Thursday, May 24, 2012

Peanut Oral Immunotherapy Study at the Food Allergy Center

The Food Allergy Center is currently conducting an oral immunotherapy (OIT) study, which involves administering small doses of peanut powder, increased over time. Currently, a total of 14 patients have been enrolled, and nine are actively receiving doses of peanut flour. The research focuses on how the immune system changes with OIT, and which changes are best associated with clinical protection. By studying these cells, researchers will better understand and improve immunotherapy. Read about Deb Edmunds’ insider experience with her daughter, Ashley Edmunds, who is currently enrolled.

Tell us about your daughter’s peanut allergy. She was first diagnosed at about a year old. She tried peanut butter and broke out in hives. Since then, her Immunoglobulin E (IgE) numbers—measures allergic severity—continue to increase and her allergy worsens. The good news is that we have avoided reactions.

Why were you interested in the oral immunotherapy study?:  My daughter is getting closer to dating age, and I want her to be safe from peanuts before she starts dating or kissing boys without having to worry about what they might have eaten. Secondary hand contact can trigger a reaction. I actually reached out to the researchers at Duke University because I had heard about their successful desensitization studies. They referred me to Wayne Shreffler, MD, PhD, because he was using a similar protocol.

When did you start the study? About a month ago, we learned that she was in the active phase of the study—not the randomized placebo group.  We did about eight hours of tests, including a physical and various other blood tests, questions and nutrition counseling. The next day she received her first dose of 0.12 milligrams of peanut flour, and then the team observed her for two hours.

Describe it for us: Now we go in every two weeks to increase the dose twofold. She eats it mixed with applesauce, and a nurse and Dr. Shreffler observe and monitor her vital signs, similar to an Oral Food Challenge. Now she is consuming 0.24 milligrams of peanut flour. She eats her dose at 3 o’clock every day after she gets home from school. The Food Allergy Center provides us proper amounts of peanut flour to mix with the applesauce.

Has it made you nervous? No. My background in the pharmaceutical industry helps me understand, and I know Dr. Shreffler is using the Duke protocol.

Have you had a good experience at the Food Allergy Center?  It’s been great. We’ve spent the last year adding nuts to my daughter’s diet.  Previously, we had been told that she was allergic to all tree nuts, but Dr. Shreffler explained to us that a positive skin prick test—a method for medical diagnosis of allergies—does not always mean a true allergy upon ingestion.  In Ashley’s case, it turns out she isn’t allergic to any nuts despite her skin test results. It’s wonderful that Dr. Shreffler makes the additional effort to find out for sure whether his patients are actually allergic.

What about Ashley? Ashley has no problem understanding what’s going on. She knows it’s a hospital setting and feels comfortable.  We all feel like Dr. Shreffler and his team are amazing. We just want her to be safer in the world.

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