Running Head: PROMISING RESEARCH
Promising Research
Keean Amiri-Razavian
UC Davis
Theresa Walsh
8 December 2013
PROMISING RESEARCH
Jack and Tessa, ages eight and nine respectively, woke up every day wondering if what
they ate that day would end up killing them. Their food allergies were so severe that an
allergic reaction could end up being lethal. The fear of an allergic reaction impacted
Tessa’s social development as she became withdrawn in school, would not touch anyone
or anything, and feared leaving her mother. Similarly, Jack’s allergies had caused him to
be hospitalized multiple times before his eighth birthday. Everyday was a struggle for
Tessa, Jack, and their families, until Dr. Kari Nadeau entered their lives. Nadeau, an
Associate Professor of Allergies and Immunology at the Stanford University School of
Medicine, developed a breakthrough treatment known as oral immunotherapy. Nadeau
began by giving Jack and Tessa tiny doses of their allergens everyday, increasing the
dosage over time. After a few years of treatment, Jack and Tessa were both allergy-free.
And Nadeau’s treatment is just one of many advancements in food allergy research
(Thernstrom 2013). Though food allergy researchers have been looking at numerous food
allergy treatments, the most prominent treatments today are Oral Immunotherapy,
Sublingual Immunotherapy and Food Allergy Herbal Treatment. Despite the
complications that continue to persist with each variety of treatment, the benefits far
outweigh these setbacks. The findings and implications of all this new research are being
used to discover the factors affecting allergies and any sociological trends related to
allergies; understanding of food allergies has increased dramatically in recent years.
Oral Immunotherapy is arguably the most prominent food allergy treatment
currently. Oral Immunotherapy is a treatment where the patient receives small doses of
their allergen, and as the doses increase, the patient should develop a tolerance to the
allergy. Oral Immunotherapy has been effective in more than 70 percent of patients in
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early clinical trials (Food Allergy Research & Education 2013). There are numerous Oral
Immunotherapy studies currently being done, each hoping to make advances in this
already promising research. While Oral Immunotherapy has been especially successful in
patients with a single food allergy, before Dr. Nadeau conducted her trial on Jack and
Tessa, there had never been clinical trials involving patients with multiple allergies. This
was a new research opportunity for Nadeau to create a multi-allergen desensitization trial.
Nadeau wanted to see if someone could be desensitized to multiple allergens
simultaneously or whether they had to be desensitized individually. Tessa started with
just one milligram of each of her allergens, but by the end of the treatment, she was
eating four to six grams of each of the allergens. After over a year, Tessa had become
officially desensitized to all of the allergens causing her allergies. She became the first
person to go through a successful multi-allergen desensitization trial (Thernstrom 2013).
If further trials are consistent with Nadeau’s research, it means that instead of having to
desensitize each food allergy individually – which would take many years in cases
similar to Tessa’s – a patient can have all their allergies desensitized at once. This could
save the patient many years that would otherwise be spent undergoing tedious therapy.
Unfortunately, there continue to be a number of drawbacks with Oral
Immunotherapy. For one, researchers still have yet to pinpoint an effective dosage and
time frame for the treatment. Additionally, they must also test the treatment on a larger,
more representative pool of patients to confirm the effectiveness of Oral Immunotherapy
for patients more generally (Food Allergy Research & Education 2013). Furthermore,
none of the patients who have undergone this treatment are actually cured. Researchers
have only developed a method of desensitization to the allergens; the patients still have to
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take doses every day. If they do not, they may become sensitive to the allergens once
again. The biggest problems that can occur with desensitization are the allergic reactions
that can occur when taking doses. For instance, Jack would still experience some asthma
attacks, rashes, and stomach pains even after his last-up dose (Thernstrom 2013).
Nonetheless, Jack eventually overcame his allergies, indicating that the future prospects
of this treatment are promising.
However, the implications of this research do not stop there; Dr. Nadeau’s initial
research has influenced others to test a possible range of applications for this treatment.
For example, Dr. Hugh Sampson of the Icahn School of Medicine at Mount Sinai is using
OIT (Oral Immunotherapy) to find a way to induce tolerance to milk for children. His
idea is radically different than previous OIT trials as Dr. Sampson is looking to cure the
child of the allergy, whereas previous trials only desensitized the child. He and his team
are currently using OIT, in addition to humanized monoclonal anti-IgE antibodies, which
bind to IgE antibodies in one’s body, to see if combining the two will produce a safer
method for treating milk allergies and building a tolerance for the allergen. There is
certainly promise for using this treatment on other allergens. Currently, the anti-IgE,
Omalizumab, has been approved for clinical testing. Testing has not met its goal of
creating tolerance to milk and no definite outcome has come from it yet, but scientists are
confident it may provide some useful outcomes from those with allergies (Food Allergy
Research & Education n.d. ).
Another similar type of treatment that has recently emerged is Sublingual
Immunotherapy, where the allergen is dissolved in a solution and then placed under the
tongue. According to the John Hopkins Sinus Center, it is a very safe treatment that
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allows the patient to stay home rather than go to the doctor for an injection. The World
Health Organization has even endorsed it as an alternative to Oral Immunotherapy.
Though sublingual immunotherapy has not been as effective as OIT, “many published
scientific studies have shown that it significantly reduces allergy symptoms” (Sunlingual
Immunotherapy n.d.). If researchers can improve the rate of success for this method of
treatment, they may achieve a breakthrough with both safety and effectiveness.
