encourage desensitization as a treatment for people with food allergies since desensitizing
provides assuring results of a progressive tolerance and can potentially reach a widespread
treatment.
Factors of Food Allergy: Characteristics and Alteration
Food itself does not simply trigger an allergic reaction in the human body. In general,
there are two types of reactions to food allergies: an immediate reaction and a late reaction. An
immediate reaction occurs minutes or seconds after consumption. Symptoms include shock,
rashes, or skin swelling. As for the late reaction, a reaction occurs a few hours or days after
consumption. The late reaction includes symptoms such as fatigue, diarrhea, irritability, asthma,
and indigestion (Zukiewicz-Sobzsk et al., 2013). For the latter reaction, determining the cause of
the food allergy is difficult (Zukiewicz-Sobzsk et al., 2013). According to Zukiewicz-Sobczsk et
al. (2013), food allergen proteins’ structure and properties determines its strength. In addition, its
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structure contains parts of antigens that could directly “interact with the antibody” (ZukiewiczSobzsk et al., 2013, p. 114). Due to its molecular structure, these antigens were understood that
they could more or less affect an entire immune system. Along with structure, immunoglobulin
E, IgE (Brock, 2013), antibodies also proved to be part of the allergy. Zukiewicz-Sobczak et al.
(2013) stated in a healthy immune system, small quantities of IgE antibodies are found. When
there is an excessive amount of antibodies, that amount may be enough to trigger a reaction.
Thus, these antibodies were founded as a measure for food allergy (Zukiewicz-Sobzsk et al.,
2013).
Food is consumed each day with numerous ingredients that could either be tolerable or
intolerable for people. Moreover, these ingredients should be carefully reviewed for any
characteristics of food allergens. In Zukiewicz-Sobczak et al.’s (2013) research, it seemed that
alteration to products could be a cause to rising rates of food allergies. They found that altering
the proteins and frequently consuming specific products could lose stability of reactions.
Therefore, a deficiency was created in the immune system. Overall, components of a product
trigger the defect in the immune system to react.
Oral Immunotherapy
Studies of prevention for food allergies were developed in hopes of curing the disorder
rather than following the usual rule of strict avoidance. In the Nadeau Laboratory, Brock (2013)
stated consistently practicing immunotherapy, which progressively exposes patients to an
allergen, could eventually build up a tolerance against food allergies. She said that
immunotherapies such as Oral Immunotherapy (OIT) would increase the rate of desensitization.
In OIT, different increments of doses of the food allergen were given to the patient over time.
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This act of therapy literally forces one to be exposed to the allergen until the exposure feels
tolerable.
According to Kim Yates Grosso, her daughter, Tessa, was severely allergic to more than
a dozen of assorted foods such as milk, wheat, eggs, and nuts (Thernstrom, 2013). Grosso heard
Dr. Kari Nadeau’s treatment of OIT and hoped for Nadeau to cure her daughter. Tessa’s starting
dose was one milligram consisting her allergies’ proteins. Progressively, she boosts the
increments from a range of 4,000 to 6,000 milligrams. After keeping a daily routine of
consumption, Tessa was finally desensitized of her multiple allergens (Thernstrom, 2013). While
Tessa tried this method of desensitization, there is also another method that could have been
used.
Sublingual Immunotherapy
Sublingual Immunotherapy (SLIT) is another method of desensitization similar to oral
immunotherapy. Rather than consume the allergen right away, the allergen extract is kept under
the tongue for absorption. Like OIT, SLIT tests for reductions of symptoms for the allergy
(Wilson, Torres Lima, & Durham, 2005). For example, a study for kiwifruit allergy treatment
under SLIT brought tolerance without any harmful effects (Narisety & Keet, 2012). Extracts of
the allergen were diluted and kept under the subject’s tongue for a minute before consumption.
The dose intake began to build up over a period of time. This daily routine continued for five
years, which had included an absence of the allergen for four months (Narisety & Keet, 2012).
Once the subject consumed the kiwifruit, the subject managed to tolerate the allergen without
harm (Narisety & Keet, 2012). Like OIT, SLIT managed to build up a tolerance for the food
allergen. Both methods have definitely contributed well into desensitization. However, while
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both methods bring positive results, it seems that there is confusion between desensitizing and
tolerating allergies.
Desensitization vs. Tolerance
Even if the oral immunotherapy was a success for its patient, the patient is still not
necessarily cured. OIT, according to Nadeau (Thernstrom, 2013), OIT was still in its
experimental stage. In order to avoid regaining the food allergy, daily doses of the food is still
considered to maintain tolerance. These daily doses are what differs desensitization from
inducing a tolerance. While desensitization requires daily doses of the food to avoid a reaction,
inducing a tolerance has treatment involving discontinuity. This strategy calls for a halt in daily
dosage for a certain amount of time (Narisety & Keet, 2012). After a period of time, ingesting
the allergen should not create a reaction to its subject. A tolerance should be seen as
“reprogramming of the immune response to allergen” (Tang & Martino, 2013). Tang and
Martino means that the tolerance is changing the way how the immune system reacts to an
allergen. What makes desensitization and tolerance different is that desensitization requires
ongoing treatment like OIT. In contrast, tolerance is achieved only when there is no reaction
after taking the dosages as well as discontinuing treatment (Tang & Martino, 2013). In short,
desensitization requires a constant routine until tolerance is reached.
