New therapy may help reduce peanut allergies in children

Imagine your child being able to enjoy the simple pleasure of a peanut butter sandwich without worrying about a potential allergic reaction. For parents of children with peanut allergies, this may no longer be a distant dream, but an attainable reality.

Researchers have found a promising new treatment strategy and the secret ingredient is regular, store-bought peanut butter.

The study revealed that, after ingesting peanut butter at incremental doses over an 18-month period, all children with a moderate level of peanut allergy were able to consume three tablespoons of peanut butter without an allergic reaction.

This presents a potential solution for many children with mild to moderate peanut allergies who have a higher tolerance threshold, which equates to tolerating at least half a peanut.

A breakthrough for peanut allergies

“Children with high-threshold peanut allergy couldn’t participate in previous food allergy treatment trials, leaving them without opportunities to explore treatment options,” noted NIAID Director Dr. Jeanne Marrazzo.

“Today’s report focuses on this population and shows that a very safe and accessible form of therapy could be liberating for many of these children and their families.”

While existing FDA-approved food allergy treatments are primarily designed for children with low-threshold peanut allergy, the recent study offers a glimpse of hope for an estimated 800,000 U.S. children who have high-threshold peanut allergy.

Before now, their only management strategy has been peanut avoidance.

Focus of the study

The researchers aimed to identify whether a simple, low-cost treatment could help children with high-threshold peanut allergies tolerate an even greater amount of peanut protein.

The mid-stage trial was conducted with a diverse group of 73 children, aged between 4 and 14 years.

The children were randomly assigned to either implement the new treatment strategy or persist with their peanut avoidance regimen.

Those following the new protocol started with a daily dose of 1/8 teaspoon of peanut butter, which was gradually increased every eight weeks to a maximum of one tablespoon.

This increase was carefully monitored by medical professionals with minimal reported cases of severe allergic reactions during the treatment.

Exceptional success rate

After successful completion of the treatment plan, the children participated in an oral food challenge to evaluate how much peanut butter they could consume without an allergic reaction.

All of the children who completed this challenge successfully tolerated up to 9 grams of peanut protein, which is equivalent to 3 tablespoons of peanut butter.

This was in stark contrast to the avoidance group, where only a fraction of the children could tolerate this amount.

The trial notably took place during the COVID-19 pandemic, with certain essential logistical restrictions.

Nevertheless, using statistical techniques to account for missing results, the study showed an exceptional success rate among the children in the trial who were exposed to increasing amounts of peanut butter.

Peanut tolerance: A lasting effect?

After the initial treatment, the children continued to ingest 2 tablespoons of peanut butter weekly for 16 weeks, then avoided peanuts entirely for eight weeks.

The children returned to the study site for a final oral food challenge after this period. The sustained success rates were impressive, with over 86% of the treated children continuing to tolerate peanut protein.

Follow-up trials are needed to determine whether the therapy has a long-lasting effect on peanut tolerance.

Expanding food allergy treatments

The researchers are now exploring whether similar strategies could be applied to other common allergens, such as tree nuts, eggs, and dairy.

If effective, this approach could revolutionize allergy management, reducing the burden of strict food avoidance and offering a more inclusive diet for millions of individuals.

Additionally, experts highlight the importance of accessibility. Unlike existing FDA-approved treatments that rely on pharmaceutical interventions, this method of desensitization uses an affordable, widely available food product. This makes it a practical and scalable solution for families worldwide.

Looking ahead, the experts aim to conduct larger, long-term studies to confirm the durability of peanut tolerance and assess whether sustained exposure is necessary for lifelong immunity.

Ultimately, the research could reshape food allergy treatment and offer renewed hope to families navigating the challenges of food allergies.

The full study was published in the journal NEJM Evidence.

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