Still, other researchers have gone even further and are using Chinese herbal
medicine in the search for allergy treatment. After increasing scientific evidence showed
the effectiveness of Chinese medicine, Mount Sinai School of Medicine Dr. Xiu-Min Li,
along with his team of researchers, began developing a treatment known as Food Allergy
Herbal Formula-2 (FAHF-2). The formula comes from the traditional herbal formula,
Wu-Mei-Wan, the near mature fruit of the arbor plant Prunus mume which has been used
for centuries in treating parasitic infections and food allergy-like symptoms. Early trials
have proven the safety of FAHF-2 and its effectiveness in preventing a reaction in an
animal model of peanut allergy. The FAHF-2 diminishes the activity of the cells that
specialize in the inflammatory process (Food Allergy Research & Education n.d). This
means that cells would no longer activate during an allergic reaction. This treatment has
now entered clinical trials in order to determine the effectiveness of the treatment.
Though clinical trials have been a major source of research, they are not the only type of
research that is being done.
On a related but completely different note, another branch of research currently
underway has the goal of finding the scientific and environmental reasons behind
allergies. Finding the reasons behind allergies may be very helpful in preventing allergies
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in future generations. Currently, the Learning Early About Peanut (LEAP) clinical trial is
confronting the question of whether avoidance or exposure to peanuts can help in
building tolerance in infants. Answering such a question can “drive future
recommendations on peanut exposure”(Miller,Brown, & Hawlyer 2012 p. 9). The LEAP
trial is expected to provide definitive answers on how to manage and prevent peanut
allergies.
Not only is research being used to prevent allergies, it is being used to uncover
sociological trends in allergies. Dr. Ruchi Gupta has already completed a grant that
compares allergies between children living in rural areas and those living in urban areas.
In urban communities, 9.8 percent of children had food allergies, while only the same
was true for only 6.2 percent of children in rural areas. Gupta concluded that urban
children have a significantly higher chance of having an allergy than rural children. The
study also found the states with the highest allergy prevalence. Furthermore, his study
found that the allergies were equally severe regardless of the geographic location. The
study, which concluded in 2012, was the first to map allergies based on geographic
location (Food Allergy Research & Education n.d). Earlier in 2011, Gupta conducted a
study that collected information on 38,000 families and the food allergies the may have
had. Gupta ended up finding that more than a third of the children in the study had severe
allergies. He also found a correlation between national origin and allergies. He concluded
that Asian and African-American children had a higher chance of having food allergies
than children not of Asian or African descent (Food Allergy Research & Education n.d).
His studies may have important implications. Finding trends in food allergies can help
develop new questions or theories to pursue and to study. For example, by finding that
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Asian and African American children have higher chances, researchers can test whether
heredity and cultural aspects have impact on developing allergies.
Lastly, though the developed world has learned much about the prevalence of
food allergies, the Third World has not gained such knowledge. A study done by the
Food Research and Development Centre shows the concerns that arise due to this
ignorance. The study concluded that the limited data in third-world countries could
prevent a correct diagnosis, as many food-allergy symptoms are similar to malnutrition.
The Centre concluded that understanding the correlation between food allergies and
nutrition is becoming more important in order to ensure the safety of the people in
disadvantaged communities. They go even further and state, “large, well-designed
epidemiological studies are needed so that the scale of the problem can be understood,
public awareness can be increased and important food allergens can be identified” (Boye
2012).
Food allergy research is by no means complete, and many problems still exist
with today’s treatments and studies. There is still no cure for allergies and the genetic,
environmental, and socioeconomic factors behind allergies are still largely a mystery.
Nonetheless, there have been great strides in research in just the last few years. The
plethora of new research being completed as well as the development of new treatments
that have helped curb allergic reactions foreshadow a promising future for continued
research in this field. Food allergy research has the potential to make groundbreaking
breakthroughs that will not only help us understand allergies better, but also help cure
this disease.
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Work Cited
Boye, J. I. (2012, December 20). Food allergies in developing and emerging economies: Need
for comprehensive data on prevalence rates. Clinical and Translational Allergy.
Retrieved November 22, 2013, from http://www.ctajournal.com/content/2/1/25
Food Allergy Research & Education. (2013, November 22). Food Allergy Research &
Education. Retrieved from http://www.foodallergy.org/research/overview
Food Allergy Research & Education. (n.d.). Food Allergy Research & Education. Retrieved
from http://www.foodallergy.org/research/research-grants
Miller, D. S., Brown, M. P., & Hawley, J. D. (2012). Medscape Log In. Medscape Log In.
Retrieved November 22, 2013, from http://www.medscape.com/viewarticle/777380_12
Sublingual Immunotherapy. (n.d.). John Hopkins Sinus Center Retrieved November 22, 2013,
from http://www.hopkinsmedicine.org/sinus/allergy/sublingual_immunotherapy.html
Thernstrom, M. (2013, March 7). The Allergy Buster Can a Radical New Treatment Save
Children With Severe Food Allergies? NY Times. Retrieved November 22, 2013, from
http://www.nytimes.com/2013/03/10/magazine/can-a-radical-new-treatment-savechildren-with-severe-allergies.html?pagewanted=1&_r=1&ref=magazine