Peanut allergy: Steps towards effective desensitization

Allergy to peanut has exploded in the last twenty years. Affecting 0.5 to 1.4% of children in developed countries, it is food allergy that causes the most severe life-threatening reactions. No cure exists and it is difficult to identify those most at risk. The instructions given to parents of children with allergies is to avoid any food containing even that traces of peanuts, which strongly affects the quality of life of the family and induces a lot of stress.

However, the track desensitization developed by several teams in recent years with encouraging results. Particularly those of British researchers, published Thursday in the journal Lancet .

The team of Dr. Katherine Anagnostou (University of Cambridge) has 85 children to ingest a meal-based protein peanut in increasing doses, so that their immune system gets used to the allergen.Increased quantities every 15 days for 6 months, 2 mg at baseline (equivalent to a 70th peanut) to 800 mg. At each step change, the child received the first dose at the hospital so that doctors can intervene in case of reaction. The rest was taken home. After six months, more than 84% of young patients tolerated the daily intake of 5 peanuts and almost one in two could eat 10. Few allergic reactions have been reported and they were subdued.

"I could eat a donut! "

"For them, this is a dramatic change, says Dr. Andrew Clark, co-author of the article. Before this test, these children do not tolerate even tiny bits of peanut and their parents should scrutinize the labels of everything they ingest. "The goal of this treatment is to put these children away from hazard if swallowed peanut, not allow them to eat large quantities. "I've never eaten donuts before my 11 years because they could contain traces of peanut, shows Lena, who participated in the study. When you offered me one after the treatment, it was so good that I finished the package! "

In an accompanying commentary, Dr. Matthew Greenhawt, Central Food Allergy at the University of Michigan (United States), welcomes the results "exceptionally promising" but recalls that remain unknown. Including the duration of the protective effect, previous studies have shown that it may fade. "That is why it is very important that patients take their daily dose of peanut," says the Figaro Dr. Patrick Rufin, an allergist at the Necker Hospital in Paris, some patients were treated similarly.

In France also

Adverse side effects long term must also be studied. "The experimental research phase will still take years before possible generalization of treatment routine," warns Greenhawt. Meanwhile, it is not advised to attempt a desensitization of this type by itself, the risks can be fatal.

In France, a handful of hospitals (CHU de Toulouse, Hôpital Saint Vincent de Paul in Lille, Epinal hospital) already offer oral immunotherapy against peanuts. Dr. Dominique Sabouraud pediatrician allergist CHU Reims, practice for four years using a slightly different method, since only the first dose is given at the hospital, after Evalution of the minimum dose eliciting a reaction in the child. Control then takes place at 6 months and one year. "Some of our patients can now eat 15 peanuts a day," she says in Figaro . "This is a big change for these people: there ten years, they were told that their allergy was final and had to take it everywhere with them an emergency kit in case of a severe reaction. It was very anxiety. "