Skin patch lets toddlers with mild allergy eat peanuts safely: ScienceAlert

Peanut patch may help lessen allergic reactions in children with nut allergies, advanced stage claims clinical test conducted by an international team of researchers.

Wearing the patch for 12 months effectively desensitized toddlers with mild peanut allergies, meaning they could tolerate eating a small number of peanuts without allergic symptoms.

The trial, led by a pediatric allergy specialist Matthew Greenhawt of Children’s Hospital Colorado, was conducted on toddlers aged 1-3 years in eight countries across the United States, Australia, Canada and Europe.

Two-thirds of the 244 children who wore the skin patch became desensitized to the peanuts, compared to one-third of the 118 toddlers in the placebo group (who likely outgrew their allergy over a longer period of time, as some children can).

The results of the trial “are very good news for toddlers and their families as the next step towards a future with more treatments for food allergies”, writing Alkis Togias, an allergist-immunologist at the US National Institute of Health, who was not involved in the trial.

Children were considered desensitized if they could tolerate the equivalent of about one to four peanuts after treatment – ​​enough to protect them from accidental exposure.

For many families, this type of protection would provide immense relief from the anxiety of living with a food allergy. This seriously harms young children and their caregivers, who are on high alert for any traces of nuts or foods to which they are allergic.

“Families reported that treatments that protected their children from reactions to unintended peanut exposures would improve children’s socialization and the quality of life of children and their families,” writing the team of researchers.

The patches are designed to expose children to small, controlled doses of a known allergen, in this case peanut protein, through the skin. Knowingly exposing children who are allergic to their kryptonite seems risky, but new evidence suggests it could work.

Our understanding of food allergies in children is changing rapidly. A lot of research comes out of Australia, food allergy capital of the worldwhere studies have shown that one in ten infants has a food allergy.

Although researchers aren’t sure why food allergy rates are rising in countries like Australia, they have some theories: this could be related to environmental factors, such as low levels of vitamin D, or changes in the intestinal microbiota resulting from a decrease in childhood infections.

children with eczema also have higher rates of food allergies, and mounting proofs suggests this may be because they were exposed to allergenic foods through their skin before eating them, confusing the body’s immune system into thinking the food is harmful.

Allergists have also understood that there is a small window where to intervene to prevent food allergies. In Australia, like the United Statesparents are now advised to introduce known food allergens such as peanuts into their babies’ diets, rather than avoiding them, to “nip allergies in the bud”.

But for children who develop a food allergy, there’s no cure — and no therapies approved for children under four. Research also shows about two-thirds of young children do not resolve their peanut allergy by the age of six. This is why there is so much interest in developing a therapy for food allergies in children.

“The beautiful thing about [a skin patch] is that much, much, much safer than taking something by mouth,” pediatric allergist from the Murdoch Children’s Institute and co-author Kirsten Perrett said at a conference last year about emerging new therapies for food allergies.

The doses of allergens applied in a skin patch are much lower than the doses used for oral immunotherapies (basically crushed peanuts taken in tablet form). And although children can still develop skin irritations or adverse reactions, the patches are a much simpler – and potentially safer – alternative to oral immunotherapy, which involves strenuous treatment schedules.

The results of trials testing oral immunotherapies have been powerful encouraging. A type of oral immunotherapy for peanut allergy has been approved in the United States, but only for children over four years old, and oral immunotherapy remains controversial because he carries a high risk severe allergic reactions.

The safety of peanut patches is also under close scrutiny. Four toddlers participating in the patch trial experienced an anaphylactic reaction related to the patch; one child withdrew from the trial while the other three resumed treatment without responding again.

How long a child should wear a patch to ensure lasting benefit is also a big unknown which other trials explore.

Whether future trials can replicate the study results and show that peanut patches are a safe option that evenly balances the risks of a reaction in a few children with the benefits of many more children who can tolerate peanuts in small doses, then we could be onto a good thing.

The study was published in the New England Journal of Medicine.