- A new oral immunotherapy could help lessen the severity of allergic reactions to peanuts in those with an allergy.
- Typical existing therapies involve exposing children at a young age before they demonstrate an allergy.
- This new potential treatment puts low levels of peanut allergen in toothpaste, which appears to be well-tolerated among people with peanut allergies.
For adults with peanut allergies, lowering your risk of having an allergic reaction to the nut could someday be as simple as brushing your teeth, new research suggests.
Adults with peanut allergies who received oral immunotherapy in the form of a specially formulated toothpaste that contained tiny amounts of peanut allergens experienced no moderate or severe allergic reactions to an escalating dose of the allergen over the course of a 48-week trial, according to an abstract presented at the American College of Allergy, Asthma and Immunology (ACAAI) 2023 Annual Scientific Meeting.
The findings haven’t been published yet in a peer-reviewed journal.
In their study, researchers evaluated immune responses to the allergens in the toothpaste by looking at blood biomarkers as well as conducting oral “food challenges” to gauge allergic responses under the observation of medical professionals.
Study participants who had reactions to the toothpaste experienced mild itchiness in the mouth, but it was not significant enough to make them drop out of the study, the researchers noted.
“We noted that 100 percent of those being treated with the toothpaste consistently tolerated the pre-specified protocol highest dose,” Dr. William Berger, a lead study author and a pediatric allergist at the Children’s Hospital of Orange County in California said in a press release. “No moderate nor severe systemic reactions occurred in active participants. Non-systemic adverse reactions were mostly local (oral itching), mild, and transient.”
This was a small study of 32 adults ages 18 to 55.
Nevertheless, the fact that side effects were mild and adherence was high (97%) suggests the safety and efficacy of this treatment bears further study, the study authors said.
“Oral Mucosal Immunotherapy (OMIT) appears to be a safe and convenient option for adults with food allergies,” Berger added. “The results support continued development of this toothpaste in the pediatric population.”
“This is a good first step in seeing if OMIT works for patients with peanut allergy,” said Dr. Purvi Parikh, an allergist and spokesperson with the Allergy & Asthma Network who wasn’t involved in the study.
“We were able to see that the treatment is safe based on a small group of people. Now it needs to be tested on a larger scale to see if it works,” she told Medical News Today.
Oral immunotherapy for allergies has been successfully employed in helping babies and young children avoid certain food allergies.
For instance, babies fed peanuts between the ages of 4 months and 11 months are 70% less likely to develop peanut allergies than those not exposed to peanuts at that age, some studies show.
“Early exposure is for healthy children without allergies [but] this is very different from children or adults that are already allergic,” said Dr. Mona Kidon, an immunologist and director of the Pediatric Allergy Clinic at Sheba Medical Center in Israel. “Very low-dose immunotherapy has been tried before, and on its own has not been very successful. Additionally, in very allergic patients, such therapies often cause a lot of side effects.”
“Theoretically, all allergic foods can be treated in a similar manner,” Kidon told Medical News Today, although she urged caution in drawing too many conclusions from this single study.
“Besides this abstract, there are no publications on this topic in the literature, so it’s hard to form an opinion on the potential of such a treatment,” she added.
However, if this research does bear out upon further study, it could pave the way for future allergy treatments, especially for hard-to-resolve nut allergies.
And there is at least one similar treatment out there. A series of clinical trials for a “peanut patch” that delivers a low dose of the allergen to children and young adults with peanut allergies that has shown promise in desensitizing them to the allergen.
The most recent phase three clinical trial of the patch showed that about two-thirds of toddlers were desensitized to peanut allergies in this manner. Those researchers were quick to caution this did not represent a cure for peanut allergies.
“The goal of the peanut patch and this type of therapy is to increase the amount (also known as the threshold dose) that may trigger an allergic reaction,” Dr. Terri F. Brown-Whitehorn, told the Children’s Hospital of Philadelphia in a recent interview.
Parikh agreed.
“Certain food allergies like peanuts and tree nuts are harder to outgrow or get rid of than allergies like milk or eggs,” she said. “Especially if you are an adult with the allergy, then it’s unlikely it will go away on its own.
“This [toothpaste study] is first step in establishing this treatment is safe; next, we will see if it’s effective in lowering one’s severity for a currently existing peanut allergy,” she added.
