New Treatments Ahead for Food Allergies

SEATTLE—New effective therapies are being developed to combat the rise in food allergies, said experts at the annual meeting of the American College of Allergy, Asthma and Immunology (ACAAI).

U.S. food allergies are now estimated at 3.7 percent in adults and 6 percent in children. Main manifestations include atopic dermatitis, anaphylaxis, and eosinophilic gastrointestinal disorders. Random phone interviews in 2002 showed peanut and tree-nut allergy in the general population to be 1.2 percent. Compared to a similar survey in 1997, the prevalence doubled.

Sami Bahna, MD PhD, professor of pediatrics & medicine, chief of Allergy & Immunology, Louisiana State University Health Sciences Center, Shreveport, La., attributes increasing causes of food allergy to the increase in food consumption and obesity, including the highly allergenic foods such as fish, peanut, tree nuts, milk, egg and soy; eating out, and the prevalence of buffet restaurants; food varieties and food cross-reactivities; food cross-reactivities with non-ingestant allergens such as latex, cockroach, dust mite and pollen; commercial foods incorporating multiple nutrient and non-nutrient allergenic ingredients; and incorporation of food proteins in medical diagnostic and therapeutic agents, particularly dermatologic.

Reactions to food allergy can be severe and even fatal. Current treatments are strict avoidance of the offending food and treating reactions as they occur.

Robert A. Wood, MD, professor of pediatrics and international health, and director, Pediatric Allergy and Immunology at Johns Hopkins University School of Medicine in Baltimore, said there are currently three approaches to the treatment of food allergy in development: anti-IgE antibodies, Chinese herbal remedy and immunotherapy.

“Anti-IgE therapy at the highest dose would protect most patients (75 percent) from reactions due to accidental exposures, but it is a medicine, not a vaccine, and it must be given on a continuous basis,” he said. “Although it could be used for any food allergy, it doesn’t work if patients are too allergic, and there are concerns about its safety and cost.”

The first clinical trial for food allergy recently was initiated with Chinese herbal formula FAHF-2. Studies in mice showed allergic reactions on a variety of measures of peanut allergy were markedly reduced and no side effects were seen.

Several preliminary studies on oral or sublingual immunotherapy for food allergy have very encouraging results, with strong evidence of at least short term desensitization. Preliminary research findings also show modified allergens, including peptide vaccines and mutated recombinant vaccines, offer promising new treatments.