Oral Immunotherapy: Someday Your Child's Allergy Could Be Gone

From the Show: Healthy Children
Summary: It may offer real hope to parents of children with allergies to wheat, peanuts, eggs, milk, or shellfish.
Air Date: 3/4/15
Duration: 10
Host: Melanie Cole, MS
Guest Bio: Jen Kim, MD
sinai headshot hi resDr. Kim joined NorthShore University HealthSystems in January 2014 and is on faculty at the University of  Chicago Pritzker School of Medicine. She earned her MD from Northwestern University Feinberg School of Medicine, completed internship at St. Louis Children’s Hospital at Washington University in St. Louis, and finished residency in pediatrics at Children’s Memorial Hospital, where she also completed her fellowship in Allergy & Immunology. She stayed on as faculty at Children’s Memorial (now Lurie Children's of Chicago) where she served as the division’s Clinical Practice Director for five years. In 2010, she moved to New York City to join the Icahn School of Medicine at Mount Sinai. During her 4 years as part of the Jaffe Food Allergy Institute, she published studies on the effect of dietary baked milk inclusion in children with milk allergy and served as clinical investigator of the first randomized double-blind, placebo-controlled study of the use of omalizumab in milk oral immunotherapy.

Dr. Kim is a member of the American Academy of Asthma, Allergy, and Immunology and American College of Asthma, Allergy, and Immunology and is a current committee member of the Section of Allergy & Immunology of the American Academy of Pediatrics. She serves as the assistant editor of the AAP Section of Allergy & Immunology Newsletter and provides input regarding allergy and immunology content on the website.
Oral Immunotherapy: Someday Your Child's Allergy Could Be Gone
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So many children develop some type of food allergy, but amazing new clinical trials are showing promise. Over the last 20 years, more studies in the United States, Europe, and Australia have focused on oral immunotherapy. Jen Kim, MD, believes this type of treatment may be the key to one day eliminating food allergies.

What is Oral Immunotherapy?

Dr. Kim likens oral immunotherapy to an allergy shot. You get injected with hay fever and environmental allergens like pollen and dust mites, with the small concentrated dose gradually increasing until your body becomes desensitized to it.

Injections have been proven to work well for environmental allergies, but deemed too dangerous and unpredictable with food. Oral immunotherapy is taken through the mouth, since that’s how food is ingested, and in much smaller doses.

Oral immunotherapy studies typically focus on the most common food allergens: milk, egg, and peanuts. Overall, there are about eight foods that cause 95 percent of food allergies: milk, egg, peanuts, fish, shellfish, soy, tree nut, and wheat. There is a lot of information already for milk, eggs, and peanuts, while wheat studies are just beginning and not enough information is available quite yet.

The study gave subjects small amounts of allergens and gradually increased the dosage every two weeks until they reached a goal dosage. Once the goal dosage was achieved, the subject would continue to take the allergen for a period of time. Even though results have been promising, the door is still considered “wide open,” because studies tend to use different protocols, dosing, and length of time, says Dr. Kim.

Promising, Yet Incomplete Studies

Undergoing oral immunotherapy can also be difficult to complete. Almost everyone experiences mild reactions to the food allergens, like oral itching or abdominal pain, but up to 20 percent of children do end up needing epinephrine at some point. Dr. Kim stresses that it’s not a risk-free form of treatment, and can be nerve wracking for parents.

Researchers are still unsure if dosages should continue for life, or if there is a point where therapy would not be necessary. Follow-up studies are needed to find out more information regarding length of treatment, chance of redeveloping the food allergy, and how to standardize the oral immunotherapy method. For now though, the slew of recent studies are showing positive results in the right direction, and eliminating or greatly reducing food allergies may be in the near future.

In the accompanying audio segment, Dr. Jen Kim shares the latest advancements in oral immunotherapy and the hope it's giving your children's appetite.

Alonso is a long-time health and wellness advocate who loves to write about it. His writing spans the scope of blogs, educational magazines, and books, both on and offline.

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