Peanut allergy – improving the safety and effectiveness of a new treatment

Peanut allergy affects at least one in 50 children in the UK and has been increasing in recent decades[1,2]. For some, eating even milligram amounts of peanut can cause potentially life-threatening reactions, so looking after a child with the condition can be extremely stressful.

Dr Sharanya Nagendran of Imperial College London is investigating ways to improve a new type of treatment called oral immunotherapy that can help prevent severe reactions in children with peanut allergy. She hopes that finding ways to boost the safety and long-term effectiveness of this treatment will help more children with peanut allergy and their families live without fear.

This Research Training Fellowship is supported with Rosetrees Trust.

How are children’s lives affected now?

Peanut allergy usually develops in early childhood and is caused when the immune system abnormally reacts to the protein found in peanuts. Allergic reactions tend to be mild, but many children can experience more serious symptoms (anaphylaxis). These reactions aren’t usually life-threatening, but some are – and unfortunately, severe anaphylaxis can’t be predicted.

“It is important to make sure that a child with peanut allergy avoids all peanut in their diet, but accidental exposure is still common,” says Dr Nagendran. “So looking after a child with peanut allergy causes anxiety for parents and caregivers – and impacts on the young person’s quality of life.”

Oral immunotherapy (OIT) is emerging as a new treatment for peanut allergy. It involves introducing very small, increasing amounts of roasted peanut flour to desensitise a child’s immune system.

“Although studies have shown that OIT can be effective, most children experience reactions during treatment and up to one in five can’t tolerate the treatment – so it isn’t safe for everyone,” says Dr Nagendran. “And unless the regular exposure to peanut continues, the treatment stops working.”

How could this research help?

“Our goal is to improve the safety and effectiveness of OIT so it provides long-lasting benefits for more children with potentially life-threatening peanut allergies.” says Dr Nagendran.

Her project builds on previous work that suggests using a boiled peanut product for OIT may be safer and more effective than the conventional approach of using roasted peanut flour.

“We will now compare the safety and effectiveness of boiled peanut OIT versus conventional treatment in children with peanut allergy,” says Dr Nagendran. “We will also investigate how the duration of OIT treatment influences its success at treating their symptoms in the long term.”

The researchers will also look for changes in the immune response during and after treatment, which they hope will lead to new ways to predict who is most likely to benefit from OIT.

“Ultimately, this knowledge could help doctors offer personalised advice about whether unrestricted peanut consumption is likely to be possible for a child after OIT – which is arguably the most important outcome for children and their families,” says Dr Nagendran.

References

1. Allergy UK: https://www.allergyuk.org/information-and-advice/conditions-and-symptoms/778-peanut-allergy
2. Prescott, SL et al. A global survey of changing patterns of food allergy burden in children. World Allergy Organ J. 2013; 6(1):21.

*Research Training Fellowships:

Each year, Action Medical Research awards these prestigious grants to help the brightest and best doctors and scientists develop their career in medical research.

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