Doctors conducting trials with investigational peanut allergy treatments in children

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Southampton researchers are investigating potential treatments for children with peanut allergy that may build up tolerance to reduce the risk of reactions if they accidentally eat peanut.

Peanut allergy affects around 1 in 50 children in the UK and has been increasing in recent decades. Although some children outgrow their peanut allergy, most will have it for life.

Currently, the main treatment for peanut allergy is avoidance. Yet this is not always easy and requires constant vigilance to prevent accidental exposure.

Southampton researchers are investigating a new approach - known as immunotherapy or desensitisation - to see if gradually introducing peanut-based treatments can help children build up a tolerance.  

About peanut allergy   

Peanuts are not from the same family as tree nuts but are a type of legume, making them more similar to peas and lentils. Despite this, they are more likely to cross-react with tree nuts than other legumes.

The first sign a child has a peanut allergy will often be a mild reaction, such as nettle rash (hives) anywhere on the body, or a tingling or itchy feeling in their mouth. However, in rare cases exposure to peanuts can trigger anaphylaxis - a severe reaction that affects breathing and can potentially be fatal.

Oral immunotherapy

Dr Stephanie Cross, a consultant in paediatric allergy at University Hospital Southampton NHS Foundation Trust, is leading a study to see if children aged one to four years with a peanut allergy can become less sensitive to peanuts by gradually increasing the amount they eat.

Children who take part will be given a small amount of a special peanut flour, mixed into food such as apple sauce or yoghurt, with the amount increasing every two weeks until they reach a ‘maintenance’ dose. Half of the children will be given the active product and the other half will be given a placebo, for comparison.

They will be closely monitored throughout the study, with face-to-face visits and phone calls to check on the child’s progress and ensure the doses are well tolerated. 

“Our end goal is for the children to be able to tolerate the equivalent of a whole peanut, making them ‘bite safe’ if they accidentally eat a small amount.”

Peanut patch

Dr Mich Lajeunesse, a consultant in paediatric allergy and immunology in Southampton, is leading another study looking at whether young children can develop a tolerance to peanut through a peanut skin patch.

Children who take part in the study will wear a patch that will expose a small area of their skin to a peanut protein. They will wear this daily, while being closely monitored by the research team.

Many children with a peanut allergy develop a strong aversion to the smell and taste of peanut, so this approach could help them to become desensitised without needing to ingest peanuts.

 “For many years guidelines and health professionals have recommended children with peanut allergy avoid it completely but more recently we have seen controlled exposure to allergens can help develop tolerance,” said Dr Lajeunesse.

“We hope that by exposing children to a small amount of peanut when their immune systems are still working out what is and isn’t harmful, will allow us to teach their bodies to accept it and not become susceptible as they grow older.”

Please note that the safety and efficacy of these investigational agents has not yet been established. This research will be carried out under close supervision, and anyone with a peanut allergy should seek medical advice before attempting to reintroduce peanut into their diet.

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Posted on Monday 25 November 2019