Atlanta's Oral Immunotherapy Treatment Center
Until recently, the only practical option for patients with a food allergy (like peanut allergies, for example) was to avoid the allergenic food. However, even the most careful people with food allergies feared reactions caused by eating mislabeled or cross-contaminated foods. However, scientists today have devised a treatment that can enable a patient to eat the food they’re allergic to without fear of a reaction. This is called “oral immunotherapy” or “oral desensitization.”
In oral immunotherapy, the patient – with their allergy doctor’s help – basically “teaches” their immune system to tolerate a food it over-reacts to. They eat the food in small but increasing amounts to reintroduce it to their system gradually, without causing a reaction.
Since food allergies can unfortunately be lethal, only a Board-Certified Allergist should administer oral immunotherapy. The initial treatment should be administered only in a hospital or medical center – not at the patient’s home. Because oral immunotherapy does carry some risk, most notably a severe and potentially fatal allergic reaction called “anaphylaxis,” a thorough discussion with your allergist is required before this treatment is initiated.
What Does Oral Immunotherapy Treatment Involve?
Oral immunotherapy takes time. The procedure begins with a “desensitization day,” during which the patient is given doses of very dilute versions of the allergen over four to five hours. These doses prepare the patient’s immune system to accept dilute preparations of the allergen at home. The allergist increases the strength of the doses every 2–4 weeks over a period of months. Eventually the patient reaches their “maintenance dose,” at which point they can tolerate the allergen and no longer fear the possibility of accidentally eating it. They are also less susceptible to anaphylaxis.
In select younger patients with mild food allergies, oral immunotherapy has been demonstrated to get them beyond just “bite-proof” (safe from accidents), eventually reaching free eating of the food they were previously allergic to. This can be true for those patients with mild reactions, low allergy numbers on blood testing and who start the program young (below age 18 months). Allergy doctors often start the desensitization in infants at 7–9 months old. Generally, the earlier the better for certain food allergies (peanut in particular).
When carefully and successfully implemented, oral immunotherapy can change a patient’s life for the better. It gives those with severe allergies a sense of security and freedom from constantly worrying about accidental ingestions. For some, it allows them to enjoy the foods they once had been allergic to. Even people who have multiple allergies can be helped, though the allergies are generally treated one at a time.
What Food Allergies Does Desensitization Treat?
While research investigating food allergy desensitization continues, today our allergy doctors use the treatment primarily for the following allergies:
- Peanuts
- Tree nuts
- Egg
- Milk
- Sesame
- Wheat
Currently, the above foods account for a large portion of the allergies faced by adults and children in the United States. As clinical trials are pursued, results may lead to additional foods that can be treated by food allergy desensitization.
What Are the Limitations of Oral Immunotherapy?
Oral immunotherapy does have its limits. It is only effective with IgE-mediated food allergies, not food intolerances. Patients with severe, uncontrolled asthma and those with EOE (eosinophilic esophagitis) are not good candidates for oral immunotherapy. Patients who cannot commit to daily treatments (i.e., taking their daily dose of OIT at home) are not good candidates for OIT.
How Effective Is Oral Immunotherapy for Food Allergens?
Desensitization can be achieved in approximately 60–80% of children for any food allergy, including peanuts. The rate of permanent tolerance (being able to tolerate the allergen without taking a daily maintenance dose) is unknown, but appears to be low for foods such as peanuts. The longer the duration of oral immunotherapy treatment, the better the outcome of this treatment.
The Main Goals of Food Allergy Desensitization
As patients will have varying levels of immune system tolerance and different responses to an allergen, OIT treatment will produce varied results. Through careful testing and consultation, a patient and their allergist will define goals that allow for a better quality of life – with a reduced chance of severe allergic reactions. Treatment success is determined based on achieving these predetermined goals. Starting at a young age (as the immune system is still “learning”) is the best time to start OIT to provide the greatest benefits.
Common Questions About Oral Immunotherapy Treatment
Is oral immunotherapy considered a cure for food allergies?
For the most part, no. Especially for those past infanthood and who are dealing with severe allergies, currently there are no food allergies cures. However, food allergy desensitization can help patients reach a point where they no longer experience allergic reactions when consuming a type of food. This process will require the ongoing consumption of a maintenance dose to support immune system tolerance.
For infants with lower allergy numbers, it does appear possible to “cure” their food allergies by initiating oral immunotherapy and going low and slow with the administration of doses of allergenic foods. For instance, our allergy doctors have several patients who were previously allergic to peanuts that started peanut OIT quite young (under 12 or 18 months of age), and can now eat peanuts freely.
Is the peanut pill an effective food allergy desensitization method?
The peanut pill, Palforzia, has been shown to be effective in desensitizing many patients to peanut protein. However, Chacko Allergy, Asthma and Sinus Center uses real peanuts and peanut butter rather than peanut powder. This OIT approach has been proven to be effective long before FDA approval of the peanut pill.
Who will make a good candidate for food allergy desensitization?
A patient who has been confirmed to have a food allergy through allergy testing can make a good candidate. In addition, a person must be committed to the treatment schedule over an extended period to realize the benefits of OIT.
Contact Chacko Allergy, Asthma and Sinus Center to See if You Qualify for OIT Treatment
Chacko Allergy, Asthma, and Sinus Center’s oral immunotherapy treatment may allow you to stop avoiding foods that trigger your allergies. Call (678) 668-4688 to request an appointment today.
