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New Ways to Fight Nut, Milk Allergies

Studies Show Peanut-Rich Diets During Pregnancy and Injection-Free Milk Immunizations May Help

Can a Peanut a Day Keep Allergies Away?

Vivian Hernandez-Trujillo, MD, an allergist at Miami Children's Hospital, in Florida, says that pregnant women with allergies often ask what they can do to protect their babies from developing allergies "and we really don't know what advice to give."

As a step toward finding out, researchers at Mt. Sinai School of Medicine in New York City studied pregnant mice with peanut allergies.

Some of the mice were fed small amounts of peanut protein while they were pregnant and breastfeeding, the idea being to increase their tolerance to the nuts. The other mice were fed a normal diet.

After birth, the baby mice were given escalating amounts of peanut protein for five weeks in an effort to further sensitize them to peanuts. Doctors call this oral immunotherapy.

At the end of the study, the researchers "challenged" the pups with a larger serving of peanuts, to see if it would evoke an allergic reaction.

Almost all the babies born to mothers who ate a normal diet had allergic reactions, the study showed.

In contrast, only two of eight mice whose mothers ate a nut-rich diet during pregnancy and breastfeeding had allergic responses, and both were mild.

"The results are fascinating and thought provoking," says Hernandez-Trujillo, who moderated the session at which the studies were presented.

Peanut Oral Immunotherapy

The best way to avoid food allergies is, of course, to simply avoid the food.

But that's not as easy as it sounds and accidental ingestion is common, says Scott David Nash, MD, an allergist at Duke University.

For years, allergists have used immunotherapy, which includes the ubiquitous allergy shot, to combat allergies to insect stings and nasal allergies.

Nash's team tried another tactic: oral immunotherapy. They gave 20 children with known peanut allergy escalating doses of peanut protein in the form of a flour mixed into applesauce or other food. Once they reached a daily dose of 300 milligrams, about the equivalent of one peanut, they stayed on that dose for four to 11 months.

At the end of the study, Nash's team challenged the kids with a hefty serving of peanut flour. It contained nearly 8 grams of peanut protein, or the equivalent of more than 13 peanuts.

"Nineteen of 20 (95%) of the patients were able to ingest the full amount of the challenge, and most did not have any symptoms during the food challenge," he tells WebMD. A few participants broke out in hives.

One person, who developed hives and airway tightening after the full dose, was immediately and successfully treated with epinephrine.

Immune system changes from the start to the end of the study showed growing tolerance to the peanut protein, Nash adds.

The long-term goal is buildup of enough tolerance so the food allergy "goes away," says researcher Wesley Burkes, MD, chairman of the AAAAI program committee and a professor of pediatrics at Duke University, Durham, N.C. He also worked on the study.

"But for now we've shown that even though they have to keep eating the food, the chance of having an accidental allergic reaction is less," he tells WebMD.

More study is under way.

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