DI physician hones in on peanut allergies
Baseball season is almost around the corner, reminding us of a familiar tune: “Take me out to the ball game, take me out to the park. Buy me some peanuts and ...” Wait! Hold that thought! Maybe a hotdog would be a better idea?
Approximately five million people in the U.S. and Europe are allergic to peanuts, nearly half of them children under 12. Just one innocent taste of a peanut, even a tiny fraction of a single kernel or even a quick rubbing of tired eyes with fingers inadvertently - and invisibly - sullied by a peanut or peanut containing product - can lead to an emergency room visit. Frighteningly, hospitals in the U.S. report as many as 200,000 peanut-allergy ER visits each year.
How could such a tiny particle of food create such havoc? Dr. John Ramey, a board-certified allergist and immunologist with National Allergy and Asthma, a specialist in the field of food allergies, and a Daniel Island resident, explains: “With food allergies, the body’s faulty immune system over-reacts to a protein found in the peanut - the allergen - and sets off alarms that manifest in a number of possible symptoms, like tingling around the mouth, nausea, diarrhea and skin rash, to more severe symptoms like racing heartbeat, severely low blood pressure tightness of throat and even life threatening anaphylactic shock.”
Dr. Ramey points out that, while an injection of epinephrine may provide immediate relief of these symptoms, there is no known preventative cure, aside from keeping distance from the culprit food itself. Patients should always go to the emergency room after using epinephrine in case the reaction doesn’t resolve. But simple avoidance is no easy feat, especially for parents of children with peanut allergies, who must always be hyper-vigilant, examining food labels for any mention of peanut (including indication that a food might have been made in a facility that processes with peanuts). They have to be careful at restaurants, worry about classrooms, school cafeterias, camp environments and social activities, like birthday parties, where the dangers of peanuts and peanut-tainted foods lurk around every corner. Even with clear, insistent communication with teachers, camp counselors, waiters and other parents, the threat of accidental ingestion of, or contact with, peanut-laced foods is always a concern.
But good news may at last be on the horizon. Two biopharmaceutical companies, Aimmune and DBV Technologies, are studying possible new treatments, that while not a panacea for peanut allergy sufferers, could literally help peanut allergic patients and parents breathe a little more easily.
Experts at Aimmune have developed AR101, an orally administered biologic immunotherapy for treatment of peanut allergy; it’s a product that helps to desensitize the body to the protein. The company’s website describes the product as a “convenient dosing of consistent amounts of peanut protein together with highly controlled dosages of peanut allergens, administered through [the company’s proprietary] CODIT™ desensitization…regimen delivered over an approximately 20-week period.” Patients would be assessed initially at their allergist’s office for the optimal dosage, followed by subsequent, slightly increased dosings scheduled every two weeks, supplemented with steady-level daily home dosing in between visits. Once the regimen of incrementally increased dosings is complete, patients would continue taking a set amount of AR101 at home to maintain desensitization. Dr. Ramey points out, “the hope is that, once desensitized, patients will be far less likely to suffer such severe and potentially life-threatening reactions and that they and their families will enjoy a better quality of life.”
Two prior successful clinical trials have yielded very promising results. A third trial, already underway, known as PALISADE (Peanut Allergy Oral Immunotherapy Study), is working with patients aged 4 -55, in 60 clinics across the United States, Canada and Europe. Once successfully completed, the Food and Drug Administration will evaluate the results from this Phase III trial and determine if AR101 is safe and efficacious to release to the general population.
DBV Technologies is also testing the efficacy of a product intended to mitigate severe allergic reactions to peanuts: the company’s promising Viaskin® patch helps the body to build an immunity to the peanut allergen. The patch offers a less intrusive method of desensitization as it prompts the immune response to kick in at the dermal (skin) level rather than in the body’s bloodstream. Two successful clinical trials to evaluate the product’s effectiveness have already been successfully completed. A third trial, to study the efficacy, safety and real-life practicality of Viaskin®, is underway, and currently enrolling volunteers (pediatric patients) across 30 medical centers in the U.S., Canada, Europe and Australia.
Dr. Ramey’s National Allergy and Asthma practice location is the only site in SC participating in the Viaskin® clinical trial and is currently enrolling volunteers (pediatric patients ages 4-11) with a history of allergic reaction to peanuts. Contact the practice at 843-261-2222 for further information, or visit the websites www.nationalallergyandasthma.com or www.ClinicalTrials.gov.