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One Step Closer to Solving the Peanut Problem

peanut butter on bread

Rady Children’s is conducting clinical trials for new immunotherapy allergy treatments

For most kids, a peanut butter sandwich is more of a treat than a threat. But for more than a million kids who have a peanut allergy, a PB&J is a surefire way to ruin a day. Historically, these kids haven’t been able to do much about their allergy except avoid peanuts at all costs, but researchers at Rady Children’s are working to give them a more reliable solution.

Stephanie Leonard, MD, director of the Food Allergy Center at Rady Children’s, and her team are investigating promising oral immunotherapy treatments, which work to desensitize the patient by exposing them to small but gradually increasing amounts of the allergen, so they’ll eventually be able to tolerate accidental ingestion. It’s not a cure, but it could shield the patient from a severe reaction. In 2020, the Food and Drug Administration approved the first peanut oral immunotherapy product, Palforzia.

“That is really exciting,” says Dr. Leonard. “We finally have something to offer our patients besides the standard recommendations of ‘strict avoidance’ and ‘carry emergency medication.’”

To build on those advances, Rady Children’s has opened its Food Allergy Immunotherapy Clinic, which offers personalized treatment plans and long-term support. They’ve also begun recruiting for a clinical trial of a multi-oral-immunotherapy treatment for people allergic to peanuts plus another common food allergen. The combination of biologics and oral immunotherapy in the treatments is thought to partially suppress the part of the immune system that responds to allergens and decreases the risk of side effects. The study is funded by the National Institutes of Health, sponsored by Stanford University and also involves UC San Diego and UCLA.

“What I find really exciting is that we’re building a food allergy research collaboration on the West Coast and bringing state-of-the-art research to our patients here,” says Dr. Leonard.

Severe allergies are a quality-of-life issue, and being able to go out to restaurants, friends’ houses, sleepovers, birthday parties—all the places people with allergies are wary of—would give patients and their parents peace of mind. Researchers hope to one day be able to build up enough tolerance in a patient that they no longer need medication to prevent a life-threatening allergic reaction from exposure to a small amount. Dr. Leonard and her team are also testing a peanut allergy patch designed for children ages 1 to 3. Young children have especially pliable immune systems, so there’s potential for long-term benefits.

“The word ‘tolerance,’ at least in allergy, really means that you’ve outgrown your food allergy,” she says. “That’s our aim; that would be a cure, and we haven’t gotten there yet.”

Published in Healthy Kids Magazine, Spring 2022