Why Should We Support Desensitization?
Food allergies are on the rise in many developed countries. With desensitization methods
like OIT and SLIT, these methods have given hope to those with food allergies. Both treatments
have been able to provide promising results. In oral immunotherapy, subjects became more
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tolerant while taking higher doses of the allergens. Meanwhile, sublingual immunotherapy
appears as a slightly tougher process due to the limited amount of space under the tongue.
However, doses in SLIT could increase if concentration in the allergen extracts increase
(Narisety & Keet, 2012). The two desensitization techniques are continuously developing.
Although oral and sublingual immunotherapy provides promising results, these two
methods are “not US FDA approved or advisable for use outside the research setting” (Narisety
& Kreet, 2012). Research in which treatment is more effective for long-term tolerance is needed.
According to Brock (2013), SLIT may have fewer harmful effects in comparison to OIT, but it is
less effective in desensitization and tolerance due to its finite amount in allergen dosage. (The
maximum in SLIT is 700 mg while OIT could be as high as 5000 mg (Brock, 2013).) With one
side having less harm while the other is bringing more effect, it is difficult to determine exactly
which is the best treatment.
In a combined SLIT and OIT study, treatment involved subjects with milk allergy
(Narisety & Keet, 2012). Subjects started off with SLIT for at least four weeks. Later, subjects
were divided into three groups: to continue with SLIT treatment, to move on to OIT treatment
with 1 g (OITB), and to move on to OIT treatment with 2 g (OITA). After treatment, if subjects
passed, they are taken off treatment and later proceed with the food challenge, trying the food
itself. As a result, in the SLIT group, ten subjects tolerated the entire challenge (Narisety & Keet,
2012). Both OITB and OITA had nine subjects manage to tolerate. Then, these subjects were
asked to avoid milk for a week and try it afterwards. Only two failed from the OITB group. After
six weeks, another subject from the OITB group as well as three others from OITA group also
failed the re-challenge. One subject from SLIT and eight from both OIT groups claimed
tolerance (Narisety & Keet, 2012). Both sides have proven variation of desensitization. Overall,
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the three groups showed immunological changes. Immunological changes in desensitization are
“a decreased weal size from a skin prick test (SPT), a decrease in immunoglobulin E (IgE)
antibodies, and an increase in IgG4 – a subclass of immunoglobulin G (IgG) antibodies“ (Brock,
2013). For the three groups, SPT decrease and the cow’s IgG4 increased in comparison to the
baseline. For the OIT subjects, IgE decreased, but not for the SLIT subjects (Nariesty & Keet,
2012).
In short, the variation of what these desensitization methods have given a glimpse of the
benefits desensitizing could bring. With these promising results, a widespread treatment for food
allergies is needed to figure out a treatment that compensates for effectiveness as well as few
harmful effects. With help, there is a possibility of helping others with severe food allergies and
increase chances of finding a cure.
You Control Yourself
As food allergies are on the rise in our society, we should make it a point to promote
desensitization to help prevent these allergens. If we support desensitization in the community,
food allergies should not be on the rise. Desensitization may be the greatest treatment to defeat
the deficiency in the immune system. The defect created may be from the alteration and/or
characteristics of the allergen’s protein in products as well as IgE antibodies. Treatment such as
oral immunotherapy and sublingual immunotherapy could potentially build up a tolerance of the
food allergen. However, due to certain aspects like effectiveness and harming effects, we should
take it into account that further research is needed for which treatment is the best. Food allergies
may be able to react within one’s body, but one could overcome it by desensitizing it. A food
allergy may appear strong, but a simple command could actually defeat it.
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Resources
Brock, E., (2013). Recent findings in food allergy research, Nadeau Laboratory in Stanford
School of Medicine, 1-3.
Narisety, S. D., & Keet, C. A., (2012). Sublingual vs oral immunotherapy for food allergy:
identifying the right approach, Springer International Publsihing AG, 72(15),
1977-1989.
Tang, M. L. K., & Martino, D. J., (2013). Oral immunotherapy and tolerance induction in
childhood, Pediatr Allergy Immunol, 24, 512-520.
Thernstrom, M., (2013). The Allergy Buster, The New York Times, 1-9.
Wilson, D. R., Torres Lima, M., & Durham, S. R., (2005). Sublingual immunotherapy for
allergic rhinitis: systematic review and meta-analysis, Blackwell Munksgaard, 60, 4-12.
Zukiewicz-Sobczak, W. A., Wroblewska, P., Adamczuk, P., & Kopczynski P., (2013).
Causes, symptoms and prevention of food allergy, Postepy Dermatol Alergol,
30(2), 113-116.