Five-year-old Sia Dalial would have broken into hives if she accidentally devoured peanuts, but after participating in a study led by B.C. The children's hospital, she can now eat 10 peanuts M & M without reaction.
Most pre-school children who are allergic to peanuts can be safely desensitized by eating small amounts of peanuts, as indicated by allergy specialists, a study led by B.C. and B.C. Children's hospital researchers show.
In a study published Tuesday in the Journal of Allergy and Clinical Immunology: In Practice, 243 children (90 per cent) reached the desired dose for desensitization over an average period of 22 weeks. The remaining 10 per cent dropped out for reasons such as recurrent allergic reactions and anxiety in children and parents. The participants lived in BC, Alberta, Manitoba and Nova Scotia.
"According to our data, children with peanut allergies can be considered oral immunotherapy," says leading author, Dr. Edmond Chan, who is the head of pediatric allergy and immunology at UBC and in B.C. Children's Hospital. "However, it's important to note that this should always be done under allergic supervision, not by the parents themselves or by non-allergy health care providers."
He said older children with a history of severe, life-threatening reactions to peanuts and those worried about treatment are not good candidates for the desensitization approach.
While some experts believe that the effects of allergic reactions can be compounded and worsened every time anaphylaxis occurs, Chan said that the severity of allergic food responses is difficult to predict. "The likelihood of a food allergy is dependent on the type of food and other factors (and only) about 20 percent of children from peanut allergy."
Oral immunotherapy is a new approach in which children consume small amounts of food that causes allergy, by gradually increasing to a certain level or level of maintenance that is maintained for one or two years. The goal is to desensitize them so that if they are accidentally exposed to the allergen, they will not have a life-threatening reaction.
In the study, children with an average age of 23 months went to an allergy clinic every couple of weeks – a total of eight to 11 times – to be monitored every time their peanut dose was increased. The highest daily dose is 300 mg peanut, equivalent to peanuts or 1/4 to 1/3 of a teaspoon of butter.
The children in the study ate doses of peanuts in the form of powder (for example, mixed in yoghurt) or in popular Israeli peanuts, called Bamba.
Almost 68 percent of pre-school children experienced at least one allergic reaction during the growing phase, but the reactions were largely mild.
Only four per cent of children in the trial sought epinephrine to eliminate allergic reactions, while 0.4 per cent experienced severe reactions that required traveling to the emergency department.
Chan said the study, which had 18 co-authors, should help calm the fears of such an approach.
"Our group's goal was to be as safe as possible, as this was not a clinical trial, and allergologists were not always available if an allergic reaction appeared at home.
"So we made a mistake on the side of the caution and we encouraged parents to give epinephrine if there is an opportunity to show anaphylaxis."
Rawwinder Dalawal entered her four-year-old daughter, Saiya, as her pediatric nurse at the Memorial Hospital in Surrey noticed how serious peanuts and other food allergies might be.
"I've seen a lot of anaphylaxis, never death, thank God, but that's my biggest fear. At work recently, the child in anaphylaxis had to be put into the intensive care unit and then transferred to B.C. Children's Hospital" , she said.
While her daughter's allergic reactions in the past were mild, there is no way to predict when a reactive life can occur. Her daughter, who now has five children, had only one instinct of vomiting after the peanut dose was increased.
It's about a year and a half after Saiya entered the study, and now she can eat the equivalent of 10 peanuts without reaction.
"We will always have some level of anxiety about this," Dalival said. "We still carry EpiPen and it is still considered as peanut allergic, but now it's like having a protective shield around it," she said.
Saiya is also allergic to wood nuts and is on the same protocol for immunotherapy for them.
Chan believes that the protocol is ready for wider use.
"Our data suggest peanuts Oral immunotherapy in pre-school children is ready during the prime minister's time. The strength of our study is that about 90 percent of allergologists who have participated in community practice.
"In order to ensure patient safety, only allergologists should be offered with appropriate training and experience in performing oral food nutrition and managing life-threatening anaphylaxis."
Offering treatment for children when they are young, "parents are given precious tranquility and will help to improve the quality of life of children and reduce their anxiety as they grow."
Therefore, the desensitization protocol is a way to "look for a safety margin for accidental exposure".