New Hope for Those With Life-Threatening Peanut Allergies

In the U.S., approximately 3 million people report allergies to peanuts and tree nuts, according to Food Allergy Research & Education, a non-profit organization focused on food allergy research, education and advocacy. Allergies to peanuts and tree nuts are among the most common food allergens.
“The prevalence of peanut allergies has actually tripled from 1997 to 2008,” said allergist Arveen Bhasin, director of Mayo Clinic’s Peanut Desensitization Clinic in Jacksonville, Florida. Although researchers have several theories, there’s no definitive explanation for the increase.
“The leading premise in the rise of peanut allergies is the hygiene hypothesis, which states that we are too clean a society … and the body doesn’t have anything to actually attack anymore, so it starts to attack things that it normally is able to tolerate,” Bhasin said.
Peanut allergy symptoms can be life-threatening. For some people with peanut allergy, exposure to even the tiniest amount of peanuts can send patients into anaphylactic shock and be life-threatening if epinephrine is not administered quickly.
In the past, the strategy always has been strict avoidance, especially in children.
Recently, the National Institute of Allergy and Infectious Diseases, a division within the National Institutes of Health, issued new recommendations for safely introducing peanut exposure. In addition, development of targeted oral immunotherapy has helped many patients with peanut allergies.
“The idea behind oral immunotherapy to peanuts or any other food that may be selected is to actually induce an immune tolerance to the food,” explained Bhasin, noting that Mayo Clinic’s Florida campus launched its peanut desensitization program in 2016.
The protocol, she said, is geared for patients who have a known peanut allergy. “We introduce very, very small amounts of the peanut protein and, over time, increase the amount. We are asking that their immune system recognize and slowly tolerate the peanut protein,” she said.
The treatment is performed under strict observation, and the patient is monitored and prepped to receive emergency medications, if necessary.
Once the patient can tolerate a dose, he or she continues that dose twice a day for one week. The following week, the dose is increased until the patient can tolerate about 12 peanuts daily.
Patients must continue to eat peanuts daily to maintain the tolerance.
“The goal of the program really is to help patients not live in fear and provide a huge improvement in their quality of life,” Bhasin said.
“Having an allergy can be challenging, because you are always on alert. But, now, hopefully, patients can go out and feel more comfortable, knowing that they can eat at a certain restaurant with friends, or they can eat baked goods,” she added. “They do not have to live in fear of accidental exposure to peanuts, which is how they live now.”