Clinical Trial Helping Kids with Peanut Allergies

Everywhere Luke Roberts goes, his parents must worry about peanuts.

If 7-year-old Luke eats peanuts, he could vomit, break out into hives or even stop breathing. Avoiding them isn’t as simple as passing up on Snickers bars. Many processed foods contain trace amounts of peanuts. Luke once had a reaction while playing with a friend who had peanut butter smeared on his shirt.

That’s why the Roberts family and nine others in central Virginia decided to enroll their children in a UVA study that confronts the allergy head-on. Luke — under careful supervision — consumes a tiny amount of peanut daily. Every two weeks, the daily amount increases. The hope is that Luke’s body will learn to tolerate peanuts to the point that an accidental exposure will no longer be life-threatening.

Increasing Tolerance

Scott Commins, MD, PhD, began the UVA study after a similar one at Duke University Medical Center and Arkansas Children’s Hospital found that the kids involved lost much of their peanut sensitivity.

The kids in Dr. Commins’ study start by swallowing daily a saline solution with .1 milligrams of peanut. That amount “is like taking a peanut and running it across a cheese grater one time,” Dr. Commins says.

Every two weeks, the kids come back to visit Dr. Commins, and their daily dose increases. They swallow the new dose under the watch of Dr. Commins’ team. If all goes well, they start taking it daily, but with many restrictions: They must take it on a full stomach, and parents must monitor them for two hours afterward.

“The whole idea is to increase their safety so an accidental exposure wouldn’t send them to the emergency room,” Dr. Commins says. “It’s hard to say that they’ll be cured to the point where they can eat lots of peanuts. Some of them may be, but some of them may still have a minor symptom such as itching or an upset stomach.”

Eventually, the kids will get to the final dose of 300 milligrams, about as much as one whole peanut. They’ll be on that dose for four months. Dr. Commins is expecting it will take each child more than a year to finish, because they sometimes have reactions and have to go back to a smaller dose.

Luke, who is also allergic to sesame and all tree nuts except almonds, began the study in March. At one point, he began throwing up and had to backtrack to a smaller dose. But he and his parents want to persevere.

Mary, Luke’s mother, doesn’t have any hope that her son’s allergy will disappear. Even if it did, the family would still have to be very careful to avoid his other allergens.  But “if this has a chance to help him be a little bit safer, it’s worth it,” Mary says.

A Peanut-Free Lifestyle

Peanut allergies are on the rise, but experts disagree about how much and why. The Food Allergy and Anaphylaxis Network mentions one study that found from 1997 to 2002 peanut allergy incidences doubled in children.

“Depending on what you read, the incidence ranges from .5 to 5 percent,” Dr. Commins says. “I think the truth is somewhere in that range. It’s clearly increased. Why is anyone’s guess.”

The increase has led schools to create nut-free classrooms, lunch tables and cafeterias or to ban peanut-containing foods altogether. Luke’s first-grade classroom last year was nut-free.

Still, Luke’s parents worry. Even foods that don’t list peanuts as an ingredient can have trace amounts from having come into contact with peanuts during preparation. Desserts, Asian and Mexican food and even pizza can be problematic.

Dr. Commins describes peanut allergies as “a quality of life issue” as well as a safety issue. “The way you have to live your life when your kid has a severe food allergy is incredibly stringent. You’re worried all the time when they’re in school or camp or at the neighbor’s.”

The Roberts family supplied snacks for Luke’s class all of last year to avoid the possibility that he’d be exposed to trace amounts of nuts. They rarely eat out, although they’ve found some restaurants that promise to avoid nut contamination. They bring their own food to friends’ houses, and Luke doesn’t eat anyone else’s dishes at potlucks.

“People might say, ‘I know this doesn’t have nuts in it,’” Mary Roberts says. “But they can’t be sure. We’re trying to help Luke learn how to talk to other people without offending them. We want him to see it as an opportunity to be a strong person, a confident person, and to not apologize for who he is.”

Peanut Allergy Questions?

Are you allergic to peanuts? Dr. Commins’ study is full, but if you’d like to be added to a waiting list, contact him.

For more information about food allergies, check out:

• UVA’s allergy program, which treats food allergies as well as drug allergies, seasonal allergies, asthma, sinus headaches, hay fever and other allergic and immune conditions
• The Food Allergy & Anaphylaxis Network, which has allergy-free recipes, research and advocacy information