Promising peanut trial offers hope for children with life-threatening allergy

Boiled peanut could provide a safe and effective treatment for children with potentially life-threatening peanut allergy.

The findings come from a small clinical trial in which 47 children were given a new oral immunotherapy, based on boiled peanuts, to desensitize their immune systems to peanut.

These findings show we can potentially ‘teach’ these children’s immune systems to tolerate peanut, using a cheap and potentially cost-effective treatment. Dr Paul Turner Study author

The research, presented at the AAAAI 2019 meeting in San Francisco this week by researchers from Imperial College London, showed that the boiled nut immunotherapy was safe and effective as existing treatments currently being assessed, and  could offer a far more affordable option for patients and their families.

Dr Paul Turner, a Clinician Scientist in Paediatric Allergy and Immunology at Imperial, said: “It is impossible to determine how a child reacts to exposure to something they are allergic to, and whether they may have anaphylaxis. These findings are very promising and show that we can potentially ‘teach’ these children’s immune systems to tolerate peanut, using a cheap and potentially cost-effective treatment.”

Peanut allergy affects up to one in 30 children in the UK, with allergic symptoms triggered by exposure to milligram amounts of allergen. In most cases, the allergic response could be anaphylaxis, a serious and potentially life-threatening allergic reaction causing breathing difficulties.

Training the immune system

In the trial, researchers recruited 47 children with peanut allergy and randomized them to receive either standard care (dietary avoidance) or the boiled peanut immunotherapy.

They found that all patients who completed a year of the boiled nut therapy were able to tolerate eating 6-8 peanuts without experiencing significant symptoms. No patient in the standard care group outgrew their allergy during the same time period.

Current protocols to treat peanut allergy involve using tiny amounts of carefully-prepared peanut flour, which costs thousands of pounds to implement and therefore may not be made available on the NHS.

Cheaper option

According to the researchers, their boiled peanut therapy would be cheaper. However, they highlight the potential dangers of parents attempting to self-medicate children with exposure to boiled peanut, stressing that 10 patients experienced episodes of anaphylaxis during the study.

“It’s important to remember that the children on this trial were following a strict protocol and had 24/7 access to the study team,” Dr Turner added.

“We’re now planning to compare the boiled peanut treatment to conventional peanut immunotherapy in a head-to-head study, and hope to demonstrate that this type of immunotherapy is a safe and affordable option for children with peanut allergy being treated in the NHS. But we advise strongly advise people not to try this at home, and seek medical advice from their doctor.”

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The findings are expected to be published in a peer-reviewed journal later this year.